GUEST POST from Arlen Meyers

You’ve heard about the 4 P’s of Marketing: Product, Price, Promotion and Place (distribution channels)

Whether you are an intrapreneur, a technopreneur, a service provider, own and run a private practice, an edupreneur or a social entrepreneur, the success of your product, service or non-profit will depend on your answering the 5Ps:

1. What is the problem you are trying to solve? Start by being a problem seeker, not a problem solver. Non-profits seek to help specific underserved people as beneficiaries. For profits seek to solve a particular customer problem. Doctors treat patients with problems.
2. Who is the person who has the problem? Defining an industry segment, not a person, as the customer is a rookie business model canvas mistake.Organizations, buildings or companies don’t have problems. People inside of those entitities do. Find out who that person is and get inside their heads and walk in their shoes.
3. How painful is the problem? In part, we have an opioid epidemic because health professionals have not done a good job of quantifying a given level of pain and prescribed the most appropriate analgesic. Entrepreneurs shouldn’t make the same mistake. Is your customer bent over in pain begging for morphine or do they simply have a minor ache and just want an aspirin to make it go away? Unlike the desirability of unwanted addictive medicines, however, creating an addictive technology, e.g.a cell phone, a game or a social media site, can result in a trillion dollar company.
4. How much are people with the problem willing to pay to solve it? Whether and how much someone will pay for your solution depends on several factors, including how much the customer values your solution compared to competitive offerings or the status quo, whether it is a nice to have or a must have solution (like regulatory or compliance requirement satisfaction) or whether it is something proximately linked to the next step, like requiring some education or training to get a certain job or having to have a tool to do a certain job. How much customers are willing to pay will determine, in large part, whether you can make and sell the product at a profit.

Sickcare is a different case because the patient, who is the end user, and the doctor, who acts like a purchasing agent, is often not the person who pays for it. However, look for models where someone else would be willing to pay to have a customer use your product. The most common example is a bilateral market model (dating service) that is sponsored by a company so they can get access to your data or sell something to the users e.g. a medical device company sponsoring an online surgical video journal.

5. Do you have a pipeline/platform to get, keep and grow people willing to pay you? In other words, how will you market and sell your product?

Answering these questions is the purpose of your customer discovery journey and eventually informs your value proposition and business model canvas. Start with answering these basic questions and don’t do anything else until you find the answers.

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GUEST POST from Arlen Meyers

Innovation starts with the right mindset. Doctors who are considering a side gig or an alternative non-clinical career, have a hard time getting their heads around the entrepreneurial mindset. There is a difference between the clinical mindset and the entrepreneurial mindset.

In my view, only about 1% of doctors have an entrepreneurial mindset because premeds don’t get selected for that trait. They get selected because they know how to memorize a bunch of stuff, take standardized tests, perform at scripted interviews that neither the interviewer nor the interviewee know how to do and they generally know how to conform. They are exceptional at checking off boxes and increasingly refine that skill as they go into clinical practice. Those that get off the reservations do so despite the medical education system, not because of it. They learn early how to diagnose and treat craniorectal inversion syndrome. They have cured their credentialitis.

So, if you are struggling with these head games, try to avoid these mindset mistakes and stop thinking that:

1. Because you have lots of initials after your name that you add value
2. You have to get a non-clinical job to learn the mindset. In fact, the idea is for you to create your own job and hire other folks, not vice versa.
3. You will get paid what you are earning now
4. You are the person who decides whether your ideas, inventions or discoveries have any value. All value is user defined. Here are some business model canvas rookie mistakes.
5. The knowledge, skills, abilities and competencies that got you to where you are now will get you to where you want to go
6. Networking and schmoozing is not important
7. It will take a few months
8. You have to quit your day job
9. You have to create a company
10. You can do it by yourself
11. You can tell truth to authority without consequences
12. You can disrupt without consequences
13. You can blow the whistle without consequences
14. You will get academic promotion and tenure credit for your entrepreneurial activties
15. You won’t get fired

Personalities are fixed. Mindsets, however, can be changed and you and only you can do it. If you are unwilling and/or unable to do that, then maybe you should just continue to see another 20 patients a day until you retire and just stop complaining.

