Making a
Narrative Turn
Enabling strategic fit to a new era — where real advantage goes to the side with the skills to harness a carnival of markets and manage them as a single economic system.
Blue Spoon specializes in helping organizations — particularly in healthcare, pharmaceuticals, and digital health — reimagine market structures and business models. The work is built on a conviction: roadmaps to the next hundred billion in growth from the largest and most lucrative market on Earth don't start with "data interoperability" to enable big tech visions. They start with market interoperability to invent better economic systems.
In healthcare, it's not just one market that drives innovation and determines value but an infinite flow of them. If you accept that premise as your jumping-off point, then what follows is this: real strategic advantage goes to the side with the skills to harness a carnival of markets and manage them as a single economic unit — as a system of markets, cohering and collaborating on shared space for growth.
Blue Spoon is a partisan of innovation, growth and progress. Our mission is to lead the next cycle of evolution in the business and economics of healthcare, focusing on continuous health engagement and competing on outcomes. Ecosystem-centered market strategy is a platform shift in health innovation — a unique way to deal with competitive pressure, and stock market pressure.
Call it the Big Strategic Rotation.
Four Disciplines for a New Operating System
Market Interoperability
Aligning life sciences, healthcare, technology and government markets into cohesive ecosystems. Not data integration — market integration.
Systems Thinking
Applying complex adaptive systems theory to navigate and leverage complexity. The problem lives in the connections, not the components.
Ecosystem-Centered Strategy
Shifting from product-centric to platform-based strategies that foster sustainable growth. Competing on systems, not portfolios.
Big Design
A repeatable process for market innovation aimed at disintermediating established industry norms. Constructing new markets, new growth curves, and gravitational pull into a new orbit for competition.
Blue Spoon is a unique capability to help brands, businesses and industries construct new markets, new growth curves and gravitational pull into a new orbit for competition. The framework comes from When Burning Man Comes to Washington: A Field Manual for Riding Chaos, which applies complexity theory and systems thinking to the question every leader is asking right now: what do you do when the playbook stops working?
The Burning Man Index™ — Blue Spoon's proprietary scoring framework — measures 27 institutions across five dimensions of narrative coherence to map exactly where system collapse is happening, how fast, and what distinguishes the institutions exiting the old operating system from those still trapped inside it.
Now Available Worldwide on Amazon
Blue Spoon wrote the book on modern strategy. Literally.
When Burning Man Comes to Washington is the first practitioner-written strategy book grounded in live market construction, treating narrative, markets, and power as interlocking systems rather than separate domains.
Read it before the meeting. You'll hear different things once you're inside the room.
"John's work shaped some of the most transformative strategy I've ever been part of. His ability to see, and reimagine, entire systems enabled us to build a direct-to-patient ecosystem at Pfizer that most believed was impossible."
Former Senior Director and Team Leader, Global Access Transformation, Pfizer
The Latest Signal from the Blue Spoon Substack, Hardcore Zen
Strategic Problems Don't Have Technical Solutions
Healthcare is the economy, not something statistically separate from it. You can't tech your way to fixing it.
Healthcare is one of the most hellishly complex businesses in the world. Many with deep pockets and expert knowledge have attempted to "fix" it; none have been successful. From our perspective, the reason why not is simple: strategic problems don't have technical solutions.
"Strategy" becomes the imagination and skill to align the commercial determinants of health — intentionally combining the life sciences market + healthcare market + technology market + government market — into new economic systems. This is a new kind of creative vision.
The better way to script market access is through market integration, where "value" becomes a flow, not an end state. It's not just one market that produces a health outcome; it's an infinite number of markets interacting simultaneously over time, as a cohesive ecosystem.
From One-Dimensional Competition to Three-Dimensional Systems
Piece vs. Piece
One-dimensional competition. Product against product. Share against share. Optimizing inside a frame that no longer matches the world.
System vs. System
Three-dimensional play with systems thinking, where the goal is shifting the center-of-gravity for power and control.
Data Interoperability
Technical integration as an end in itself. Enabling big tech visions. Making the horseless carriage run more efficiently.
Market Interoperability
Inventing better economic systems. Aligning four markets into cohesive ecosystems where value flows, not stalls.
