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Episode 1: Building a New Discipline: Business and Health with Prof. Nora Colton
Host: Prateek, Programme Lead of UCL’s Business and Health Undergraduate Programme Guest: Professor Nora Colton, Director of UCL Global Business School for Health
Music: Intro/outro: Clean and Dance · An Jone
https://www.youtube.com/watch?v=OHCyTZKWTLc
Prateek: Hello and welcome to the very first episode of the global business and health Podcast. I'm Prateek Raj, the program lead of UCL’s Business and Health undergraduate program and an associate professor here. At UCL, we have a long tradition of pioneering new disciplines, from establishing architecture as a formal subject to driving the frontiers of neuroscience. Today, we stand at the birth of another discipline, which is business and health, and who better to guide us through this exciting journey than our first guest - Professor Nora Colton. Prof. Nora Colton is the founding director of UCL Global Business School for Health, the world's first business school dedicated entirely to health. Nora, thank you so much for joining us.
Nora: Thank you, and it's a pleasure to be here, and I'm really excited to talk about our business and health interconnection.
Prateek: Yes, I'm really excited about it as well. So before we begin and dive into it, I just wanted to learn more about your story. Nora, you trained as an economist at Oxford, and today you're leading the world's first business school dedicated to health. So how did that journey unfold for you?
Nora: Well, I think for me, I've always had a curiosity that spans multiple disciplines. Of course, I'm not just an economist. I'm trained as a social scientist, and I've always gravitated towards topics and things that that I saw as really impactful in the world. So actually, when I started my training in economics, I did a lot of work in Middle East Studies. I speak Arabic. I spent years in the region looking at questions around economic development. And then, of course, health creeped in there, and I saw how important health and healthcare are to productivity, to life, in so many different ways that I became very interested and intrigued in questions around health. So I went back and actually, even after doing my PhD at Oxford, and did a master's in pharmacoeconomics and health economics. And so I think unlike many academics
who latch on to one particular discipline or subfield within a discipline and become super experts on that topic, I've allowed myself the opportunity to think more interdisciplinary, to kind of blur the lines and to explore topics in a different way. So I think for me, coming and being the founding director of UCL Global Business School for Health was a natural fit. It fed my curiosity. It fed my desire to make a difference in the world and to bring people who were really excited about applied research, and who realized that to solve those wicked problems in health, they needed to blur the boundaries that this was the place to do it.
Prateek: That's great. I've always been interested in the back story of the school. It was during the pandemic that Global Business School for Health - the idea - emerged and it got established. So I'm very keen to know, how did the idea of founding a business school dedicated specifically to health come about? Was there a moment when people realized that the world really needs this?
Nora: Well, that's, you know, a great idea, right? And the school is a huge success. But I honestly can't take credit for having the idea. I can take credit for executing the idea. The idea actually came from Chris Outram who himself is a strategist and he was one of the founders of OC&C strategy here in London, and he's always had a kind of an intellectual curiosity. And so actually, in about 2015, he actually asked himself this question - why business schools were always very generic, and he was particularly interested in this question around health and why business schools actually didn't even really dabble that much in 2015 in the health space. So he set out, he actually commissioned a piece of research to be done to look into this idea of a business school for health. And he became very passionate about the idea. He tried to go visit a few universities to see if they were interested. And I actually was at that time, able to hear Chris give a talk about how business schools needed to narrow down. Now, of course, from business school standpoint, it didn't make a lot of sense, right? Because if you keep generic, you can bring students in with all sorts of interests and for all different kind of sectors. But when it came to UCL, for all the reasons you said in your intro, UCL is a unique place. It's a very intellectually curious place. It prides itself in being a disruptor. So when he arrived at UCL, he got a hearing that he had not gotten, and particularly the Dean at that point, Graham Hart of the Faculty of Population Health Sciences, was quite intrigued with this idea. Thought it was brilliant, and wanted to take it forward. But you can imagine that it was really quite bold, and so it kind of sat in committees, until the pandemic hit, and then that's when I think Graham and others, it really crystallized for them, given the kind of management, leadership imperative that was needed during the covid period, that such a school really was going to resonate. And secondly, that it was so needed. And that's at the point I was hired in, the fall of 2020, and, of course, an online interview, I
hired my first employees in the winter of 2021, having never actually met them in person. So, so that's really the origins of how the idea came, came to be, and then how, really, in many ways, covid breathed life into that idea.
