What Can Healthcare Learn from Apple and Tesla
It's Not Just Design Thinking-It's Culture
Executive Summary
Cultural transformation delivers measurable ROI: Healthcare organisations that adopt design-led cultures report 30% improvement in patient satisfaction, 33% reduction in staff turnover (saving $3,500 per nurse annually), and 40-60% lower administrative overhead through flattened hierarchies.
True transformation requires more than technology: Despite significant investment in technology and process improvement, most healthcare innovation initiatives struggle to achieve systemic change. Organisations that align leadership, culture, and design thinking achieve sustainable transformation that survives beyond individual champions.
Apple and Tesla demonstrate complementary transformation approaches: Apple's design coherence builds self-sustaining excellence that outlives its founder, while Tesla's system-level innovation challenges outdated assumptions. Both capabilities are critical for healthcare leaders navigating today's complex challenges.
The 'Teal Organisation' model offers a practical blueprint: Healthcare organisations like Buurtzorg in the Netherlands demonstrate that self-managing teams can reduce overhead, improve staff engagement, and enhance patient satisfaction while creating environments where talented professionals want to stay.
Successful transformation requires strategic differentiation: Leaders must distinguish which healthcare elements to protect (e.g., clinical safety standards) versus challenge (e.g., fee-for-service incentives) to enable decisive action without undermining essential system functions.
Healthcare Transformation Isn't Just About New Tools
Healthcare today is full of well-intentioned innovation attempts: design thinking workshops, digital front doors, patient engagement apps. Yet systemic transformation remains elusive. Why? Because too often, we try to 'bolt' innovation on top of rigid, hierarchical cultures that resist change, rather than rethinking the systems themselves.
To imagine what real transformation looks like, we can learn from two very different organisations: Apple and Tesla, and the leadership of Steve Jobs and Elon Musk. Then, we need to look beyond individuals to the structures and cultures that support enduring change - like those described in Frederic Laloux's book Reinventing Organizations [1].
The Apple Way: Design-Led Transformation
Steve Jobs didn't just use design methods; he embedded design culture at the core of Apple. He built the company with a relentless focus on user experience, prioritising:
Recruiting and empowering 'A-players'
Designing end-to-end systems that are coherent and human-centred
Radical attention to quality and simplicity
Jobs' famous hiring rule—"A-players hire A-players; B-players hire C-players"—created a flywheel effect: excellence attracting excellence. He didn't just want smart people [2]. He wanted people who were:
Obsessed with quality
Willing to challenge him and each other
More concerned about the product than power
This approach created a culture where innovation was the standard, not the exception. Crucially, this culture has outlived Jobs himself. Apple's DNA is now self-sustaining. That kind of cultural resilience is something healthcare must aspire to.
From Startups to Systems: Why Context Matters
Steve Jobs built Apple with a clean slate - a founder's privilege to design not only products but the organisation itself. He embedded his philosophy into Apple's structure, talent model, and culture from day one.
Most healthcare leaders don't have that luxury. They inherit sprawling, risk-averse systems with deeply embedded norms and performance pressures that prioritise throughput over transformation. That makes the challenge fundamentally different—not one of inventing a new culture, but of reshaping one from within.
Healthcare often claims to value excellence, but in practice it overvalues credentials over creativity. Underperformance is tolerated due to rigid hierarchies. There is limited space for intellectual or emotional risk-taking. If healthcare wants to transform meaningfully, it needs to:
Recruit and empower A-players in clinical, operational, and design roles
Create environments where high performers stay and thrive - not burn out or leave
Build cultures that outlive individual leaders, just as Apple's did
Tesla: Redefining the System, Not Just the Product
If Steve Jobs exemplified the power of design-led cultural coherence, Elon Musk's Tesla represents a different kind of transformation logic: rooted in system-level innovation, vertical integration, and a willingness to challenge entrenched industry conventions.
VERTICAL INTEGRATION AS STRATEGIC COHERENCE
Tesla didn't just build electric cars; it completely rethought the entire automotive business. While traditional carmakers outsource most components to a complex web of suppliers, Tesla took control of the entire value chain - from battery production to software development to sales. This end-to-end approach, or 'vertical integration,' gave Tesla unprecedented control over the customer experience.
