Rarely to random people say: "Hey, that looks like a good industry to disrupt!" It usually comes from the people that actually work in the industry and have experienced the inefficiencies first-hand. They then work with outsiders to actually implement solutions.
I work in med-tech on the tech side. Every CEO of the small companies I deal with have 15+ years in medicine. Almost all of them have experience in both the practitioner and administrator roles. From my experience, these arrogant outsiders you speak of either don't exist or make such an insignificant impact that you'd have to put effort into actually finding them.
I agree they tend to have insignificant impact but they definitely exist and try. Look for a late 1990s article (I think it was in Wired, maybe rolling stone) about the founding of Healtheon. In it James Clark (My memory anyway) explains that healthcare IT sucks because only dipshits have worked on it so far. Now that a genius like him was getting into, everything would be great.
I work in med-tech on the tech side. Every CEO of the small companies I deal with have 15+ years in medicine. Almost all of them have experience in both the practitioner and administrator roles. From my experience, these arrogant outsiders you speak of either don't exist or make such an insignificant impact that you'd have to put effort into actually finding them.