Prateek: That's just a fascinating story about how many different people were involved in curating this idea. And it doesn't seem surprising that it began at UCL. When you joined as a director was there any moment - were you a believer of the idea from the get go, or given that it's so niche, did you think that is it going to work or not? What were your perspectives about this? Just like in the past, people might have thought, is civil engineering something to do, or was it worth doing. The same way did you have your thoughts like that at that point?
Nora: Well, it's interesting. And I think, like many people who are founders, you have to love the idea. And the second I heard about the Global Business School for Health, I just thought, wow, that is so needed. What an incredible concept. And it was a concept. I have to say I was really fortunate, I got to shape the school and create the vision in how I interpret what a business school for health should be and look like. But no, I never doubted it for a minute, and actually later on, once the school started to be a huge success, I had people say to me, “Wow, I that was really risky. Like, you know, kind of risked your career, taking that job. I mean, it could have failed and wow, you know, I'm shocked. You know that, that it's turned out to resonate.” I had none of those apprehensions. I said this is needed, this is what we need to do. I think the challenge was really, conceptualize, creating the vision so that people could really understand that. And of course, that was no small task, given that I was creating a school that started out with no staff, in, as you say, a really grey space between silos. And so I had to really be able to conceptualize it, to explain it, and also to sell it, not just to students, but to the academics who would eventually join the school and ensure its success.
Prateek: Yes, so you talked about vision, and a question that has always been on my mind is that, would you call business and health a brand new discipline, or do you think of it more as something within the business discipline, or something within the public health discipline. So when you are articulating the space for business and health, where do you see it in the academic landscape?
Nora: So that's a really great question. Of course, when we think about the academy and we think about universities, they're so focused on disciplines and silos. So I try to avoid allowing GBSH to be boxed in like that. We are very much interdisciplinary. We
don't sit in business and we don't sit in health. We sit in in the intersection of those two areas and if I look to the world today, and I look the grand challenges and the wicked problems that we want to solve in the health sector, I can assure you, having a kind of a siloed approach, or trying to sit in one discipline is not the way forward. We need to be really thinking much more out of the box, and if we want to reimagine health and health care, then we can't do that by replicating the past, we need to forge a different kind of future, and that's what GBSH is about. And I sometimes even have to correct my own employees, because I really feel strongly that we're interdisciplinary, we're not disciplinary. So and I often can be a bit hard on myself if I feel that people are trying to see us as traditional business school or put us in that box. But I think it's normal because most of us, unfortunately, are educated in these silos. And so when I'm hiring staff and academics, they have to be brave, they have to be pioneers. They have to be able to blur the lines and allow themselves. And I think that's really important for academics, because sometimes they feel so much pressure to be the expert that they don't allow themselves to blur over and use knowledge theories, concepts, frameworks from other disciplines. So I think that's what makes GBSH so exciting, and the potential for cutting edge, real world, impactful research is enormous.
Prateek: Well, that's absolutely true. So I've been to and worked at many business schools - in UK, in US, in India. And one of the things that I've found particularly noticeable about GBSH is its emphasis on system level thinking and this word “reimagining health and health care.” Why do you think it is so difficult for us to think at systems level in health? And what is unique about what is being offered within the discipline of bringing business and health together, that we can actually start to think about system level at a place like GBSH, and why can't others do the same?
