GUEST POST from Arlen Meyers

The US is increasingly becoming a gig economy. Part timers and freelancers are creating portfolios, not careers. Corporate loyalty is dead and only a fraction of employed workers are engaged. The American dream is on life support, if not dead. The fundamental future of work is changing, wages remain stagnant for most and the workforce of the future need new skills and new ways to get them other than buying into a broken higher education model that comes with a questionable value proposition for most and a very high price tag for all.

A recent Intuit study estimates that 34 percent of the current workforce belongs to this growing pool of workers and predicts that 40 percent of American workers will be independent by 2020.

Online freelancing platforms are transforming work, organizations, and their business models. Ranging from start-ups to multinational enterprises (MNCs), platforms enable firms to tap into resources and expertise beyond their traditional boundaries. These platforms allow hiring managers to connect with millions of freelancers around the world—doing so at a speed and scale that was unimaginable just a few years ago. Between 2016 and 2017, there has been a 26% increase in the number of projects sourced via these platforms.

Career change for physicians used to mean changing specialties, whereas now, it means leaving medicine itself. A research study published in Mayo Clinic Proceedings reported that 9.7% of the 6,695 doctors surveyed between August 28, 2014 and October 6, 2014 planned to leave clinical work for an administrative position in healthcare, while 1.9% indicated that they planned to leave practice altogether to pursue a different career.

As we are all living longer, it is getting harder for older Americans to find well paying jobs, resulting in bigger retirement savings shortfalls.

Some think it’s time to rethink the social contract and let people work from anywhere. How about co-working spaces for radiologists, pathologists and all those bean counters and administrators that no one sees anyway?

Here are the problems with being a digital nomad.

A recent report by FlexJobs, an online resource for those seeking flexible work, found that opportunities in government and politics, engineering, project management, communications, and travel and hospitality grew on the website by over 50% between July 2015 and June 2016, more than any other career fields. According to FlexJobs, these are defined as professional-level jobs that have a telecommuting, flexible schedule, freelance, or part-time component.

A review by Linkedin showed that of all the users who list freelance work on their LinkedIn profiles, 20% have a full-time job in addition to their freelance business. That means full-time freelancing still dominates, but the side-gig model is quickly catching up. These are the top five industries for full-time professionals who freelance on the side:

1. Financial services and insurance
2. Professional services
3. Technology and software
4. Entertainment
5. Staffing

Most are full timers doing a side gig, which might be a stepping stone to portfolio careers or entrepreneurship. The difference between one and the other is that freelancers get paid to work in a business. Entrepreneurs create value by working on a product, model or process that adds user defined value.

Uber has not only changed the taxi business, it is part of the transformation of the future of work and laws and regulations that advance or impede it. As reported, all this comes alongside a heavily publicized proposal for the creation of a system of worker protection for the gig economy by two Democrat big hitters – Alan Krueger, a former chair of the White House’s council of economic advisers, and Seth Harris, a former labour secretary. It argues a hybrid category of “independent worker” is needed to accommodate situations in which an “employer” exerts control over much of what a worker does at the same time as the individual retains the right (like the self-employed) to work as much or as little as they want, when they want. Many doctors are pursuing portfolio careers and abandoning the full time practice of medicine.

Here are some of the benefits.

The opportunity is big in sick care to educate, train, recruit and develop low income workers using new teaching technologies. In addition, it is not just the lower skilled workers that are getting into the act. There are more 1099 Docs too.

The sick care work force of the future is being created every day, but several things are becoming clearer:

1. Digital health will create jobs that have yet to be defined

2. There is a gap for workers that can’t be filled by present offerings

3. Wage stagnation will persist until we figure out ways to replace exported manufacturing jobs that are unlikely to return

4. We need new business models for education that starts in k-12

5. Pension and benefits packages will need to conform to the new gig economy

6. Medicine will have to change its mindset and approach to using paramedical personnel to help doctors practice at the top their licenses.

7. Market based learning objectives should drive sick care gig learning

8. We need a different approach to defining competencies and using learing managment systems to measure life long learning and improvement. Doctors screwed up MOCs and we should not repeat their mistakes.

