GUEST POST from Arlen Meyers

A friend and colleague physician entrepreneur was recently lamenting the fact that , in business, being disruptive is a good thing , but, in medicine, it can result in , among other bad things, losing your license to practice. Despite that, the AMA wants you to be disruptive.

In business, disruptive innovation, a term of art coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.

Medicine sees it a different way.Patients identify being confident, empathetic, humane, personal (ie, viewing the patient as a person, not a disease), forthright, respectful, and thorough as ideal physician behaviors. Valuing teamwork, handling stress, punctuality, and self-motivation to pursue professional and personal growth are also ideal physician behaviors. On the other hand, the American Medical Association, in its Code of Medical Ethics, states that “personal conduct, whether verbal or physical, that negatively affects or that potentially may negatively affect patient care constitutes disruptive [physician] behavior.” Such behaviors include inappropriate language, yelling, gossip, facial expressions and other mannerisms as well as physical boundary violations.

Unfortunately, the line between the two is not so clear and some doctors are branded as disruptive, not because they cause patients harm, but because, through their efforts and actions, they are disruptive to the existing sickcare business model. Those that dare to tell truth to authority are branded as provacateurs, naysayers, grenade-throwers and “just not team players”.

Those who threaten the status quo in any industry at any time are outsiders and run the risk of suffering from the full force of those seeking to resist change. Physician entrepreneurs are no different. Being disruptive in pin-stripes is one thing. Being disruptive in a white coat is another. Few vested interests tolerate either in the clinic, the bedside or the OR.

So, what differentiates a disruptive from a disruptive doctor? What’s the difference between a good rebel and a bad rebel? Here are the differences.

The disruption lexicon gets even more complicated. Do you want to know what else is disruptive in sickcare?

1. Alarm fatigue

2. Change fatigue

3. Cell phones in the OR

4. Music in the OR

5. Non-ergonomically designed surgical instruments and ORs

6. Shooters in the ER

7. Electronic medical records and workflow

8. Electronic medical records and the doctor-patient relationship

9. Meetings

10. Two words

Here are some tips on how to deal with rule breakers.

• Let employees define their missions.
• Tailor jobs to employees’ strengths.
• Ask “Why?” and “What if?”
• Stress that the company is not perfect.
• Maximize variety.
• Continually inject novelty into work.
• Hire people with diverse perspectives.
• Design processes to include dissent.

Ask, “What information suggests this might not be the right path to take?”

Part of doctors acting badly might be traced to loss of control or threatened masculinity.

Digital disruptors are making their mark in healthcare. The new triple threat is a doctor/technologist/entrepreneur. Many are outside of the industry, some are physician entrepreneurs and , increasingly, many are patients. As more a more doctors shift their attention from the practice of medicine to the business of medicine, the medical establishment will have a hard time distinguishing one disruptor from the other.

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GUEST POST from Arlen Meyers

It’s been said that data is the new oil that is fueling the 4th industrial revolution. Others disagree. However, while the business models and value chains of oil and data might be different, the metaphor is used to describe the increasing value of data. Transforming into the cyberintellingent, mobile, digital economy has created a lot of pain to many people and made old industrial models, and their employees, obsolete or redundant, much like renewal energy is doing to the coal industry and workers.

Now we are hearing rumbles about changing sick care to healthcare , the fee for service model to value based care and the present payor model to “Medicare for all”…whatever that means. However it plays out, the die has been cast and there is an ongoing restructuring of the sick care industry that will cause a lot of pain and make the coal and petroeconomy meltdown look like a mere blip on the labor economy radar screen. Even clusters and innovation districts have a life cycle.

For everything, there is a time to live and a time to die.

The US sickcare system of systems medapocalypse is looking something like this:

1. The future of sickcare work is changing
2. The doctor persona of the future is changing
3. Care delivery business models are changing
4. Patient expectations and demands are changing
5. Biopharma and medtech business models are changing
6. Hospitals and traditional care delivery models are increasingly obsolete
7. The primary care model is being unbundled
8. One on one care is changing to team on team care
9. Medical education is being reformed
10. Biomedical and clinical ecosystems are changing driven by digital health technologies
11. Innovation financing is changing
12. Sickcare policy is changing
13. Intellectural property laws and FDA regulations are changing.
14. Reimbursement models are changing
15. Patient and doctor behavior change models are evolving

The personal computer changed the world. Sustainable energy technologies are doing the same to the petroeconomy as will self-driving electric cars, robots, AI and the other shiny objects on the shelf.

