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/

Land Mines of Intrapreneurship

Land Mines of Intrapreneurship

GUEST POST from Arlen Meyers, M.D.

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

Intrapreneurs are employees trying to act like entrepreneurs within their organizations or non-profits. Here is the textbook of physician intrapreneurship.

Here is how to get your ideas noticed:

If you are trying to develop and deploy an AI solution in your sickcare organization, have you answered these questions?

Here are some reasons why your initiative will fail.

Do you have a VAST edupreneur business model?

Studies show that around 60 to 80% of new products fail. The same is probably true for programs and new educational offerings. It is difficult to determine the exact number of unreported cases, because who would like to talk about his innovation flops? The odds are against you.

So, what are the landmines to detect and avoid?

  1. You did not do your homework because you where unwilling, unable to do so ,or ,you do not have an entrepreneurial mindset and think because you already have 2 people who said they were interested that you could forge ahead.
  2. You did not have an exit strategy.
  3. You did not read the field manual.
  4. You don’t have the right sponsor with staying power.
  5. You tried to bite off more than your stakeholders are willing or able to chew.
  6. You are a bad rebel and chalk it up to “being authentic.”
  7. You do not have the right clinical champions on board.
  8. You have empty seats on the bus or the wrong people sitting in them.
  9. You are making these rookie intrapreneur mindset mistakes.
  10. You are not addressing the dysfunction of teams.
  11. You are not aligned with your organization’s strategy or vision.
  12. You are working in the wrong place with a toxic or fixed culture or for the wrong person.
  13. You don’t have an innovation strategy
  14. You don’t get sales and marketing
  15. You didn’t ask and answer these four questions before you started
  16.  If you’ve got a major change on the horizon, here’s how to avoid three of the most common saboteurs of company transformation. First, understand that significant change will be harder than you think it will be to achieve. Next, be realistic about your organization’s capacity to implement changes. Finally, make sure your organization understands how and why the transformation is important to you.
  17. You have not learned how to win at Survivor  1) Don’t expect friendship. Invest in relationships outside your company to meet your emotional needs; 2) Manage sideways. Your reputation with your peers becomes an important factor as you’re being considered for senior ranks; and 3) Hone your political skills.

If you get too far ahead of your troops, it is hard to tell the difference between you and the enemy. De-risk yourself. Be careful out there.

Image credit: Pixabay

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Should you be a physician entrepreneur?

Should you be a physician entrepreneur?

GUEST POST from Arlen Meyers, M.D.

Not every doctor is cut out to be a physician entrepreneur. Are you?

It seems to me there is confusion about physician entrepreneurship, its definition and whether it represents a threat to professionalism. I’m not alone. Is a physician entrepreneur someone who starts and runs a business, or is it something more?

Entrepreneurship is the pursuit of opportunity under variable, uncertain, complex and ambiguous conditions. The goal of all entrepreneurs, including physician entrepreneurs, is to create user defined value through the deployment of innovation using a VAST business model to accomplish, in the case of medical professionals, the quintuple aim or, if applicable, shareholder value.

Here are three things to know about physician entrepreneurship.

Because of the many changes in the art and practice of medicine, many doctors have decided to get involved in non-clinical side gigs or, in some instances, leave medicine entirely. Here is a guide to non-clinical careers.

Doctors are practicing the art of entrepreneurship for many reasons:

  1. It helps patients
  2. It’s fun and challenging
  3. It gives them the ability to exercise creativity
  4. It creates alignment and engagement with organization
  5. The profit motive
  6. It creates meaning
  7. It satisfies psychic needs
  8. It provides another sources of external vaidation
  9. It’s a way to get outside of your comfort zone
  10. It allows you to take more risk
  11. The sick care business model is broken and they want to be part of the big fix after feeling ignored and disempowered
  12. They have to to surthrive

Whether you are a pre-med, a medical student, a resident, a fellow or a practicing clinician thinking about beginning the entrepreneurial journey, you should take some time to identify your persona.