9. We need to use the experiences and insights of low wage minorities to deliver care, particularly when it comes to using community based resources to manage the crushing burden of non-communicable diseases

10. New gig workers need to have an entrepreneurial mindset. They also need to learn how to negotiate the terms of service agreements if they are agile talent.

11. Sick care gig workers have unique challenges when it comes to career development

12. All of these challenges will be opportunities for business process outsourcing, HR firms, policy makers and recruiters to meet the needs of potential clients with innovative product offerings and business models.

13. Like most other service dating service models, the intermediaries will be replaced with online matching platforms for much less. Think what happened to travel agents as a model for what will happen to locum tenens headhunters.

14. Older Americans are working more even as those under 65 are working less, a trend that the Bureau of Labor Statistics expects to continue. By 2024, 36 percent of 65- to 69-year-olds will be active participants in the labor market, the BLS says. That’s up from just 22 percent in 1994.

15. 54% of gigers say it takes too long to get paid. Insist on automatic fund transfers, negotiate the time (a week or two) or on a recurring basis if an advisor, and monitor payment. You might have to terminate your contract if you are repeatedly not being paid on time.

16. Gig workers have hard time affording health insurance and that is trouble for them and the people who care for them.

Increasingly, employers are looking or ways to trim full time payrolls and eliminating patient facing workers will be no exception.

There are many ways to participate in the sick care gig economy, so before you create your LLC, decide how you want to work and why. Do you want to be a freelance, an independent business owner or run a consulting company? Even if you have an MBA, here are some reasons to join the gig economy.

Remember there is a difference between a teacher (educates), a coach (teaches a skill), a mentor (helps you improve as a person) and an advisor (helps your company). Being a consultant and running a profitable consulting company has it’s own issues.

On the contrary, sickcare work means sacrifice and placing the needs of patients above your own. Many times there is little room for work-life balance, self-fulfillment and flexible work schedules so there will be a conflict between generational attitudes and the demands on the ground. Here are some stories about the dark underbelly of the contract workforce.

Here are some common reasons why your side gig, like your startup, is likely to fail.

Making money doing a side gig requires the 4P’s: product, pipeline, pitch and an engagement and marketing communication plan.

Product: How to build you personal brand

Pipeline: How to build a 30,000 member Linkedin group

Pitch: Your pick up line: what to know about value propositions

Plan: Do you have a strategic marketing and communications plan?

If you are thinking of “going gig” , here are the skills you will need to succeed.

The sick care work force is changing before our eyes. For many to succeed, the knowledge economy takes a brain and a computer with WiFi access. It can no longer be sustained by mostly rich white folks wearing white coats. We need to change the mix to close the gaps.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

We teach a lot to medical students and residents. One thing, however, we don’t teach is leadership and entrepreneurship. While some schools are trying to remedy that, there are still significant holes,particularly when you try to put both together and create leaderpreneurs.

Here are the top 10 mistakes we make when we try to create leaderpreneurs:

1. We try to manage innovation instead of leading innovators
2. We don’t select medical students based on their leadership and/or entrepreneurial mindset
3. We don’t train the trainers
4. We don’t reward leadership or entrepreneurship or create incentives to do it
5. We give a mixed message. One the one hand we want you to innovate and lead. On the other, we want you to conform and not be a disruptive (in the business sense) physician
6. We confuse management with leadership
7. We don’t give students leadership experiential learning and a place to fail
8. We don’t have enough physician leaderpreneur role models students can emulate
9. The followers don’t trust the leaderpreneurs because they don’t get sh$t done and they don’t do what they expect followers to do.
10. We don’t agree on the definition and intended outcomes of entrepreneurship and innovation.

Here’s why executive coaching doesn’t work.

Here’s why leadership development programs fail.

Creating leaderpreneurs in about changing mindsets. Most of that comes from experiential learning, not chalk talk. Until we provide that, what we are doing is simply leadership theater.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

Claiming status as the #1 digital health, bioscience, technology, finance or education cluster is new eco-devo blood sport. Should funding be the only KPI?

Innovation districts are the new clusters, and urban planners and stakeholders ask 5 questions during an audit:

1) Where are your region’s highest concentrations of innovation assets?

2) Is the district leveraging and aligning its distinctive advantages to grow and strengthen firms’ innovation capacity?