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GUEST POST from Arlen Meyers

Entrepreneurship means many things to many people. Perhaps the biggest misconception is that entrepreneurship refers, exclusively, to starting businesses. In fact, if we use the definition that entrepreneurship is the pursuit of opportunity with scarce or uncontrolled resources with the goal of creating user defined value through the deployment of innovation, then it means much more. In fact, there are many ways to innovate and create user defined value, whether it be in sick care or education, other than taking care of patients, starting a business or teaching students.

The conventional wisdom is evident in articles like this one that talks about how institutions of higher learning can help targeted segments start businesses. Instead, they should be talking about how to create entrepreneurial universities and medical schools.

The missing link in all of this is that we don’t recruit, develop and promote edupreneurs- faculty-technologists/social activists acting like entrepreneurs in their schools who are trying to create student and other stakeholder defined value through the deployment of innovative, value creating educational technologies, structure, process and outcomes.

Here is what the academic intrapreneur dossier looks like and what would appear in an updated teaching portfolio when it’s time to be considered for promotion and tenure.

Edupreneurship rests on several foundational principles:

1. Having an entrepreneurial mindset
2. Intra- and entrepreneurial knowledge, skills, abilities and competencies
3. Design thinking focused on creating stakeholder and beneficiary defined outcomes
4. A systems engineering approach to solving wicked problems, like how to fix outcomes disparities and their social determinants
5. A different business model
6. More respect for and attention to edupreneurial champions
7. Better teacher education and training
8. An incentive and reward system for not just tweaking a failed system , but rather, making it obsolete given the basic structural changes in the US economy
9. Eliminating unnecessary and burdensome bureaucracy, credentialing that does not add value and administrivia
10. Paying more attention to and measuring student defined outcomes
11. Better public-private integration
12. K-20 integration and alignment

Other types of edupreneurs, in addition to faculty, are educational technology entrepreneurs, foundations and funders of educational technologies, work force agencies and those in the government sector experimenting with college to career and retraining models and those offering support for at risk and vulnerable student populations.

Edupreneurs are a neglected pool of talent who are being stifled, ignored and buried by an industry highly resistant to change. Since talent goes where it is treated best, the result will be a death spiral and students will be the victims.

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GUEST POST from Arlen Meyers

The US Armed Forces has a problem with soldier suicide and depression.

In early 2013, the official website of the United States Department of Defense announced the startling statistic that the number of military suicides in 2012 had far exceeded the total of those killed in battle—an average of nearly one a day. A month later came an even more sobering statistic from the U.S. Department of Veterans Affairs: veteran suicide was running at 22 a day—about 8000 a year.

The situation became so dire that the U.S. Secretary of Defense called suicide in the military an “epidemic.”

Medicine has it’s problems too. It’s estimated that at least 400 U.S. doctors kill themselves every year. Many are struggling with depression, anxiety, or addiction.

Now, add to the list entrepreneurs. Depressed serial entrepreneurs are coming out of the closet and advocating for awareness and change.

Contrary to popular belief, poor self esteem is a component of some entrepreneurs that drives compensatory behaviors that are misinterpreted as egotistical, self-centered or narcissistic. The results are isolation, depression and loneliness or a feeling that they areimposters.

The commonality of these groups seems to be a “warrior mentality” that encourages soldiers, doctors and entrepreneurs to suck up and repress feelings of anxiety, inadequacy or depression, to “fake it till you make it” or to hide things for fear of retribution or adverse consequences. The military,medical and entrepreneurial cultures see those with self doubt as weak or cowardly.

