Why Outside Perspectives Are Critical for Innovation Breakthroughs

Lessons from the story of Dr. Patricia Bath, the inventor of modern cataract surgery and the first African American woman to receive a medical patent.

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Innovation is widely viewed as an engine of progress — not only for driving economic growth, but also for bringing vital improvements in a variety of domains, from science and medicine to inequality and sustainability.

Anyone can have a good idea, so you could expect the distribution of U.S. patents to resemble the demographics of the workplace. Of course, this is far from the case. Multiple studies have shown that two groups lag far behind in terms of leadership in innovation: women and African Americans.

This imbalance is often attributed to their underrepresentation in the fields of science, technology, engineering, and math, aka STEM. But data also shows that women and African Americans within STEM fields are far less likely to apply for patents than White males are.

If the past two years have taught us anything, it’s that we urgently need innovative solutions to our most pressing problems — from pandemics, climate change, and vulnerable electricity grids to systemic racism and the spread of disinformation and hate via Big Tech platforms. We need our best innovative minds working on these problems, yet significant barriers prevent underrepresented groups from bringing their breakthrough ideas to life. Interestingly, it’s these “outsiders” who often find it easier to engage in the kind of combinatorial thinking that’s critical to developing novel solutions.

Research shows that it’s often easier for outsiders to connect disparate thoughts because they come to the table with fewer preconceptions than insiders. In one research study, for example, separate groups of carpenters, roofers, and in-line skaters were asked for ideas on how to improve the design of carpenters’ respirator masks, roofers’ safety belts, and skaters’ kneepads. An independent assessment of the solutions found that each group was significantly better at generating novel solutions for the fields outside their own.

A larger-scale study of 166 problem-solving contests posted on the InnoCentive innovation platform found that the winning entries were more likely to have come from “unexpected contributors” whose areas of expertise were foreign to the focal field of inquiry. Confirming this advantage of marginality, a separate crowdsourcing study revealed that industry outsiders were more likely than insiders to come up with breakthrough solutions to relatively complex and intractable R&D problems.

The story of Dr. Patricia Bath, a groundbreaking ophthalmologist and the inventor of modern cataract surgery, provides a powerful example of how those considered outsiders possess key skills for developing innovative solutions — and the formidable barriers they face when attempting to introduce their much-needed innovations to society.

Thirty-five years ago this year, Bath filed a patent for a laser technique to treat cataracts — and two years later, at age 44, she became the first African American woman to receive a medical patent. Bath’s invention marked a breakthrough in combating preventable blindness that has helped improve or restore the sight of millions of people worldwide.

But her journey was a tortuous one, filled with gender and race-related barriers that would have led most innovators to give up.

In 1969, as a young Black woman entering a White male preserve, Bath faced gender, racial, and age biases that affected her perceived credibility and, therefore, ability to advance in her chosen field. But she used one of the key advantages conferred by her demographic differences and fresh perspective: the ability to see problems that others missed. Pursuing her medical internship at Harlem Hospital and a fellowship in ophthalmology at Columbia University, she quickly noticed a disparity: About half of the patients at the eye clinic in Harlem were blind or visually impaired, compared with very few at the Columbia facility.

Bath discovered that the prevalence of blindness among African Americans was double that of White Americans. And by trawling through the medical records of patients at both clinics, she came to realize that this was no genetic quirk, but rather the result of poor access to proper eye care — foreshadowing current discussions of health inequity in marginalized communities during the COVID-19 pandemic.

Bath persuaded her professors at Columbia to operate for free on blind patients in Harlem, where she got a crash course in cornea and cataract surgery as a volunteer assistant surgeon.

Four years later, when she became the first woman faculty member at UCLA’s Jules Stein Eye Institute, she was forced to prove herself all over again. Only after rejecting the offer of an office in the basement next to the lab animals was she able to secure a more acceptable location to do her work.

For many women and minorities, the cumulative effects of such microaggressions impact their self-esteem and organizational commitment. Research has also shown that they inhibit cognitive performance. Those effects are bound to erode engagement in innovation, which demands focus, self-belief, and a willingness to challenge orthodoxy.

