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Acceptance Remarks by Dr. Paul G. Yock
Thank you, Dan, Asad, and Daniel.
Needless to say, this is a wonderful honor—certainly the biggest honor in my career. I am deeply grateful to the members of the academy and their colleagues for their work in researching and evaluating Biodesign. I’m particularly happy that our program is receiving an award in the name of Bernard Gordon, who is an extraordinary role model for all of us in the way he blended a career as a prominent inventor and a leading innovator in engineering education.
Every so often we get asked by a visitor what makes the Biodesign program effective. The answer is pretty straightforward, and I can illustrate it with a quick demonstration. I’d like to ask the staff and faculty of Biodesign, both past and present, to stand. Now I’d like to ask those of you in the audience who have at some point mentored Biodesign fellows, students, or faculty, or taught in one of our classes to stand. If you are a department or division chair who hosted Biodesign over the years, please stand. And then I’d like to ask the Biodesign alums in the audience to stand—our powerful, secret teaching resource.
There you have it—the reason Biodesign has been effective. All of you have earned a share in this award. Thank you and please take a seat again.
The bottom line is, we have an amazing community of experts in health technology innovation who have been exceedingly generous with their time and expertise in building a next generation of leaders.
The main impression I want to convey how very proud we are of the alumni of Stanford Biodesign. In the early days we didn’t really appreciate how important a force this alumni community was going to become. It has turned into a very impressive network: Currently 30 Biodesign alums are CEOs of the companies they founded. An additional set of alums from the earlier years of the program have risen to senior ranks—the equivalent of vice president and above—in established companies. Many of our engineers have assumed leadership positions in corporate and academic settings. Some of these folks lead innovation programs at their universities or companies. A number of our physician inventors, in academia and in practice, have cofounded companies, having seen a technical innovation from clinical need to implementation planning. And other leaders are in a fascinating range of positions in design, consulting, marketing, even patent law. This is an amazing group—I hope you get a feeling for why we are so proud of them.
A couple more thoughts to share. Although we are celebrating the success of the Biodesign program, I want to focus on two important challenges where we will be directing our strategic efforts and resources, including the Gordon Prize money.
The first is in the area of diversity. I am talking about diversity in the broadest sense of the term, including differences in educational backgrounds, intellectual talents, and values. In the 17 years that we have been working with interdisciplinary groups we have learned how difficult it is to help shape a group of fellows with very different backgrounds into a functional team. Our fellowship directors and our team psychologist do a masterful job in guiding this process—and I am certain that from the fellows’ standpoint this is in fact the single most valuable part of the training experience that we offer. But, to be candid, our teams still struggle, and we struggle with leading them. We still have a lot to learn, and each new group of fellows provides a great opportunity for us to take another step forward.
In the past few years in particular it has become clear that we need to focus more energy on specific axes of diversity. We have a crisis in the health technology field with respect to gender balance. By some measures—senior leadership roles, for example—we are even less diverse than other tech sectors. On the plus side, this is a tremendous opportunity for us to move the needle, because Biodesign is attracting some of the most talented young women in the world. And this gives us the opportunity to provide a training environment where we focus on helping young men and women learn together to create a mutually supportive and productive intergender team experience. I’m happy to say that 7 of the 12 fellows joining us next year are women. We are also putting heavy emphasis on enhancing recruitment of underrepresented minorities to the program—this is a major thrust of our recruiting efforts for future fellowships.
Here’s the second major challenge. As many people in this audience are keenly aware, we are in the midst of a historic shift in the ecosystem of health technology innovation. Healthcare costs are out of control, and the payers—private insurers and the government—are aware that introduction of new technologies is one of the biggest drivers of cost escalation. These payers have reacted by placing major barriers in the way of paying for technology innovation. As a result, the entrepreneurial ecosystem in health technology innovation in this country has suffered a major disruption. The pipeline of innovations in health technology that are actually moving forward to patient care has become seriously clogged. More worrisome still, there is very little awareness of this fact and even less political will to do anything about it. In fact, I believe this is an issue where the National Academy might provide some very productive data and perspective on a policy level.
But for us in Biodesign, this challenge also presents a significant opportunity. The truth is that, in the 60 years of the modern medtech industry, inventors of new technologies have not paid primary attention to the cost of new technologies. With the innovation process we follow in Biodesign, where need drives invention, there is no reason we cannot make cost effectiveness a key component of the upfront clinical need. Over the past few years we have infused our training experience with a major dose of health economics—and we are beginning to see some real results in the area of value-focused, needs-based innovation.
This attention to cost effectiveness is important for another reason. In our strategy group we have been discussing the fact that the standard approach to health technology innovation—that is, inventing progressively more sophisticated technologies for increasingly more difficult diseases—inadvertently helps accentuate disparities in healthcare delivery. Inventions have disproportionate benefit for patients in the top economic levels who can afford them. A truly needs-based innovation process like that of Biodesign can, on the other hand, look at needs across the socioeconomic spectrum and provide new technologies that use the power of engineering to achieve less disparity in health care. This is a critically important and highly motivating challenge, and one that we are focusing on actively in Biodesign.
Let me add one final thing: a sincere thank you to all of you for being here this evening. Many of you are colleagues and friends who have worked shoulder to shoulder over the years as we built Biodesign. I feel enormously lucky to have had the privilege of partnering with you in this project. I can’t help but think we have been part of a special time and place here—our own little tipping point—and I will always be grateful for the opportunity to have gone through this wonderful experience together. Thank you all.