In addition, at least for successful serial entrepreneurs who thrive on success, like to drive fast, take chances , make money and learn something along the way, their innate make up might make them susceptible to breakdowns. Few want to talk about the loneliness of success, but it is pervasive and the head count seems to be rising.

However, there are at least four personality types of entrepreneurs, and we all have a fall back pattern.

On the other hand, hypomanic, ADHD entrepreneurs are also coming out and turning their behavior into the ADHD Advantage. You can also be more creative is you stop paying attention so much. Research is finding that greater distractibility and a reduced ability to focus—what scientists call decreased cognitive control—is often associated with greater creativity in problem solving. But, being married to an ADHD entrepreneur can kill a marriage, so here are some coping tips for you both.

Here is how one CEO with dyslexia and ADHD runs his company. Here’s another.

If you think you have ADHD, here are some tips on how to deal with it.

If you have Asperger’s Syndrome, Peter Thiel wants to hire you. In her book, The Autistic Brain, Temple Grandin explains the positive side of autism and those with austistic spectrum disorders (ASD) or high function autistics (HFAs): 1) attention or an obsession to detail, 2) being able to see the forest from the trees and patterns others don’t see and 3) creativity that disregards and frequently challenges the convention wisdom or status quo.

In her new book, Andy Warhol was a Hoarder: Inside the Minds of History’s Great Personalities, medical and science journalist Claudia Kalb looks at twelve famous figures and weighs the evidence suggesting that each suffered from a different kind of mental health condition. The table of contents could be mistaken for the diagnostic and statistical manual of mental disorders.

One common way of assessing the presence of psychopathic traits in people is to use an assessment known as the Hare Psychopathy Checklist. Here’s a look at some of the traits it lists to see whether they can cause destruction or promotion in a work environment.

Or, maybe you are suffering from Childhood Emotional Neglect (CEN).

Do You…

1. Sometimes feel like you don’t belong when with your family or friends ?
2. Pride yourself on not relying upon others ?
3. Have difficulty asking for help ?
4. Have friends or family who complain that you are aloof or distant ?
5. Feel you have not met your potential in life ?
6. Often just want to be left alone ?
7. Secretly feel that you may be a fraud ?
8. Tend to feel uncomfortable in social situations ?
9. Often feel disappointed with, or angry at, yourself ?
10. Judge yourself more harshly than you judge others ?
11. Compare yourself to others and often find yourself sadly lacking?
12. Find it easier to love animals than people ?
13. Often feel irritable or unhappy for no apparent reason?
14. Have trouble knowing what you’re feeling ?
15. Have trouble identifying your strengths and weaknesses?
16. Sometimes feel like you’re on the outside looking in ?
17. Believe you’re one of those people who could easily live as a hermit ?
18. Have trouble calming yourself ?
19. Feel there’s something holding you back from being present in the moment?
20. At times feel empty inside ?
21. Secretly feel there’s something wrong with you ?
22. Struggle with self-discipline ?

And then there is loneliness and workaholism. A workaholic is a work-obsessed individual who gradually becomes emotionally crippled and addicted to power and control in a compulsive drive to gain approval and public recognition of success. These driven men and women live a Gerbil-wheel, adrenalin-pumping existence rushing from plan A to B, narrowly-fixated on some ambitious goal or accomplishment. Eventually, nothing or no one else really matters.

In addition, there are other other unsung heros. One of the most critical (and most unsung) roles in an entrepreneurial company is not the founder or owner—it’s the role of that person’s significant other or spouse. This has always been true, but the challenges (and importance) of these individuals is even greater and more crucial in the challenging business climate we currently face.

“If an entrepreneurial company fails, it can often take the family’s finances down with it, which can lead to marital troubles or even trigger divorce.”

Everyone pays the price for their choices, whether they accept it or not. But, our infatuation with successful entrepreneurs comes at a price we would rather not see, let alone accept and the results are soldiers fighting the business wars and medical students coming home in body bags.