Prepare yourself and your kids now for the opportunities all this presents

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GUEST POST from Arlen Meyers

Suppose you are running a pitch competition and need to create a scoring rubric? Or , maybe you are the head of a technology transfer office or innovation center and need to screen lots of ideas? Or maybe you teach innovation and entrepreneurship and need to clearly explain to your students how their submissions will be graded?

How do you score innovation ideas?

At many companies, the idea evaluation process revolves around detailed Excel spreadsheets, comprehensive PowerPoint documents, and an orchestrated sequence of pre-meetings leading up to a decision meeting. This kind of disciplined approach works very well when companies have knowledge that lets them be precise in their analysis, and executives have the relevant domain experience to make informed decisions.

Applying this same discipline to nascent opportunities in new spaces can be disastrous. People spend days discussing Excel spreadsheets that are nothing more than mathematical relationships between made-up numbers. Managers working on ideas discover that detailed PowerPoint documents are their biggest enemy, because the details act as bait for nit-picking devil’s advocates. Endless pre-meetings crowd out action-based learning.

Here’s how one investment team screens and scores.

There are many ways to screen, score and scale your innovation management system, but, here are some considerations when you do:

1. Should judges do it or should you task the innovator with self scoring?
2. How many ideas do you anticipate and how will you scale the process?
3. How will you communicate the structure, process and criteria to those who enter the process? How will you engage innovators?
4. How will you create fairness and eliminate bias in the selection process?
5. How much money do you have to spend on screening, scoring and scaling?
6. How will you determine the selection criteria that are consistent with your strategic objectives?
7. What will you do with those who have submitted ideas that have been rejected?
8. How many stages of evaluation will you have? Pass-fail or stage gate?
9. What is the most appropriate process for your industry or point of view? Should a new medical practice idea be judged the same way you would judge a digital health idea at a pitch competition or, a technology if you worked at a technology commercialization firm?
10. Should you automate the process?

Most managers and many leaders fail at picking winners, regardless of how they go about picking the jockey and not the horse. The thumbs up or thumbs down approach, with death to the vanquished, creates innovation cultural chaos. “Ave, Imperator, morituri te salutant”  If might have worked for Caesar, but, when it comes to leading innovators, those who are about to die won’t salute you. They’ll leave and compete with you.

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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

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.

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.

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GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

Despite rumors to the contrary, private medical practice is not dead. Yes, the numbers of employed physicians are growing, but, according to a recent AMA survey, 60% of physicians work in physician-owned practices. In addition, the report revealed that eighteen percent of physicians were in solo practice, down 6 percentage points over 5 years.

Some define a solopreneur as a business owner who works and runs their business alone. Going by this definition of solopreneur, about a third of the American workforce comprising freelancers and consultants fit under category. Here are 20 of the top self-employed business opportunities right now.

However, if you define physician solopreneurs as those who create patient-customer defined value through the deployment of clinical innovation working , primarily, on their own, then the universe of solopreneurs gets much bigger.

Solopreneurs have an inherently entrepreneurial mindset, and they prefer single-handedly managing their business. The entrepreneurial mindset, in some ways, is similar to the clinical mindset but , many ways, is different. That’s important because innovation starts with your mindset.

There are many different kinds of physician solopreneurs. Some, like solo private practitioners, run small to medium sized professional services businesses. Some are technopreneurs, trying to get a product to patients. Others are social entrepreneurs, striving to improve the human condition, or intrapreneurs, acting like entrepreneurs in their organizations. Others are freelancers,consultants, independents, or contractors, offering services in many different realms including financial services, marketing, revenue cycle management, executive recruiting and coaching and many more. Solopreneurship, however, is a contradiction in terms, since entrepreneurship is a team sport and requires many people and moving parts to succeed.

The Bureau of Labor Statistics estimates that by 2020, about 65 million Americans will be freelancers, temps, independent contractors and solopreneurs, making up about 40% of the workforce. The result has been an explosion of co-working spaces to meet the demand for flexible, imaginative offices that catalyze creative thinking, collaboration and innovation. Some are not sold on the idea, and , in fact think it inhibits productivity and is a fad.

