Amazon, healthcare and head noise

Molly Gamble (Twitter)

Ask anyone to name healthcare’s emerging disruptors, and Amazon will be among the top three – if not No. 1. The company with a $6.7 billion Q2 profit has a strong chokehold on the industry’s hypothetical thinking.

When leaders in legacy healthcare discuss Amazon’s power, the tone is often defeated: This faceless, looming force will end up controlling most aspects of our lives anyway, right?

But looking at Amazon’s moves into other industries, there might be some evidence to suggest that healthcare leaders and professionals need not give up the ship — at least not yet. A time of great workforce fragility in healthcare is not the time to prematurely credit the e-commerce goliath with more mindshare than it deserves.

Consider Amazon’s acquisition of Whole Foods Market. When the upscale grocery chain sought a buyer, it courted Warren Buffet and prompted consideration from Albertsons before Amazon ponied up $13.4 billion to acquire its nearly 500 locations in 2017. At the time, the deal was described as one that would “instantly transform the company that pioneered online shopping into a merchant with physical outposts in hundreds of neighborhoods across the country,” as The New York Times put it.

Six years later, Amazon’s changes to the Whole Foods business are readily apparent. It has added more local brands. It executed rounds of grocery price cuts to counter the “Whole Paycheck Foods” nickname. It lowered the price premium gap with other regional grocery chains, but remained higher than national chains. Last year, Whole Foods got a new CEO for the first time since 1980.

Beyond corporate minutiae, Amazon’s moves in grocery may have thrilled futuristic tech enthusiasts but added little to its value proposition in the eyes of everyday customers. In many ways, the acquisition has been less of a transformation and more of a science experiment, as online grocery shopping continues to remain less common than in-person shopping.

“[Amazon’s] best-known addition to the retail experience is the ‘just walk out’ technology in physical stores, equivalent to its one-click shopping online. Yet cashierless supermarkets sound like something more beloved of geeks than grocers,” The Economist wrote.

Amazon’s cashier less, palm-scanning transaction technology has been installed at “more than 30” stores operated by other companies in the U.S., according to The Information, which characterized the tech’s takeoff as a “stumble.” (The modest uptake is in line with consumer disappointment with self-checkout, which dates back to the early 1990s, has not revolutionized the grocery experience as once expected, and can be described as unloved.)

When the former executive of British supermarket chain Tesco was hired by Amazon in 2022 to bring more human touch to its QR code, data-collecting and surveillanced customer experience, he visited an Amazon Fresh store to find “the fresh-meat and -fish counters were so barren they looked like part of a going-out-of-business sale,” according to The Economist. “He bought one of the three rotisserie chickens on display out of sympathy, because he feared they had been there all day.”

As for grocery access, Walmart continues to dominate with about 4,700 outlets, compared with 530 Whole Foods, 44 Amazon Fresh and 22 Amazon Go shops. Amazon Fresh is accessible to just over a third of Americans while 90 percent of Americans live within 10 miles of a Walmart, one broker calculated for The Economist. Whole Foods is Amazon’s successful brick-and-mortar presence because it closed all of its 4-star, Books and Pop Up stores.

Missteps can be harder to feel when half a trillion dollars in annual revenue is streaming in. Amazon’s grocery and brick-and-mortar venture was first seen as a conventional move, and arguably would be more successful if it had stayed that way. Instead, things got wacky and esoteric. Common sense steps like meaningful price improvements or more storefronts were muted as palm-reading technology was pushed, as if it were something customers couldn’t wait to experience.

Amazon’s attempt to strip human interaction from brick-and-mortar shopping paints a dark picture for what it could do in healthcare, which faces a dual challenge: its humanity is essential and it is short on humans to do the work. Amazon might be able to solve the latter challenge, but what it could cost healthcare’s humanity is painful to think about. Patients and those caring for them deserve more than anything resembling a soulless experience of shopping for sad rotisserie chicken.

As civility shrinks and differences grow, it’s tempting to think the tech giants that once spelled less-than-great news for healthcare might actually be a source of salvation. Virtual this, virtual that; scan your palm here, talk to a bot there. The Vision Pro Apple released in 2023 is a great sign of our times — a 0.8-pound piece of hardware for your face to blend digital and real worlds. Just what society needs: one more way to avoid eye contact and reality.

Medical professionals and workers who care for patients deserve confident leadership from people with feet firmly planted on the ground who do not shiver at the thought of Amazon, Apple or Silicon Valley’s next move. The people who continue to power healthcare deserve more recognition, attention and concern than a company, Amazon, whose CEO devoted all of 100 words to healthcare in its latest earnings call.

Many big tech moves will be declared as “transformational” before results prove it. (Compare this to the work of U.S. academic medical centers, where research with potential to change lives receives a fraction of the same notoriety.) Outsized bravado for big tech can leave these companies holding more space in healthcare leaders’ minds than they deserve. The big talking point today is that technology doesn’t need to compromise humanity, but the bigger talking point is that it certainly can.

Health system leaders should fully embrace their humanity right now, listen closely to what patients, workers and communities say, respect and uphold the expertise and specialization of their medical teams. These leaders should look just as intently at the next 10 days as they do the next 10 years, and manage their enthusiasm for flashy, first-of-its-kind technology. Leaders who can’t shake the big tech obsession may continue the hand-wringing and what-iffing. Leaders who keep it in check and focus on people and their goals and concerns — big and small — will be the ones who truly lead.

For what it’s worth, I shopped at Whole Foods throughout the pandemic. I made a point to check out with one specific cashier if he was working. He would ask my name before sharing his, recommended what has become my favorite chocolate bar, and could recite poems on the spot, even going so far as to write short ones on the back of my receipt if I enjoyed them.

It is people, not tech, that surprise and delight me most.