Robin Strongin has been working at the intersection of health care, science, and technology policy for decades. She has testified before Congress, advised federal agencies, and spent years tracking the gap between what the evidence says and what the system does.
In September 2008, she launched Disruptive Women in Health Care — a platform built on the conviction that the health care system would not fix itself, and that what it needed most was bold, non-traditional thinking from people willing to say the uncomfortable things.
Sixteen years later, she reflects on what that has meant — and what the work still requires.
Why did you start this in 2008?
The financial crisis was unfolding. The health care debate was intensifying in ways that would eventually produce the Affordable Care Act. And I kept noticing that the voices at the center of those conversations were not representative — not of the patients the system was serving, not of the researchers who understood what the evidence actually showed, and certainly not of the women who bore a disproportionate burden of the system’s failures.
I wanted a place where provocative ideas could be tested. Where someone could say, “the standard of care for this condition was derived almost entirely from studies on men, and that is a problem we have been tolerating for too long,” without having to first get permission from an institution to say it.
What does ‘disruptive’ mean to you in this context?
It means being willing to challenge the assumptions that hold the status quo in place. Not provocative for its own sake — grounded in evidence, but unwilling to defer to authority when the authority is wrong.
The health care system has enormous inertia. The people who benefit from the current arrangements — financially, professionally, institutionally — have significant incentives to maintain them. Disruption requires identifying those arrangements, naming them clearly, and building the political and cultural pressure to change them.
What has changed in sixteen years?
More than people give credit for, and less than the scale of the problem requires.
Women’s inclusion in clinical research has improved. The conversation about sex differences in biology and medicine has moved from the margins to the mainstream. Menopause is being talked about in ways that would have been unusual a decade ago. Maternal mortality is on the national policy agenda. These are not small things.
At the same time, the disparities by race and income have not closed in the ways they should have. Access to care has improved for some women and worsened for others. The research infrastructure that drives progress — the NIH, the Office of Research on Women’s Health, the institutes that fund equity research — is now under threat in ways that could undo decades of hard-won progress.
What does the next chapter look like?
More voices. The platform has always been an invitation, and the invitation stands. If you have a perspective that challenges the conventional narrative, evidence that complicates the consensus, a story that illustrates what the data misses — this is the place for it.
The health care machine does not disrupt itself. That is the work. It has not finished.