Author Archives: Arlen Meyers

About Arlen Meyers

Arlen Meyers, MD, MBA is an emeritus professor at the University of Colorado School of Medicine, an instructor at the University of Colorado-Denver Business School and cofounding President and CEO of the Society of Physician Entrepreneurs at www.sopenet.org. Linkedin: https://www.linkedin.com/in/ameyers/

Trends in Medical School Innovation and Entrepreneurship Education

Trends in Medical School Innovation and Entrepreneurship Education

GUEST POST from Arlen Meyers, M.D.

Biomedical and health entrepreneurship continues to expand around the world. Driven by global pressures to optimize the allocation of scarce resources, life science bioentrepreneurs are creating innovative products, platforms, service and systems that deliver more value. As a result, the demand for biomedical and health professional entrepreneurial talent has increased and biomedical and health innovation and entrepreneurship education and training (BEET) programs are growing to fill the gap.

Authors of a 2019 analysis of 171 allopathic medical schools conducted an exhaustive search of the published literature and websites of existing medical school innovation and entrepreneurship (MS I&E) programs, with an emphasis on answering the following three questions:

1. How are I&E programs organized and integrated with the medical school curriculum?
2. What are the core competencies of the I&E program?
3. How are the core competencies measured/evaluated?

Twenty-eight I&E-oriented medical education programs were identified from 26 schools; all of the programs integrated faculty leadership with backgrounds in medicine, engineering, and/or business/entrepreneurship. Of the programs, 57% (16/28) had been launched within the past four years and 75% (21/28) based program enrollment on a selective application process. Nearly all (27/28) incorporated lecture series and/or hands-on modules as a teaching technique. The most prevalent metric was completion of a capstone project (22/28; 79%). At least 15.2% (26/171) of American and Canadian allopathic medical schools include the option for students to participate in an I&E curriculum-based program.

In a few short years, educational offerings in MS I&E have accelerated, in part due to the impact of the COVID pandemic. Trends include:

  1. Sharing lessons learned teaching medical students innovation and entrepreneurship
  2. Experimenting with various program business models
  3. Creating medical student entrepreneurs
  4. Rethinking MS I&E
  5. Designing a curriculum map and defining learning objectives, entrustable professional activities and knowledge,skills, abilities and competencies
  6. Mentoring and guiding medical students
  7. Offering non-clinical-career options
  8. Providing exit ramps
  9. Rethinking how we select medical students
  10. Resetting the future of academic medical center work
  11. Using principles of medical education reform and what we should be teaching in MedEd 2030
  12. Training MS I&E faculty
  13. Encouraging interprofessional and transdisciplinary entrepreneurship programs
  14. Integrating premed, medical student and postgraduate programs
  15. Encouraging life-long learning

We should teach innovation, entrepreneurship and the business of medicine in medical schools, not MD/MBA programs. MBE programs are a better option for those interested in getting an idea to a patient.

Here are the many reasons why physician entrepreneurship is important and why we are likely to see more of the international design, development and deployment of MS I&E programs in both allopathic and osteopathic schools as well as other health professional schools, including nursing, pharmacy and public health schools. Ultimately, as a result, patients and sickcare systems will be the beneficiaries and doctors will be better and happier.

Image credit: Pixabay

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Why We Need Digital Health Package Inserts

Why We Need Digital Health Package Inserts

GUEST POST from Arlen Meyers, M.D.

The Food and Drug Administration announced new rules for nutrition labels that can go on the front of food packages to indicate that they are “healthy.”

According to one source, a package insert is a document included in the package of a medication that provides information about that drug and its use. For prescription medications, the insert is technical, and provides information for medical professionals about how to prescribe the drug. Package inserts for prescription drugs often include a separate document called a “patient package insert” with information written in plain language intended for the end-user — the person who will take the drug or give the drug to another person, for example a minor. Inserts for over-the-counter medications are also written plainly.

In the US the document is called “prescribing information” or the “package insert” (PI) and layperson’s document is called the patient package insert (PPI). In Europe the technical document is called the “summary of product characteristics” (SmPC) and the document for end-users is called the “patient information leaflet” (PIL) or “package leaflet”.

Given the confusion about 1) which digital health product to prescribe for any given patient, 2) the fact that many products are actually consumer products designated to provide information and education, not diagnosis or treatment, and 3) most are not clinically validated or cost-effective, perhaps it’s time to require package inserts for the prescriber and the patients.

Prescription digital therapeutics is also being added to the therapeutic armementarium and is raising several questions about safety, effectiveness, cost-effectiveness, ROI, reimbursement and regulatory requirements, including whether package inserts should be required, how they should be made available to patients, and what they should include.

What is in a package insert is described and required by the FDA and includes:

  • Clinical pharmacology – tells how the medicine works in the body, how it is absorbed and eliminated, and what its effects are likely to be at various concentrations. May also contain results of various clinical trials (studies) and/or explanations of the medication’s effect on various populations (e.g. children, women, etc.).
  • Indications and usage – uses (indications) for which the drug has been FDA-approved (e.g. migraines, seizures, high blood pressure). Physicians legally can and often do prescribe medicines for purposes not listed in this section (so-called “off-label uses”).
  • Contraindications – lists situations in which the medication should not be used, for example in patients with other medical conditions such as kidney problems or allergies
  • Warnings – covers possible serious side effects that may occur
  • Precautions – explains how to use the medication safely including physical impairments and drug interactions; for example “Do not drink alcohol while taking this medication” or “Do not take this medication if you are currently taking MAOI inhibitors
  • Adverse reactions – lists all side effects observed in all studies of the drug (as opposed to just the dangerous side effects which are separately listed in “Warnings” section)
  • Drug abuse and dependence – provides information regarding whether prolonged use of the medication can cause physical dependence (only included if applicable)
  • Overdosage – gives the results of an overdose and provides recommended action in such cases
  • Dosage and administration – gives recommended dosage(s); may list more than one for different conditions or different patients (e.g., lower dosages for children)
  • How supplied – explains in detail the physical characteristics of the medication including color, shape, markings, etc., and storage information (e.g., “Store between 68 and 78°F “)

Of course, there would need to be some modifications, like:

  1. Safety and efficacy
  2. Cybersecurity risks
  3. Data security
  4. Data , privacy, ownership and transfer rights
  5. Side effects
  6. Designation as a consumer product or a diagnostic or therapeutic device
  7. Generic substitution possibilities
  8. Adverse app reactions
  9. App-app interactions
  10. Compatibility with other drugs or devices

One thing that will not be in the insert will be what all this costs to you or someone else who has to pay for it.

Research shows that “Safety of apps is an emerging public health issue. The available evidence shows that apps pose clinical risks to consumers. Involvement of consumers, regulators, and healthcare professionals in development and testing can improve quality. Additionally, mandatory reporting of safety concerns is needed to improve outcomes.”

It is short-sighted, however, to let DTC medical apps slip under the regulatory radar. As described in a recent article for Nature, they could turn out to have costs which insurers or taxpayers might ultimately be responsible for.

But, the FDA is not the only agency with regulatory power. How about the Federal Trade Commission? Almost every promotion these days claims “AI-powered” What should be the truth in advertising standards to make that claim? Should there be something like a nutrition label ?

Medical student and resident education in clinical informatics, including artificial intelligence, is a good start. Here are some potential curricular and extracurricular learning opportunities for artificial intelligence in medicine.

At this point you are probably thinking, “We have enough regulations and we love our APPs. So what if they don’t make us any better.”

Go shove your insert.

Next, you’ll be telling us it has to have all that cotton in the bottle too.

Image Credits:

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Should a Bad Grade in Organic Chemistry be a Doctor Killer?

NYU Professor Fired for Giving Students Bad Grades

Should a Bad Grade in Organic Chemistry be a Doctor Killer?

GUEST POST from Arlen Meyers, M.D.

A recent article described the termination of an NYU organic chemistry professor in response to a student petition. When the professor pushed students’ grades down, noting the egregious misconduct, he said they protested that “they were not given grades that would allow them to get into medical school.” The reporter noted that, in short, this one unhappy chemistry class could be a case study of the pressures on higher education as it tries to handle its Gen-Z student body. Should universities ease pressure on students, many of whom are still coping with the pandemic’s effects on their mental health and schooling? How should universities respond to the increasing number of complaints by students against professors? Do students have too much power over contract faculty members, who do not have the protections of tenure?

And how hard should organic chemistry be anyway? One faculty member said, “Unless you appreciate these transformations at the molecular level, I don’t think you can be a good physician, and I don’t want you treating patients.”

I know the feeling. While organic chemistry is termed a “doctor killer” by premedical students, getting any grade less than an “A”, typically in science, technology, engineering, or math subjects, can doom your application. When I saw that B I got in physics in my junior year of college, I started thinking about Plan B. Then I really learned the gravity of the situation.

Despite the noise and groaning, medical school applications continue to rise, driven by many factors. However, the medical school education model dates back to the Flexner report issued in 1910. Many are trying to address the challenges of how to train the biomedical research and practice workforce to win the 4th industrial revolution, but progress has been slow. Here were the challenges facing medical schools in 2015. Things have not radically changed. Medical educators, particularly those in public medical schools, will continue to face several basic problems in the coming years. The “invisible enemy” has exacerbated many.

We should rethink how we recruit and accept medical students.

Here are some questions that should inform that transition:

1. Do doctors really need to be that “smart”? GPAs can vary significantly across different medical schools, so it pays to do your research before applying. The Association of American Medical Colleges (AAMC) reported an average GPA for medical school of 3.60 across all applicants for the 2021-2022 application cycle. For the same year, applicants had an average science GPA of 3.49 and an average non-science GPA of 3.74.

2. What kind of intelligence do doctors need to meet the needs of their stakeholders and communities?

Types of Intelligence by Mark Vital

3. Do patients really care what grade their doctor got in organic chemistry, or, for that matter, whether they graduated last in their class from medical school?

4. How has the pandemic and the persona of Gen Z changed medical education?

5. What do doctors and patients need to know to win the 4th industrial revolution? Organic chemistry?

6. How does the present system and its reliance on undergraduate STEM academic performance impact inequitable socioeconomic and demographic acceptance rates?

7. How should we transform premedical, medical, and post-graduate pedagogy? Examples are project-based learning and peer reviewed feedback.

8. Why do we insist that undergraduates declare a major?

9. Is the purpose of a medical school education solely to graduate students who have the knowledge, skills, abilities, and competencies to take care of patients, or should we provide them with exit ramps too?

10. How do we balance a medical culture of conformity with a culture of creativity?

11. What will be the future of medical work?

I’m lucky that I dodged the bullet. But I still have Plan B.

Image Credits: Adioma (Mark Vital), Pixabay

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The Problems with ‘I’ll eat what you kill’ Arrangements​

The Problems with 'I'll eat what you kill' Arrangements​

GUEST POST from Arlen Meyers, M.D.

As more health professionals get involved with biomedical and clinical innovation and entrepreneurship, some are becoming advisors, mavens, salespeople, consultants and connectors. As such they are hired to help potential clients or employers meet benchmarks or the next critical success factor. In many instances, that means finding investors or helping to raise money for their early-stage company, newco or startup.

The success fee model also applies to sales and marketing, where the advisor is hired to source leads, leverage their relationships and networks and work around the gatekeepers of decision makers. They only get paid if contacts eventually buy the product.

Most say they do not have money to pay a retainer or recurrent cash payment so, instead they offer equity or some form of incentive or success fee model. Unfortunately, if you are considering such an “I eat what you kill” model, it comes with some problems:

  1. You might be running afoul of SEC regulations concerning raising private money if you are not a registered broker dealer
  2. If you are compensated with equity, the vesting schedule and amounts may not be mutually agreeable
  3. The company might not have the business development, sales operations, CRM or customer success infrastructure or people to follow up on leads and convert them to investors and track them back to you
  4. The client does not give you regularly scheduled updates on performance
  5. The client has unrealistic expectations about your ability to raise money from members of your network
  6. The client does not have a valid fundraising plan with the appropriate target investors
  7. After making an introduction or handoff, the result is no longer related to your efforts, much like a dating service
  8. There may be conflicts of interest for the advisor
  9. You may damage your reputation or personal brand if you are not transparent about your role
  10. You may not have the necessary education, skills, attitudes and competencies to raise money

11. The company or CEO you work for does not have the infrastructure, people or knowledge to close deals that you have sourced or people you have referred. Here are some reasons why and what they can do about getting a bigger ROI on their digital marketing tactics.

If you are asked to help a startup raise money, keep these issues in mind before agreeing to negotiated terms and conditions. Better to find your own meals than relying on eating what someone else kills.

Image Credit: Pixabay

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The Reasons Physicians are Losing the Branding Wars

The Reasons Physicians are Losing the Branding Wars

GUEST POST from Arlen Meyers, M.D.

Maybe the last time you walked into a retail-based clinic, you did not see an MD. Maybe the same thing happened at your hospital outpatient clinic or an urgent care center. Physician “extenders” and advanced practice professionals, like primary care pharmacists, nurse practitioners and physician assistants are winning the war on branding. They and their professional associations have done a good job branding their services while complacent doctors have not. What happened? Doctors are now “providers”. The latest spin is to call yourself a surgicalist. A surgicalist is a highly trained, board-certified surgeon who provides emergency surgical care within a dedicated hospital setting – the foundation of a surgical hospitalist program. A surgicalist career path affords talented surgeons the chance to design the life they want.

Staffing shortages among healthcare providers are having numerous downstream effects on everything from patient care to reimbursement and thinning margins. But they’re also causing a shift in public perception: More people now trust pharmacists to play a larger role in their care management, according to new research from Columbia University Mailman School of Public Health in New York City and Express Scripts Pharmacy.

With more than half (51.8%) of the U.S. population experiencing at least one chronic condition, and one-quarter suffering from multiple chronic conditions, prescription medications are often the first line of defense to help patients manage these conditions, the report found.

In the period from 2015–2018, nearly one-half of the U.S. population was using at least one prescription drug, nearly one-quarter (21.4%) were using three or more, and over 10% were using five or more prescription drugs.

All of that is putting pharmacists in the spotlight – along with the rise of chronic disease, increased medication use and shifts to value-based payment models.

Doctors don’t understand that branding a service, particularly one that is becoming more and more commoditized, is not like branding a product, like toothpaste. There are four keys to branding a service:

1. Don’t Mass Market To Your Target Market Take a look at the doctor ads. They are filled with platitudes like “quality care”, “personalized service” and “caring staff”. I would sure hope so. But, marketing to the masses with platitudes is like a CPA saying “I can do your taxes”. Instead, you need to “touch” your patients with highly targeted messages.

2. Focus On Relevance Over Differentiation Most product branding is about cheaper, smarter, faster, better compared to the competition. Service branding is about how I can solve your unique problem.

3. Worry About Growing Revenue, Not Market Share. Payer mix is an obvious difference when it comes to sickcare branding compared to product branding. As we all know, doctors don’t make the same profit seeing all patients. Some, in fact, are loss leaders. Soon, all of sick care might be a loss leader.

4. Help Your People Be Your Brand. Particularly in sickcare, your people are your brand, including the doctors. You are the product, not the doctor.

When it comes to these four elements, non-physicians are doing a better job than physicians and they are building brand equity. Take a page out of the FedEx playbook, and expect to see

  • A genuine and defensible market position
  • Improved external awareness, perception, and desirability
  • The development of a collaborative internal culture
  • Alignment and integration of all messaging
  • Revenue growth

Here are 10 ways to beat Commodity Care. For doctors to brand their services and win as incumbents in the market, they need to practice Othercare .

In the face of competition, substitutes and turf wars, doctors need to do more about their sustainable competitive advantage, particularly when it comes to practicing at the top of their license, building brand equity and innovating, all things that, up to this time, they have not done because they didn’t have to.

Maybe then, they won’t call you a provider anymore, doctor.

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The Seven P’s of Raising Money from Investors

The Seven P's of Raising Money from Investors

GUEST POST from Arlen Meyers, M.D.

Budding sickcare entrepreneurs inevitably want to know, “How do I raise money for my idea?” Most of the time, they are not ready for fundraising prime time and they have not taken the necessary steps to begin to do so or understand when and if it is the prudent thing or right time to do.

Here are the 7 P’s of raising money from investors:

1. Preparation

You should prepare to raise money by 1) derisking your idea as much as possible and 2) understanding what it will take to raise money i.e. technical, clinical and commercial (traction) validation.

