Taking Lessons from the Open Source Movement & Craft Brewers, Doctor Revolutionizing Healthcare

What Doctors Can Learn From Craft Brewers to Transform Medicine

Dave ChasePioneering doctors are showing the way to a much higher performing system as I highlighted in Doctors' Declaration of Independence. They understand that every example of great societal movements to our toughest challenges have come from the bottom up. The fundamental structure of politics is to cement the status quo. If the status quo was performing well that would be OK, but it's clearly failing miserably. In fact, Chapter 1 of my new book is "America Has Gone to War for Less" (link to free copy of the book here) referring to the collateral damage from this wildly underperforming status quo. Fortunately, doctors are collaborating to change this such as the Direct Primary Care conference starting today in Orlando.

I've had the good fortune to become fast friends with a key architect (Chris Brookfield) of a movement that has led to 10's of millions being lifted out of poverty in India (via microfinance, small business loans and rural hospitals) and the remaking of the food system in the America and is drawing attention worldwide. Brookfield shared with me a draft of a paper on lessons learned from 12 years of system change. His closing paragraph is particularly instructive for change agents in healthcare. This approach directly informs the Health Rosetta Institute's Theory of Change.

One indicator that a movement is ready for development in the commercial sphere is indicated when the movement ceases to be perceived as political within the relevant communities. While movements remain politicized, there is insufficient agreement; when the community itself is split in its support, this method of commercial development is doomed at the outset. On the other hand, it was obvious in the case of both microcredit and local food, that virtually everyone in the local communities agreed with the underlying premise. When the commercial values aligned community business models were tested, they were able to attract nearly unanimous support.   

The Direct Primary Care movement is a great example of that. DPC pioneers range from progressives to conservatives and libertarians. It was progressives who baked DPC into the ACA but today it is conservatives such as former HHS Secretary Tom Price or Senator Bill Cassidy (both former MDs) who have been championing it. Most of the DPC champions I know care more about fulfilling their calling than politics.

Lessons on Collaboration from the Craft Brewing industry

Just as craft brewers have faced stiff competition from entrenched interests, doctors trying to overhaul healthcare face steep entrenched interests. That spirit of open collaboration has served them well. From my own experience, I also have learned from them. Paradoxically, the more aggressively we give away copies of the book, the more sales increase. I've excerpted some articles on craft brewer collaboration that is reminiscent of what I've seen with DPC doctors or the folks behind the Conscious Medicine movement. The common thread is they seek a Fair Trade for clinicians and patients.

SAVEUR: Breweries across the country are proving teamwork really does make the dream work

Brewers will be the first to tell you that "competitor" collaboration is not just encouraged—it's necessary for the survival of craft brewing. "With US-based Craft Brewers only making up 11% of all the beer sold in America," explains Scott Kerkmans, founder of Beer Conscious Training, an online prep course for industry exams, "every brewery should have a vested interest in supporting their fellow craft competitors. The more craft beer drinkers there are, the more there will be to support your brand, even if they drink your competitors' first." Higher visibility and sales benefit everyone.

There are more direct economic benefits to collaboration as well. Thomas Larsen, Head Brewer for Ska Brewing, knows firsthand that many craft breweries initially have trouble getting distributed by the larger companies. "In the beginning, we had to distribute ourselves. It didn't take long to realize we were in the same boat [as other small brewers] and could work with each other to further our mutual goals." Stone Brewing began distributing Ska’s beers in Southern California this past June, while Ska has been distributing Stone's beers in Durango, CO, since 2003. "If we thought a brewer would do well here in Durango, we would bring them on," he explained. "Mostly because we wanted to drink the beer…but also to give other people a choice they didn't have before."

Fast Company: Sam Adams Tries To Raise Up Craft Brewing By Supporting The Competition

The program has made 1,300 loans worth $17.7 million total since it started. That includes about $1 million for 40 small independent craft brewers. According to that the Brewers Association, indie craft brewers generally make less than 6 million barrels a year with the brewery owning at least 75% of its own operations. All Brewing The American Dream recipients fit under that umbrella, with the majority having less than $500,000 in revenue. The average loan amount is $10,000, a sum that, if used wisely, often spurs job creation. Once you create a keg wash system, say, you need a person to run it. As production increases, the demand for delivery drivers and sales staff might grow. (Sam Adams estimates that each infusion ultimately leads to three to four more employees.)

Greg Hoy: Collaborate like a craft brewer

While ultimately a bunch of individual businesses that have to look out for their own interests, [breweries] tend to share similar stories of origin, growing pains, distribution obstacles, legal and legislative pitfalls and struggles for shelf space. There are a whole lot of shared interests and goals between them, but that results in the occasional shared recipe as well. In other words, they aren’t precious about all of their secrets, because it makes no sense to be. They purposefully work together, because they realize the collective brainpower they harness and put into action will serve to increase their market share and tip the scales more quickly than going it alone. Smart.

Radical Openness Key to Systemic Change

Openness is an advantage largely because information networks have coalesced over the past 15 years and have exponentially increased the flow of information to local communities. There is no way to transmit proprietary ideas at anywhere near the speed and coverage that open sourced ideas move. As information networks have grown, so has the relative advantage in propagating open ideas as compared to contracting proprietary property. Not only does openness maximize the impact of innovation, it maximizes economic opportunity for all involved.

About the Author

Dave Chase leads the vision for Health Rosetta which is to empower community-owned health plans. Health Rosetta’s blueprint and platform powers the health plans of your dreams: high quality, trustworthy, local, affordable care -- that you thought had disappeared forever -- from caregivers we know & trust. We free up compassionate, well-trained, community-based caregivers to rediscover love in medicine so they can do what they have always been called to do: serve their patients not just in disease, but toward their fullest health. A trusted & sacred caregiver-patient bond is built through transparency & openness that equips and empowers patients wherever they can best achieve their unique health goals -- at home or any setting best optimizing their well-being. By avoiding the 50% wasted healthcare spending, we can ensure our caregivers have the independence & resources to address the psychosocial and medical issues their patients face. Human-centered health plans restore health, hope & well-being. More...