3) Does the district have an inclusive, diverse, and opportunity-rich environment?

4) Does the district have physical and social assets that attract a diversity of firms and people, increase interactions, and accelerate innovation outcomes?

5) Does the district have the leadership necessary to succeed?

There are two key principles to ecosystem value co-creation: 1) in order to encourage the active participation of ecosystem actors in the value co-creation process, efforts must be made to ensure a clear vision and a shared value base on which the ecosystem activities can be built and 2) facilitation is needed to support the ecosystem actors to make new connections and to share their knowledge and resources in concrete ways. Most importantly, the more diversity there is among the ecosystem actors, the greater the support for innovativeness within the value co-creation process.

Like bioclusters of yesterday, regional governments and elements of the ecosystem are knee deep in accelerators, investment funds, innovation districts and endless Meetups. But, how would you know a top tier digital health ecosystem when you see one? In other words, how do the outcomes of of clusters and innovation networks create economic impact? What should the key performance indicators? How do they align with your vision, mission and goals the value proposition to key beneficiaries, stakeholders or customer segments?

Impact and KPIs can be specific or broad. They can measure narrowly focused value,for example for the customer or entrepreneur, or more general like regional or US global competitiveness.

A recent analysis generated a list of more than 300 potential indicators. The authors sought to focus on a few key indicators that matter so they selected the subset most relevant in assessing the impact of programs on job quality/worker prosperity and business dynamics. In both cases, they considered whether a measure might also address greater economic inclusivity. They also separated program indicators with a direct link to economic development activities from those that represent broad economic outcomes. The presumption is that modest sized state or local economic development initiatives are more likely to influence specific business activities among a targeted group of firms than to “move the needle” on an entire economy. While economic development organizations focus much of their performance monitoring on tracking program outcome indicators, monitoring broad economic indicators can guide policy makers in determining which program activities are most relevant to current policy priorities

Here are some themes:

Connect metrics to program activity. Develop and document the logic model for each economic development program to articulate explicitly how inputs (investment or activity) are expected to translate into outcomes.

Consider adopting performance indicators that address job quality and business dynamics, where appropriate, such as:

• wage levels, benefits provided, occupations, and/or skill development and career pathways;
• business churn metrics in addition to year-over-year summary trends;
• indicators related to innovation, productivity, or global business activity among assisted businesses.

Report program-related outcomes as distinct from broader economic benchmark indicators.

Evaluate data source options, including the feasibility, quality, and availability of data when selecting indicators.

Determine which indicators can be used to understand economic inclusivity within the state’s overall economic development portfolio.

• capture relevant information about program impacts related to racial, ethnic or gender diversity and distress of the places where investments are made
• report data internally even if not required for external reporting

Create a communication plan to drive productive use (and accurate dissemination) of economic development program outcome data.

Here is a seven step guide for creating a strategic communications plan

Some suggest these metrics:

1. Is there a focus on creating digital health solutions in the ecosystem?

2. Do the members of the ecosystem have experience supporting large-scale initiatives?

3. Is the ecosystem partnered with healthcare providers?

4. Is the ecosystem partnered with corporations, academic and government researchers?

5. Is the ecosystem partnered with investors?

6. Is the ecosystem partnered with governmental and regulatory bodies?

7. Does support for the development and scaling of innovation exist within the ecosystem?

8. Does a virtual and physical support structure exist for the entrepreneurs within the ecosystem?

9. How accessible is information within the ecosystem?

10. What evidence exists to support the efficacy of the ecosystem in driving innovation?

I’d suggest several other domains in the scoring system:

Education and manpower development: Are you meeting the needs of the community?

Technology transfer metrics: Patents, revenues, spinouts

Economic development metrics: Taxes, new venture creation, employment numbers

Patient value metrics: How and how much have the products helped patients?

Firm and entrepreneur metrics: How much wealth has been created?

Contribution to US global competitiveness and international trade: Are we winning against our global competitors?

Value proposition: Are there multiple value propositions for each user segment or just one ?

Business model: Is it VAST?

Information flow: How easy is it for people and information to connect

Open innovation quotient: How open open is the network?