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GUEST POST from Arlen Meyers

Several years ago, I decided to give sailing a try. I started by going on a few local trips with some folks who owned a small boat and then, gradually, decided to improve my skills and confidence. Eventually, I completed “ground school” and then took several trips that required more and more skills, like navigation, man overboard drills, dealing with weather and un-grounding your boat.

We need to do the same thing with startups. Many have questioned the success rates of accelerators, innovation centers and innovation buildings as a way to make scaleable companies. Instead we need scalerators and scaling schools to get founders and their teams from point A to point B.

Here’s what should be included in the school catalogue:

1. Scaling schools, like any school, should have clearly defined learning objectives based on market derived competencies, and a process that delivers the curriculum cheaply and fast.
2. They should emphasize experiential learning
3. They should provide students with not just the education, but the money, mentors. leadership teams and connections to open innovation networks
4. The process should be lean
5. The idea is to not just improve existing products and processes, but to create things that create substantial multiples of user defined value. Typically, that means at least 10x more value than what you are offering customers now. Here’s what you will learn about innovation and value and how ideas are inventions, improvement or innovations.
6.  They should be laboratories to create minimally viable pilots
7. They should have clearly defined innovation outcomes and impact metrics
8. They should have a dedicated leadership team that is held accountable for results
9. The school should be closed if they are not producing high performance students
10. The sponsoring organization should have clearly defined and aligned innovation objectives and strategic priorities.

Scaling schools should be designed to get you from the classroom to navigating choppy channels in the shortest time. Sooner than later, you will be in treacherous waters with considerable headwinds so you had better be prepared to know what to do when you lose your mast.

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GUEST POST from Arlen Meyers

The evolution of the cyberintelligence driven economy-the fourth industrial revolution-is forcing everyone, including entrepreneurs, to answer some tough questions:

1. How to not just create but share the value they create
2. How to provide people with the knowledge, skills, attitudes and competencies they need to succeed and grow into the middle class
3. When and how to use technology to scale humans, not replace them
4. How to mitigate the adverse impacts of science/technology on society
5. How to live a virtuous life of meaning and happiness

In his book, The Human Advantage:The Future of American Work in the Age of Smart Machines, Jay Richards, a PhD in philosophy and religion, provides us with some suggestions.

His answer to the tough questions is human virtue, explaining that a virtue is a good, freely chosen action that is repeated so much and so well that it becomes instinct. Of course, for those of us who actually went to our philosophy classes, leading the virtuous life is nothing new and dates back thousands of years. The contemporary sound bite goes something like doing well by doing good, or, in US medicine for example, practicing compassionate capitalism.

The process starts with discarding the fatalist myth and embracing free will, driving a growth mindset. The good news is that unlike most personality traits, mindsets can be changed.

But, in addition to mindset, the good professor argues that leading the virtuous entrepreneurial life during these times will require:

Courage-the willingness to risk failure

Antifragility-the ability to learn from failure and suffering. These days we call it resilience.

Altruism-acting for the benefit of others, like social enterprise or social entrepreneurship

Collaboration-working with and learning from others

Creative freedom-mastering yourself and the skills needed to create value for others. BEET programs are filling the gaps. Daniel Pink calls it mastery, independence and purpose. The Japanese call it ikigai:

Taking the spiritual approach to entrepreneurship is not just good for your soul. It’s also good for society and your spread sheet. You and your kids should try it on for size.

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GUEST POST from Arlen Meyers

Back in the day, during the Vietnam era, the suggested credo was “Declare victory and go home”.  Some sick care entrepreneurs have taken a similar approach by hyping digital health and process solutions that will create “Uberized, disruptive, cutting edge” change. Most are too early and wrong in declaring victory.