Building its own batteries, chips and manufacturing robots
Writing its own vehicle operating system and autopilot software
Bypassing dealerships to sell and service directly
Designing industrial die-casting machines to streamline production
This approach allows Tesla to tightly align strategy, product, and customer experience, iterating quickly and reducing dependence on legacy constraints.
In healthcare, this is the equivalent of a provider owning not just hospitals but also the EMR, diagnostics, patient communications, and AI tools - and making them all interoperable by design.
CHALLENGING CONVENTIONS
Tesla's trajectory has been marked by bold decisions that transformed industry norms:
Refusing to adopt third-party software like Apple CarPlay
Rolling out over-the-air software updates to improve safety and performance post-sale
Pushing forward on controversial self-driving features in live environments
Betting the company on electric vehicles when the market was still nascent
The healthcare parallel? Challenge sacred assumptions like fee-for-service reimbursement, siloed specialist care, or the idea that innovation can be outsourced to tech vendors without structural reform.
SIDEBAR: BREAKING THE SYSTEM OR BREAKING THE RULES? THE DOGE EXPERIMENT
Elon Musk's recent work with the US Department of Government Efficiency (DOGE) represents a fascinating real-time experiment in system transformation. Unlike his approach with Tesla, where he reimagined automotive systems while working within regulatory frameworks, DOGE takes a more radical approach to government reform. Musk is attempting to dismantle or bypass parts of the federal bureaucracy from within - a significantly higher-stakes endeavour. This raises crucial questions for healthcare leaders: What happens when you ‘break the system’ rather than just challenging its rules? While bureaucratic inefficiency certainly exists, there's danger in dismantling structures that may serve essential societal functions. Healthcare transformation requires the wisdom to distinguish between outdated processes that obstruct progress and foundational elements that protect public wellbeing, even when imperfect. DOGE's successes and failures will provide valuable lessons about the limits and possibilities of radical institutional reform.
Teal Organisations: A Model for Healthcare
Jobs and Musk show us what vision can achieve when you build from zero. But most healthcare leaders don't get that chance. They inherit fragmented, risk-averse institutions with deep structural inertia. That's where 'teal organisations' offer a compelling alternative.
Frederic Laloux's breakthrough book Reinventing Organizations introduces the 'Teal Organisation' model - a practical framework that is already transforming companies across multiple industries [1]. For healthcare leaders, these organisations offer a proven alternative based on three principles that directly counter healthcare's traditional pain points:
Self-management: No traditional hierarchy—decisions are made by those closest to the work. Teams govern themselves.
Whole-person centred: People are not just roles; they're complex, creative humans. Employees bring their full selves to work.
Evolutionary purpose: Organisations are living systems that adapt and grow.
Buurtzorg, a Dutch home-care organisation, embodies these principles at scale: 14,000 nurses working in 1,000 autonomous teams of 10-12 nurses, each handling everything from scheduling to care plans. Overheads dropped, staff engagement soared, and patient satisfaction leads the country.
The ROI of Cultural Transformation
Healthcare organisations that successfully implement the principles discussed in this article have demonstrated measurable returns:
Reduced staff turnover: Buurtzorg's self-managing teams have 33% lower nursing turnover than traditional home care organisations, translating to approximately $3,500 in savings per nurse annually in recruitment and training costs.
Lower administrative overhead: Teal organisations typically operate with 40-60% fewer middle managers, allowing resources to be redirected to frontline care.
Faster innovation cycles: When decision-making authority is distributed closer to patients, changes can be implemented and evaluated in weeks rather than months.
Improved patient satisfaction: Organisations that establish ‘Teal islands’ report 15-25% improvements in patient satisfaction.
The InterAlign Transformation System™
As we've seen from both Apple and Tesla, transforming healthcare isn't about implementing isolated tools or techniques - it's about creating a dynamic, self-reinforcing system where multiple elements work in concert.
To conceptualise this holistic approach, I've developed the InterAlign Transformation System™, which visualises the critical relationship between the five key elements of healthcare transformation:
”No transformation without innovation. No innovation without design thinking. No design without empowered leadership. No leadership without a culture that permits risk, purpose, and change. And no culture shift without the momentum of real transformation."