Quality of newcos: What is the likelihood that the companies in the cluster will generated substantial user defined value and be able to scale?

Survival rate: The estimated 5 year surival rate for new businesses is 50%. Is your cluster record better?

We’re halfway through 2017 and already a group of startups that together raised $1.48 billion have shut down. 

Building a digital health cluster requires leveraging public, private industry, academic and investor assets.

It is not enough to use vanity metrics to be #1. Fundamentally, the yardsticks need to go beyond process and structure and take a world view. The measurements need to be transparent determinants of value. Finally, we need ecosystem KPIs that measure impact, not just output. In most instances, that can only be defined by the patient end users.

Only then can you stand in the winner’s circle.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

Here was my schedule during residency training:

Monday: arrive 5 am and leave the hopital when everything that needed to be done was done, usually about 7pm. Since call was every other night, I worked on call until the following morning, sleeping the in the hosital on call room (my room mate was a opthalmology resident who had to get up at 3am to prepare pre-op patients.)

Tuesday: Wash, rinse, repeat. Leave hospital about 7pm to do my laundry

Wed: Same. On call

Thursday: Same. Off call

Friday: Same On call

Saturday: Conference morning from 7am-noon. Off call

Sunday: Same. On call

You do the math. I was usually too tired to. Then came work hours reform. Now residents can cruise through an 80 hour work week, and, at an average salary of $60K, doing it for minimum wage. Did I mention the median $200k in medical student debt?

A recent analysis of work hour reform and quality of outcomes, at a minimum, showed that the data suggests that the incremental experience gained from working more than 80 hours per week as a resident doctor doesn’t generally translate into improved patient outcomes later. And with rates of physician burnout increasing in recent years, it’s worth considering whether residency work hours could be reduced further, or restructured to address other causes of fatigue (such as electronic health records and insurance issues), without compromising clinical expertise and quality of care for patients downstream. Although there are no serious proposals to rethink residency training hours, it’s an open empirical question worth investigating.

I think we should pay attention to the quality not quantity of the work that gets done when we consider how to train the doctors of the future.

1. The doctor persona has changed.
2. The world has changed and we need to train people how to win the 4th industrial revolution
3. The pace of innovation has changed and what you learn in residency will increasing be obsolete in shorter and shorter times after completion of your residency. Life long learning cannot be measured in hours per week and is just part of the job
4. Physician productivity has been stagnant if not dropping
5. Administrivia and EMR compliance mandates are wasting precious learning and practice time and frying doctors
6. Medical schools and residency programs are facing these problems as well
7. Here are my principles of medical education reform
8. Technology is forcing us to confront the high tech-high touch tensions in care
9. Data might be the new oil but sick care is the new coal
10. Hospital based care compared to training in non-hospital care delivery environments is bcoming a smaller and smaller part of how the work gets done
11. The business of medicine should be another ACGME competency
12. Frustration and burnout are resulting in practitioners pursuing non-clinical careers or abbreviated clinical half-lives

The quality of a graduating resident has more to do with the quality of their training, not its quantity. Yes, case numbers are important, whether it be an internal medicine resident or a ear, nose and throat resident. However, case exposure is frequently random and competencies are variable no matter how many you see or do or how many hours you work. Scut work adds little to learning.

You never get it completely right no matter how many hours you clock doing it. That’s why it’s called practicing the art of medicine.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

Boomers are back on stage for an encore.Whether it’s for financial reasons or a chance to try something new, more baby boomers are embarking on an encore career—a second professional career that can bring in not only money but often the fulfillment that may have been lacking the first time around the career bend.

In fact, adults over the age of 50 comprise one of the fastest-growing groups of entrepreneurs in the United States, according to a new Gallup study. Among those people who don’t currently own a business, baby boomers are twice as likely as millennials to say they plan to start a business in the next year.

Here are 5 myths about boomers:

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

Investment in fintech (financial technology) continues to boom — breaking records in 2017 with an 18 percent rise in venture capital investment across the globe, and 30 percent in the U.S., according to Accenture’s latest report. Here are 5 fintech trends.

At the same time, investors continue to have a strong appetite for digital health with investment in the sector totaling $4.2 billion across 180 deals through the first half of 2019.

