Arlen’s Healthcare Entrepreneurship Substack

Arlen’s Healthcare Entrepreneurship Substack

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Arlen Meyers, MD, MBA's avatar
Arlen Meyers, MD, MBA
Jun 30, 2025
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In his latest book, The Evolution of Everything, Matt Ridley argues that social engineering policies, whether initiated by governments or some other organization, are unlikely to reach whatever dedicated goal they have because it is the action of humans that change society and not the ideas of a select group of people. What's more, ideas seem to evolve simultaneously in various parts of the world, often unknown to individual innovators in any given place and move forward because of trial and error. Centralized planning fails because it cannot predict or control the outcomes of these innovation experiments, nor can it provide timely and effective feedback to guide the direction of innovation. People on the ground can and do.

In the case of biomedical and health innovation, there are multiple examples of how decentralized collaborative online innovation networks have coalesced to create bottom-up innovation, including crowd sourcing, crowd funding, innovation networks and many digital health businesses that use the model to drive innovation that delivers value to patients.

Unfortunately, social policy and the structure of work lags the reality on the ground as we continue to morph from an industrial economy to a knowledge-based economy that drives the entrepreneurial and innovation economy. An example is a gig economy that represents about a third of the US workforce. How should society organize and respond to release the power of bottom-up innovation?

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