The InterAlign Transformation System™ represents these elements like a cohesive molecular model, where each 'atom' exists in a state of dynamic interaction with all others:
Design Thinking provides the structured approach and human-centred methods that make innovation possible and sustainable
Innovation creates the practical changes and novel solutions that enable transformation
Transformation represents the systemic evolution that reshapes healthcare delivery and experiences
Leadership provides the vision, direction, and empowerment needed to initiate and sustain change
Culture creates the environment where innovation can flourish and transformation can take root
What makes this model powerful is the recognition that each element influences and is influenced by every other element. The connective arrows demonstrate that these aren't sequential steps but interactive forces.
When healthcare organisations can align these five elements - treating them as a unified system rather than separate initiatives - transformation becomes not just possible but inevitable.
Strategic Framework for System Transformation
What should healthcare leaders transform, and what should they protect? The Strategic Transformation Matrix helps leaders decide what parts of existing systems should be preserved, reformed, challenged - or broken entirely.
It distinguishes between 'load-bearing systems' that uphold societal goals (e.g., equity, safety) and legacy burdens that obstruct progress (e.g., bureaucracy, rigidity). This helps leaders decide where to focus their efforts when driving healthcare transformation.
For instance:
Preserve & Protect: Public health agencies, universal coverage goals, clinical training standards
Reform Carefully: Hospital-centric delivery, over-specialisation, fragmented IT systems
Optimise or Delegate: Outdated paper records, legacy appointment systems
Challenge & Replace: Fee-for-service incentives, regulatory bottlenecks, scope-of-practice silos
In a diagram:
From Design as Method to Design as Ethos
If we want truly transformative healthcare systems, design must be more than a toolkit. It must be a way of being:
Like Jobs, we must obsess over user experience and build teams that self-replicate excellence.
Like Musk, we must question the status quo and take bold action—but with a deep sense of social responsibility.
Like Teal organisations, we must treat healthcare institutions as living systems—capable of growth, healing, and purpose.
The Time for Transformation is Now
Healthcare stands at a pivotal moment. Rising demand, unsustainable costs, burnout, and technological disruption have created both urgency and opportunity. But transformation won't come from surface-level innovation or isolated tools. It will require a deep rethinking of how healthcare organisations are led, structured, and experienced.
The reality is: most healthcare leaders aren't founders. They haven't had the luxury of designing culture from a blank slate like Steve Jobs or building outside the system like Elon Musk. They inherit complexity, regulation, inertia - and still, they are expected to deliver transformation.
But that doesn't make change impossible. It makes it more demanding and more meaningful.
The path forward is not about burning down what exists, but courageously redesigning from within:
Start by identifying 'Teal islands'—small, autonomous teams where a different culture can take root.
Use the Strategic Transformation Matrix to distinguish what to protect, what to reform, and what to release.
Shift leadership energy from controlling operations to cultivating conditions where innovation, empathy, and excellence can thrive.
Use the InterAlign Transformation System™ as a compass - aligning culture, leadership, design, innovation, and transformation into a unified force for change.
The future of healthcare will not be designed in blueprints or policy papers. It will be shaped in the daily decisions of leaders willing to challenge assumptions, empower talent, and reimagine what a healthcare organisation can be—with the design coherence of Apple, the system logic of Tesla, and the evolutionary purpose of a Teal organisation.
Transformation won't be easy. But it's not out of reach. It's already happening - one bold team, one redesigned unit, one cultural leap at a time.
Discussion Questions
What legacy assumption in your organisation is no longer serving patients? What would it take to challenge it?
How could you create a ‘Teal island’ within your current healthcare system? What small team or unit might be ready for greater autonomy?
Which quadrant of the Strategic Transformation Matrix contains most of your organisation’s challenges? What does that tell you about your transformation priorities?
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This article is part of the "Designing Healthcare" series on Substack, which explores transformational ideas at the intersection of leadership, culture, and innovation. Next in the series, we'll examine "The Limits of Lean: Why Continuous Improvement Isn't Enough" - showing why traditional efficiency frameworks fall short in creating truly adaptive healthcare organizations.
References
[1] Laloux, F. (2014). Reinventing Organizations. Nelson Parker.
[2] Isaacson, W. (2015). Steve Jobs: The Exclusive Biography. Abacus.