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the rules in
10 inputs
Rule # 1
The older you get, the
less beautiful and
intelligent you are
Redefining rule # 1

What if - as you aged - you became

more beautiful and intelligent?

Source: Michalko, Michael: Thinkertoys, p. 242.

Rule # 2
The sicker people get,
the more money
physicians earn
Redefining rule # 2

What if nurses and primary care doctors were

compensated to help people not to get sick?
In China, some doctors are paid monthly when you are
healthy. If you are sick, you don’t pay that month.

Rule # 3
Treatment is the main
revenue generator
Prevention = Main revenue generator

The healthy patient Reinventing pharma

No Perso-
Perso- nalized
nalized medicine

Business as usual My.medicine

Treatment = Main revenue generator

Source: Osterwalder, Alexander & Pigneur, Yves: Business Model Generation, p. 187.
The result of this toxic combination of unhealthy
lifestyles and focus on acute treatment is an
explosion in the number of chronic patients who
require regular medical care for the rest of their lives.

That’s why chronic disease treatment now accounts

for between 70-80% of healthcare costs in Europe.

Speech by Mr. Gerard Kleisterlee, CEO of Philips, at FT Event in Brussels on November 12, 2009
”What we have now is a disease industry, an illness
industry. We spend almost 20% of GDP on sickness,
less than 2% on prevention.”

Dr. Walter Bortz.

Redefining rule # 3

How about putting more focus on prevention?

Jamie Oliver: Teach every child to cook
10 recipes that will save his/her life

Sport in a park in Beijing, China

Rule # 4
People communicate
with doctors at the
doctor’s office
Redefining rule # 4

What if health professionals and other people,

who are interested in health, communicate
with people about health issues anytime and
anywhere, not least using communication
Rule # 5
Nurses are not
allowed to write
Out of concern for patient safety, many states still
prohibit nurse practitioners from writing prescriptions
without the direct supervision of a doctor, even for
precisely diagnosable, rules-based disorders like strep

This effectively prevents retail clinics from competing

against physicians’ practices in those states – even
though in the other states the patients are doing just
fine, at less than half the cost.

Source: Christensen, Clayton: The Innovator’s Prescription, p. 384.

Redefining rule # 5

How about that nurses continually educate

themselves - including in use of new technology -
to be able to help patients better and faster?
An example

By using Google Translate, any nurse

can communicate with any patient.
Rule # 6
Patients are
tested by
Redefining rule # 6

Patients also test themselves, for

example using their smartphones
Blood pressure.
Cardiac rhythm Oxygen. Temperature


Ultrasound Calories


Rule # 7
People are involved little in
managing and keeping
track of information about
their health
Redefining rule # 7

“..patients ought to be viewed as partners in

managing and keeping track of this information.”

Rule # 8
Health professionals
wear white uniforms
Redefining rule # 8

What if health professionals decided themselves

what clothes they wear – including the colour of the

In other words, what if they wore their own clothes?

Rule # 9
People go to the
hospital to get treated
Redefining rule # 9

What if hospitals go to the people?

“Doctors would like to have the possibility of literally
moving the hospital to the patient’s driveway.

That will only happen, if Denmark gets a sufficient

number of high-tech ambulances…”

Danish Medical Association.
Rule # 10
Insurance companies,
pharmaeutical companies,
and physicians have
contrasting goals
Redefining rule # 10

What if everyone working in healthcare

had the same goal?