If this pace holds steady, the sector is on track to raise $8.4 billion in 2019 and could top 2018’s record-breaking annual funding total of $8.2 billion, according to Rock Health’s midyear report.

Just in the first six months of 2019, the digital health sector is close to surpassing the $4.6 billion in funding raised in 2016.

The two are colliding-finsicktech

1. Here’s a conference on fintech opportunities in healthcare
2. Here’s a combined fintech/sicktech accelerator

3. Here are 5 fintech trends that will benefit digital health products

4. Here is a time stamping and synchronization technology for use use in finsicktech

5. Here are some lessons sicktech can learn from fintech

6. There are 3 key barriers to the fintech industry around the world

7. These are places where you can learn about fintech

8. Want a career in fintech?

9. Watch these fintech companies

10. 5G will impact fintech. 5G will impact sicktech

As finsicktech evolves, the goal should be to improve the patient revenue cycle management experience, reduce errors, make information portable and interoperable, inprove security and reduce admininstrative costs. A study published in The New England Journal of Medicine examined data from 1999 to project administrative costs of health insurers, employers’ health benefit programs, hospitals, practitioners’ offices, nursing homes and home care agencies. The study found administration accounted for 31 percent of healthcare spending in the U.S., compared with 16.7 percent of healthcare spending in Canada. According to the Times, the same estimates today would mean administrative costs in the U.S. account for $5,700 of the about $19,000 on average that this nation’s workers and their employers spend on family coverage annually.

Sickcare cannot be fixed from inside.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

If you work for a big, established company, you’ve probably been noticing the sudden rise of a new trend: the innovation lab. Companies as diverse as Delta Air Lines, Target, Google, Pfizer, Marriott, Autodesk, Fidelity Investments, Ford, Verizon, and Stanley Black & Decker are jumping on the bandwagon. Most don’t deliver.

Open innovation labs like this bring The Garage Experience inside the four walls of the corporate business environment – freely available for everyone to use and experience.

Univerisities have joined the parade, creating undergraduate and graduate innovation and entrepreneurship centers, despite the fact that there is scant evidence that they work.

The new thing in sick care administration is to create healthcare innovation centers, modeled somewhat after other industry R/D and skunk works. Their goal, ostensibly, is to innovate our way out of the sick care and health care mess. They focus mostly on quality, cost, process improvement, patient experience, sometimes doctor experience and access to care and range in size, scope and vision. A recent review identified 50 hospital innovation centers. Steve Blank calls it innovation theater

Considering how deeply companies rely on innovation, it is astonishing how bad most of them are at finding, developing, and implementing new ideas. Global companies pour roughly $1 trillion yearly into innovation; estimates are that at least 10% of that sum — $100 billion — is completely wasted.

Here is an example of one that is successful. Some have combined designers and, can you imagine, are also asking patients what they want.

Here is a building dedicated to sick care innovation in Denver.

Now,even the AMA is in the game and has anted-up $15M.

As you would expect, there are now conferences, webinars and white papers about health innovation centers, best practices and their impact to date. Accelerators are changing to accomodate the realities of the sickcare industry. 

 It is not always a good thing for a startup to join an incubator or accelerator. Or, rather, there are multiple aspects of business incubation practices that could affect negatively early-stage companies, and founders of new ventures should be very careful when selecting a specific incubation program.

Corporations are creating innovation outposts to stay ahead of the curve.

Sick care (over 90% of the US “healthcare” spend is for taking care of sick people) innovation center leaders and participants will need to address some issues to be effective and deliver impact:

1. The last mile. All the systems engineering in the world won’t make a difference until we crack the code on how to change human behavior.

2. The rules. Most will have relatively limited impact until and unless the reimbursement rules substantially change. Rules drive ecosystems that create business models that deploy and scale innovation. Right now innovation centers are trying to use new tactics but can only deploy limited innovation strategies without a new playing field. They are living in the no man’s land between the now and the new.

3. Systems thinking overcoming silos. Healthcare is notoriously siloed at almost every level, from department to department to one sick care system to the next.

4. Patient willingness and ability to engage. The assumption is that more patient “engagement” will be mean better outcomes. That needs to be validated and we need to do a better job of targeted patient segments who want to take responsibility for their care and assume the consequences for the results.