When you have an exciting new idea, it’s easy to focus on all its benefits and jump to action. But doing so can lead to failure. Your limited perspective may mean you’re not seeing potential hurdles — and you may be leaving other promising options unexplored.

If you want the best ideas to flourish, you need to open your mind to different people from people beyond your team, whom you don’t usually talk to — and ask open-ended questions. After presenting your idea, ask: What stands out to you, and what’s missing? What would our critics say? Consider the failure of your idea: What would your premortem reveal? Consider other people outside the room and ask: What would someone on the frontlines say? Finally, put yourself in your competitors’ shoes. What flaws or weaknesses in your idea would they celebrate if you were successful?

  1. Do you understand the regulatory requirements and rules for raising private money?
  2. Do you know how much money you should raise and in what form: debt, diluting funds or non-diluting funds, like grants, contracts or some proof of concept awards?
  3. Have you validated the underlying hypotheses of your business model and demonstrated product-market fit? Do you have traction? What is the evidence? But, is product-market fit really enough?
  4. Do you have a reimbursement or revenue plan?
  5. Do you have a plan to create and protect your intellectual property?
  6. Do you have a regulatory approval or compliance plan?
  7. Have you created the appropriate corporate entity and corporate governance documents?
  8. Are you prepared to bootstrap your startup and dedicate the time, effort and capital required to be successful?
  9. Have you created the necessary fundraising and marketing collateral like a website, executive summary, social media channels to create awareness, engagement and buzz about your company?
  10. Can you answer these three questions: Is the market for the problem you want to solve big enough to make your journey worth it? How many customers want it and are willing and able to pay for it or get someone else to pay for it? Can you win at it give market competitors?

2. Plan/Strategy

After answering these questions, assuming you decide to proceed, you will need a capital raising plan and strategy. A capital raising strategy is essentially a roadmap for how your organization will pursue and obtain the funds it needs to fuel its growth. The capital raising process can take a long time and it’s a serious undertaking. However, while you may stay up late at night searching for new investors, writing pitch decks, and pouring over financial spreadsheets, building your strategy is the simplest part of the entire process. Here are the parts to the plan.

3. Pitch deck

Your pitch deck should tell your story. Who are the villains? Who are the heros? How did they win? There are many resources available to help you craft and polish your short, medium and long pitches, depending on the circumstances and the audience. Here is something to start:

4. Platform

You will need a CRM or tracking platform to keep track of the people who have contacted and how you intend to convert them as leads to investors. Crowdfunding platforms are another resource.

5. People

Do you have the right people on your startup team who can raise money? Are the founders the right people to do it? Do you have robust enough networks and contacts? Do you need a fractional of full-time accountant, controller or chief financial officer?

6. Process

The process should describe how and who will execute your fundraising plan, whether you are starting a company or scaling one. Since what you are doing is selling and marketing your idea and your team, what is your marketing, sales operations and sales enablement process?

7. Performance indicators

Performance indicators help you measure your progress and inform your strategy and execution adjustments moving forward. Here are some fundraising metrics for non-profits.

Raising money from investors is a lot like renovating your kitchen. It will take much longer than you thought it would, the costs in time, money and effort will be much bigger than you assumed and, when you see the final results, you will wish you had done some things differently.

Good luck and be sure to follow the right rainbow.

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Why Diversity and Inclusion Are Entrepreneurial Competencies

Why Diversity and Inclusion Are Entrepreneurial Competencies

GUEST POST from Arlen Meyers, M.D.

A competency is the ability to do something successfully. There are many entrepreneurial competencies. One of them is interdisciplinary teamwork and collaboration i.e. the ability of individuals to form partnerships with a team of professionally diverse individuals in a participatory, collaborative, and coordinated approach to share decision making around issues as the means to achieving improved health outcomes .

In the public health world, D & I means dissemination and implementation i.e. how does a intervention come into common use or become the standard of care. Here is what you need to know about it.

In the education and student success world, D, E & I means diversity, equity and inclusion. Here is the case for it.