You career strategy starts with answering:

  1. Where are you now?
  2. Where do you want to go?
  3. How do you want to get there?

Begin by matching yourself with one of the four core entrepreneurial personas as defined by their willingness and ability to practice entrepreneurship successfully.

The Convinced and Confident know entrepreneurship should be part of their career pathway. In fact, many of them have had entrepreneurial life experiences prior to medical school.

The Curious but Clueless don’t know what they don’t know but are willing to learn more. Many have never held a job in their life. Some might be willing, but unable to develop an entrepreneurial mindset. . Others discover their innerpreneur, and move on.

The I Couldn’t Care Less are unwilling and unable to give it a try. Their attitude is , “I went to medical school to take care of patients, not take care of business”. What they don’t realize is that if you don’t take care of business, you have no business taking care of patients.

The Conflicted have yet to discover their “innerpreneur”, but are conflicted about whether to step outside of their comfort zones and cut the chord.

Your persona will help lead you to the next steps:

  1. The Convinced and Confident: Continue to improve your knowledge, skills, abilities and competencies and learn from your experience.
  2. The Curious but Clueless: Start with education, building your networks and finding mentors
  3. The I Couldn’t Care Less: Pass on entrepreneurship until or unless you change your mind. Here are the many reasons why you should not be a physician entrepreneur.
  4. The Conflicted: Start with the 6Rs of physician career transitioning, beginning with reflection.

Where you are in the thought process will depend on who you are.

Moving from unawareness to awareness to intention to decision to action might show you someone in the mirror you would have never recognized in the past. Or, you might be looking at the same old person.

Image credit: Pixabay

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Challenges of Artificial Intelligence Adoption, Dissemination and Implementation

Challenges of Artificial Intelligence Adoption, Dissemination and Implementation

GUEST POST from Arlen Meyers, M.D.

Dissemination and Implementation Science (DIS) is a growing research field that seeks to inform how evidence-based interventions can be successfully adopted, implemented, and maintained in health care delivery and community settings.

Here is what you should know about dissemination and implementation.

Sickcare artificial intelligence products and services have a unique set of barriers to dissemination and implementation.

Every sickcare AI entrepreneur will eventually be faced with the task of finding customers willing and able to buy and integrate the product into their facility. But, every potential customer or segment is not the same.

There are differences in:

  1. The governance structure
  2. The process for vetting and choosing a particular vendor or solution
  3. The makeup of the buying group and decision makers
  4. The process customers use to disseminate and implement the solution
  5. Whether or not they are willing to work with vendors on pilots
  6. The terms and conditions of contracts
  7. The business model of the organization when it comes to working with early-stage companies
  8. How stakeholders are educated and trained
  9. When and how which end users and stakeholders have input in the decision
  10. The length of the sales cycle
  11. The complexity of the decision-making process
  12. Whether the product is a point solution or platform
  13. Whether the product can be used throughout all parts of just a few of the sickcare delivery network
  14. A transactional approach v a partnership and future development one
  15. The service after the sale arrangement

Here is what Sales Navigator won’t tell you.

Here is why ColdLinking does not work.

When it comes to AI product marketing and sales, when you have seen one successful integration, you have seen one process to make it happen and the success of the dissemination and implentation that creates the promised results will vary from one place to the next.

Do your homework. One size does not fit all.

Image credit: Pixabay

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What will it take to create a national medical records system?

What will it take to create a national medical records system?

GUEST POST from Arlen Meyers, M.D.

Almost every person that has experienced the US sickcare system has been frustrated by the lack of data interoperability. We are all paying the costs, now pegged at $4.1T. About $1T of the tab is waste.

Here is the case for data interoperability.

Larry Ellison, the CEO of Oracle, is the latest person who says he wants his company to fix that.