There is another way to view solopreneurs-those who are trying to address the loneliness public health crisis. Baby boomers are aging alone more than any generation in U.S. history, and the resulting loneliness is a looming public-health threat. About one in 11 Americans age 50 and older lacks a spouse, partner or living child, and that portion is projected to grow. It adds up to about eight million people in the U.S. without close kin, the main source of companionship in old age.

Solopreneurship comes with some hazards:

1. Thinking that solopreneurship is about just creating a business
2. Social and emotional isolation
3. Lack of robust internal and external networks
4. Faulty social support mechanisms
5. Lack of divergent thinking informed by interdisciplinary and edge technology thinking
6. Failure to see around corners
7. Not creating a product that anyone wants to buy
8. Not having a VAST business model
9. Playing in the wrong part of the novelty-value innovation matrix
10. Not finding the right mentors, coaches and sponsors

The rise of portfolio careers, encore careers, independents and structural changes in the part-time economy is changing the face of work. Doctors are undergoing this kind of facial plastic surgery just like everyone else.

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GUEST POST from Arlen Meyers

Innovation starts with the right mindset. So, if you are a sick care professional, like a doctor, nurse, pharmacist, dentist or allied health professional interested in entrepreneurship or a non-clinical career pivot, then you not only have to change your mind about things, you will have to change your mindset as well.

The 14 scales measured by the second (and final) version of the Entrepreneurial Mindset Profile (EMP).

Personality Scales

Independence: The desire to work with a high degree of independence (e.g., I’m uncomfortable when expected to follow others’ rules.)

Preference for Limited Structure: A preference for tasks and situations with little formal structure (e.g., I find it boring to work on clearly structured tasks.)

Nonconformity: A preference for acting in unique ways; an interest in being perceived as unique (e.g., I like to stand out from the crowd.)

Risk Acceptance: A willingness to pursue an idea or a desired goal even when the probability of succeeding is low (e.g., I’m willing to take a certain amount of risk to achieve real success.)

Action Orientation: A tendency to show initiative, make decisions quickly, and feel impatient for results (e.g., I tend to make decisions quickly.)

Passion: A tendency to experience one’s work as exciting and enjoyable rather than tedious and draining (e.g., I’m passionate about the work that I do.)

Need to Achieve: The desire to achieve at a high level (e.g., I want to be the best at what I do.)

Skill Scales

Future Focus: The ability to think beyond the immediate situation and plan for the future (e.g., I’m focused on the long term.)

Idea Generation: The ability to generate multiple and novel ideas, and to find multiple approaches for achieving goals (e.g., Sometimes the ideas just bubble out of me.)

Execution: The ability to turn ideas into actionable plans; the ability to implement ideas well (e.g., I have a reputation for being able to take an idea and make it work.)

Self-Confidence: A general belief in one’s ability to leverage skills and talents to achieve important goals (e.g., I am a self-confident person.)

Optimism: The ability to maintain a generally positive attitude about various aspects of one’s life and the world (e.g., Even when things aren’t going well, I look on the bright side.)

Persistence: The ability to bounce back quickly from disappointment, and to remain persistent in the face of setbacks (e.g., I do not give up easily.)

Interpersonal Sensitivity: A high level of sensitivity to and concern for the well-being of those with whom one works (e.g., I’m sensitive to others’ feelings.)

Undergraduates are accepted to medical school, in part, on their mindsets, which, given the list above, is counter to the the culture of clinical training. So, doctors who want to practice their entrepreneurial mindset will have a conflict of consciousness.

What is a “mindset”? Experts vary, but, fundamentally, is it how and why we think about things the way we do and how we interpret the world. We use mental models, that, unlike most personality traits, are malleable, not fixed, and that drive our emotions and behavior.

Mental models are created by the internal conversations we have with ourselves and, those conversations, psychologists claim, create feelings that drive behavior. Negative thoughts drive negative behavior and vice versa. In other works, you will become what you think.

Given how entrepreneurs and biomedical professionals evolve in their careers, there are some similarities between the two mindsets.

OVERLAPPING CLINICAL AND ENTREPRENEURIAL MINDSETS

However, there are some fundamental differences too, like different:

1. Cultures
2. Personality traits
3. Set of professional norms and ethics
4. Knowledge, skills, abilities and competencies
5. Problem solvers v problem seekers
6. Customer centered v paternalistic
7. Networks
8. Perceptions of user defined value
9. Incentives and payment systems
10. How they use or waste resources
11. Business models
12. Rules,legal and regulatory environment
13. Ways they look for innovation: one in the New England Journal, the other in the Wall Street Journal

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

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Links to an external site.

