John J. Crawford, MD, orthopedic surgeon and founder of the cognitive scheduling system nextDoc Solutions, spoke with Becker's Spine Review about the role physicians can play in shaping healthcare technology.
Question: How did you become interested in software development?
Dr. John Crawford: The idea I envisioned combined the need to improve the patient/customer experience in my practice with the need to harvest and analyze patient data prior to committing appointments.
The initial issue was a common observation that surgeons intuitively understand — that a call center-based appointment system inefficiently and incorrectly allocates our time, leading to revenue production underperformance. The second issue, which I had ignored for years, was that the call center-based appointment system served patients very poorly, too. Several companies were trying to address the patient-sided problem, but the solution they provided hurt the surgeon's interest in order to achieve the patient benefit. My epiphany was that I could use the patient problem to solve my efficiency problem.
Q: What advice do you have for other surgeons looking to translate their medical experience into the technology sector?
JC: First: Go for it. By the time you've been in practice a few years, you know how to do what you do and you are at risk for burnout. Running with an idea, investing hard earned money and dedicating your time to it will make you feel like a kid again. Even if you completely fail, it will keep you from making many of the other mid-life mistakes that your peers will make, because you simply will not have time for unproductive distractions.
Realize that the entire underpinning of the American experience, the idea that launched the world's wealthiest nation, is empowering ordinary people like ourselves to build something that solves an important problem, advances the human condition and rewards our work. You have not capitalized on the privilege you have been given until you experience this for yourself and show others around you that innovation and entrepreneurialism is all Americans' birthright.
Second: Read everything you can find before you commit money to it. This means books like Crossing the Chasm by Geoffrey Moore and The Lean Startup by Eric Ries, joining your local entrepreneur center, enrolling in classes and relentlessly building your LinkedIn page to curate content and contacts.
Third: Realize that it will cost far more than you think in terms of time and money. In for a penny, in for a pound.
Fourth: Realize that you will absolutely require partners. You won't have either the comprehensive knowledge that you will need nor the time to do all that needs to be done.
Q: What other opportunities do you see for software applications in private practice?
JC: Look around you and see how poorly all of your practice software works. This is for two big reasons. One, it was built by people whose last encounter with the healthcare system was when they got their booster shots in the fifth grade; they know nothing about the healthcare system that surgeons spend their lives interacting with. Two, the software you pay for and use was not built for you or for your benefit; it was built to achieve government mandates which have a very dubious relationship to patient benefit.
You know what the problems really are; they are solvable when people like us, who actually understand healthcare, are willing to apply what little free time and energy we have to building solutions. Figure out how to lower patient and physician barriers to better health using modern and ubiquitous tools like smartphones and chatbots. Build systems that link patients, payers, hospitals and physicians and provide mutual value to each party. Focus on nudging the present system in the correct direction by fixing readily identifiable problems that you face every day.