At UCLA, Bath pursued her interest in health disparities and enlisted the help of two African Americans from outside her discipline to set up the American Institute for the Prevention of Blindness, which champions sight as a basic human right. The nonprofit initiated a new discipline known as community ophthalmology that changed the course of medicine and is now practiced worldwide.

While departures from the demographic norm may bestow a creative edge in terms of spotting issues and generating alternative solutions, if you are not part of the in-group, it is much harder to marshal the resources and backing you need to push ideas through the system. Many people give up.

Bath confronted this barrier when she conceived the radical idea of dissolving cataracts using lasers — a technology primarily associated with defense systems and blinding laser weapons at the time. She believed her approach could be less invasive and faster than existing treatments.

The ecosystem at UCLA did not support her work. Colleagues there offered zero encouragement. “When I talked to people about it,” she recalled, “they said it couldn’t be done.” Bath conducted initial experiments in her lab, but UCLA did not have the necessary lasers, and she was unable to secure grants to pursue her research in the U.S. So she reached out to her connections abroad — relationships she had built through the conference circuit — and “nagged them until they agreed to provide access to their labs.” In 1986, she took a sabbatical and moved to Europe for a year to pursue testing in advanced laser facilities at institutions in Berlin, Paris, and the U.K.

Within months of returning to UCLA, she finalized her complex three-in-one device — a tiny probe consisting of an optical laser fiber surrounded by irrigation and suction tubes — and performed her first tests on donor eyes.

Having perfected the technique, Bath went to the lab director to share her scientific breakthrough. His response spoke volumes: “You didn’t do that,” he told her. “That’s impossible.” He wouldn’t look her in the face.

His disbelief betrayed his low expectations. Decades of social science studies have established the negative impact of low expectations on performance — known as the Golem effect — including innovation. By this stage in her career, Bath was robust enough to keep her “eyes focused on the prize,” but for aspiring innovators, such slights or expressions of skepticism can be as damaging to their motivation as overt discrimination. It can crush a person’s confidence and resolve.

Bath’s laserphaco probe, as she called it, could be inserted through a 1-mm incision. It guaranteed cheaper, more precise, and more reliable treatment of cataracts, with reduced pain and faster recovery for patients. In the years that followed, she went on to improve the device and the method for using it several times, resulting in five U.S. patents, the last of which was awarded in 2003 for a combination laser and ultrasound cataract device. Her technique remains in use worldwide.

In one of her last public appearances, before her death in May 2019, Bath testified before the U.S. Senate Judiciary Subcommittee on the hidden obstacles facing women inventors and depriving the U.S. of more innovation, saying, “Based on my own personal experience, the oversights, slights, and disrespect of scientific contributions of women scientists and inventors demonstrated in the 1960s continues even today.”

Among the 610 inductees in the National Inventors Hall of Fame, there are only 48 women and just 30 African Americans. Until last year, there was still not one Black woman inductee. This year, Bath will become the first (after being nominated 11 years running), along with engineer Marian Croak. Both are to be inducted into the class of 2022 on May 5.

Bath is notable not only for her inventions and advances in medical practice, but for her incredible persistence and ability to navigate around barriers that could have derailed her at multiple points on her innovation journey. How many important innovations is the U.S. missing out on because of biases and systems that make it extraordinarily difficult for those on the margins to bring their breakthrough ideas to life?

There are lessons in this story for all of us. Outsiders like Bath are able to see the world with fresh eyes and can bring forth ideas and solutions that challenge our conventional thinking. We need to explicitly pay attention to these perspectives. Yet our inherent biases, low expectations, and skepticism often get in the way. So, as a first step, we need to acknowledge our own biases so that we can keep them in check and strive to enrich our thinking.

The COVID-19 pandemic has provided a prime opportunity to do this. The great shifts that have occurred in work culture, social systems, and wellness have generated a hotbed of new ideas, many of which have come from nontraditional sources. We would be well served to listen to them.


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PARKER mabry
Thank you for this amazing article that speaks to so many important and often overlooked aspects of life, leadership, fortitude, and direction Parker Mabry