Please forgive me, but for a minute, I want to return to the subject of profit motives interfering with the development of new technologies that undermine profits in medicine (or anything else). Of course, there is pressure not to invent and deploy something that will kill the cash cow.
However, that’s where competition comes into play. If company A doesn’t do it, company B will. When no existing company does it, an upstart with nothing to lose and everything to gain will do it.
I have a couple of personal anecdotes, and I’ll share one (sorry for the long story, but it kind of fits since it’s about a death, of sorts).
One of my first jobs after graduating from college decades ago was as a designer and technical illustrator for Sperry Univac, the world’s second-largest computer company at the time, after IBM. They became that large by aggressively developing new mainframe technologies in the 1950s through the 1970s.
In 1977, newcomers and minor players, such as Apple, Commodore, Tandy, Atari, and Texas Instruments, released small, underpowered home computers. Sperry Univac dismissed them as toys. In 1980, on a whim, IBM licensed the DOS operating system from a struggling start-up named Microsoft and began building its “toy” IBM personal computer.
By 1985, Sperry Univac finally realized that the market was changing, so it (and others) developed IBM clones that could also run DOS. Sperry hired me as part of its newly formed PC development team.
After working there for about a year, the CEO of Sperry flew into town to visit. He wasn’t very impressed with our PC efforts. He gave a speech that, among other things, said that Sperry had become a multi-billion dollar company by building mainframes and that mainframes would always be its core business. He went on to say that our PC project was a valuable experiment that demonstrated that Sperry was keeping up. But he also said that Sperry had no interest in undercutting its core business and reputation by building toy computers to be sold as birthday presents in discount stores.
I remember saying to myself during his speech that it was time for me to find a new job.
So, where is Sperry today? It’s gone. It was gobbled up by a competitor a year or two later. The merged company, named Unisys, is now a minor player in the computer industry and makes its profit from government contracts. What happened to those little start-ups that aggressively embraced personal computers? Microsoft and Apple are two of the world’s largest companies.