GUEST POST from Arlen Meyers, M.D.

What’s your definition of entrepreneurship? Here’s the conventional one.

Mine is that physician entrepreneurship is the physician pursuit of opportunity under volatile, uncertain ,complex and ambiguous (VUCA) conditions with the goal of creating user defined value through the deployment of innovation using a VAST business model.

There are many myths about entrepreneurs. Here are some about physician entrepreneurs.

The life science innovation roadmap is risky, expensive and time consuming. To be successful, bioentrepreneurs whether healthcare professionals, scientists, engineers, investors or service providers, need to work as a team with their organizations to overcome the multiple hurdles taking their ideas to the market and patients. The process is neither linear nor predictable and outcomes are never guaranteed. In addition, because of global macroeconomic conditions, investors are unwilling to gamble on unproven technologies in a more hostile regulatory and legal environment. Consequently, commercializing bioscience discoveries is becoming more and more difficult. However, innovators still thrive. Where are some of these exciting business opportunities for bioentrepreneurs?

An initial understanding of the changes happening in international systems is the first step in identifying potential market opportunities. Here are but a few:

1. Major and continual healthcare policy reforms
2. Migration away from fee for service payment
3. Consumerization, commoditization, internationalization, customization and digitization of care.
4. Changing from a sick care system to a preventive and wellness system
5. Defined benefit to defined contribution health insurance coverage
6. Rightsizing the healthcare workforce
7. Do it yourself medicine (DIY)
8. Mobile and digical (physical and digital) care delivery models
9. The growth of employed physicians
10. Innovation management systems and increasing attention to health entrepreneurship.
11. Increasing demand for high touch care
12. Increasing discontinuity of cares changing quickly. All of these changes present biomedical and healthcare entrepreneurs opportunities to create new products, services, models and platforms. Patients are taking more control of funding and contributing to basic and clinical research using the internet and social media continues to play a bigger and bigger role in healthcare marketing and delivery.
13. Demographic and economic changes and social mobility
14. Closing the digital divide
15. The impact of the 4th industrial revolution

Take opportunities in AIntrepreneurship, for example, in India, China, MENA and Africa

The drivers of physician international entrepreneurship include:

1. Fear: Doctors are afraid they will suffer the professional, personal and economic consequences if they don’t adapt to change
2. Greed: Physician incomes are threatened by innovation and new business models
3. Necessity: Most doctors in industrialized countries have a relatively high standard of living. They did not bother themselves with innovation or entrepreneurship because they didn’t have to.
4. The innovation imperative: The pace of change has accelerated and markets and employers are demanding more with less
5. Generational demands: Medical students and residents are questioning their career decisions and demanding that schools provide them with the innovation and entrepreneurship education and training knowledge, skills and attitudes they need to thrive after graduation and throughout their careers
6. The shifting doctor-patient relationship: Technology and DIY medicine is disintermediating doctors and fundamentally altering the doctor-patient relationship
7. Resources: The internet, local ecosystems, acclerators and access to early stage capital has made it easier to start a business or develop an idea. People are connecting to the global economy.
8. Portfolio careers: The sick care gig economy is growing and the future of work is changing. Fewer are committing to one lifetime career or job, including clinical medicine
9. Opportunities: With change, comes opportunities and those few doctors with an entrepreneurial mindset are actively pursuing them. The opportunities in health entrepreneurship are sizable and physician entrepreneurs are increasing well positioned to capitalize on them.
10. Culture: The culture of medicine is changing and encouraging creativity and innovation
11. Politics: Access to quality care at an affordable price is in high demand as middle classes grow in developing countries. Not providing it leads to social upheaval and political instability.
12. Budget deficits: The demand for care is almost infinite. However, the supply is limited. Consequently, policy makers and markets are looking for ways to improve outcomes at a lower cost through the deployment of innovation.
13. Youth unemployment: Restless unemployed, educated citizens are demanding jobs and ways to use their talents.
14. Economic development: Innovation and entrepreneurship is fuel that that feeds the engines of economic development in emerging economies. like Africa.
15. Globalization: People, money and technology go where they are treated best, regardless of location.

The future of physician entrepreneurship is measured by progress in four domains: education, practice, research and impact. Unfortunately, each part of the physician innovation value chain is highly resistant to change and subject to multiple barriers to dissemination and implementation. We have made progress in all, but, the results are unevenly distributed.

The future of international physician entrepreneurship will be punctuated by:

• The coherence of disparate technologies from diverse industries other than sickcare
• Increasing transdisciplinary and international dependencies and collaboration
• Educational reform in health professional, public health, bioengineering and computer science programs
• Significant regulatory, legal, economic, ethical and societal issues
• Generational, social and demographic variations in dissemination and implementation
• An evolving global IT cybernervous system and interoperability
• More difficult trust, privacy and security barriers
• A high touch backlash against high tech
• The rise of patient sickcare entrepreneurship
• A slow migration to healthcare from sickcare

That said, this is the golden age of physician entrepreneurship, as reflected by the record number of applicants to US medical schools, the number of doctors pursuing non-clinical careers or side gigs, the ever increasing number of biomedical and clinical ecosystems, inclusion of digital health, business of medicine and entrepreneurship education and training in medical and graduate schools and the results and impact of entrepreneurs during the COVID pandemic.

Physician medical practice entrepreneurs, technopreneurs, intrapreneurs, social entrepreneurs, philanthropreneurs, edupreneurs and others are changing the world and the movement is spreading rapidly. Fortunately, despite efforts to the contrary, there is no vaccine to stop it.

Image credit: Unsplash

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