Like those that preceded him, he will face:

  1. Stakeholders that don’t play nice with each other
  2. An enormous cost
  3. Trying to create a VAST business model
  4. Inconsistent technical standards
  5. Competition
  6. The lack of a national patient unique identifier system
  7. Privacy and confidentiality issues
  8. A highly regulated system for patients sharing their data
  9. End user resistance to dissemination and implementation
  10. Cybersecurity
  11. Connecting the kaleidoscope of the disparate elements of the US sickcare system of systems, like the VA, safety net hospitals, rural hospitals, academic centers and DOD facilities
  12. Combining financial data with clinical data
  13. Combining research data with clinical care data
  14. Varying levels of data maturity in the system
  15. Accessing data that is created outside of traditional medical service facilities
  16. The growth of retail sickcare and sicktech companies
  17. Harnessing data from the internet of medical things
  18. Integrating artificial intelligence to not only achieve the quintuple aim, but also create shareholder value that will conflict with one another
  19. Winning the “cloud wars”
  20. The lack of trust and growing sickcare technoskepticism
  21. The Cerner VA implentation FUBAR halo effects.
  22. Changing the EMR “SHIT” -single most hated information technology- to a whole product solution
  23. Accessing unstructured data on social media sites
  24. Governance of the enterprise
  25. Regulatory oversight of software as a medical device and digital therapeutics
  26. Low levels of sickcare professional and patient data literacy
  27. Barriers to international data sharing in a era of pandemics and required rapid response
  28. Fax facts
  29. Push back from patients who want to be paid for their data
  30. Decentralized clinical trial data issues
  31. DEI
  32. Leaderpreneurship skills
  33. UI/UX Will he eliminate passwords?

Wouldn’t it be nice if Sickcare USA, Inc. could provide you with the same experience as your bank ATM system?

Is Larry really the smartest person or just in the wrong room?

Image Credit: Pixabay

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Changing Your Innovator’s DNA

Changing Your Innovator's DNA

GUEST POST from Arlen Meyers, M.D.

In their book, The Innovator’s DNA, the authors identified 5 parts to the secret sauce of innovative business success:

In thinking about how these skills work together, they found it useful to apply the metaphor of DNA. Associating is like the backbone structure of DNA’s double helix; four patterns of action (questioning, observing, experimenting, and networking) wind around this backbone, helping to cultivate new insights. And just as each person’s physical DNA is unique, each individual we studied had a unique innovator’s DNA for generating breakthrough business ideas.

Associating is about pattern recognition, connecting dots and seeing what others don’t see.

 These business school professors describe the creative mindset that they believe executives must embrace.

So, A stands for Attention, which is about noticing problems or opportunities that you and others previously missed by changing where and how you look.

L is for Levitation, which means stepping back to gain perspective and make sense of what you’ve seen to reflect on what you need to do differently.

I stands for Imagination, which involves connecting the dots in new and interesting ways to create original and useful ideas. Learn something new every day.

E is about Experimentation, which is about testing your promising idea and turning it into a workable solution that addresses a real need. Here is the value to experimentation in innovation.

Finally, N stands for Navigation, which is about finding ways to get your solution accepted without getting shot down in the process.

Here is another take on the theme

Innovation starts with mindset. Most scientists, engineers and health professionals don’t have it. However, there are ways to develop and change the gene expression by practicing epigenetic exercises. In case you missed that biology class, epigenetics literally means “above” or “on top of” genetics. It refers to external modifications to DNA that turn genes “on” or “off.” These modifications do not change the DNA sequence, but instead, they affect how cells “read” genes.

So, if you want to unlock your innerpreneurial genes, try :

  1. Associating, by realizing that sickcare USA cannot be fixed from inside.
  2. Associating by practicing open innovation
  3. Associating by thinking twice about thinking out of the box
  4. Questioning by being a problem seeker, not a problem solver
  5. Questioning why not instead of why and getting to why
  6. Observing by learning to see around corners. Avoid having to say “I didn’t see it coming” :

Look ahead of the curve – Track the trends and pay greater attention to the external environment. Beef up your information diet and endeavor to “get informed” rather than passively “be informed.”