For sick care innovation to be truly transformative, innovators need to demonstrate 4 main things :

Their solution need to be validated and verified Many innovators confuse the two.  Here’s one explanation of the difference

The terms Verification and Validation are commonly used in software engineering to mean two different types of analysis. The usual definitions are:

• Validation: Are we building the right system?
• Verification: Are we building the system right?

In other words, validation is concerned with checking that the system will meet the customer’s actual needs, while verification is concerned with whether the system is well-engineered, error-free, and so on. Verification will help to determine whether the software is of high quality, but it will not ensure that the system is useful.

The distinction between the two terms is largely to do with the role of specifications. Validation is the process of checking whether the specification captures the customer’s needs, while verification is the process of checking that the software meets the specification.

In sickcare, since we are creating products and services that impact patients directly, you need to validate and verify your solution not just at the technical and commerical level, but at the clinical level as well. Sick care entrepreneurs , particularly non-sick care entrepreneurs , don’t do the latter due to cost, regulatory risk, delays in time to market or simple ignorance about how to design, execute, analyze and report human subject trials.

Something that creates a significant multiple of user defined value in relation to a competitive offering, the status quo or non-users. Here are 10 things physician entreprneurs need to know about value. Defining and comparing end user value is tricky and filled with wrong turns that make innovators believe they have reached their destination, when, in fact, they are lost. Innovation has both a qualitative and quantitative part. End users won’t switch to your product unless they perceive at least a 5x greater multiple of value. You should shoot for much higher multiples.

It needs to go viral. In other words, it needs to get traction, overcome the barriers to widespread adoption and penetration, be applicable to populations for the intended use and , ultimately, become the standard of care.

You need a VAST business model

1. Validity Regardless or which elements of your model you choose, they have to be valid. In other words, the dogs have to eat the food. When the dog won’t eat the food, you’ll have to change your approach and try again.

2. Automaticity At the very start of planning your venture, you should think about how you are going to work on your business, not in it. Reducing hands on time to manage operations will give you more time to lead the company and create strategies for growth and give you more personal time to enjoy the fruits of your success. Outsourcing, automating or using technologies to ramp up operations, sourcing and distribution is a key part of scaling, and something that investors want to see…which brings us to the next piece.

3. Scalability Your business model is primarily a way to create a business machine that can produce an infinite number of products. Think of it as a device that takes in customers and creates profits out the other end and can do so at quicker and quicker speeds.

4. Time and Traction Finally, your model need to create as much profit as quickly as possible with a growing customer base that is loyal to your brand.

You can tell meaningful, impactful sick care innovation when it is valid, verified, value creating , viral and that is driven by a VAST business model. Unfortunately, the bar is set too low for most ideas and innovators stop one mile short of the destination. Often, getting doctors and patients to change their behavior means having to give them a nudge without being a noodge.

Doctors can see through the fog of war and can tell when innovation champions are just declaring victory and going home.

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GUEST POST from Arlen Meyers

Physician entrepreneurship describes physicians, or other health professionals, pursuing opportunity under conditions of uncertainty with the goal of creating user defined value through the deployment of biomedical and clinical innovation. One way to do that is to create a product, a service or a company, but there are many other ways as well.

Fortunately, students, trainees and clinicians at all stages of their career development are gradually embracing the trend and medical associations and medical schools are slowly responding by trying to provide them with the knowledge, skills, abilities and competencies to succeed.

However, based on feedback I received during a recent presentation to doctors interested in entrepreneurship, barriers persist:

