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Goliath, Meet David – The Health Care Blog

by Balanced Vault
September 20, 2022
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BY KIM BELLARD

I’m a sucker for underdog stories.  I love unconventional wisdom overthrowing conventional wisdom. I’m deeply suspicious of Big Tech, Big Oil, and big health.  I know unfettered competition is not always to my benefit but get nervous when I don’t really have many options.  

So when I read that Google is starting to worry about a threat to its search dominance and that TikTok and other social media giants are scared of a rival start-up, well, count me in. I just wish it was health care goliaths that were worried.

————–

You probably use Google to search online.  “Google” has become a generic term for search, like Xerox was for photocopying.  Depending on the source, it’s share of search is north of 80%, probably closer to 90%, and it’s been that way for a long time. Larry and Sergey built a better mousetrap and the world, indeed, build a path to their door. 

TikTok might change that.

Yes, TikTok again.  Face it, it’s hard to keep a finger on today’s culture without that finger pointing to TikTok. Last month the finger pointed directly to healthcare, this month it is pointing to search, and that’s what has Google nervous. 

“In our studies, something like almost 40 percent of young people, when they’re looking for a place for lunch, they don’t go to Google Maps or Search. They go to TikTok or Instagram,” Prabhakar Raghavan, a Google senior vice president, said at Fortune’s Brainstorm Tech 2022.  

The New York Times proclaimed: For Gen Z, TikTok Is the New Search Engine.  The article discerns a sea change in search:

TikTok’s rise as a discovery tool is part of a broader transformation in digital search. While Google remains the world’s dominant search engine, people are turning to Amazon to search for products, Instagram to stay updated on trends and Snapchat’s Snap Maps to find local businesses. As the digital world continues growing, the universe of ways to find information in it is expanding.

The article describes how search on TikTok is different than on traditional search engines:

Instead of just slogging through walls of text, Gen Z-ers crowdsource recommendations from TikTok videos to pinpoint what they are looking for, watching video after video to cull the content. Then they verify the veracity of a suggestion based on comments posted in response to the videos.

That doesn’t mean, of course, that the videos are factually correct – not that other search engines are either – but Francesca Tripodi, an information and library science professor at the University of North Carolina, warned The Times: “You aren’t really clicking to anything that would lead you out of the app.  That makes it even more challenging to double-check the information you’re getting is correct.”  Lee Rainie of the Pew Research Center added that TikTok “is becoming a one-stop shop for content in a way that it wasn’t in its earlier days.” 

Google should worry.

————-

Lest anyone think the world is just going to become all TikTok all the time, TikTok is scared of a two-year old French start up: BeReal.  BeReal, in case you hadn’t heard of it either, is a photo-sharing app whose key feature is that it randomly prompts users to take and share a photo, within two minutes.  It uses both front and rear camera to show both a selfie and where the user is.  

As BeReal describes it:

Everyday at a different time, everyone is notified simultaneously to capture and share a Photo in 2 Minutes. 

A new and unique way to discover who your friends really are in their daily life. 

BeReal was Apple’s #1 download this summer, and has some 56 million downloads, with the US its biggest market. It even riffed on Facebook’s initial strategy of going after college campuses, through its ambassador program.  

TikTok and other platforms have noticed. “The fear of the incumbents is that this becomes the next TikTok,” said Mark Shmulik, an analyst for Bernstein, told The Washington Post. “So they’ve all scrambled to launch their own version.”

Just last week TikTok announced TikTok Now – “a daily photo and video experience to share your most authentic moments with the people who matter the most” – and Instagram is working on IG Candid Challenges, which The Verge labeled a “murder clone,” since its sole purpose is to replicate BeReal.  Snapchat was quicker off the mark, rolling out its Dual Camera feature last month, “a new way for Snapchatters to capture multiple perspectives at the same time – so everyone can be part of the moment, as it happens.”

It remains to be seen if the goliaths can crush BeReal by simply cloning its features, or if one of them will simply acquire it, as Meta did with one-time rivals Instagram and WhatsApp.  But, as Mr. Shumulik told WaPo, “They’ve certainly caught lightning in a bottle with an idea.”  

As WaPo put it:

BeReal’s success reveals an appetite among social media users for more authentic, intimate forms of expression, and shows that Davids can still shake up a sector dominated by global Goliaths. At the same time, the scramble by those Goliaths to copy core features of an app that doesn’t even have a way to make money yet underscores the uphill battle that upstarts face just to survive.

BeReal claims: “We want an alternative to addictive social networks fueling social comparison and portraying life with the goal of amassing influence.” Perhaps that will be enough.  

____________

Healthcare is full of Goliaths; pick your favorite (or, rather, your most hated): e.g., pharma, med device manufacturers, national health insurers, EHR vendors, for-profit hospital chains or even your local non-profit hospital monopoly/duopoly.  They’re entrenched, they’ve been entrenched for a long time, and their dominance is, if anything, growing.  Health care is big business, and that business is full of big players.  

It also isn’t like Tech, much less like social media, where an entrepreneur with a good idea and some cool tech can capture that lightening in a bottle and shoot to dominance quickly. It’s too fragmented, too byzantine, too regulated, skeptics and insiders would both say.  A David would have no chance.  

Well, I’m not giving up hope. I’m looking for the thing that will make current EHRs look like the clunky billing engines they are. I’m looking for the thing that will prove hospitals to be vastly oversized.  I’m looking for the thing that will break the physician monopoly.  I’m looking for the thing that will democratize prescription drugs.  I’m looking for the thing that will rewrite healthcare’s financing.

I’m rooting for the underdog.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and now regular THCB contributor.



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