Companion Episode - The 100 Year Journey from Surgeons with Reputations to Surgical Robots

This episode is the companion episode to "The 100 year Journey from Surgeons with Reputations to Surgical Robots". It frames the value that you can takeaway for your engineering career. 

In this episode we discuss things such as:

1. Industry differentiation and the pressures that force it

2. Where values reveal themselves

3. Industry recognition vs. customer recognition

4. Who is rewarded under different paradigm

5. The right champions matter for technological adoption

6. The need for champions

Transcript

SPEAKER_00 0:13

Welcome to the Engineering Passion Express podcast. I am your host, Brandon Donnelly, and this is the companion episode to our episode on surgical robots. I'd like to take some time and tell you a bit about why I told this story, especially why I told it over a hundred year span, and go through it together and find out what the takeaways are. So, first of all, I told this story over about a hundred-year time span because it illustrates how industries shift over a long time horizon. And in those shifts, there's a lot of opportunities that arise across those times. But because it happens so slow, often most people miss the opportunity. And I think this is where a lot of engineers can increase the value in their career by recognizing when an industry has shifted enough to make a big change. So medicine is a highly competitive industry, obviously. Lots of schooling required, lots of dedication. In this story, I shared how initially 100 years ago, surgeons built their careers off of reputation. In fact, outcomes weren't measured. There was no real database. So because of that, it wasn't really about your skill, it was about maybe how media savvy you are. Then outcome measurements came along, and then it was all about mortality statistics. If you were better than the other guy, obviously more people are gonna feel comfortable with you, and you're going to get your pick of work, maybe higher pay for that work. And the people that will be stuck with the other guys are the people that can't pay as much but need surgery immediately, or they're gonna die. And so then they're stuck with surgeons with worse mortality outcomes. But over time, those outcomes are chased, and you reach this sort of inflection point where you can't really make it much better. There's some amount of people that have such bad conditions that no matter what you do surgical-wise, they're probably going to pass away during the surgery. So you kind of reach a plateau where your level of skill or the quality of your hands can't go any further. And that's when differentiation in an industry starts to begin because it's it's hard to stand out. You have to pick some other metric that other people either aren't measuring or are picking a different one. And that's when values begin to shift. I mean, you can see this in less competitive industries, or I shouldn't say less competitive, I should say you can see this in less serious industries, like fast food versus a restaurant. One cares about how fast we get you your food, the other might care about the quality. Even within a restaurant, there might be another one that cares about the ambiance. Those are differing values. You could add price to that. And that's what happens when an industry gets very competitive. You now have to have differentiation. And those different differentiations lead to different technological adaptations. Everything McDonald's does is to speed up how fast we can get your order out the window. Where everything a high-end restaurant might do is how can we impart the most flavor and the most experience onto the customer? And those two things lead to very different technological adaptations. But something that's always clear in every industry is that the customer matters and what they value matters. In particular, there's oftentimes like the patients in this story, where they just cared about surviving because that was the goal to keep their life. That's why they were going for critical surgeries. But then somebody else told them, not only can you keep your life, but I can get you back to your normal exercise, back to your normal work, all of that, in a very quick time frame, quicker than the other surgeons. And I've been measuring this, so that's how I know. When nobody else has the data like that, then you become the expertise. And sometimes what people miss, and this is what Dr. Reginald Hawthorne missed in the episode was that conflating industry recognition with metrics that a customer cares about can be two different things. I think if you wanted a cross-industry comparison here, oftentimes movie or music award shows, somebody gets an award, which is like industry recognition, but yet that song wasn't the most popular or the movie wasn't the most widely shared by the population. And so those people are being proud of their industry recognition, but at the same time, they're not being rewarded by the customer. And essentially, markets always come back to customers. So I think something special to always look for in your career is an opportunity for a values shift. Dr. John Wickham represented somebody who both saw an opportunity to shift values and was successful in campaigning them, thinking about the change in keeping someone alive to maximizing their recovery and making sure that they have as much capability after the surgery as they did before. That's a shift in where you're looking and the result that you're gonna