1. Lack of education about how to get an idea to patients, particularly in the core areas of regulatory affairs, intellectual property, the legal environment, reimbursement, business development and building high performance teams.
2. Lack of seed stage money
3. Poor internal and external networks to find the right people for their startup or development teams
4. Poor mentoring platforms
5. Lack of social support networks
6. Poor relationships with policy and advocacy partners
7. Lack of a structured digital health clinical research infrastructure
8. Inability to find clinical care delivery partners who are willing and able to test digital health products and services
9. Significant barriers to integrating digital health products into the legacy EMR
10. Poor innovation culture, structure, process, leadership and incentives
11. Lack of promotion and tenure credit for academic entrepreneurs
12. Lack of recognition for medical edupreneurs
13. Poor entrepreneurial mindset
14. A toxic, anti-entrepreneurial culture of education and training
15. High switching and opportunity costs of pursuing a non-clinical career track
16. Ignorance about non-clinical career development opportunities
17. Difficulty matching qualified physician entrepreneurs with viable startups and scaleups
18. How to manage a gig economy portfolio
19. Understanding the tax and liability consequences of various compensation schemes
20. Risk management

International physician entrepreneurs face additional hurdles. Here are the digital health bumps in the road.

While there are commonalities between the clinical and entrepreneurial mindset, there are significant differences. Business people, for example, make lousy doctors.

Since medical schools have little or no interest in teaching innovation and entrepreneurship to students, trainees are finding what they want somewhere else. In some instances, for example those that don’t do a residency, the result, some think, can be counter-productive. For others, e.g. intrapreneurs- those employed physicians trying to act like entrepreneurs- the result is a frustrating wheel spinning as a member of the cast of their local innovation theater. For independent small to medium size professional service entrepreneurs, failing to innovate and/or adapt can spell the demise of their practice.

So given these roadblocks, how should you get started? Here are some tips:

1. Connect to the right people and organizations in the nearest innovation ecosystem and begin to research potential areas of interest and opportunities
2. Start a personal branding campaign using social media and communication tools to make people aware of your interests and skills so they can find you
3. Arm yourself with the education, resources, networks, mentors and experiential learning you will need to advance your entrepreneurial career. Start by developing the right mindset and practice habits that will translate it into action.
4. Set yourself up as a business entity and separate your personal finances from your business finances and activities
5. Start small, consulting or advising to a company or entrepreneur that fits
6. There are many ways to practice physician entrepreneurship or intrapreneurship, so take a high level view. The point is to create user defined value, not companies.
7. Engage others who are like minded in your region to develop a community of interest. Talk to business schools, medical associations, economic development professionals,venture or angel networks, industry associations or patient groups interested in advancing biomedical and clinical innovation and entrepreneurship
8. Find a mentor or sponsor
9. Get as much business “clinical” experience as possible, realizing that the initials after your name really do not mean much. Start to come down off the mountain.
10. Pass it forward

Attempts to fill these gaps will need to be integrated and systemic as the culture of medical innovation and entrepreneurship slowly gets engrafted onto an already change and risk averse medical system that preaches creating value but, in reality, values the now over the next or the new. The mixed message is payers will pay you for value but they won’t teach you how to create it.

Image credit: forum.facmedicine.com

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GUEST POST from Arlen Meyers

A recent article by Juruzelski, Loehr and Holman from Booz Consulting (www.strategy-business.com) noted that there is no statistically significant relationship between financial performance and innovation spending. What’s more, they identified that the two primary elements of innovative companies are 1) a focused innovation strategy, and 2) an corporate culture that is wired for innovation.

There has been a lot of talk about innovation as a way to get us out of our sick care spending mess. Almost every CEO in any industry, including healthcare, cite superior products and services and quality as their #1 strategic goal. Whether you are in private practice, a coporate entrepreneur, a social entrepreneur or one of the rising number of employed physicians, you should ask your whether you or your company has an innovation strategy and culture to execute on that strategy. The Booz consultants mention three core innovation strategies. The strategies are based on the approach to incremental v breakthrough innovation and the role that end customers play in defining future product or service needs.

Need seekers actively and directly engage both current and potential customers and patients to help shape new products and services based on superior end-use understanding. For example, doctors interact with patients directly and via social media to g

Thus, depending on whether your are marketing new or old products to new or old markets, there are four boxes in the 2×2 matrix.

Here is another model.et feedback about their care and how it might be improved.

