Philanthropy moving toward more businesslike model

LAS VEGAS — Philanthropic foundations are adopting more businesslike approaches to charitable efforts, according to Lawrence B. Brilliant, MD, MPH, the executive director of Google.org, the philanthropy-focused arm of Google.

Dr. Brilliant spoke about the changes occurring in the field of medical philanthropy during the opening session of the American Academy of Ophthalmology meeting here.

One notable change is the focus of charitable efforts, according to Dr. Brilliant. Charitable efforts have traditionally focused on providing funding for services or providing the services themselves to underdeveloped populations, he said. In contrast, philanthropic organizations are now incorporating models from business, "where eye care is seen as a business and the drivers are the drivers of efficient business — managing demand, following efficiency, reducing costs and increasing viability," he said.

"The challenge is first to understand whether we are working in a mature market or an underserved market, and for those who have to dole it out, the challenge is how to mature underserved markets," he said. This is accomplished by following the core practices of a good business model — efficiency, sustainability, quality and focus on the patient, Dr. Brilliant said.

"The new plan is global. It's sustainable. It's focused on exit vehicles for the donors to make sure that programs that are invested in are self-sustaining. We look at the work that we do as investments," he said.

This new model will not invest in small-scale clinics, he suggested.

"We want to bring things to scale. The old charity model, in many instances, may no longer work. In the old model, donations were raised for a surgery mission. ... It strictly covered only incurred costs. It did not contribute to medicines or to buildings and the infrastructure that allowed things to scale. Just making sure the surgery gets done is against the new philanthropy," he said.

The new philosophy for philanthropy seeks instead to create a situation in which a developing population no longer has to rely on charity, but can instead sustain its own existence, providing services without supplemental funding from charitable contributions, according to Dr. Brilliant.