Mindset Innovation starts with the right mindset

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Links to an external site.

In my view, about 1% of doctors, engineers and scientists live at the intersection of the two circles.

Consequently, many health professionals struggle to make the transition to a combined clinical entrepreneurial mindset from a pure clinical mindset. Likewise, here are 10 reasons why non-sick care entrepreneurs stumble along the life science innovation roadmap.

Achieving success as a biomedical or sick care entrepreneur requires resetting your mind, not just changing it. Doing so takes time, mental discipline, knowledge, practice, self-improvement, experience, study and coaching… sort of like your residency training. Except, in most instances, it will take more than four years since old habits don’t die quickly.

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GUEST POST from Arlen Meyers

Entrepreneurs are not wild risk takers. On the contrary, they are risk managers, balancing risk with return and de-risking ventures and decisions as best as they can. Risk management generally falls into categories of 1) legal risk, 2) operational/business risk and 3) personal and corporate financial asset risk. But, another infrequently considered risk, particularly for intrapreneurs i.e. employees trying to act like entrepreneurs in their organizations, be they academic or non-academic, is career risk. Shifting from a full time employee to a part time one to run a strartup, for example, is even riskier to your career.

Here is the sickcare intrapreneur innovation roadmap.

Here is why it’s so hard to be a physician intrapreneur

Here is a physician entrepreneur survival guide

Consider a full time faculty member or corporate employee with benefits who is thinking about their career risk if they try to innovate or practice intrapreneurship or run a startup.

Career risk factors include:

1. Failure risk to their organization that will impact their performance review
2. Promotion (and tenure) risk and the opportunity costs
3. Job security risk
4. Reputation damage risk
5. Career derailment risk
6. Salary risk
7. Re-entry or future employment risk
8. Personal liability risk
9. Peer pressure risk
10. Social or emotional isolation risk
11. Emotional risk of personal failure
12. Financial opportunity cost risk

One way to innovate and mitigate your career risk is to be a good rebel, not a bad one.

Here are three things rebels do better:

1.  First, they recognize that other people look at us with more respect, not less, when we break social norms.
2. The second thing rebels assume is that rules can be changed—and they change them.
3. Third, rebels embrace the unfamiliar rather than being threatened by it.

Like all risks, career risk cannot be totally eliminated, only managed or mitigated. Before you decide to pursue your next entre/intrapreneurial venture, include a career risk assessment and mitigation strategy before making the leap.

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GUEST POST from Arlen Meyers

Creating a new venture, championing a new process or offering a new course or program is exciting. However, statistically, it is more likely you will fail than succeed and there is a fine line between determination and pig-headed optimism. You might not have the skills to do what you love. At some point, you will have to consider quitting and moving on.

Quitting is not a value in the entrepreneurial lexicon. We are all encouraged to follow our dreams, no matter the cost. It is a myth. “Winners quit all the time. They just quit the right stuff at the right time.” Some, given stress and burnout levels, would rather see you keep trying, even if it kills you. Don’t let it.

You should keep a failure resume. What’s the point of such self-flagellation?

Because you learn much more from failure than success, and honestly analyzing one’s failures can lead to the type of introspection that helps us grow — as well as show that the path to success isn’t a straight line.

Your failure resume would include:

1. Schools that didn’t accept you
2. Papers that were rejected
3. Places where you faced disciplinary action or were fired
4. Companies or projects you started that were a bust
5. Grants you applied for but never received
6. Lack of promotions or failure to get tenure
7. Failure to get a salary increase you requested
8. Lousy job assessments or online reviews
9. Personal failings
10. Poor teaching, student or audience assessments of your performance
11. You have limited emotional intelligence or lack entrepreneurial competencies
12. You have a significant personality disorder or pyschopathology

Perseverance has received lots of support in recent years from a variety of schools of research. One is from psychologists studying grit. In fact, there’s a large body of work showing that perseverance may have a harmful downside. 

