4 takeaways (and 2 questions) from Cleveland Clinic Innovation Summit

Cleveland Clinic’s 2012 Medical Innovation Summit, this year dedicated to cardiovascular technology, has come and gone. But it’s worth taking a look back at a few observations and  insights gleaned from the ninth annual summit — and asking a couple questions. The view from the top is a lot different than the view from the […]

Cleveland Clinic’s 2012 Medical Innovation Summit, this year dedicated to cardiovascular technology, has come and gone.

But it’s worth taking a look back at a few observations and  insights gleaned from the ninth annual summit — and asking a couple questions.

The view from the top is a lot different than the view from the bottom: Given recent heavy media attention to the “Occupy Wall Street” protests, it was striking to notice the wide gulf in tone between members of America’s elite professional class at the conference and regular Americans in the streets. Panelists in the aptly called “View from the Top” discussion offered a familiar prescription from the conservative playbook for righting America’s economic problems: cut corporate tax rates, loosen regulations and the like — a far cry from the sorts of policies that would actually help those who suffered the most during America’s worst economic crisis since the Great Depression.

In a must-read for conference attendees, Ezra Klein of the Washington Post did an excellent job summarizing the paternalistic and condescending tone General Electric CEO Jeff Immelt showed toward government in general and President Obama in particular — as well as the odd feeling of persecution exhibited by some top executives at the conference. Here’s a sample from Klein:

This is more a comment on the conference and some of the other panels than on Immelt himself, but these folks really, really feel persecuted and unappreciated. The common response to this, of course, is that corporate profits have hit record levels in recent years and the top 1 percent has never been richer. But if you need more evidence that money doesn’t buy happiness, you should sit with some CEOs for an hour.

It’s no surprise that the business elite favor laissez-faire economic policies, but the incongruity between what we heard at the conference and what we’re hearing on the news was particularly jarring. Several executives, including the CEOs of Medtronic and Pfizer, spoke about the need to enhance the public image of medtech companies. While no one would reasonably dispute that companies in the medical industry do some great things and help improve quality of life for millions of people worldwide, complaining about the FDA and calling for corporate tax breaks probably isn’t going to win the hearts of the American public.

Thank God for Dr. Steven Nissen: Professional conferences are usually carefully stage-managed and PR-sanitized affairs, and credit Cleveland Clinic’s staff with nearly seamlessly running the event. (One veteran attendee referred to the conference as a three-day “infomercial” for the Clinic.) But Nissen, chair of the Clinic’s cardiovascular medicine department, won’t be muzzled. And that’s why it’s imperative that Nissen speak on as many panels as possible at future Clinic conferences. Nissen’s most biting commentary included noting that unspecified divisions of the FDA are “functionally brain dead”  and that pharmacy benefit managers (PBMs) are undermining medicine. (Clinic executives particularly must’ve enjoyed that last line, considering that Medco — the nation’s largest PBM — was a “premier sponsor” of the event and had its name prominently featured in displays behind the stage.)

Nissen burnished his no-b.s. reputation as one of Cleveland Clinic’s few public voices who insists on sharing his sharply worded opinions on the state of U.S. healthcare, regardless of whether those opinions tick off powerful and influential companies that the Clinic has business relationships with. The Clinic needs more like him.

If you’re a healthcare investor, forget drugs and devices: At any gathering of medical executives there’s bound to be lots of griping about the U.S. Food and Drug Administration’s unpredictability, risk-aversion, incompetence  and sclerosis. But if the FDA’s really that bad, why not just forego drug-and-device investing and pour your cash into health IT? It’s a hot market, and lots of health IT applications don’t require FDA clearance. There’s been anecdotal talk of a shift to health IT from veteran drug and device investors — and if the complaints about the FDA are more than just heated rhetoric — we should expect to see more of it.

Maybe the FDA isn’t all bad: The conference wasn’t entirely dedicated to FDA bashing. To the extent that you consider Nissen’s opinions to be well-informed, it’s worth noting his broader comments on the agency: “The FDA is the best regulatory agency in the world, even though I’ve been a strong critic.” And another: “We’re making a big mistake as a society in not adequately funding the FDA.” And to be fair, Nissen wasn’t the only one. Several speakers praised aspects of the agency and a few others, including leaders of a couple industry trade groups, spoke of the need for more FDA funding.

Did the Big 3 trade groups stiff Cleveland Clinic? Apparently mistakenly billed as the first time the top executives from the Big 3 medical industry groups — pharma, devices and biotech — had been at the same place at the same time (the remark was later clarified as the first time they’d ever been together in Cleveland), the presidents of PhRMA, AdvaMed and BIO never showed up. That sparked lots of chatter, with conference attendees openly wondering and speculating over afternoon coffee and snacks whether the execs were sending some kind of message. (They appeared together from Washington, D.C., over a live video feed.) The lame official explanation that they couldn’t get flights did nothing to tamp down that speculation.

UPDATE: An AdvaMed spokeswoman says the speculators at the conference were mistaken. The three CEOs were scheduled to be on the same flight, and it was indeed canceled. See comment below.

Where’s the mhealth? The intersection of one of the most important shifts in consumer behavior in decades — the migration to mobile — with billions and billions in healthcare IT spending would seem to suggest that there’s no hotter area in the medical industry than wireless health. “Medical apps for mobile devices” came in at No. 4 on the Clinic’s list of Top Medical Innovations for 2012, with the Clinic calling the shift “a technological revolution in the way healthcare information is accessed and delivered.” The problem is that mhealth is already widely flourishing in 2011. So why not dedicate an entire panel to the topic? Here’s hoping we see one on next year’s agenda. And I’ll even helpfully suggest a moderator: Brian Dolan‘s not hard to find.