Nora: So I think, first of all, health systems are unique. They're not like other sectors. First of all, you're dealing with the life course. You know, if I think about retail and maybe a particular shirt design doesn't quite make it its impact is going to be much smaller in terms of it may, may impact the entrepreneur or the business. It's not necessarily going to change lives in a profound way. Health Systems you're dealing with people's life course. It can be both positively and negatively, very impactful, and health systems, by their very nature, have evolved with lots of complexities. They're very fragmented, and they differ between countries, and often that has to do with culture and values and priorities of those countries, how they finance them, whether they see health as a public good or a private good. And then the kind of decisions and the relationship between policy makers. And then, of course, entrepreneurs. So I think that complexity requires system thinking. If can’t take linear thinking to think about a health system to solve problems.
An example I often use is that at one point in the UK, because emergency rooms were so backed up, there were policymakers who put a very linear kind of thinking. Rather than seeing it as a systemic problem, they saw it as an emergency room problem. Oh, well, we just need to get our emergency rooms working more effectively, more efficiently. Okay, so they created this policy that people should be no long wait, no longer in emergency room than four hours. Well, this led to all sorts of perverse behaviours - people putting patients down a hallway, sending them home, and then having to have them readmitted, and sometimes even to tragic loss of life because they were put out without insufficient testing because the staff in these emergency rooms felt so much pressure to meet this target. What was the real issue? Well, the real issue is that there was not enough beds in the hospitals, that people in the UK spend too much time on wards because social care is insufficient and they can't be released, particularly elderly people, into the community, because there was no one to receive them. So the problems were systemic, and without addressing those other problems, you were never going to solve the wait times in the emergency room. So that's just a small example.
But if you think across health systems and all the interdependencies, you even think about systems like the United States, and you've got so many different players involved, so many providers involved. You have insurance companies involved. So this takes a very different kind of mindset, and it requires us to then train students to think differently, than they may be trained in a traditional business school. Having said that, though the health sector itself have often used what I'd call a health service approach and a very often very public sector approach to thinking about business and leadership and healthcare, and there are lots of very good practices within business and management that could enhance the way we deliver healthcare, help to create better capacities for leaders and budgets, of course, because at the end of the day, you know, these are businesses, whether they sit in the public sector or the private sector, they have to make sense financially and so by not recognizing that need for those critical business and management skills, I think we've short changed the sector. So it really is that interdisciplinary. It's bringing the best of health, healthcare, that knowledge, understanding that complexity, understanding it from prevention, diagnostics, therapeutics, and coupling it then with the best of business management practice.
Prateek: So would it be fair to say that there is a lot that public health systems can learn from business. Management, innovation programmes. However, because these programmes, do not think at the system level, the gap has not been bridged, and that's exactly what is being bridged at GBSH, by making it more interdisciplinary, more impact oriented, more system oriented. Would that be a fair characterization of what's going on at GBSH?
Nora: Actually, I think that's fair. I think that's very fair. The other thing is we're not just focused on public health, we're focused on health systems. And I think that's very important sometimes. And again, if I use the UK as an example, we come up with a 10 year plan for the NHS. But, although it's small, it exists - there is a private sector. How does that fit into that 10 year plan? So we need to be able to look at health systems, and we need to be somewhat agnostic of whether it is sitting in the private or the public. How do we build a health system that works for our populations? And I think that's something very unique at GBSH. And then the other thing is, we really think about this kind of new health economy, right? So it's not just thinking about the traditional - everything centres around hospitals - as the of anchor to the health system. There's a lot of digital health and digital innovations. And the players in the health sector have changed tremendously. If you had told me just 10 years ago, that Amazon and Microsoft would be major players in healthcare, I wouldn't have believed you. And then, of course, we have to bring in biotech, pharmaceutical companies, genomics and diagnostics and AI. So the health system as we know it is shifting, and we need to be agile and to be able to grasp all these different aspects to really do right by our students and our staff and our communities.
Prateek: That's a great summary, and I think it really helps me also understand the place of business and health and GBSH better. Looking back at your own work so far, whether it be as a project, a research or an initiative at GBSH, what is one project that you are most proud of?
