One of the few lessons that will, hopefully, remain long after the Theranos debacle is yesterday's news -- the criminal trial of CEO Elizabeth Holmes is set for this year -- is that morality is relative. Who you hurt apparently matters more than the simple fact that you're a lying scumbag. It's still perfectly fine in the Valley to actively mislead people about your company's prospects and your product's current state of being, as long as the potential consequences of the fraud are only financial.

Of course, that's never really the case since these phony unicorns and other schemes end up hurting plenty of innocents, including employees, patients, and consumers. The term "innocents" does not, however, apply to the pump-and-dump venture capital investors who promote these scams on a daily basis. No one should ever shed a tear about their losses. 

The prevailing Theranos message seems to be that it's a much bigger and much worse evil when you're lying about medical matters and jeopardizing the health and well-being of actual patients as opposed to just ripping off investors and customers. This means, in retrospect, that Holmes wasn't completely worthless. She will always serve as a bad example and a horrible warning. But only to people who are willing to listen and learn.

Unfortunately, it appears to date that Theranos isn't so big a deal that there aren't plenty of other scam artists and grifters actively pursuing their own corrupt versions of Elizabeth's little fantasy. It turns out that holding your nose and varying the elasticity of your morals by industry and type of victims is mostly a philosophical distinction (like believing you can find the clean end of a shit stick), which doesn't really make a practical difference to most of these people out there who are simply and heedlessly chasing the latest rainbow.

I guess there are those in the Valley whose greed is so substantial and whose values are so fluid that they believe you can successfully split hairs like this as long as you offer the minimally acceptable solution, don't get caught lying to or cheating your customers and/or, most importantly, get out of the game with a profit before things implode and you lose your investment.  Despite the calculated indifference to patients' health, flagrant falsifying of data and results, and shocking lack of oversight or controls at Theranos, we still have the snake oil industry shilling away: fake CBD, "medical" marijuana that cures all ills, useless dietary supplements, and poisonous vaping for kids. These bad behaviors will only change when the market, the users and consumers, and the competition drive the changes. As Bill McGowan, the founder of the phone company MCI, used to say: "These guys have great loyalty to their businesses, but their number one loyalty is to their own tush." 

We are on the cusp of a very large shift in medicine. The major tech companies, especially Google, Apple and Amazon, are moving into health care with a vengeance, and with the clear, but totally mistaken, view that these new opportunities can be addressed and served by applying the same ideas, attitudes, and technologies that they've used to master search, merch and sales. You can confidently predict that we will see another sad parade where the "virtues" of speed and scale trump the need for sanity and safety, and where it's the common folk who ultimately and inevitably pay the price.   

The only good news is that this migration is going to take a lot longer, and be a lot harder, for even the biggest tech guys to pull off. Because they just don't understand that they're entering a whole different world. You'll be banking with Amazon and taking financial advice from Google long before you're going to let them start looking after your health. And this is mainly because there's a completely different level of connection and interaction in medicine. Healthcare isn't suited to brute force solutions, outsourcing, superficial training supported by stupid scripting, and massive scale. Not to mention the fact that, to a frightening extent, we no longer trust Big Tech to do anything not exclusively in its own self-interest.

In health care, people and especially patients and their families don't care how much you know, or how smart you're supposed to be, until they know how much you care. And that's caring about each of them individually and as individuals. Telemedicine may eliminate the need to be physically present -- 7 out of 10 office visits to a doctor could be handled over the phone -- but that doesn't mean that the provider you are talking to doesn't need to have a sufficient bedside manner to actually connect with each patient.

We're willing to walk into Walgreens or CVS for a quick (and often free) flu shot, but not a whole lot more than that (especially with the slimy residue of the inaccurate Theranos testing that took place at Walgreens stores still present). Access and convenience are important, but medical care is also very much dependent on comfort, continuity, and confidence in the person you are dealing with.

Customer service in most tech businesses is an oxymoron to be begin with. Worse yet, low-level, relatively crappy and automated customer support is a conscious, cost-effective goal. Much like TV programming is still about launching the least objectionable shows so that the few remaining people watching broadcast television won't change the channel, support from the tech companies is all about providing the lowest and cheapest customer interaction the companies can get away with.

They have developed extensive strategies around varying tiers of service and support, and escalation paths that virtually assure that, even if you eventually penetrate the massive barriers to reach a human being, the experience won't be much different than talking to a chatbot. This approach simply won't fly with consumers concerned about their health. Automation is never going to replace immediacy, authenticity and actual caring in healthcare.

The absolute core of Amazon's primary business is delivery and yet, if your package disappears, good luck even finding the customer service numbers on the website. They're buried multiple layers deep in order to discourage calls. The problem-solving pages on the Amazon site give you vague instructions and "helpful" suggestions like "wait 48 hours" and hope the thing shows up. Not exactly what you want to hear if your kid's running a fever or you need immediate assistance. The situation is pretty much the same with all of the others as well.  It's about MVO (minimum viable offering) or MRE (minimum required effort) and imposing multiple tiers of pain and frustration before there's any prospect of relief, or any real solution.

Bottom line: until the tech giants wake up and understand that one size and one approach never fits every situation, they can have all the tiers of service they want, but their initiatives in health care will only end in tears all around for the foreseeable future.

Published on: Jan 28, 2020
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