Think ahead of the curve – Take the time to connect the dots, look for patterns of change, and emerging opportunities. Ask: where will this trend, technology or Driving Force of Change be in 10 years and what might I need to do in response?

Act ahead of the curve – Don’t wait for a trend to overwhelm you, take responsive action today. Disrupt yourself. “We must be willing to learn, unlearn and relearn to get ahead in this fast-paced digital world,” notes Jeff Thomson, president and CEO of the Institute of Management Accountants.

Here are 10 strategic trends that will drive data management. Did you see them coming?

  1. Observing by looking for the clues, not the roadmap
  2. Experimenting by using the business model canvas instead of writing a business plan
  3. Experimenting by applying your clinical or scientific mindset
  4. Networking by building robust internal and external networks
  5. Networking the right way when coldLinking
  6. Networking by learning how to meet up at a Meetup
  7. Networking by growing and engaging your alumni network

David Epstein explains in his book. Range, that specializing and practicing repeatedly works in environments that are “kind”. Tiger Woods excelled because he started young and engaged in a task and tried to do better. There were clearly defined rules and immediate outcomes that provided feedback. Doctors are also in this category and the educational establishment picks medical students who demonstrate narrow and deep thinking.

On the other hand, in “wicked” learning environments and domains, like entrepreneurship, the rules of the game are often unclear and incomplete, i.e. there are VUCA (volatile, uncertain, complex and ambiguous) conditions, there may or may not be repetitive patterns and they may not be obvious, and feedback i often delayed, inaccurate or both. Sometimes, you have to make up the rules as you go along and they are not necessarily transferable from one industry to the next because of the differences in industry ecosystems and cultures, like sickcare. That’s another reason why the clinical mindset is different than the entrepreneurial mindset and why it is so hard to find doctors with both.

Here are some more ways to sharpen your entrepreneurial skills.

Doctors have the potential to make great entrepreneurs because they have the DNA. No, they are not lousy business people. Downstream gene expression, though, is often a problem.

Image Credits: Pixabay, Design Council

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Sickcare AI Field Notes

Sickcare AI Field Notes

I recently participated in a conference on Artificial Intelligence (AI) in healthcare. It was the first onsite meeting after 900 days of the pandemic.

Here is a report from the front:

  1. AI has a way to go before it can substitute for physician judgment, intuition, creativity and empathy
  2. There seems to be an inherent conflict between using AI to standardize decisions compared to using it for mass customization. Efforts to develop customized care must be designed around a deep understanding of what happens at the ground level along the patient pathway and must incorporate patient engagement by focusing on such things as shared decision-making, definition of appointments, and self-management, all of which are elements of a “build-to-order” approach.
  3. When it comes to dissemination and implementation, culture eats strategy for lunch.
  4. The majority of the conversations had to do with the technical aspects and use cases for AI. A small amount was about how to get people in your organization to understand and use it.
  5. The goal is to empower clinical teams to collaborate with patient teams and that will take some work. Moving sick care to healthcare also requires changing a sprint mindset to a marathon relay race mindset with all the hazards and risks of dropped handoffs and referral and information management leaks.
  6. AI is a facilitating technology that cuts across many applications, use cases and intended uses in sick care. Some day we might be recruiting medical students, residents and other sick care workers using AI instead of those silly resumes.
  7. The value proposition of AI includes improving workflow and improving productivity
  8. AI requires large, clean data sets regardless of applications
  9. It will take a while to create trust in technology
  10. There needs to be transparency in data models
  11. There is a large repository of data from non-traditional sources that needs to be mined e.g social media sites, community based sites providing tests, like health clubs and health fairs, as well as post acute care facilities
  12. AI is enabling both the clinical and business models of value based care
  13. Cloud based AI is changing diagnostic imaging and pattern recognition which will change manpower dynamics
  14. There are potential opportunities in AI for quality outcome stratification, cost accounting and pricing of episodes of care, determining risk premiums and optimizing margins for a bundled priced procedure given geographic disparities in quality and cost.
  15. We are in the second era of AI that is based on deep learning v rules based algorithms
  16. Value based care requires care coordination, risk stratification, patient centricity and managing risk
  17. Machine learning is being used, like Moneyball, to pick startup winners and losers, with a dose of high touch.
  18. It is encouraging to see more and more doctors attending and speaking at these kinds of meetings and lending a much needed perspective and reality check to technologists and non-sick care entrepreneurs. There were few healthcare executives besides those who were invited to be on panels.
  19. Overcoming the barriers to AI in sick care have mostly to do with changing behavior and not dwelling on the technicalities, but, rather, focusing on the jobs that doctors need to get done.
  20. The costs of AI , particularly for small, independent practitioners, are often not affordable, particularly when bundled with crippling EMR expenses . Moore’s law has not yet impacted medicine
  21. The promise of using AI to get more done with less conflicts with the paradox of productivity
  22. Top of mind problems to be solved were how to increase revenuces, cut costs , fill the workforce pipelines and address burnout and behavioral health employee and patient problems with scarce resouces.
  23. Nurses, pharmacists, public health professionals and veterinarians were under represented
  24. Payers were scarce
  25. Patients were scarce
  26. Students, residents and clinicians were looking for ways to get side gigs, non-clinical careers and exit ramps if need be.
  27. 70% of AI applications are in radiology
  28. AI is migrating from shiny to standard, running in the background to power diverse remote care modalities
  29. Chronic disease management and behavioral health have replace infectious disease as the global care management challenges
  30. AI education and training in sickcare professional schools is still woefully absent but international sickcare professional schools are filling the gaps
  31. Process and workflow improvements are a necessary part of digital and AI transformation

At its core, AI is part of a sick care eco-nervous system “brain” that is designed to change how doctors and patients think, feel and act as part of continuous behavioral improvement. Outcomes are irrelevant without impact.

AI is another facilitating technology that is part and parcel of almost every aspect of sick care. Like other shiny new objects, it remains to be seen how much value it actually delivers on its promise. I look forward to future conferences where we will be discussing how, not if to use AI and comparing best practices and results, not fairy tales and comparing mine with yours.

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The 3 Student Entrepreneur Personas

The 3 Student Entrepreneur Personas

GUEST POST from Arlen Meyers, M.D.

Healthcare professional schools, healthcare innovation and entrepreneurship education, and training programs are growing. However, one question is should they be required or elective?

The medical student persona has changed in the past several years. Seeing around corners is always hard. However, to go to where the puck will be is a useful step when planning strategy and tactics to meet the needs of customers segments. Here are some ways to help build your parabolic mirror view of what’s next.

If you have a product or service and are planning not just for the now, but the next and new, then painting a picture of your customer archetype or persona is a key tool.

Do you know who your dream customer is?

There are three steps for understanding your dream customer:

  1. Consider the big issues they are facing – look wider and investigate global issues, such as hunger, environmental sustainability or education.
  2. Identify the industry trends that are affecting them – technology, big data, cyber security, etc.
  3. Describe your customer avatar/archetype/persona now – make a collage including their goals and values, demographics, their pain points and challenges.

Here are the various sickcare innovation and entrepreneurship student segments.

That said, the argument for mandatory is that all students should be exposed to core concepts, like design thinking, much like rotating through core clinical rotations, if nothing else, to get exposure to potential career choices. It might even make them better doctors and possibly help with burnout.

The argument for elective is that all students won’t have the same interests and it would be a waste of time and resources leading the laggards to water knowing you can’t make them drink.

One way to sort potential students is to understand the entrepreneurship education customer segments and their 3 core personas.

The Convinced and Confident know entrepreneurship should be part of their career pathway. In fact, many of them have had entrepreneurial life experiences prior to medical school.

