Insights (Essays)

Insights (Essays) November -0001

The End of Professional Snobbery

Neil Seeman

Imagine if no prestige attached to professions. Nobody cared about old-world credentials... MD, PhD, JD, MBA, MPH, MHsC: the letters would mean nothing, zip, in this alternate world.
It's not so far off. Welcome to 2015, the year the Facebook generation is married with kids. This is when Mark Zuckerberg, 24-year-old billionaire, Facebook founder and Harvard dropout, turns 30.

The era of post-professional snobbery will be a very agonizing time…for boomer-generation grandparents. How will they boast about their over-educated children's accomplishments as quantifiably as they can today? For the rest of society, it will mean a boon to human creativity.

The End of "Perfect Outputs"

In one of the most downloaded videos on the Web - Sir Ken Robinson explains, to roaring applause at a TED conference, how our educational system kills creativity in young people. Our system, he says, is geared to producing one "perfect output": the university professor. Robinson blames the post-industrial age educational model for vaporizing creativity from children, promoting a culture where test-taking ability, rather than intellectual agility and ingenuity, reigns.

Young people under 30 - the Google Generation, the Facebook Generation, whatever title you fancy - really are different. They care more about social good, and less about status. This is not an original hypothesis. Leading thinkers on innovation - Gary Hamel, Don Tapscott and Jeff Jarvis - have written books on this. What has been less explored is what this means for healthcare.

In the era when newspapers drove the climate of public opinion - about two years ago - OpEds on healthcare were written by PhDs and MDs. Nowadays patient-experts write many of the most popular blogs (with clinically accurate content). Google controls health-seeking behaviour, with at least 70% of all searches on healthcare information originating from the Google search box.

When MDs and PhDs carry less prestige…

Today, the only job titles that earn real respect at cocktail parties are "social entrepreneur" and "artist" (though I admit I attract a fair deal of intrigue when I tell people that I've taken up boxing). Why does this matter for healthcare? Why does it matter for governments?

As Gary Hamel has trenchantly written, "Thanks to Enron, WorldCom, Adelphia, FEMA, Lehman Brothers, AIG, Fannie Mae, et al, the generation now joining the workforce has an extraordinarily jaundiced view of authority. They are deeply (and often rightly) suspicious of large organizations and those who run them. In their view, it's not titles and credentials that make a leader worth following, but mission, self-sacrifice and world-class competence."

Line management in both the delivery and organization of healthcare will need to get flatter. This means wider scopes of practice - for all members of the care team, which includes patients and their families. Further, CEOs will need to learn how to admit their mistakes. This is the signature virtue of the Facebook generation: humility. I always laugh when people tell me that social networks such as Facebook and MySpace and micro-blogging tools like Twitter show that the "younger generation" is self-centered. In fact, the average age of a user on Linkedin is 41; Linkedin is the fourth-most popular social networking site on the World Wide Web, with 40 million users. People under 30 demonstrate both humility and ego in equal measure. These are not mutually exclusive personality characteristics.

They can chest-thump like the rest of us (witness the scores of Facebook pages boasting about winning beer-chugging contests). But they can also confess to being wrong. Mark Zuckerberg, Facebook's CEO, did exactly this when he responded to a storm of user protest and removed Beacon, a Facebook application. Zuckerberg famously wrote on his blog in December 2007:

"About a month ago, we released a new feature called Beacon to try to help people share information with their friends about things they do on the web. We've made a lot of mistakes building this feature, but we've made even more with how we've handled them. We simply did a bad job with this release, and I apologize for it. While I am disappointed with our mistakes, we appreciate all the feedback we have received from our users. I'd like to discuss what we have learned and how we have improved Beacon."

...we will start to measure innovation and good governance differently

Today, we measure "innovation" through reference to numbers of publications, the impact factor of journals, academic citations, numbers of degrees after one's name, and other proxies of knowledge translation. But if ingenuity and agility are what matters - we are currently preparing our children for jobs that may not exist as we know them. The US Department of Labor predicts that the average learner will have 10-14 jobs by the time they are 38. Niche licensing, already commonplace in healthcare, will intensify. At the same time, there simply won't be enough people with the requisite prescribed credentials (e.g. health records, information management, and health information technology) to satisfy the HR managers.

And so we will need to recruit very differently. Memo to management: drop the "fast-track executive model"; reward the curiosity-seekers, even if they fall flat-footed on their first, second, or third time round. Beware job applicants who have had perfectly linear career paths.

What is more, we may need to measure innovation capacity in the workplace differently, especially in healthcare (where the jobs will be) by qualities such as tolerance for failure; willingness to admit mistakes; and, most crucially, ability to learn from those mistakes.

Few will ever accuse Facebook's Mark Zuckerberg of modesty, but his apologia for his Beacon debacle is emblematic of the new age. Imagine if a hospital admitted in a CEO's blog that its big-budget technology implementation failed miserably? And then have the CEO tell her clients how she had learned from her mistake? That is good governance, Facebook-style.

About the Author(s)

Neil Seeman is Director and Primary Investigator of the Health Strategy Innovation Cell at Massey College, University of Toronto.

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