In the entrepreneurial world, D, E & I is even more expansive and is measured by:

  1. Your ability to lead high performance teams both face to face and virtually
  2. How you create psychological safety – Here are four ways to boost psychological safety.
  3. The composition of your teams
  4. International representation
  5. Demographic representation
  6. Functional representation (marketing, engineering, finance, etc)
  7. Results
  8. Persona representation: coaches, teachers, cynics, mentors, etc
  9. Listening to both good rebels and bad rebels
  10. The people on your leadership team, advisory board and board of directors
  11. How you incorporate ideas from industries outside of your own. Sickcare cannot be fixed from inside.
  12. How you avoid bias and noise to influence outcomes and variability in decision making.
  13. How you avoid colorism in your sales and marketing approach.
  14. Ownership, not just fairness
  15. Improving your emotional intelligence along the narcissistic-empathy spectrum

Measuring the results or your efforts requires people analytics.

Are you ready to innovate?

I’m a privileged, old white guy who won the ovary lottery. My child of immigrant, first generation to college father got an advanced degrees. Consequently, I was able to grow up in the right ZIP code and take advantage of the opportunities afforded to me by sheer dumb luck. As a result, I wound up being an academic surgeon and worked at the same place for 40 years until I retired as an emeritus professor to pursue my next encore side gig, including working with several non-profits that sit at the intersection of sick care, higher education, biomedical and clinical entrepreneurship and diversity, equity and inclusion.

Four key arguments make the case for diversity, equity, and inclusion.

What are the barriers to leading DEI?

Rather than making leaders solely responsible for their own effectiveness, these researchers allow a balance between managerial competences and the many constraints that limit leaders. With bounded leadership, they look past the leader’s characteristics and consider the many constraints they encounter at the individual, team, organizational and stakeholder levels.

In bounded leadership, there are five distinct abilities leaders require to be effective:

  • Anticipation competence: The ability to predict market patterns and conditions, which are essential to the organization, such as future trends or customer needs
  • Mobilization competence: The ability to inspire employees to put an extraordinary effort into their work
  • Self-reflection competence: The ability to analyze past experiences and draw useful conclusions
  • Values-creation competence: The ability to promote a leader’s values in the organization
  • Visionary competence: The ability to create an attractive vision of the organization, communicate this vision to followers and empower them to implement it

Each of these competencies presents several hurdles: cultural (difficulties in changing values and norms), emotional (strong negative emotions that prevent rational behavior), entitlement (formalized organizational responsibilities and hierarchy), ethical (leaders’ dilemmas), informational (difficulties in processing or collecting data), motivational (problems with inspiring others) and political (office politics and power plays).

Competencies are measured by entrustable professional activities defined by a performance rubric. Creating diverse, equitable, inclusive teams that deliver expected results is one of them. But, getting from said to done takes more than education, training and policy changes.

Being DEI competent is not about changing your mind. It requires changing your mindset.

Image credit: Pixabay

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Why Good Job Interviews Don’t Lead to Good Job Performance

Why Good Job Interviews Don't Lead to Good Job Performance

GUEST POST from Arlen Meyers, M.D.

Many hiring managers, professional school and residency interviewers and search executives know there is not a single correlation that links how someone interviews with their on-the-job performance.

“In 30 years of executive search, over 1000 search projects, and interviews with over 250,000 candidates, we cannot find a single correlation that links how someone interviews with their on-the-job performance – as interviews are traditionally conducted by the vast majority of hiring managers.” — Barry Deutsch

Yet interview theater constantly appears at a location near you.

Why?

  1. By it’s very nature, there is a power imbalance so the interviewer almost always has the upper hand
  2. Telling truth to authority can be a non-starter
  3. The process is flawed
  4. Interviewers and interviewees are not trained to interview
  5. There is an inadequate or non-existent job preview
  6. It is almost impossible to understand the culture of a potential organization without acually experiencing it for a while
  7. Interviewers look for personality, not performance, fits
  8. There is bias and the inability to accept cognitive, demographic and psychographic diversity
  9. Here is how not to answer 10 medical school and residency interview questions
  10. The process for selecting those who are interviewed in flawed.
  11. It is impossible to pick your parents or pick your boss
  12. You can’t always trust people to do what they said they would do if you work for them.