The Curious but Clueless don’t know what they don’t know but are willing to learn more. Many have never held a job in their life. Some might be willing, but unable to develop an entrepreneurial mindset. Others discover their innerpreneur, and move on.

The Could Care Less are unwilling and unable to give it a try. Their attitude is , “I went to medical school to take care of patients, not take care of business”. What they don’t realize is that if you don’t take care of business, you have no business taking care of patients.

Here is what I learned teaching sickcare innovation and entrepreneurship to 1st year medical students.

Here is what I learned teaching sickcare innovation and entrepreneurship to a cohort of xMBA/HA students.

If you are part of creating or teaching these programs, you will eventually have to sort the wheat from the chaff. If you are a leaderpreneur, your job will depend on doing so.

Image Credit: Pixabay

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17 Reasons Not to Be a Physician Entrepreneur

17 Reasons Not to Be a Physician Entrepreneur

GUEST POST from Arlen Meyers, M.D.

Judging by the headlines on their LinkedIn profile and their presence on social media, more and more MD/DOs are innovators, coaches, entrepreneurs and non-clinical consultants. Many are starting or working with biomedical and clinical startups, including a group of medical school graduates, who don’t do a residency or starting their own company.. But:

  • They are not trained to do so
  • Entrepreneurship in the US has been in a downward spiral in the US for the past 40 years.
  • Most startups will fail
  • Most startups don’t have money to pay people
  • There is an innovation bubble.
  • Job security is low
  • You have to deal with people who have entrepreneurial psychopathologies are simply untrustworthy.
  • Students loan burdens are rising
  • Many are not in it for the long run
  • There are unrealistic expectations on both the consultant/employee and employer side.
  • Most MD/MBA programs should be terminated
  • Innovation theater is pervasive.

What is physician entrepreneurship? Entrepreneurship is the pursuit of opportunity under volatile, uncertain, complex and ambibuous conditions (VUCA).. The goal of physician entrepreneurs, is to create user defined value through the deployment of innovation using a VAST business model to accomplish the quintuple aim. There are many ways to do that other than creating a company.

Here are some reasons why you should think twice about being a physician entrepreneur:

  1. You are not ready to innovate
  2. You do not have the courage to innovate
  3. You do not have the mindset to innovate
  4. You think that your clinical mindset and your medical degree and training is enough to succeed
  5. You are not in a financial position to take the risk
  6. You are doing it to get away from someone of some job instead of towards something that is a better fit
  7. You do not have a career transition strategy
  8. You or your family are not willing to pay the price of successive failure
  9. You are unwilling to come down off the mountain
  10. It’s not personal
  11. You are not ready to quit your day job
  12. If you decide to create a company, or work for one, making money for the company is not that important to you.
  13. You don’t have the knowledge, skills, abilities and competencies to add value to a business
  14. You don’t have entrepreneurial DNA
  15. You don’t have a big enough network or know how to manage it as part of building your personal brand
  16. You don’t know how to sell things
  17. You are a problem solver, not a problem seeker.

Think twice about telling someone to take your white coat and shove it. You will save yourself and lots of other people heartburn and other people’s time, effort and money.

Image Credit: Pixabay

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The Lost Tribe of Medicine

The Lost Tribe of Medicine

GUEST POST from Arlen Meyers, M.D.

I can remember opening my medical school acceptance letter. I was, of course, excited to go down a lifelong career pathway, but also, felt joy at knowing that I was accepted into a tribe of international doctors that would welcome me anywhere in the world, who spoke a common language and had a common culture and ethos. A sense of community and belonging is important to mental health.

Research has shown that when employees feel that they belong to a team or organization, they will not only tend to perform better, but also experience higher levels of engagement and well-being. But our feeling of belonging at work has become challenged over the past year as we’ve shifted away from in-person interactions and found ourselves relying on video calls and screen activities to stay connected.