Nora: Well, I think what I'm most proud of is around executive education, because I think it's such an important area, we're talking about all these changes to the health system. And of course, it's great for young people early in their careers to come in and get degrees, but there is a huge number of people who are mid-career, and they are trying to get a hold of this data informed, data driven approach to health care. They're trying to understand how to use AI ethically and effectively within their clinical practices. And they're also trying to figure out how to do more with fewer staff and often fewer resources, so offering opportunities for individuals who are already in the workforce who need to come back and get what I call short bursts of learning is so important, and even for the students who come and do degrees with us, the reassurance that they can be lifelong learners at GBSH, that they can come in and take courses and upskill at various moments, because health and healthcare are probably the most dynamic sectors out there today, and they are changing and evolving in some very exciting ways. But that requires continual training and upscaling to really make a difference. So I'm really excited and proud to have set up the Executive Education Unit, and I see that as a key area of growth for GBSH.
Prateek: That's fascinating. So another question. So GBSH today offers programs across the spectrum from executive education to PhDs, MBAs, Masters, and our first undergraduate cohort is joining us as well very soon. What's your message to all these new students who are joining and who are, believers of the idea that business and health is a discipline of the 21st Century. What do you have to say to them?
Nora: To them that, first of all, congratulations in making such a wise decision. The investment you make in your education is integral. It's one of the most important decisions one makes in their whole life. And what a fantastic area to do it in, where, as I've just articulated, you've got lots of innovation, new ideas and also so much you could do to really make the world a better place. And the health sector is just going to keep growing for multiple reasons. We've got aging populations, particularly here in Europe, but other parts of the world, we've got lifestyle diseases that are not going away real soon, and of course, we've got climate change, and that will affect people's health. So the opportunities are immense, and the need for fresh ideas. So I would really encourage these students to really embrace this opportunity to learn as much as they can about the health sector, to be bold, in taking forward their ideas, imagining what things could look like, because it is a sector that's in the middle of a huge disruption. And I don't know when it's going to settle, if it will settle, but now's the time for people to come in and really offer up fresh perspectives and that's why, also historically, health hasn't been an area that people at the undergraduate level would pursue necessarily, but I think when you couple it with business and the opportunities are immense, and I can tell you, I talked to lots of employers, they are so excited about our undergraduate program, and they can't wait for us to start to have our first graduates. I think back to my own education, and I think about how linear and siloed it was, and I just am very envious of these students.
Prateek: Absolutely. I wish I had done an undergrad program of this kind, which had such hands on focus, and you could be anything from an entrepreneur to work at giant international organization, the opportunities and the skills you're expected to learn out of business and health as a program are just immense. So one final question, and this is the last one - how do you want all those people- who are coming together students, faculty, alumni, who are joining this movement or this new space called business and health - to change the world? Or how would they reimagine health? So what is like 30 years down the line. What is it that you hope to see people at GBSH and others associated with this discipline doing?
Nora: I really look for GBSH to be known across the world, to be the place to come to learn to be part of this big community, and I imagine, and I can already see it percolating and evolving as our alumni start to get into key roles and jobs. I mean, I'm so excited with some of the posts I see on LinkedIn from some of our former students. So this community of practice, and this thinking differently and thinking across disciplines, and focusing on solving problems and addressing them, with a toolkit that is interdisciplinary and crosses health and business, this is so exciting. Exciting and so needed. And I just hope that the school will just keep evolving into this incredible organization within UCL that is socially impactful and life changing for everyone who encounters it or encounters those who went there, and that's really what I want. I want us to be a community of change makers and innovators who will make a lasting impression on society.
Prateek: Nora, thank you for sharing your story and insights with us. It’s inspiring to hear about the journey of building this new practice and discipline of Business and Health, and the vision for what business and health can achieve. And thank you to our listeners for tuning into the very first episode of the Global Business and Health Podcast. Stay tuned — in future episodes, we’ll be exploring more voices, ideas, and innovations shaping this exciting new field. Until next time, I’m Prateek, and this has been the Global Business and Health Podcast.