Americans, on average, currently spend more than $10,000 a year per person on healthcare. This is a dramatic and unsustainable increase from an average of $160 per person in 1960. The only real mechanism for both decreasing the cost and improving quality in medicine is through innovation and the creation of new technologies. As a result, the U.S. medical system, with otolaryngology-head and neck surgery being no exception, is in desperate need of innovation.
Explore This IssueSeptember 2018
So why is innovation so difficult in our field? There are tremendous challenges and requirements inherent to surgical innovation. For one, training a practicing otolaryngologist requires 13 to 15 years of education and an aggregate combined cost to the student and society of greater than one million dollars. Most practicing otolaryngologists starting their careers, typically in their early 30s with several hundreds of thousands of dollars in educational debt, are risk-averse and are not looking to enhance their risk by devoting a significant portion of their careers to the creation of new technology. Furthermore, technology creation is not a core portion of medical school or residency training, and access to mentors and the experiences of medical inventors are not readily available to most otolaryngologists.
Despite these challenges, most of our workforce chose otolaryngology because of the possibility of making a positive and lasting impact on the lives of others. Young otolaryngologists bring creativity and a fresh outlook to the problems facing our patients. Older otolaryngologists bring years of mastery and an exquisite understanding of the salient aspects of particular challenges in our field. Academic otolaryngologists have access to scholars from a wide variety of disciplines to provide collaborative input on solving difficult problems. Private practice otolaryngologists have tremendous insight gained from the large, accumulated volumes of patients and experiences on the front lines of medicine and exposure to the entrepreneurialism required to be successful in new ventures. As a result, almost all courageous otolaryngologists are uniquely suited to bring their skillset and experience to drive innovation in our field.
How to Start
So where to begin? The first step involves identification of the most expensive problem facing our patients, with which the otolaryngologist has sufficient expertise. The problem has two obvious components: cost to the patient and number of patients facing this problem. The overall cost to society needs to be greater than the development costs, which typically are greater than one million dollars in aggregate for medical devices, diagnostics, and especially therapeutics. This is a significant, but not insurmountable, burden. As a result, beginning inventors should not devote their limited time and resources to developing solutions for inexpensive, rare problems. This is the first major obstacle to successful commercialization of a new invention: choosing the wrong problem to work on.