Market readers , sometimes called market perceivers, closely monitor their customers and competitors, but are more cautious and incremental in their approach. They are “fast followers”. Are you following other industries, like telecommunications, IT and other service industries for the next “new,new thing”?

Technology drivers , also referred to at technopreneurs, They seek to solve the unarticulated needs of their customers (think Steve Jobs) through leading edge technology. They don’t do focus groups, because they anticipate, not respond to customer needs and wants. They create new drugs and devices that leapfrog the competition.

In other words, are you working inside out, inside in or something in between?

There is a fourth, more common strategy, which is to sell more existing products and services to more existing customers and just call it innovation.

Here is another model

Any of these strategies work. However, of the top 10 innovative companies surveyed, 60% were need seekers. In other words, they focus on being a problem seeker before being a problem solver.

Here are Google’s nine rules of innovation.

Health care and biomedical innovation will drag until we move from a reimbursement driven model to an innovation driven model. It will happen, but there is no way to know how quickly, or what the unintended consequences will be. Regardless of when it happens , you should be creating an innovation strategy in your company, probe leadership in your organization to create and adopt one, and build a culture that can execute. Your future , and the future of US healthcare depends on it.

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GUEST POST from Arlen Meyers

The Theranos story continues to unfold in the headlines and will likely be the stuff of Harvard Business School cases for years to come. Here is a brief history of Theranos. and where they find themselves now. According to the WSJ, Theranos Inc. said it will shut down its blood-testing facilities and shrink its workforce by more than 40%.

Now, she has been indicted for fraud.

The moves marks a dramatic retreat by the Palo Alto, Calif., company and founder Elizabeth Holmes from their core strategy of offering a long menu of low-price blood tests directly to consumers. Those ambitions already were endangered by crippling regulatory sanctions that followed revelations by The Wall Street Journal of shortcomings in Theranos’s technology and operations.

The shutdowns and layoffs could help the closely held company accelerate its shift to developing products that could be sold to outside laboratories. Ms. Holmes announced in August a new blood-testing device called miniLab, which is about the size of a printer but hasn’t been approved by regulators.

Unless you reside on a remote planet, by now you know that the Centers for Medicare and Medicaid Services has fined the Palo Alto startup, banned Holmes from owning and operating a lab testing company for two years and yanked the CLIA certification of its lab testing facility in Newark, California.

If you would rather have the cartoon version, try this.

You decide

Now, she won’t be going to jail, but will be fined and barred instead.

Many journalists have offered lessons to be learned from the Theranos ordeal. Yet, we continue to see examples of people who develop businesses and technologies that, it seems, have ignored them.

The latest postmortem is Bad Blood: Secrets and Lies in a Silicon Valley Startup John CarreyrouKnopf (2018)

For those just getting started, beware :

1. Digital health companies that create products that are not clinically effective
2. Companies that continue to tug on the FDA’s cape in an attempt to bypass regulatory rules that they don’t think should apply to them
3. Unbridled hubris of some sick care entrepreneurs
4. Just not doing the right thing, particularly when the company interest is placed above the patient interest
5. Not knowing when and how to tell the truth to authority
6. Massive PR and crisis mismanagement
7. Getting caught up in the techno-hype and smelling too much of your own perfume
8. Not acknowledging truth, regardless of its source
9. Building a company around a personality instead of a product that makes a difference
10. Not recognizing the difference in sick care compared to other highly regulated non-sick care industries

We have not seen the last of companies like Theranos who are fueled by dumb money and a rapacious technomedia industrial complex.

Doctors suffer from the same faults when they try to manage a patient with complications that are spiraling out of control. Many times, one bad decision leads to another. It is never comfortable presenting at Innovation Morbidity and Mortality Conference.

Physician entrepreneurs should take a breath and apply the lessons they learn at the bedside to crises in the boardroom. The clinical mindset is not that different from the entrepreneurial mindset.

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