How we are filling the sickcare worker pipeline is not working. Interview theater has had it’s run. It’s time for Medical School Powerball.

While you are at it, get rid of exit interviews and annual performance reviews too.

Image credit: Pixabay

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Laddering Up Your Career Portfolio

Laddering Up Your Career Portfolio

GUEST POST from Arlen Meyers, M.D.

A career used to describe your roles in one company throughout your working life, like a career at Monsanto, Deloitte, a university or IBM. But, the workplace and generational attitudes have changed, along with a prolonged life expectancy, so careers now mean something different. Now, a career includes all the roles you undertake throughout your life – education, training, paid and unpaid work, family, volunteer work, leisure activities and more.

In today’s world the term career is seen as a continuous process of learning and development. For physicians, those activities that contribute to a career can include:

  • training
  • education
  • employment
  • work experience
  • community activities
  • enterprise activities
  • employment
  • different life roles
  • volunteer work
  • leisure activities

The traditional career ladder for doctors meant 4 years of college, 4 years of medical school and then 4-6 years of residency or fellowship followed by 30-40 years of practice, if not more. The contemporary career trajectory is much different. Exit ramps exist and clinical practice half-lives are shorter.

Investment advisers often suggest bond laddering as an investment risk management strategy. A bond ladder is the name given to a portfolio of bonds with different maturities. For example, you buy bonds with maturation dates that are 1 year, 3 years,5 years and 10 years with variable returns. When one matures, you retire it and buy another on the ladder. Physician entrepreneurs should consider doing the same with their careers as a way to hedge career risk. Doctors, like most everyone, need some side gigs. But, you don’t want to quit your day job until the time is right.

Career laddering is a also a way to leverage your impact. As you move how you spend your time on one thing to another, the results of your efforts should be more meaningful and impactful, whether it be helping more people, helping to solidify your personal brand or creating a higher return the investement of your time. Think about your position, authority, and influence. How are you using them to positively impact the lives of your sphere?

Instead of putting all of your eggs in one basket, diversify your interests and job roles, gradually retiring one to assume another. For example, while clinical practice is the focus of most doctors, take time to build your interest portfolio and dedicate the requisite time and attention to those roles to build value in them. Such roles can be teaching, volunteering, advising, writing, consulting,entrepreneurship or many others. Then, when it’s time, prune or retire one of the roles to assume another on the ladder.

The strategy also applies to advising or consulting. At some point, if you have done things right, people will be coming to you to ask for help. Here are some tips on how to navigate the gig economy.

For example, you might want to apply these criteria to whether you accept your next gig based on fit:

  1. Does it meet your personal and professional needs?
  2. Do you trust the people ?
  3. Do you think the business is viable and how long will it take?
  4. What are the next critical success factors and do you have the knowledge, skills, attitudes and competencies to deliver them?
  5. Are you satisfied with the compensation being offered?
  6. Is there a conflict of interest with other projects?
  7. How much will this intrude into your non-work life and other commitments?
  8. Is the problem the company wants to solve important to you?
  9. How much time, effort and travel is expected?
  10. How much liability is there?

Don’t get stuck in the three boxes of life. Laddering jobs during your career, including after traditional retirement age as an encore career, is a great way to keep you engaged and satisfied.

Here is the case against early retirement. Many of these studies clearly show that health problems intensify after workers qualify for retirement benefits and abate after policies encouraging work are introduced. In addition, there are financial and social consequences.

The word is out. For the first time in 57 years, the participation rate in the labor force of retirement-age workers has cracked the 20 percent mark, according to a new report from money manager United Income (PDF). Some work longer because they want to. Most do it because they think they have to.

What’s more, since social security costs will exceed income in 2020, by delaying retirement ,you will be doing your part for your country’s budget.

You don’t have to do all this full time. Instead you can be a digital nomad or follow the 10/20/30 plan.

Some cities or towns will pay you to move there. Job switching for higher pay is common.

Create a career portfolio and rethink your encore career: You lower your risk, increase your return and can wake up with a smile on your face having made a wise investment.

Image credit: Pixabay

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How marketable is your invention?

How marketable is your invention?

GUEST POST from Arlen Meyers, M.D.

