Today’s response to a world that continually changes, becomes ever more complex, and relies more and more on increasingly complex systems and expertise to achieve goals is to increase control, to demand guarantees and to manage through legal contracts.
The thinking is that it is not wise to simply ‘trust’ the experts to know what they are doing, when we no longer understand everything ourselves. So we step in, seeking out more and more information to cope with our uncertainty, trying to “get” what the experts are talking about and to try to stay on top of things. We end up telling the experts what it is we want, how they have to do it, how to report and which guidelines to follow. But in doing so we restrict the utilisation of the experts’ expertise. Both in how (using what product and services) they can best meet our challenges and in how they can deliver their solution against minimal resources.
This is also what happens in the field of proton therapy. Everybody sees risks everywhere, and instead of minimising this risk the impulse is to try to manage the experts — which increases cost. Which is exactly what the field doesn’t need. For a considerable group of patients proton therapy offers significant clinical benefits. To offer these benefits to patients both proton therapy vendors and proton therapy centers must have healthy operations: financially sound and optimally using the talents and expertise available to them.
But this is not what we find in proton therapy. The problem is not a lack of talent and expertise. The problem is not the complexity of the technology. The problem is only to a degree financial. The real problem is lack of transparency in the communication between vendors and clients. Vendors and clients are experts in their own fields each speaking their own language. To remedy the situation both vendors and clients must change the way they communicate with each other.
Clients don’t always know what their particular aims and challenges are. They need help. The established way forward is not to identify a vendor’s expertise but to select equipment. So they spend considerable amount of resources on gathering detailed technical information the relevance of which is often poorly understood. They then turn this information into a long list of requirements for vendors to fulfil. A list of requirements which is never “complete”, with relative weights which are impossible to define in isolation, with plenty of items which are not relevant to the project at hand and which may both intentionally and unintentionally exclude vendors with the right expertise.
Vendors tend to market and try to sell their equipment using technical information and a long list of features non-expert clients may not be able to assess whether they actually need them. Vendors also tend to highlight technical differences with competing products when the relevant differentiation for the client generally lies not in technology but in solutions. Vendors are asking their clients to become experts themselves or to “trust” the one vendor over the other.
In the field of proton therapy you must get many things right. There are many challenges to be met, and perhaps the biggest challenge of all is to establish a collaboration between vendor and client. What does the client need most? Which vendor has the right expertise to make the center a success? How can the vendor leverage their enormous expertise in engineering and software development to develop services their clients are — often unbeknownst — in great need of?
This conversation is not taking place. Everybody — both vendor and client — tends to automatically focus on equipment and the initial cost. This despite the fact that all vendors are able to accurately deliver identical protons with great precision in the target. Despite the fact that it is shown all too often that the success of a proton therapy center does not depend on the type of technology used, and only to a point on initial cost.
To make proton therapy a success — a healthy and innovating industry allowing healthy centers to offer clinical benefits to their patients — a different conversation has to take place. A conversation which begins with both vendors and clients bringing their respective expertise to the table to identify what the client is actually in need of in their particular situation. This will then become the starting point for vendors to communicate how both their solution and their expertise is relevant for the client to make the center a success over its operational lifetime. The vendors have to communicate this in a transparent non-technical way, making use of data and past performances, so that the client will not be asked to simply “trust” the vendor.
There have been too many proton therapy centers who have failed or are failing to meet their often unrealistic financial targets. The industry must start to fully utilise the tremendous expertise that is available on both the vendor and the client side. By changing the nature of the conversation between vendors and clients, risk — both real and perceived — will go down. And so will cost.
The founder of Trees with Character not only has a lot of experience in proton therapy, he also developed the approach of Decision Free Solutions (DFS). DFS is an approach to achieve desired outcomes against minimal resources by optimally utilising expertise. DFS identifies decisions as unsubstantiated choices which need to be either avoided or treated as risks.
Trees with Character is passionate about utilising expertise to minimise risk in proton therapy as the way forward to establish a healthy industry and to increase the number of patients who have access to the significant clinical benefits of proton therapy.