Category Archives: #BCSM

The 4P’s Of Healthcare


Warning: If you are a patient, a healthcare professional, a marketing professional, or a fellow social media enthusiast, this is not another post about Product, Price, Placement, and Promotion.

This is my take on the 4P’s and how they relate to all topics of healthcare.

The 4P’s of Healthcare: Patient, Physician, Payer, and Politician

Patient: Everything we do in healthcare on a daily basis needs to begin and end with the patient in mind. The work we do on a daily basis needs to impact the patient. Directly, not indirectly. As we identify challenges to focus on we need to define them from the patients perspective. Beginning with the patient in mind, we can then draw from our teams, our expertise, and pick the best answer(s) that will meet the needs of the patient, and the others stakeholders. (4P’s)

Physician: Physicians are responsible for so many aspects in healthcare, and many times we forget to include them in the defining and decision process. It is imperative to ensure that as we prioritize challenges, define them from the patients perspective, we need to include the physician and their perspective into this definition as well. Physicians want the same things as the patients, the right diagnosis, at the right time, for the right patient, leading to an open conversation on options, to allow the patient to understand and select the best treatment, and lead to the best possible outcomes. In sharing the information with physicians, we can also incorporate their inputs to help generate the best possible outputs for the entire team.

Payers: A majority of the time decisions are made on a top down basis. A payer decides that they are going to reimburse for a specific test, exam, or a intervention and then healthcare adopts and changes their practice accordingly. Payer reimburses, change happens. Yet the more we include payer(s) in the midst of identifying problems, how we define those problems, and share our opportunities to design an improved option to meet our patients needs leading to better outcome, we can begin to develop new payment models.

Politicians: Whether this group is politicians, government, or regulatory bodies, we need to ensure that we are aware of new rules and regulations coming out, as well as approach them early and often on new opportunities to change models in healthcare.

Most of the time when we struggle or encounter barriers, it is because we forget to tell the story with these 4 world views in mind.

When we approach topics in healthcare we need to keep the 4P’s in mind. Always be able to draw a straight line from the work you are doing to the patient. Be able to articulate your story in the “native tongue” of the physician/providers, payers, and politicians to ensure their understanding and inclusion. Share early and often. Iterate and learn.

Implement with the 4P’s as a team, and we all succeed.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek



Patients Created Crowdsourcing


Crowdsourcing is a phenomena that was coined in 2005 by Jeff Howe and Mark Robinson, editors at Wired magazine. Their initial definition was specific to how businesses at that time were were leveraging the internet to outsource work to individuals.

3 years later, Daren C. Brabham was the first person to use the term in a scholarly article. He also wrote a book by the same name, Crowdsourcing, in 2013. (Jeff Howe wrote a book by the same title earlier in 2009: find it here)

Daren’s definition in his paper was the following:

Crowdsourcing is a type of participative online activity in which an individual, an institution, a non-profit organization, or company proposes to a group of individuals of varying knowledge, heterogeneity, and number, via a flexible open call, the voluntary undertaking of a task. The undertaking of the task, of variable complexity and modularity, and in which the crowd should participate bringing their work, money, knowledge and/or experience, always entails mutual benefit. The user will receive the satisfaction of a given type of need, be it economic, social recognition, self-esteem, or the development of individual skills, while the crowdsourcer will obtain and utilize to their advantage that which the user has brought to the venture, whose form will depend on the type of activity undertaken.

I believe that healthcare was the original pioneers in “crowdsourcing.”

I can remember being a small boy, and my aunts, uncles, and grandparents always calling my mother, a nurse, and asking her about their symptoms. They would discuss their aches, pains, coughs, phlegm, and number of days with my mother.

After seeing their physician, they again would call my mother and ask her about what the doctor told them. They would ask her questions about the diagnosis, the medications, the doctors recommendations.

As I moved into my own clinical expertise in oncology, I have had several family members, friends, and professional colleagues call and ask me the same types of questions.

I started to think, patients have always done crowdsourcing for their diagnosis. Healthcare just never had a formal name for it. (full disclosure, I give the “hat tip” to Dr. Krishnaraj for planting the thought for this post in my mind)

Screen Shot 2015-01-27 at 10.04.22 AM

In the days before the internet, it took place via a phone call. We would wake up, not feel well, pick up the phone, call our trusted friend, talk about how we are feeling, and they would weigh in with their opinion on your diagnosis.

We would go to the store, buy some medicine, and see what happens. Maybe after a few days we finally go see a physician. As soon as we arrived home, we would pick up the phone and share with the diagnosis and recommendations with our friend.

Original Crowdsourcing.jpg

Today, it is even faster. We have access to more people. Instead of being able to call and talk to one person, we can instantaneously go to Dr. Google, input our symptoms, and come up with a self diagnosis in seconds.

We can now turn to blogs, websites, Facebook, Twitter, Instagram, Pinterest, and many other sites to connect with people and get their opinion. We can connect with medical societies, hospitals, online physicians, and quacks. We can even connect with children posing as medical professionals.

Modern Crowdsourcing.jpg

We can input out our signs and symptoms into a search engine and easily receive a diagnosis.

The diagnosis may not be correct, but we can receive one none the less.

We want an answer to our “What” question. (post here: Diagnosis Is King) Since we have immediate access to the internet, friends, family, and colleagues, we crowdsource their knowledge to alleviate our own anxiety.

To arrive at an answer to the “What” question.

Even though magazines like Wired, Inc, and the cool startup culture of Silicon Valley are known for their crowdsourcing endeavors, patients have always used “crowdsourcing” when it relates to their diagnosis.

Patients created crowdsourcing. Healthcare just never acknowledged it.

As I mentioned during the #JACR discussion, if the “insiders” of healthcare can begin to leverage technology to disseminate and leverage all of the medical knowledge globally, in a crowdsource manner, maybe we will bend the cost curve. Increase access, improve wait time, and decrease patient anxiety.

Maybe, just maybe, healthcare “insiders” will finally learn from what is already happening outside the four walls of their own organizations….

Patients always have, are today, and always will crowdsource their diagnosis.

Don’t ignore the crowd. The crowd is full of your patients. Join the crowd. Listen to understand, not to respond. The crowd will tell you what they need.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek