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/

What are your roles, holes and goals?

GUEST POST from Arlen Meyers

If and when you decide to start your own company or work with a client, you will have to have a plan to evolve as a leaderpreneur i.e. someone who know how to lead innovators. Doing so will require that you periodically assess your personal and oganzational roles, holes and goals to see if you are still the right person to do the jobs that need to be done.

Roles have to do with which position you will play on the startup, scaleup or grown up team? Is it a problem seeker, a problem solver, a money finder, a business builder, a customer finder, a scorekeeper, a legal eagle, a people connector or some other role that your title may or may not completely convey?

Holes have to do with which problems you are tasked to solve not just in your organization, but where you have personal knowledge, skills,attitude and competency gaps as well. What are the expectations?

Mindset is but one of many entrepreneurial competencies you will need to succeed. Others include:

Opportunity recognition pertains to one’s ability to scan and search for new information, connect the dots between incidents that appear to be unrelated with limited cues, and recognize patterns or ideas that suggest potential opportunities in the myriad cues or signals that they receive (Baron, 2006).

Conveying a compelling vision/seeing the future reflects an individual’s proclivity for effective communication where he or she can translate his or her vision into condensed, clear, and intriguing messages to important stakeholders (Chen, Yao, & Kotha 2009).

Ability to maintain focus yet adapt speaks to the entrepreneurial experience. This ccan include considerable ambiguity and uncertainty, significant obstacles, ongoing emergence of new opportunities, and continuous change in circumstances (Morris et al., 2012). The entrepreneur must continuously adapt, change, modify, and switch while maintaining a self-regulated focus in the midst of volatile conditions (Haynie & Shepherd, 2009)

Resilience captures the cognitive tendency of an individual to cope with stressful, adverse, and devastating situations, to be able to recover from failures, and to constructively sustain his or her efforts to pursue goals. In reality, successful entrepreneurs are not easily beaten by distress or rejections. Instead, they are able to remain or resume a calm state of mind, to tactically frame and analyze problems, dig into the root cause of failures, and to search for ways to get back on track again (Sinclair & Wallston, 2004).

Interdisciplinary teamwork and collaboration refers to the ability of individuals to form partnerships with a team of professionally diverse individuals in a participatory, collaborative, and coordinated approach to share decisionmaking around issues as the means to achieving improved health outcomes (Orchard & Curran, 2003).

Assessing the feasibility of an opportunity emphasizes the need for innovators to make evaluations or judgments on whether emerging information or changes would lead to viable opportunities with profit potential (McMullen & Shepherd, 2006).

Self-Efficacy/Confidence relates to an entrepreneur’s self-confidence and selfassurance about his or her ability to take on challenges, to perform certain set of tasks as needed or expected, and to control processes, contingencies, or consequences in the entrepreneurial pursuit (Bandura, 1997; Baron & Markman, 2005; Tierney & Farmer, 2002).

Building and using networks concerns one’s ability to establish, maintain, and structure his or her contact network(s) in ways that foster relationships, enhance access to opportunities and/or resources, and potentially lead to realization of his or her objectives (Aldrich, 1999).

Tenacity/Perseverance refers to the extent to which entrepreneurs are committed to seeing their vision through, to endure the long journey to carry out venture creation, to work fervently despite challenges or adversity, to maintain interests, and persist with efforts in achieving goals (Duckworth & Quinn 2009; Hmieleski & Corbett, 2006).

Understanding of healthcare systems entails having a firm grasp of the various components of the health system and an understanding of the major issues faced by the stakeholders.

Resource leveraging/Bootstrapping describes the need to overcome resource constraints by leveraging resources from others. It also reflects a tendency for innovators to demonstrate an inclination towards effectual rather than causal reasoning in bringing together unique resource combinations (Greene &Brown, 1997; Honig, 2001; Politis, Winborg, & Dahlstrand, 2011).

Creative problem solving/Imaginativeness is characterized by Schumpeter (1942), who posited that creative destruction plays a key role in the innovation process. Innovators who start something are engaged in a process of creative imagination in which opportunities are exploited by continuously combining resources in new ways (Kirzner, 1973; Chiles, Bluedorn, & Gupta, 2007).

Design thinking is a human-centered, prototype-driven process for innovation that can be applied to product, service, and business design. It is the process of questioning, observing, and experimenting, so that you can become better equipped to capture valuable information and develop new business ideas. It requires experimentation in order to understand how things work, to test new business ideas or different approaches, and to look for valuable insights that may emerge in the process (Brown, 2008).

Guerrilla skills is a label adapted from a warfare context, describing approaches that center on clever ways to take advantage of one’s surroundings, do more with less, to rely upon unconventional tactics, and to utilize resources not recognized by others in accomplishing tasks within entrepreneurial firms (Schindehutte, Morris & Pitt, 2008).

Risk management/mitigation involves the systematic monitoring, assessing, hedging, transferring, and/or exploiting multifaceted risks encountered as an innovation initiative unfolds. Risk-aversive attitudes discourage individuals from innovative activities (Cramera et al., 2002), while successful entrepreneurs are willing to first recognize and bear the uncertainty or risk needed to take entrepreneurial actions, and are able to manage risk rather than simply trying to avoid risk (McMullen & Shepherd, 2006).

Cross disciplinary knowledge refers to an understanding of the connections, interrelations, and interactions between different fields of knowledge (Mosseri, 2006).

Change management is the ability to understand and manage driving forces, visions, and processes that fuel large-scale transformation (Kottler, 2011).

Information management is the collection and management of information from one or more sources and the distribution of that information to one or more audiences.

Behavioral economics refers to an understanding of psychological, social, cognitive, and emotional factors on the economic decisions of individuals and institutions, and the consequences for market prices, returns, and resource allocation (Lin, 2012). It is the understanding that drives decision making.

Leadership There is a strong link between leadership and innovation

Mindset Innovation starts with the right mindset

Goals have to do with your personal and organizational key performance indicators , objectives and key results.

Your compensation will often be tied to how you answer these questions, so be sure you understand and agree with the answers before joining the team.

Your roles, holes and goals will evolve as an enterprise grows ( or be irrelevant if your enterprise fails) so you will need to evolve with them. Here are some tips on how to change your personal leadership strategy as things inevitably change.

It is but one of many startup and scaleup challenges

Here’s how to keep your job as your or your client’s company grows:

Creating, scaling and reinventing a business is a movie, not a snapshop. So is your personal development, so pay attention to both and create a plan for next steps or someone will find it for you. Sometimes that’s the exit.

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How to survive the quarter-life crisis

GUEST POST from Arlen Meyers

Some doctors are getting restless. Whether they are part of the young and the restless, the desperados or the old and the grumpy, they are thinking about limited career half-lives or how to help patients in a way other than seeing 20 a day for forty years.

We’ve all heard about the mid-life crisis. It’s that “is this all there is ?” moment. But, did you know that the quarter life crisis, is, according to some experts (particularly those interested in getting you use their products) an epidemic?

But, let’s first define the quarter-life crisis quickly in case you’re not aware of it. “Many people have heard of the quarter-life crisis, a period of insecurity and doubt surrounding careers, relationships and finances experienced by people in their mid 20s to early 30s ”

For most doctors, this is the period when they are just starting their medical careers due to the 12-15 years required to complete premed, medical school and residency. Then, it takes another 5 years in clinical practice to just find the bathroom.

As if becoming secure in medical practice isn’t enough, now you have to deal with questionable relationships, a mountain of debt and an iffy career pathway given all the changes in medicine and the lack of corporate loyalty and generational attitudes about job security, the gig economy and work-life balance. Add to that, you are skiing down the happiness curve.

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What should you do?

  1. Start building a side gig
  2. Have a financial plan to pay off your debt, save for retirement, live within your means and protect your assets
  3. Adopt an entrepreneurial mindset and develop and practice entrepreneurial habits
  4. Expand your networks, particularly with people who are not doctors. Are you Linkedout?
  5. Have a Plan B career option. You probably won’t want to pay someone to help you, but find a coach if possible.
  6. Adjust your expectations
  7. Develop resilience in the face of headwinds and PISS on burnout
  8. Find a mentor, sponsor or friend who you can trust
  9. Have a sit down with your spouse or partner
  10. Take advantage of the multiple free resources available
  11. Build your social support network and engage them face to face and online
  12. Get experience doing something other than clinical medicine.

Count on it. There will be hard day ahead.

The Medicare trust fund will be depleted in 2026, the administration said. By contrast, the government said last year that the trust fund would be exhausted in 2029.

In a companion report, federal officials said the Social Security Trust Funds for old-age benefits and disability insurance, taken together, could be depleted in 2034, the same year projected in last year’s report. The fund that helps tens of millions of retirees is expected to be depleted a year earlier than projected last year, while the outlook for the disability trust fund is more favorable.

The bottom line is prepare yourself, your relationships and your career for what lies ahead. Don’t die with regrets.

Wouldn’t it be great if you had the choice of practicing medicine for free, moving on to something else or being able to be on the 10/20/30 plan ?

Now that the snow is starting to fall, you might also want to buy a new pair of skis.

 o Twitter@ArlenMD and Co-editor of Digital Health Entrepreneurship

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How to build successful community open innovation networks

GUEST POST from Arlen Meyers

Everyone seems interested in getting the most impact out of their innovation efforts. Collaborative Innovation Networks (COINs) have mushroomed since the invention of the Internet and cheap mobile communications. Community based innovation and biomedical and health online innovation networks have the potential to speed new product development, offer alternative financing platforms for early stage ventures, provide education, information and support to those with particular diseases and help to lower the costs and speed of clinical trials. A recently announced collaboration between the FDA and PatientsLIkeMe will make it easier to do post marketing surveillance for drugs.

However, questions remain about their effectiveness in creating value, security, commercial and clinical validity, legal status and sustainability.

A important question is whether COINs, particularly in biosience and health, create lasting impact, and , if so, under what circumstances. Based on my experience co-founding a non-profit COIN and contributing to efforts to transform it into a sustainable entity that meets its mission i.e. getting biomedical and health ideas to patients, leaderpreneurs need to overcome several hurdles:

1. A relentless focus on advancing a clearly defined, easy to understand mission.

2. Creating and validating a business model that generates enough revenue to sustain the organization.

3. A marketing effort that uses state of the art social media techniques to target those most interested in supporting your mission.

4. Minimizing spending on things that don’t add user defined value.

5. Continually offering new products and services as part of the platform.

6. Telling your story in a way that it appeals to the heart, not the head of potential supporters.

7. Engaging and building the community of interest until it reaches a tipping point.

8. Transitioning from working in the COIN to working on the COIN once it has reached a critical mass.

9. Cheaply creating and killing experiments early when it is clear they won’t yield positive results

10. Expanding your influence to interface or open networks with overlapping interests. COINs need to be COPINs-collaborative open innovation networks

Building collaborative open innovation networks requires:

  1. An organization with leadership to coordinate, grow and engage the community of interest
  2. A compelling value proposition that meets the jobs, gains and pains of participant stakeholders
  3. A communications plan that uses various message delivery channels

4. Metrics and a dashboard to measure both inputs and valid outputs

5. A viable business model

6. Leadership

7. Network engagement and advocacy

8. Innovation

9. Branding

10. A sustainable competitive advantage

Open innovation is about encouraging your teams and leaders to expand their internald external networks, make diversity and inclusion part of the corporate culture, encourage people to have outside interests and understant that your industry cannot be changed from inside only.

Collaborative, or open innovation, collaborative innovation, are “…activities organizations use to improve their rates of innovation and problem solving by more effectively leveraging the diverse ideas and insights of employees, customers and partners.” Here are some ways to measure their efficiency and effectiveness.

There are four essential steps to open innovation.

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The perils and pitfalls of DIY medicine

GUEST POST from Arlen Meyers

Have you noticed all the self checkout stations at your grocery store? One person overseas 10 stations instead of having 9 more, expensive clerks at each register. Or how about beer walls that make bartenders obsolete?

DIY medicine is coming to an iPhone near you and investors are taking notice. Maybe it’s time to fire your doctor. Here’s is an analysis of the future of sickcare and the impact of digital technologies. Your doctor will much different in 2025.

Chinese companies have been busy weaving together the online and offline worlds, trying for an ever more seamless fit. Convenience stores that have no sales assistants or cashiers are popping up in big cities. E-commerce giant Alibaba Group Holding Ltd. BABA +0.23%and its rival JD.com Inc. JD +0.17% have poured money into department stores and grocery chains. Some day will will see clerkless sick care convenience stores so patients can get what they need to do DIY medicine. After all, customers go to convenience stores to get convenience, not service.

Now, Amazon has taken it one step further. The deceptively simple premise of the proposition is that you simply scan an Amazon Go phone app at an entry gate, shop for whatever you like and walk out the door. No checkouts, no card transactions, no bagging.

A concerned father recoded a glucose monitor to make it easier to track his newly diagnosed diabetic son’s blood sugar. Dr. Siri is in your pocket.

We are witnessing the transformation of patients to patient-customers to patient-scientists to patient clients to patient consumers to prosumers to patient-self providers. Want to know your latest numbers? Just order your test online. How about knowing your genetic profile or testing yourself for HIV or an over the counter genetic test for breast cancer?

Here are some more technologies that can prevent you from having to visit a doctor.

Want to change your DNA using mail-order parts? Just go to Body Hacking Con to find out how. Here’s why it is a bad idea.

Do it yourself (DIY) medicine and behavioral health is becoming commonplace with the availability of online diagnostics and blood tests, more sophisticated consumer health products, remote sensing devices and wearables, digital health mobile medical apps, and community based support and education groups. Crowd funding platforms and digital clinical research tools have also turned patients into clinical research investigators and investors. For example, a recent evaluation of remote monitoring for abnormal cardiac rythm points out the issues with false negatives and false positives and how that affects guidelines for detection and evaluation.

In a recent ruling, manufacturers of direct-to-consumer (DTC) genetic health risk (GHR) assessment systems were directed to withdraw pending 510(k) submissions to the US Food and Drug Administration (FDA) as this device type is now exempt from premarket notification.

What will be the impact of DIY medicine? While there will be many unpredictable results and unintended consequences, there are major considerations:

1. Is DIY diagnosis and treatment better than the present model and does it achieve the goals of improving population health while lowering costs? Does it add value, and , if so, where? Digital symptom checkers aided by AI are largely operating in the dark. The saying goes that a little knowledge can be a dangerous thing. Will these technologies actually drive up the costs of care instead of lowering them? In most instances in medicine, unlike other industries, new technologies tend to supplement, not replace other technologies thus adding to the cost and utilization.

The market for direct-to-consumer (DTC) genetic tests is booming—with companies such as AncestryDNA, 23andMe and MyHeritage blanketing media with ads for the at-home tests to uncover information about ancestry or genetic mutations and variants that could lead to health problems.

A recent small-sample survey published online March 22 in Genetics in Medicine found these tests may produce false-positives in 40 percent of variants when subjected to clinical confirmation testing.

2. How will the enormous amounts of self generated data created by the these quantify self initiatives be stored and accessed given the present EMR infrastructure and models? In previous posts, I’ve discussed the anatomy and physiology of digital health and it’s evolving embrology. Who or what will be responsible for doing something with the results? Will it be the responsibilty of the patient to enter results in an open electronic medical record?

3. What new business models need to emerge to sustain any improvements in health that result?

4. What impact with DIY medicine have on the legal and regulatory environment of biomedical and health innovation and entrepreneurship?

5. What is the role of the doctor as they become increasingly disintermediated?

6. What are the ethical and legal implications and challenges?

7. How to we educate and train doctors to partner with patients?

8. What new jobs will need to be created to manage increasingly complex patients self diagnosing and treating themselves?

9. How do we solve the issues about data, data everywhere?

10. So what? Who cares? How much? Who pays?

11. How do we address the challenges of direct to consumer health products?

12. We run the risk of a Sickcare as service business (Sickcare a a S) model. We would just sell you what you need to take care of yourself and then, if you have problems, don’t call us (we won’t give you a phone number of the person who sold it to you, like Comcast). Instead you’ll have to call tech support and waste hours getting your product or service to work.

Unfortunately, the research shows that 1) patients are terrible consumers, 2) there is little or no correlation between quality of service, bedside manner or patient experience with quality of care, and 3) patients are also lousy diagnosticians, at least according to their doctors.

Do we really want sickcare to be like self driving cars? Putting the ability to diagnose and treat illness in the hands of patients will create profound change. Much like the personal computer revolutionized and, in some respects, fundamentally altered our society, decentralized medicine and it’s democratization is doing the same. Fasten your seat belts. Your doctor will watching as you use the check out kiosk.

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Can sickcare really be a self-driving car?

GUEST POST from Arlen Meyers

The 4th Industrial Revolution has happened, but it is taking a very long time for it to create the sick care spring . The convergence of technologies has already impacted many industries, including heavily regulated industries like financial services, mining, energy and the automotive industry. Take that self-driving Googlemobile you see speeding down your block and you’ll experience what I mean.

Can or should the sick care industry experience ever have something comparable to the self-driving doctor or the self-driving patient? There are barriers and sick care ain’t Uber.

  1. AI in sick care comes with its own issues not the least of which are the lack of large data sets.
  2. Sickcare has overlooked 5 basic digital principles
  3. We are still trying to balance whether to ask for forgiveness or permission
  4. We lack a whole product Healthcare IT solution. Instead we have smokestacked bits and pieces: a sickcare haphazard IT solution (SHIT)
  5. Trying to balance high tech with high touch and maintaining some semblance of a doctor-patient relationship when the forces seem to be more centrifugal than centripetal
  6. The lack of data scientists who understand sick care
  7. Too much sick care and not enough healthcare
  8. The costs of IT solutions that are severely impacting the hospital and practitioner bottom line and, in some instances, driving them bankrupt.
  9. Patients and doctors who are unable. fearful or unwilling to ride in a self driving car and assume the risk of being in one
  10. Regulators and status quotidiens who are resisting the inevitability of it all.

The two technologies – electric vehicles and digital health – and their market and industry dynamics seem to running parallel courses:

1. Both function in highly regulated industries.

2. Both require large capital expenditures to be scaled.

3. Both are driven by technology innovation, particularly, in the case of EVs, battery storage.

4. Both are supported or hindered by rules and regulations and the economic incentives to buy, lease or use them.

5. Both are dominated by a few major industry players.

6. Both are facing similar technology adoption and penetration challenges.

7. Both rely on supporting ecosystems, like charging stations around the US, to sustain growth.

8. Both have high-profile entrepreneurs wearing the sneakers who are rabid earlyvangelists.

9. Both are challenging heavily entrenched status quotidiens.

10. Both will have many unintended consequences that are impossible to predict.

Just like smarter cars will be traveling on smarter roads, smarter patients and doctors will need smarter ways to help them navigate the complex sick care highways.

Of course, the pace of change is relentless and one of these days DIY medicine, AI and machine learning and the internet of things will be mandatory courses (online of course) for all first year medical students. Just be sure you are wearing something civil when the driverless Sickcaremobile is parked in front of your house and puts your picture on Sickcare Earth.

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The Value of Value Chain Analysis

GUEST POST from Arlen Meyers

Disrupting competitors or an industry essentially means doing something to take market share away from your competitors or get non-users to buy your product or service at at profit. There are many examples of sickcare entrepreneurs doing it and usually the tactic is to introduce new technologies. However, according to one researcher, most disruption comes from inprovements in how you change and improve the value chain.

Value chain analysis means looking at each of your customers or potential customers and mapping out all of the activities that they are need to do in order to acquire products and services. For example, here is pharmaceutical company value chain:

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Value chain analysis is a way to visually analyze a company’s business activities to see how the company can create a competitive advantage for itself. Value chain analysis helps a company understands how it adds value to something and subsequently how it can sell its product or service for more than the cost of adding the value, thereby generating a profit margin. In other words, if they are run efficiently the value obtained should exceed the costs of running them i.e. customers should return to the organisation and transact freely and willingly.

Conceptually, this was an industrialized view of how a company works. The arrow starts with the supply chain, with the customer at the end. Most S&P index companies founded before the internet era still operate with this value chain mindset.

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A Business Model (BM) describes the way a company returns profit/value to the business while delivering the product to customers. A Business Model shows as such how a company makesprofit from its products. Creating a VAST business model in sick care is elusive for many reasons. Not having one is one of the main reasons why your business will fail.

Defining the value chain to a customer helps you indentify and exploit potential business model opportunities. Here is how the value chain informs the business model canvas.

Here are some differences between the two and a brief history of how these terms have evolved.

In sick care delivery, there are three basic ways for doctors or other sickcare professionals to innovate their way out of the mess we’ve caused: technology innovation or adoption, execution and customer/patient experience. In most instances, changing the value chain or business model is more effective than technology diffusion and implementation.

If you are trying to change sick care to healthcare, seek to understand before being understood. One step in that process is to be a problem seeker , not a problem solver and that means understand the value chain. You’ll find it valuable.

 
Image Credit: Pixabay

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How to Be a Compensated Connector

GUEST POST from Arlen Meyers

It seems more and more people are becoming part of the gig economy, either part-time or full time, and 1099 docs are no exception.

Building a network has a lot of tangible and intangible benefits. The most obvious intangible one is you get to make more money and meet a lot of interesting people you can help, and , given the pervasiveness of social media, how many people are in your electronic Rolodex simply depends on how much time you want to spend clicking buttons. These days these kinds of people are called social media influencers.

The one thing you don’t want to do is be a yenta, a gossip or complainer that has a negative connotation. The correct term for a Jewish matchmaker is shadchanit for a woman, shadchan for a man.

However, in addition, to the intangibles, you can monetize your network either directly or indirectly. Here’s how:

1. Build network value and trust, not numbers. As noted, almost anyone can post big follower numbers, but, when it comes to asking for something or getting people to pay you, that depends on trust and the depth of the relationship

2. Find out what a your potential clients need. Like all products and services, the value of your network is user defined. For example, some will pay you to be an advisor because they think you can connect them to your network, open doors or make introductions to people who might want to use their products, help design them, finance them or provide strategic direction. Others want your help to find talent for their emerging company. Others want help finding a job. When they get it, they usually don’t forget to dance who brung ’em. Here are the 7Ms of being an advisor . Some might want you to be an innovation mercenary.

3. Don’t expect payment to come immediately Building your network should be a long term investment , not a way to sell something once someone joins your Linkedin network. For example, you never know who might be interested in investing in your startup venture or product 3 years from now.

4. Define your interests. Don’t expect payment to come to you directly in the form of cash. In exchange for your acting as a maven, connector, or salesperson,some will donate or give money to a charity, organization or third party you support or barter for products or services in exchange for your help.

5. Remember, charity begins at home. Being a compensated connector means asking for and negotiating the amount and terms of how and how much someone is willing to compensate you. Some will agree to success fees. Others might pay you in options or other forms of equity. A regularly scheduled cash payment is another option.

6. Be sure you disclose and make transparent conflicts of interest, particularly if you have a stable of clients in your network portfolio

7. Walk before you run. There are escalating levels of engagement. Use uncompensated ways to test and prove your value that might result in more compensated involvement e,g, agreeing to connect someone to another on social media with an introductory note. Advisory roles can be informal, where you look out for threats and opportunities and send a “heads up” to someone who should know, or more formal , i.e. serving on an Adviory Committee or Board, that would be compensated.

8. There are many ways to participate in the sick care gig economy. Don’t be surprised when one gig leads to the next since nothing succeeds like success.

9. You can do this any time during your career, from the first day of practice to your first day or rewire-ment.

10. Having Plan B should be part of your 10/20/30 plan

11.Another way to make money is to blog.

12. Here are some tips on how to be a coach or consultant either as part of your portfolio career or an encore career.

13. You will also need to determine your fee and you won’t make as much gross income as a freelancer as you probably work fewer, more flexible hours.There are two parts to your revenue model-how and how much you get paid.

14. When it comes to being an influencer, there is actually too much of a good thing. A microinfluencer is someone with 1,000-10,000 followers. Why? “People connect with microinfluencers because of their authenticity and honest perspective. They feel as if they are a person just like them. And with authenticity at the core of what brands desire, they’ve started looking more toward smaller influencers with higher engagement rates.”

Models include compensation in cash and/or equity, project based compensation, success fees for accomplishing certain benchmarks, and periodic payments for participating in meetings or events

Be sure to negotiate your compensation.

For a start, take your cash compensation and divide by 250(which is the number of billable days after factoring in vacations, sick time, and typical downtime) and then add 25%–50%. Then take that figure, compare it with the rates you’ve gotten from your network, and find a middle-ground number you can float as an experiment and then adjust based on feedback from potential clients.

In most instances, you will be paid in cash, equity or a combination of the two. Be sure you have some kind of advisory service agreement that defines the scope of work.

 Here are four things to keep in mind to become more comfortable charging what you’re worth.

14. Advisors can be informal or formal. Informal advisors are connectors or others in the community who offer themselves as pro bono resources. Formal advisors get paid to do specific things the role as an advisor to the CEO or the Board of Directors or as a member or leader of a more formal advisory board.

15. You might be offered a contingency, referral or success fee, depending on how much business you refer that results in a sale or contract for someone or the company. In addition, beware of illegal finder arrangements when it comes to raising money.

16. Be sure you get paid on time. Here are some tips on how.

17. Volunteer to work for a nonprofit that satisfies your interests. It is a fast way to get connected to another big community where you can offer and leverage your skills while you are giving back help you create more personal brand equity.

18. Here are some more tips on how to make a living being a solopreneur

19. When you consider speaking engagements, define your goals, the likelihood you will achieve them and whether the cost/benefit (travel and honorarium offered, or not) is worth your time and effort.

20. As you develop your personal brand, be sure to promote it.

21. Be sure there is a cultural fit

22. Write and speak about your area of expertise. Start doing it for free. Then, once you have developed your personal brand, start charging for your services. Here’s how much to charge.

23. You won’t need a lot of money to get, keep and grow customers. Here are some tips on how to get clients for your consulting or advisory services.

NB: These techniques do not include sending a blast email to 25000 Linkedin connections or Facebook ads asking them for business.

The value of your network depends on the end user perception of how you can help them and solve their problem. In some instances, scarcity creates value whereby connecting to key people or decision makers and filtering the gate keepers is the goal. For others, “wearing their sneekers” as a key opinion leader means the more people who see them on you the better. In other words, how and how much you get paid will correlate with your brand equity and your negotiating skills. As someone recently told me, you can’t buy genius by the hour. You should get compensated for results, not face time or clock punching.

Here is how some people have created single person million dollar businesses.

Social media increasingly is a part of everyday life. Why not make a few bucks doing it while you are sipping your latte reading this? Stop kvetching and start Merching.

 
Image Credit: Pixabay

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Why We Need Medical Practice Entrepreneurs, Not Managers

GUEST POST from Arlen Meyers

Take a look at the course catalog of the medical schools in the US or the ACGME (American Council on Graduate Medical Education) competencies following residency training and it is unlikely you will find a mandatory course or competency with the learning objective of teaching attendees physician entrepreneurship i.e. how to run a private practice profitably using a viable business model, how to add value as an employed physician intrapreneur, how to be a social entrepreneur or how to get an idea, invention or discovery to patients.

At best, those dwindling number of graduates interested in private practice are forced to take week -end “practice management” seminars or courses at their national specialty society meetings. Many focus on the IT- mandate- to- get- paid of the week by highly trained specialists, but, in many instances, they are offered by the blind leading the blind.

“Practice management” is an archaic, out-dated term that limits the scope of what 21st Century physicians need to know and know how to do to serve the needs of their communities of patients, while making a fair profit doing it. While operations management is important, instead, the future belongs to those who add user defined value through innovation. In other words, medical societies,medical schools and graduate resident education programs should offer mandatory courses, and require demonstrating competencies, in medical practice entrepreneurship, not practice management.

The purpose of these courses is to offer the knowledge, skills and attitudes necessary to thrive in the contemporary and rapidly changing medical landscape at a sustainable and scalable profit. At a minimum,courses should include:

1. Revenue Cycle Management including coding, billing and collecting

2. Human Resources

3. Digital Health

4. Innovation,Entrepreneurship and Intrapreneurship

5. Marketing

6. Personal Financial Planning

7. Basic Accounting and Financial Statements

8. Operations Management

9. The legal and regulatory environment of health

10. Comparative health care systems and alternative delivery channels

11. Value proposition design

12. Business model design

It is extremely unlikely that medical schools will offer these courses. Consequently, doing so will devolve to other independent or non-profits who embrace biomedical and health innovation and entrepreneurship education as part of their mission.

Here are some reasons why they should offer biomedical and clinical innovation and entrepreneurship education and training:

  1. Employed physicians are expected to add more and more value as intrapreneurs
  2. More and more doctors want side gigs but don’t have the knowledge, skills, abilities and competencies to add value.
  3. There are many ways to create patient defined value other than starting a company or seeing 20 patients a day.
  4. Innovation requires involving end users early to be successful
  5. As we migrate from paying for volume to paying for value, we should teach doctors how to create it.
  6. Doctors are interested in social enterprise and social entrepreneurship
  7. Doctors are interested in alternative non-clinical career development
  8. We need more leaderpreneurs
  9. Every doctor has a great idea. Unfortunately, few have an entrepreneurial mindset, know what to do next with their idea and are unlikely to be taught what to do with it in medical school or residency.
  10. It is a way to recruit new members and generate dues revenue.
  11. Members need guidance when it comes to policies and procedures for working with biopharma, medtech and digital health companies
  12. The demographics and psychographics of the medical workforce has changed and they are struggling to adapt to the new world of work
  13. Both the American College of Cardiology and the American Gastroenterological Association are investing in startups.

Here are 10 reasons why practicing medicine using a viable business model should be an ACGME competency.

The sooner we move forward, the sooner doctors will have the ammunition they need to re-empower themselves, bend the private practice participation and cost curve, and add value to a system badly in need of it.

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Why is innovation execution so hard?

GUEST POST from Arlen Meyers

If innovation starts with mindset and practicing entrepreneurial habits, it will fail without proper execution. By now you have probably heard these quotes about execution or have an aspirational poster of one in your employee lounge posted next to your company mission statement.

Turning an idea into an innovation is a hard, arduous journey whether you are an intrapreneur – an employee trying to act like an entrepreneur- or some other kind of entrepreneur e.g someone trying to get an idea to patients by creating a medical device or a digital health solution. The result is that the vast majority of ideas go down the drain during your morning shower and never see the light of day, perennial hostages of your mind.

Why is it so hard to execute? Generally, because there is a lack of :

  1. Leaderpreneurship, i.e. those who lead innovators and not manage innovation systems
  2. Followers with an entrepreneurial mindset. Here’s how to find GSC Club members.
  3. Communication skills
  4. Project management skills
  5. A dog that will eat the food
  6. People skills and emotional intelligence
  7. A culture of innovation
  8. Incentives to fail and persist
  9. Acceptance of anything not invented here
  10. Ways to track relevant key performance indicators, results, timelines and deliverables along the stages of development
  11. Poor teamwork
  12. Insufficient engagement of those who will be ultimately be affected by the proposed solution and have to use it and incorporate it into their workflow.
  13. A VAST business model
  14. A champion
  15. Strategic and tactical alignment

Moving an idea to an invention to an improvement or innovation, or somewhere else on the novelty-value matrix, requires that you identify all the above barriers and figure how to fill the gaps to overcome them. Otherwise, you will be stuck in project purgatory, practicing innovation theater spewing innovaganda (innovation fake news) while your project dies a swift, merciful death on the executioner’s block.

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Recent advances in the diagnosis and treatment of craniorectal syndrome

GUEST POST from Arlen Meyers

Craniorectal syndrome describes a symptom complex that includes:

1. Putting one’s head in places where the sun don’t shine

2. Ignoring the realities and impact of change

3. A overwhelming, and sometimes incapacitating, sense of denial and anger

4. Complacency

5. Sticking with the same game plan and lineup despite years of losing seasons

EPIDEMIOLOGY

While the incidence and prevalence of the disease is unknown, it seems to affect males and females in the same ratio. Research suggests , but has not proven, that the disease is more common in those over age 60. Workers in some industries appear to be more affected than others e.g. government, healthcare and higher education.

ETIOLOGY

The cause of craniorectal syndrome is unknown. Theories include metabolic, infectious and psychosocial abnormalities that result from environmental stimuli. There is no proven genetic basis but early childhood upbringing and behavior patterns seem to be predictive.

DIAGNOSIS

There are no lab or imaging tests that can confirm the diagnosis. Instead, the diagnosis is made clinically by observing behavior and how the sufferers deal with the consequences. There is a spectrum of disease. While no staging system has been widely adopted, symptoms range from mild to moderate to severe.

Stage 1: Some effort to spend time on environmental awareness and response (the new), while, at the same time, focusing on operational effectiveness ( the now) and efforts to expand products and markets (the next)

Stage 2: Paying lip service to innovation, but basically ignoring it and dabbling in new product development, most of which will fail. Signs include practicing innovation theater, hiring a Chief Innovation Officer, new signs promoting the company vision and mission on the wall and calling removing the wall clocks to avoid having to reset them on daylight savings time an innovation initiative.

Stage 3: A sole focus on short term, quarter to quarter numbers ignoring dropping ratings and market share.

Abnormal physical findings are rare although, in extreme cases, the cranium is located in some strange places.

TREATMENT

Treatment modalities include:

Pharmacotherapy. Mind altering drugs, including marijuana, have been shown to be effective in some cases. Pharmacogenomic determinants might predict outcome.

Cognitive behavioral therapy. Therapy is designed to alter negative thought patterns that trigger abnormal responses and behaviors that cause psychosocial harm.

Surgery. While indicated in rare circumstances, physically removing a patient’s cranium from their rectum is sometimes indicated when other therapies fail. Office based surgery with minimal sedation is equally as effective as surgery under general anesthesia.

Physical therapy. There have been isolated case reports of success using a brisk slap in the face.

Shock therapy These include misguided stock buy-backs or promoting people to higher levels of incompetence.

Palliative care includes:

  1. Hiring Chief Innovation and Strategy officers
  2. Creating Innovation Centers
  3. Financializing the entity
  4. Engaging in fraudulent billing practices
  5. Consolidating
  6. Selling to private equity
  7. Retreating to the ivory tower
  8. Using patients as loss leaders so you can sell their data
  9. Eating your young
  10. Marketing

Craniorectal syndrome appears to be increasing in endemic proportions. Clinicians should be aware of this trend and increase their diagnostic awareness. Unfortunately, there is as yet no ICD-10 code for craniorectal syndrome nor a CPT code for treatment, although a consortium of medical societies have formed a task force to lobby the AMA for a code designation. Here is the one you should use in the meantime.

Medicare and Medicaid routinely deny payment. Private insurance coverage for treating craniorectal syndrome is virtually non-existent because it is still deemed to be experimental and yet to be proven to be cost-effective.

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