Illustration by Jake Dwyer

What does Healthcare Design have to do with Ramen and Pork Buns?

Lessons for Healthcare Innovation from the Culinary World

Doctor as Designer


David Chang is a culinary innovator and wildly successful chef and restaurateur who is famous for his ramen noodles and his pork buns. His culinary activities started with the Momofuku Noodle Bar in New York City and have expanded to his larger enterprise which has included opening more restaurants across the globe, and producing and starring in a number of Netflix television shows like Ugly Delicious and Breakfast, Lunch, and Dinner.

In 2004 he opened his first restaurant Momofuku, the concept of which was a simple ramen shop. His motivations for opening the restaurant were simple:

“I’m not an awesome cook — I just want to make noodles.”

And he is very transparent about the fact the he was not initially successful. As described in this Forbes article:

“We were a terrible restaurant.” There were no waiters, bussers or dishwashers — or glasses. “We thought we could get everyone to buy bottles of Poland Spring.” Noodle Bar was a total failure — and, as it would turn out, the best thing that could have happened to him. “I really believe that if I just had a little bit more experience and a little bit more wisdom, Momofuku would never have happened,” he says. “I viewed it as a death sentence. Like when people learn they have a year left to live — they finally start living.”

What’s interesting about his story is that the constraint of imminent failure combined with the proximity to customers eventually led to success with Momofuku:

My first restaurant, Momofuku Noodle Bar, had an open kitchen. This wasn’t by choice — I didn’t have enough money or space to put it farther away from the diners. But cooking in front of my customers changed the way I look at food. In the early years, around 2004, we were improvising new recipes every day, and I could instantly tell what was working and what wasn’t by watching people eat. A great dish hits you like a Whip-It: There’s momentary elation, a brief ripple of pure pleasure in the spacetime continuum. That’s what I was chasing, that split second when someone tastes something so delicious that their conversation suddenly derails and they blurt out something guttural like they stubbed their toe.

The Momofuku Pork Bun was our first dish that consistently got this kind of reaction. It was an 11th-hour addition, a slapped-together thing. I took some pork belly, topped it with hoisin sauce, scallions, and cucumbers, and put it inside some steamed bread. I was just making a version of my favorite Peking duck buns, with pork belly where the duck used to be. But people went crazy for them. Their faces melted. Word spread, and soon people were lining up for these buns.

That became my yardstick: I’d ask, “Is this dish good enough to come downtown and wait in line for? If not, it’s not what we’re after.”

Because he was cooking in front of the customers, he could iterate on recipes, test them with customers, and receive direct feedback. That’s the design process, yet how often in healthcare do we actually develop prototypes, test them with consumers and learn from their feedback on a daily basis?

Lesson #1: Design with consistent and constant feedback from your users.

Despite his personal success, Chang has a lot of humility. This attitude translates to his staff.

We’re not the best cooks, we’re not the best restaurant...But we’re gonna try our best, and that’s as a team. Recently, over at Ssäm Bar, a sous-chef closed improperly, there were a lot of mistakes, and I was livid and I let this guy have it. About a week later, I found out that it wasn’t him, he wasn’t even at the restaurant that night. But what he said was ‘I’m sorry, it will never happen again.’ …I felt like, Wow, this is what we want to build our company around: guys that have this level of integrity. Just because we’re not Per Se, just because we’re not Daniel, just because we’re not a four-star restaurant, why can’t we have the same ****ing standards? If we start being accountable not only for our own actions but for everyone else’s actions, we’re gonna do some awesome s***.”

Lesson #2: You need humility, attention to craft, and accountability as a team, not just as an individual.

Finally, I am fascinated by his curiosity and desire to learn and understand the world from people outside his tribe. I would love to visit Chang’s Momofuku culinary lab, which has a team of food scientists and chefs experimenting:

“I don’t know any other way to get my guys to embrace failure,” he says. “I just want them to go for the big f***up.”

There have been a lot of those in the five years Chang has run the lab. Hundreds of turkeys have been sacrificed in his noble attempt to create the perfect turducken. Experiments with modern gear to make ancient rice paper, rice noodles and rice balls were all disasters. Then there was the pressure cooker explosion that almost destroyed the place. “The top cracked in half — lima beans were going at 1,000 miles per hour . It looked like a grenade went off,” Chang says, as he shakes his head and laughs. “It was scary. I feel like something really bad could have happened.”

The lab has made pine nut, pistachio, sesame, lentil, and mung beans misos. The lab has made Butabushi, which is pork loin that is steamed, smoked and “left to rot”. After making the Butabushi he had to reach across the aisle to microbiologists at academic institutions to determine whether this was even safe to eat (Watch the second episode of the first season of The Mind of a Chef to learn more!)

He has clearly been successful as a restaurateur, but combines the scientific method with innovation to infuse new ideas and products into his enterprise.

“the man with the secret food lab believes that experimentation is the key to it all. He cites El Bulli’s legendary chef Ferran Adrià, who famously closed his restaurant for six months every year so he could turn kitchen catastrophes into gastronomic gold. “I believe that all the good ideas are where the bad ideas are, at least in the culinary world.”

Lesson #3: Don’t be Afraid to be Creative and Try Some Crazy New Things, backed by the Scientific Method. Chefs should definitely connect with microbiologists and Healthcare folks should definitely connect with…

Which unconventional partner will you connect with to learn from and iterate your health innovations?

I tweet and blog about design, healthcare, and innovation as “Doctor as Designer”. Follow me on Twitter and sign up for my newsletter!

Click here for information about creative commons licensing. Disclosures: T1D Exchange, Grant funding from Lenovo.



Doctor as Designer

Joyce Lee, MD, MPH, Physician, Designer, ACMIO, #EHR, #learninghealthsystems, #design, #makehealth