get. In this value shift range, I think we overlook a lot of times that those are who are rewarded from the old values will resist the new values. And you can't really outlogic it, you can't really help them see it because they've been so rewarded that they almost don't want to see it. And the speech that the character Dr. Reginald Hawthorne made here was to share a bit of an old man's wisdom on that fact. Within this story, Hawthorne and other surgeons resisted Wickham and Mull's contributions to the medical field because recognizing them might possibly reorder the hierarchy, which is always a threat, even as most people don't recognize it themselves. But sometimes you just need to speak a different language or find a different champion of your idea. In this case, Fred Mole eventually spoke to hospital administrators and quit trying to convince surgeons who already felt like they were at the top of their game and didn't want to be replaced with robots. Instead, he made a business case to the hospital administrators about why their patients would like it, how they would get a boost to the business, more patients, more throughput, better quality, less lawsuits, all kinds of things that are very, very beneficial. And now today, these robots are everywhere because once they realize the benefits, once the customer was happy with the results, it's hard to go back, no matter how resistant the industry was at the beginning. And oftentimes these value shifts require entirely new methods and tools. So in our story, John Wickham didn't yet have surgical robots. His values were for minimally invasive surgery. So what he first did was refine techniques that under the old methods and the old tools. He didn't revolutionize the technology, he revolutionized the techniques that were used that fit his values. And oftentimes these values shift that do require a champion because they don't change overnight and they don't change without somebody fighting for them. And when you fight for a long time for something better, you're gonna both feel worn out, but at the end of a years-long or decades-long campaign, you're typically rewarded, which is what Wickham saw, and it's what Mole saw. But I guarantee for both of these gentlemen, there was a huge amount of self-doubt. Am I really the authority here? As they got pushback, they probably wondered, is there someone else that can take this on? This seems like a heavy burden. And in the early days, it's all burden and no payoff. And the longer you go, the higher the stakes become. Will this ever pay off? Or will I have just accepted sort of a beating from the world without anything to show for it? So where you can look for opportunities is look for shifting values, look for customer values, and look for values that can be strengthened. And then ask yourself what are the tools, what are the methods, what are the techniques that I could use that we're not using today to better serve all of those values? I think it's important to share a little bit of the inspiration for this episode. I made this because a recent experience brought me into contact with these robots and their usefulness. Engineers often can't see the shifts in values that follow an industry until the end of their careers. You have to sometimes be in it for 20, 30, 40 years to realize, wow, we were moving the whole time. When you join an industry, it seems like it's always been that way and is always going to be that way. And so it feels much more static. But further towards the end of your career, it feels like things have been dynamic. And I think if engineers can see that maybe five, ten years sooner, then we can have an explosion of innovation, of creative ideas. But I think there's a lot of room for industries to improve, but yet there aren't enough champions out there. So the first step to creating more champions is to create more people that see. And I hope that that's what the episode accomplished. Anyway, I enjoy the fact that you're listening to this short companion episode. I'm gonna try to make these from now on for each story episode, because the story episodes take a month or so to decide on the story, do some research, script it out, and it's a lot of effort. And I know that it feels like a long time between episodes. So, what I'm planning on doing, do one of those a month, do one of these where we kind of go through the story, and then I would like to do one interview style format for something that's useful to engineers with actionable items once a month. It would boost us up to three episodes a month, give you more consistent items to listen to and help build value in your career and help you see the world and understand where you can maximize your value. Thank you for listening to The Engineering Passion Express. As I mentioned before, my name is Brandon Donnelly, and I'm enjoying the work that I'm doing with this. I hope you are too. I would really appreciate it if there's anyone that you can send the podcast to to say check it out. As we got going here, there are some episodes that I feel are much higher quality than others. So if you can send them some of the ones that you really liked as their hook in, that would be greatly appreciated. In the future, I will also look to start to organize these episodes into common themes that can help illustrate different kinds of topics that you may want to learn as your career progresses. Thank you again for being a listener. And if you haven't, subscribe, and we'll see you on the next episode of the Engineering Passion Express.