Our unique perspective comes from applying systems theory to help leaders understand and navigate the deep chaos and complexity of the moment. We work across contexts to position and sell strategic vision, define objectives and invent leverage to displace embedded economic systems.
We do this from a novel vantage point and base of experience, helping you shape a sustainable, if not unassailable, edge.
Fortune Favors
the Aggregators
As technology becomes more irrelevant than ever, and as storytelling gains traction as the only real differentiator, the process knowledge to position, sell and manage new economic systems becomes a next-level capability.
Competitive convergence has come to define most industries. Technology alone no longer differentiates. The winners are the aggregators — the ones with the imagination and fluency to mold an ever-expanding galaxy of technological possibilities and market fragments into new business and industry ecosystems.
Fundamentally, Blue Spoon is a platform for big system change — market innovation approached in a way that makes a hard break from deeply embedded habits and assumptions, cognitive patterns sustaining an epidemic of stasis and structural stalemate, if not outright strategic collapse.
A Creative Practice Centered on Total System Leadership
Strategic Vision
Position and sell the vision. Work across contexts to define objectives and invent leverage to displace embedded economic systems.
Broad Framing
Mold technological possibilities and market fragments into new ecosystems. Different assumptions about innovation, competition, and value alignment.
Computational Imagination
Fuse commercial opportunity with computational power. Make technology upgrades flexible enough to ingest an infinite, accelerating cascade of digital applications.
Outcomes Architecture
Shift the center-of-gravity for market engagement from technical potential of a product to outcomes. Value as a flow, not an end state.
Cross-Functional Evolution
Change that dissolves divisions. Designed collaboratively, with customers and partners in adjacent markets. Not imposed from above — emergent from within.
Systems Fluency
The capability to make all of this happen. The core discipline. The operating language of everything Blue Spoon builds.
We are pushing the envelope further and faster than most, from a novel vantage point and base of experience. It's not cheap or easy to shift the center-of-gravity for an entire market. It's not cheap or easy to make a hard break from the cognitive patterns sustaining structural stalemate.
Efficient.
Not Inflated.
We believe in an efficient approach, not an inflated consulting engagement. Our aim is only a handful of clients.
In addition to a complete vision from decades of experience spanning pharmaceutical, medical device, provider, and payer domains, the Blue Spoon advantage lies in a service model based on working personally and quickly with your business and technology teams — and vendors — supplementing where necessary with a unique, bespoke network of partners, collaborators and novel industry relationships.
We help your teams step out of convention and cliché, see space for differentiation, and create new structures of ideas to operate with originality.
What You Get That They Don't Offer
Cross-Domain Fluency
Decades spanning pharmaceutical, medical device, provider, and payer domains. Not a specialist silo — a complete systems view.
Direct Engagement
Working personally with your business and technology teams. No junior associates. No delegation chains. The thinking happens in the room.
Network Leverage
A unique network of partners, collaborators and novel industry relationships — activated on demand, not warehoused on a bench.
Velocity
Projects completed in days, not quarters. An efficient model built for leaders who need to move, not leaders who need to be reassured.
A Unique
Vantage Point
The Blue Spoon mission is to lead the next cycle of evolution in the business and economics of healthcare.
Continuous health engagement is the real strategic transformation in a $4 trillion market. Competing on outcomes is the story behind all other stories about what it means to "disrupt" systemically. It means adapting to a massive shift underway in how the world works and thinks, and what consumers expect.
Positioning business models for value-based success comes from thinking outside the clinical setting, with a whole new taxonomy for market innovation — less "patient adherence" to a drug or device, more aligning and curating the commercial determinants of health as a new economic system.
A New Taxonomy for Market Innovation
Patient Adherence
Compliance-driven models tethered to a single drug or device. Value defined by the clinical setting. Growth limited by the frame.
Commercial Determinants of Health
A new economic system where markets cohere around outcomes. Value as a flow across an ecosystem, not an end state inside a silo.
Inside the Clinical Setting
Strategy constrained by the walls of the institution. Innovation measured by what the product does in isolation.
Continuous Health Engagement
Strategy shaped by how the world actually works and thinks — and what consumers actually expect. The real transformation.
Against this backdrop, Blue Spoon helps you work through the complexity of options that can be brought to bear to enable a novel strategy — one centered on the value customers are really craving.