Marketability may apply to things i.e. goods or services or people. When it applies to people, we are talking about making them attractive to potential employers or clients. People may study for a degree to improve their marketability. This means that they believe that getting a degree improves their chances of getting either a job or a better job.

Are you looking for a non-clinical career job? Here is how to make yourself more marketable by building your personal brand.

When it applies to things, we are talking about their ability to be marketed or sold. If you are selling your house, you might improve its marketability if you convert the loft into a living area. In other words, converting the loft will make it easier to sell the house.

If you have invented a new medical device, how likely are the multiple stakeholders likely to buy, use or prescribe it? Will they choose it, use it or just lose interest in it? Is your product just another brown cow or is it a purple cow?  Is your new product sufficiently better than the standard of care for doctors to go to bat with administration to change vendors?

SmallBusiness.Chron.com has the following definition of the term:

“Marketability is a measure of whether a product will appeal to buyers and sell at a certain price range to generate a profit.”

The business model canvas is a way to validate your hypotheses about the desirability, feasibility, viability and adaptability of your idea.

But, how marketable is your product and how do you determine marketability in advance? Of course, there are no guarantees the dog will eat the food, but here are some things to consider:

  1. Early on, startups must identify the market type in which they plan to operate. In The Four Steps to the Epiphany, Steven G. Blank describes four different types of market:
  • Existing market
  • New market
  • Re-segmentation of an existing market as a low-cost player
  • Re-segmentation of existing market by employing a niche strategy

Winning in some markets is harder than others. For example, entering a “never been done before at scale”, like electric cars, is expensive and takes lot of convincing the early majority to buy it. On the other hand, the upside potential is enormous.

2. In markets where there are lots of stakeholders, personas and members of the buying group, like sickcare, you have to satisfy the jobs, pains and gains or each with a somewhat different value proposition for each one.

3. A “marketability evaluation” is what all inventors should have completed prior to attempting to market their invention. A marketability evaluation basically considers whether the invention is “marketable” within the current and future market. This is extremely important to you since a manufacturer will not license your patent rights for an invention that may be “really neat” but is not competitive with the other products currently on the market.

Here is a quick 20 Factor Invention Evaluation Form that you can complete yourself or have a friend complete. Remember, this form is only effective if you or your friend are honest with the scoring.

4. While you may have determined that your invention has a high marketability, the results are in the execution of your go to market strategy by your sales and marketing team.

5. Marketability exists in a particular moment in time and can easily change by competitive entries, and other threats.

6. The VUCA (volatile, uncertain, complex, ambiguous) world demands that you constantly test your ideas and explore and exploit new business models and products and their marketability.

7. Complacency erodes marketability.

8. Markets constantly change. The modern marketplace is unlike anything seen before in human history. For example, eCommerce allows anyone to order practically anything from anywhere in the world with virtual currency, often with the help of a virtual assistant that personalizes its recommendations so that each person’s buying journey is unique. In this new age, previously reigning marketing paradigms like the 4Ps of marketing are also undergoing a transformation. Welcome to the age of the 4Es instead.

The “4Es” of Marketing are “Experience”, “Everyplace”, “Exchange” and “Evangelism”. Anyone familiar with Marketing theory will recognize that the 4Es draw their basic wisdom from the famous “4P” mnemonic in modern marketing theory.

9. Many startup founders have low marketing IQs

10. Different business models require different marketing strategies and tactics, e.g. direct to patient marketing v B2B v B2B2C

11. Dissemination and implementation among healthcare professionals is a complicated and often unpredictable process. It often takes many years.

12. Successful social media marketing involves finding the right influencers and “sneezers” to help your idea go viral.

If you are a physician entrepreneur looking for investors, or an academic entrepreneur trying to commercialize your idea with your technology transfer office, then the first three questions you will have to answer are:

  1. What is your intellectual property and other barriers to entry?
  2. What is the technical and commercial feasibility of your product?
  3. What is the marketability of your product?

If you fail to convincingly answer these questions, it is likely that you will not pass GO and collect $200. But, given the dismal track record of investor’s and inventor’s new product success and portfolio returns, the exercise might all be marketability theater and just a Wild Ass Guess, that, ultimately, will be tested in the marketplace.

Image credit: Pixabay

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