Here are some signs that it might be time to hang up your cleats and move on:

1. It is not fun any more

2. It is making you sick

3. The people you work for or with are unethical

4. You realize that the window of opportunity has permanently closed

5. Your innerpreneurial instincts are telling you that you are doing what you are doing for the wrong reasons.

6. You are willing to take personal responsibility for your failure and apply the lessons to your next initiative

7. You have shown that your business model is fundamentally flawed and that you don’t have the time, resources or interest in fixing it

8. You have changed your priorities

9. Your life is out of balance and practicing entrepreneurship is further tipping the scales

10. You believe the fates are working against you. Truth be TOLD, sometimes they are.

There is a difference between quitting a project and quitting on yourself. Sh$t happens and learning from mistakes and how you adapted to the inevitable slings and arrows of misfortune shapes us all, if we let it. It will discourage and destroy us if we don’t.

Being innovative isn’t just about what you start — it’s about what you stop. “You don’t have the capacity – the time, resources or energy – to do the new things because you are busy maintaining the old ones,” explains innovation expert Jeff DeGraff. Don’t get caught in this trap: Figure out what practices or ideas are no longer serving you and make room for new ones.

“Stopping things is hard. It’s full of feelings of loss, disappointment and failure. It takes more than creativity. It takes courage to stop what you’ve been doing to make room for the things your organization wants to start doing now.”

The history of business and innovation proves that some of the biggest winners have been the biggest quitters at some point in their career. The important point, is that, after quitting, they continued to move forward, not sideways or backwards, with their next idea.

Along the way, tidying up is a good idea. Let go of the banana and don’t slip on the skin.

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GUEST POST from Arlen Meyers

Many have praised the value of a liberal arts education in business, to the point where some even think the MFA is the new MBA. One of the founders of my alma mater Dickinson College, Dr. Benjamin Rush, thought it would be a good idea to create a school that trained the leaders of the newly formed nation, after the signing of the Treaty of Paris ending the American Revolution in 1783. The backbone of this revolutionary educational model is a solid foundation in the liberal arts. This “liberal education” teaches students to embrace new ways of thinking, solve problems creatively and address important social issues purposefully.(http://www.dickinsonson.edu). I think the main benefit of my liberal arts education has been learning to connect the dots, see patterns and leave space for the unexplainable.

Most of you who are reading this are technical, linear, analytical, left -brain, ESTJ’s who have been taught that the shortest distance between a problem and a solution is a straight line. You know the drill:

• Problem Definition – including problem analysis, redifinition, and all aspects associated with defining the problem clearly.
• Idea Generation – The divergent process of coming up with ideas.
• Idea Selection – The convergent process of reducing all the many ideas into realistic solutions
• Idea Implementation – Turning the refined ideas in reality.
• Processes

There are lots of ways to ideate and skin the cat. For 192 ways to solve a problem, check http://www.mycoted.com/Category:Creativity_Techniques

Unfortunately, research indicates and experience teaches us that innovation doesn’t work that way most of the time. The technology push-market pull model proposes that success happens when, during a deliberative, data-driven process riddled with MBA’s and spreadsheets, a problem is matched with a solution. Magic happens when technopreneurs meet market perceivers. The “structured serendipidy” model, on the other hand, is closer to reality. Ask the guy who discovered penicillin.

In his book, Where Good Ideas Come From: The Natural History of Innovation Steven Johnson discusses how serendipity works in innovation, along with six other patterns throughout history: the adjacent possible, liquid networks, the slow hunch, error, exaptation and platforms.

Bryan W. Mattimore, in his new book Idea Stormers: How to Lead and Inspire Creative Breakthroughs, outlines seven ideation techniques that consistently deliver excellent results and can be used to address nearly any kind of creative challenge:

1. Questioning assumptions

2. Opportunity redefinition

3. Wishing

4. Triggered brainwalking

5. Semantic intuition

6. Picture prompts

7. Worst idea

The common thread is that the roots of innovation are anything but linear or predicable, but , instead result from a combination of everything from evolving networks, the rise of the modern city, to happy accidents.

Unfortunately, sitting around waiting for the “Ah-hah” is not the best use of your time. Follow the recommended steps for developing your innovation, but reserve some space in your cerebral cortex for ambiguity, the unexpected and luck. Recognize that your agonizingly prepared Plan A is unlikely to be what ultimately succeeds, so reserve space for Plan B, C or whatever works.

Being bored some of the time is not a bad idea either. Here’s the case for doing nothing for the next 15 minutes.

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