5. Shifting value factors. Medical care is becoming commoditized. Patients can’t judge quality and cost since they are so opaque so they use service, speed, convenience and experience as proxies. There is relatively little correlation between satisfied patients and the quality of care they receive.

6. Data integration and interoperability. Resolving the protect but share dictum will be challenging.

7. Measuring and defining innovation. Big orbit change is necessary, not incrementalism. Innovation is a measure of the multiple of user defined value that results when compared to the existing competitive offering.

8. Lead innovators, don’t manage innovation. We need leaderpreneurs and followers with an entrepreneurial mindset willing to fail at low cost.

9. Innovation management systems. There are many ways to foster, package, test, validate, prioritize and deploy components of an R/D portfolio. The process needs to efficient, effective and transparent to the users .

10. Execution. Inspiration and perspiration. In the end, no idea, invention, discovery, or process is worth much without a team who can execute or deploy it.

11. Long sales cycles prolonged processes of decision making.

12. Different business models to develop digital health and process improvement products

13.Overcoming the main barriers to physician adoption: a)evidence based safety and effectiveness, b) concerns about liability, c)getting paid to do whatever you propose that d) will not interfere with workflow, take more time and further abbreviate face time with patients.

14. Entrepreneurs outperform intrapreneurs

Here is an example of a “different” model. We need scalerators, not accelerators.

Healthcare innovation centers seem to have a different focus than community based entrepreneurship centers. Yet, they should both be focused on the same thing: transfering value to patients. Physician centered value centers should have the following features:

1. Focus on creating value transfer to patients, not startups

2. Create a separate value proposition for the different kinds of physician entrepreneurs: private practitioners, technopreneurs, intrapreneurs, investors, consultants.

3 Include rapid prototyping facilities

4. Integrate non-MDs from other industries to create a larger, more eclectic community of interest

5. Include patients and others who might help with the customer discovery and development process

6. Include human subjects trial support

7. Accomodate the schedules of practicing clinicians

8. Use state of the art teaching technologies

9. Have an active and effective mentoring process

10. Create a business model that doctors will buy

A recent study provides details for the 10 top success factors for hospital innovation:

1.      Use a clear step-by-step innovation method

2.      Establish an Advisory Group to guide innovation concepts and proposals

3.      Focus on consumer needs, rather than technologies to direct the innovation

4.      Generate Big ideas by focusing on core outcomes, not the symptoms

5.      Minimize early funding by focusing on a minimal viable product

6.      Support projects with innovation experts (design, engineering, business)

7.      Utilize an iterative prototyping to quickly build and test the best product

8.      Nurture publicity and storytelling to raise visibility, excitement and funding

9.      Include industry experts/ vendors/ investors to support commercialization

10.  Develop power users to give hands-on training and coaching for innovations to build key behaviors and practical experience

“What is the source of this hostility to innovation?”, “Is the under-performance in innovation episodic or systemic?” and, “What is causing this value-destroying gap between stated intent and actual reality?” Here are 3 reasons.

In fact, like many industry innovation centers, my guess is that few sickcare innovation centers are creating much impact and should be closed, particularly if they are just high priced, high tech suggest boxes. Here are five reasons why they should be shuttered.

In addition, the establishment of university-affiliated incubators is often followed by a reduction in the quality of university innovations, according to a new study co-authored by a Baylor University entrepreneurship professor.

Here are some reasons why it is so hard for BIG MEDICINE to innovate

Most don’t and that’s part of the reason doctors have been disintermediated and marginalized from the value creation process.

We need to rethink accelerators and incubators given their marginal success record of creating scaleable companies. Scale up expert Sherry Coutu believes that most innovation facilities today are failing in their duty to help startups and corporates work effectively together and bring products to market at scale. Whether in terms of running successful proof-of-concepts, giving access to talent and finance, or even providing the hardware required to scale up their work, these things are traditionally lacking from the modern incubator.

