Nobody gets disrupted by a surprise. They get disrupted by a trend they watched coming for ten years and decided to sit out.
That’s my argument in “Disrupt Yourself.” Biology is industrializing. Drug discovery is moving from an artisan craft (a talented chemist, a lucky screen, a decade of work, a coin flip at the end) to something you can engineer, schedule, and repeat, and AI is the machine doing the moving. Most people read that as a story about companies. I think it’s mostly a story about people, and the ones who wait for their employer to make the call will lose a decade.
Previous revolutions are useful because they show you where the pressure lands. It lands at four levels, and you can be winning at one while quietly losing at another. Call it the Disruption Ladder.
Career. The people running biology in 2035 are coming out of gaming, graphics, and cloud infrastructure, not out of a wet lab. (My own version: Folding@home ran on hardware built for video games. In 2007 a network made mostly of PlayStation 3s became the first distributed system to cross a petaflop, a thousand trillion calculations a second, and what it was doing was protein folding.)
Company. Move the business model while the old one is still healthy. Netflix started streaming in 2007, when mailing DVDs was what paid the bills. Nobody self-disrupts from a position of weakness. That’s called a restructuring.
Industry. Put the future into the product before the market shows up. Nvidia shipped CUDA in 2006, a way to program a graphics card like a general purpose computer, six years before AlexNet made anyone care about deep learning.
Ecosystem. This is the nearly impossible one. You have to bring partners, payers, and customers into a future they haven’t agreed to yet, on their contract cycle instead of yours.
So why now? The economics finally flipped. Eroom’s Law (Moore’s Law spelled backwards, named that on purpose) says the cost per approved drug roughly doubled every nine years for half a century, even while the science underneath it got cheaper by orders of magnitude. Sequencing ran the other direction: the first human genome cost something like three billion dollars, and today it’s a few hundred. One of those curves is chance. The other is engineering.
And healthcare is not the problem people label it. Most of what’s broken isn’t medicine, it’s logistics and engagement, getting care to a person and keeping that person going. That’s closer to what Amazon solved than to what a hospital solved. Which is why I’m still confident the biggest company in the world will be a consumer health company, built by people fluent in software, biology, and prevention, who never worked in the industry they end up owning.
The essay ends with an ask, this won’t happen on its own. Pick the level you’re actually operating at and disrupt yourself there first. Then work your way up to greater and greater impact.