Here is the painting I passed under on my way to class for the first two years at Jefferson Medical College (The Surgical Clinic of Professor Gross/ Thomas Eakins):

Jefferson Medical College

Here is a painting I passed in the halls at the University of Pennsylvania (The Agnew Clinic/ Thomas Eakins):

University of Pennsylvania

Here is the painting of William Osler I passed in the halls of Philadelphia General Hospital:

Philadelphia General Hospital

Here is portrait of Florence Sabin where I work now.

Florence Sabin

One of the preeminent medical and scientific minds of the early twentieth century, Dr. Florence Rena Sabin (1871–1953) was a public servant devoted to improving public health. As the first woman to receive a full professorship at Johns Hopkins University, Sabin was also a successful woman in the medical field at a time when the profession was still dominated by men. In addition to helping Colorado’s fight against polio and tuberculosis, Sabin championed legislation that created the State Health Department in 1947 and successfully lobbied for a variety of other public health improvements. She is regarded as one of the best scientists Colorado has ever produced, and her legacy is honored with a statue in the nation’s capital.

Patrick Hanlon, is his book “Primal Branding”, defines a brand as something people feel something about. He goes on to state that believing is belonging. When you are able to create brands, like the medical profession, that people believe in , you also create groups of people who feel that they belong.

Primal branding is about delivering the primal code. Unlike the four elements of the code in DNA, though, there are seven: the creation story, the creed, the icons, the rituals, pagans, the sacred words and the leader.

Researchers have lumped tribes into 5 stages:

The reality is something else. Unfortunately, in many ways, the medical tribe has become fractious and unaccepting. The results are burnout, depression, suicide, disenchantment and fragmentation of power.

Examples include:

1. Medical education and training that some have described as abusive
2. Turf wars
3. Jealousy, greed and resentment for those who want to upset the apple cart, potentially threatening the cash cow and status quo
4. Marginalizing disruptive doctors
5. Subconscious or implicit bias against colleagues based on race, gender or other factors.
6. Hostility between MD and non-MD “providers”
7. Pushback against scope of practice creep
8. Specialists v generalists
9. Grunts v physician executives and administrators
10. Conflicts in interprofessional relations and care teams.
11. Racism. Is your doctor a racist?
12. Gender pay gaps

Here are 10 reasons why doctors don’t play nice with others.

Plus, all doctors have multiple affiliations and are more engaged with some than others. For example, they have varying levels of engagement with their employer, their specialty association or their local, regional or national medical association. Most tend to go where they are treated best and drop or ignore the others. Mentors,sponsors,coaches and colleagues help with burnout.

Many of us recall with fondness, particularly those who have served in the military, those times we shared with “foxhole buddies” e.g residency training, project teams, shock and trauma units and circumstances, like following mass killings or natural disasters, when the community comes to together. Even the doctor’s lounge is a thing of the past because the real estate is “too valuable” and doughnuts and coffee costs too much.

In many places, doctors have lost their sense of community and attachment to the tribe. The dark underbelly of medicine has damaged the brand.

When was the last time you visited the Museum of Physician Happiness?

Some solutions are:

1. Physician leadership academies that emphasize monitored experiential learning throughout medical school and residency
2. Reform the toxic culture of medical education and residency
3. Hold department chairs and deans accountable
4. Empower physicians to regain control of their destiny
5. Save private practice
6. Regulate overreach of private equity and corporate consolidation
7. Physician innovation and entrepreneurship fellowships
8. Kill most MD/MBA programs
9. Demand interprofessional cooperation or coopetition
10. Teach doctors how to rebuild the medical brand

We should also show more appreciation for each other.

Doctors have lost their sense of belonging. They don’t need a therapist. They need an anthropologist.

Image Credit: Pixabay

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Future of Global Physician Entrepreneurship

Future of Global Physician Entrepreneurship

GUEST POST from Arlen Meyers, M.D.

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

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

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

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

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

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

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

The drivers of physician international entrepreneurship include:

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

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

The future of international physician entrepreneurship will be punctuated by:

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

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

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

Image credit: Unsplash

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