The challenge for enterprises looking to make strides then is to back up their innovation strategy with the organizational capability to scale up the experiment i.e minimally viable pilots.. Hagel and Seely Brown advocate a seven-step process:

1. Locate your edge, which is likely to be an emerging business opportunity that has great potential to scale up rapidly.
2. Identify your changemaker/s who fully understand and will embrace this opportunity.
3. Position this individual/s outside the core of the organization.
4. Take a lean startup style approach and experiment relentlessly in order to accelerate learning.
5. Deprive the team of much in the way of support or resources.
6. Encourage the team to connect and partner with other parties outside of the organization to gain the support they need.
7. The new venture should look to create a new product or service and not cannibalize the core business, at least to begin with

Sick care organizations can also learn some lessons from other industry corporations that are trying to partner with startups.

Sick care innovation centers might be a fad or an important tool for fixing what’s broken. We’ll have to see. In the meantime, enjoy yourself at all those conferences.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

Being an innovator takes courage, confidence and conviction. You are a guerrilla fighter waging war against the status quo, vested interests and corporate bureaucracy that have sophisticated defenses against intruders that seek to threaten their cash flow, culture and business models. You are fighting for the hearts and minds of patient customers ,payers, providers and non-users alike and will need to overcome your fears, willing to sacrifice and do the hard work. But, would you push someone who is afraid of flying into an airplane?

Here are some tips on how to overcome your fear of failure. You can also try these tips to overcome your other fears. What will you do today that scares you?

Attachment theory might help explain your fears and help you find a safe place to confront them.

Entrepreneurship, the pursuit of opportunity with uncontrolled, scarce resources has its goal the creation of user defined value through the deployment of innovation. Entrepreneurs confront the unknown with not just a mindset, and entrepreneurial habits but with courage based in their hearts. The very act of entrepreneurship involves embracing uncertainty. often living in darkness. After all , the English word for courage is connected to the heart, coming from the Latin word cor, which means heart.

Courage. Encourage. Two words, same origin. Heart. You gotta have heart. Miles and miles and miles of it. There’s no bravery or boldness without heart. There’s no spirit or support without heart. There’s no sacrifice or soul without heart. Nothing great ever gets done without heart. You gotta have heart.

And at the heart of leadership is caring. Without caring, leadership has no purpose. And without showing others that you care and what you care about, other people won’t care about what you say or what you know. As a relationship, leadership requires a connection between leaders and their constituents over matters, in the simplest sense, of the heart. It is personal and it is interpersonal.

But, to get stuff done, you need to have the power to do it. Feldman writes that according to French and Raven (1959), and later Raven (1974), there are six bases of social power:

1. Reward Power
2. Coercive Power
3. Referent Power
4. Legitimate Power
5. Expert Power
6. Informational Power

Author and psycotherapist Estelle Frankel offers some perspective on confronting and accepting the unknown in her book, The Wisdom of Not Knowing. There are many similarities between the spiritual lexicon and the entrepreneurial one, for example, walking through the valley of death, going to the dark side, embracing the journey instead of the destination and having faith in how failure in one thing will open the doors to success in another.

Frankel further notes that the basis of creativity is often suspending your concepts of reality and entering the unknown as if in a dream or mindful state. For example, did you know that the brain scans of jazz musicians during improvisational work resemble those found during deep states of REM sleep?

Former Surgeon General Vivek Murthy noted that, “In the end, two emotions drive the decisions we make: love and fear. Everything else is a manifestation of one or the other, Murthy said. Love manifests itself as generosity, kindness and compassion. Fear shows itself in jealousy, anger and rage. “When fear drives our decisions, more often than not it tends to lead us to darker places. It tends to have negative impacts on our health and it tends to drive us apart, separate us and isolate us,” he said. “When love is driving our decisions, and informing our interactions with each other, it tends to be nourishing, it tends to be good not only for our health but it also builds that connection, that cohesion in society that we ultimately need.”. Drive out fear. Do something every day that scares you.

Here are some lessons from the cowardly lion.

Confronting the uncertainties of customers, products and markets is child’s play compared to having the courage to confront your inner demons or the ultimate uncertainty, death. And yet, do it you must if you are to have enough courage to live your life as an entrepreneur. Remember Steve Jobs at the Stanford graduation.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

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

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.

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 instead of you marketing to them. In that case, like everyone else, you will have to prioritize your time and build your portfolio to meet your needs, not just those of potential clients. 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.

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.

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.