Category Archives: Entrepreneurship

Scale Your Business in Four Simple Steps

Scale Your Business in Four Simple Steps

GUEST POST from Helen Yu

As a new founder at the beginning of your entrepreneurial journey, you have many tasks at hand and little bandwidth to do them all. There are countless responsibilities, from everyday tasks like investor pitch decks and elevator pitches to longer-term tasks like business plan revisions, product launch strategy and much more. How do you know if you are putting your time and energy into things that matter? It all comes back to why you started your business in the first place — understanding your “why” will keep you going when the road gets tough. But “why” alone is not enough for the long haul. You must couple your “why” with four specific steps needed to scale a business:

  1. Intentional go-to-market preparations
  2. An ability to adapt to customer needs
  3. A willingness to acclimate or even restart in the face of changing or more demanding market environments
  4. The heart to celebrate with your team when you collectively hit milestones along the way

I learned this approach while ascending one of the world’s most famous mountains.

Here is how I learned how to scale a business to success:

In 2007, I climbed to Mount Everest base camp. It took hundreds of hours of training and dedication to achieve my goal — including staying committed to the climb while my hands were freezing from the cold and my head felt heavy from the rising altitude.

Why did I keep climbing?

Because I had made a promise to my grandmother to spread her ashes on a tall mountain. That “why” gave me the will to keep moving forward. It gave me the courage to see my limitations and overcome them: to learn mountain climbing and train my body to withstand it, to find a Sherpa guide who could lead me into new territory. My goal of climbing Mount Everest started not on any map but in my mind. It was a dream that became my North Star, helping me choose the actions and paths needed to fulfill my grandmother’s wish.

Your startup has a similar North Star: the reason that led you to start the business in the first place. You also have an inner voice that serves as Sherpa guide. Why did you start this business? Who are you serving with it?

By asking yourself these questions, you will find the determination and grit to keep moving forward and find the keys to scale a business. A North Star may look distant and unattainable, but it is achievable when you take consistent actions to reach it.

1. Prepare

You may already have an answer to your “why” in a formal mission statement or vision statement, but are your company’s actions in alignment?

When strategy and execution aren’t aligned to the mission and vision, disconnects occur. Internal communications break down. Customers are dissatisfied with their interactions with your company. Growth opportunities are missed. Investors become wary of your potential to survive.

With your “why” kept front and center, you will be able to choose the actions that support it and overcome these common disconnects. It all begins with preparation. Before you begin your startup climb, be sure that you’ve lined up your partners and support team. Don’t go to market until you have processes in place to hear and respond to your customers.

Your startup’s “why” must not simply be mentioned in a high-level vision statement but must also be integrated into all of your company’s operations, from product creation to marketing.

Do your employees understand your company’s mission and vision? When your team understands their impact, they can find more fulfillment in their jobs, which leads to alignment across the company and higher performance.

2. Adapt

Your North Star, or “why,” will not change, but the vision and strategy for reaching it might. You may find the business you started is not the one that will move you forward toward that North Star. At that point, you must either implement changes within your business to move you closer to those goals or create something new entirely.

Often wedded to their original ideas, many founders resist adapting even when it becomes evident they’ve misread the voice of the customer. Stay aware and agile. This is the time to pivot, perhaps even redirect, to incorporate the customer’s voice into decision-making.

Be ready to test your assumptions of what is working and what is not. Your “why” may take you on new roads that you never thought possible, and your ability to adapt to your customers along the way can keep you moving forward.

3. Acclimate

Adapting is all about shifting direction. Acclimating means pausing, or even restarting, listening to the customer’s voice and adjusting to demanding markets that have little margin for error.

Like climbers who reverse and go back to base camp after reaching each summit, the reflective, backward steps of acclimatization will allow your business to figure out repeatable success (the cornerstone needed to scale a business!) and keep you moving forward in the long run.

4. Celebrate

Finally, don’t save all the confetti and high-fives for the very top of the mountain. Remember to celebrate small wins, too. As a founder, you need to inspire devotion in others. Celebrating the little victories along the way is an expression of gratitude to your partners and teams and reminds people why they started the journey with you.

Startup culture is complicated, with many opportunities to get off track and lose the point of why you started in the first place. By keeping the “why” of your North Star front and center while preparing, adapting, acclimating and celebrating along your journey, you will make the necessary adjustments to avoid many of the pitfalls that cause startups to fail and, instead, start to scale a business with confidence.

Originally published on Startup Nation.

Image credits: Pixabay

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Three Steps to Digital and AI Transformation

Three Steps to Digital and AI Transformation

GUEST POST from Arlen Meyers, M.D.

In his book, The Four Steps to the Epiphany, Steve Blank described what has become the gospel of lean startup methodologies: Customer validation, customer discovery, customer creation and company building

The path to sickcare digital transformation is a bit shorter, but certainly no less difficult and plagued by failure: Personal innovation readiness, organizational innovation readiness and digital/AI transformation.

PERSONAL INNOVATION READINESS

Are you prepared to innovate? Here’s what you should know about innovation.

Before you start, prepare yourself with these things:

MINDSET

Starting down the entrepreneurship path means that you will not only have to change your mind about things, more importantly, you will have to change your mindset. Don’t make these rookie mindset mistakes. Here’s what it means to have an entrepreneurial mindset. There is a difference between a clinical and an entrepreneurial mindset. Innovation starts with the right mindset.

Here is how to cope in a VUCA world.

MOTIVATION

Organizational behavior gurus have been studying how to motivate employees for a very long time. Most have failed.

Indeed, most of your ideas will fail. Consequently, you will need a source of intrinsic motivation to keep you going. Make it personal, but don’t take it personally. Find the right mentors and sponsors to keep you on track and support you when you are down. Create a personal advisory board. Develop these entrepreneurial habits. Practice the power of negative entrepreneurial thinking.

MEANING

Meaning should drive what you are about to do. Practice virtuous entrepreneurship and find your ikigai. Instead of starting with the end in mind, start with the why in mind. Prune. Let go of the banana.

MEANS

Once these attitudes are in place, then focus on building your entrepreneurial knowledge, skills, behaviors and competencies. Take a financial inventory. Start accumulating the physical, human and emotional resources you will need to begin and sustain your journey. In addition to knowledge, you will need resources, networks, mentors, peer support and non-clinical career guidance.

METRICS

What are some standards and metrics you can us to measure your innovation readiness e.g. in the use of artificial intelligence in medicine?

The American National Standards Institute (ANSI) has released a new report that reflects stakeholder recommendations and opportunities for greater coordination of standardization for artificial intelligence (AI) in healthcare. The report, “Standardization Empowering AI-Enabled Systems in Healthcare,” reflects feedback from a 2020 ANSI leadership survey and national workshop, and pinpoints foundational principles and potential next steps for ANSI to work with standards developing organizations, the National Institute of Standards and Technology, other government agencies, industry, and other affected stakeholders.

The newly developed Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) was found to be valid and reliable tool for evaluation and monitoring of perceived readiness levels of medical students on AI technologies and applications. Medical schools may follow ‘a physician training perspective that is compatible with AI in medicine’ to their curricula by using MAIRS-MS. This scale could be benefitted by medical and health science education institutions as a valuable curriculum development tool with its learner needs assessment and participants’ end-course perceived readiness opportunities.

As an important step to ensure successful integration of AI and avoid unnecessary investments and costly failures, better consideration should be given to: (1) Needs and added-value assessment; (2) Workplace readiness: stakeholder acceptance and engagement; (3) Technology-organization alignment assessment and (4) Business plan: financing and investments. In summary, decision-makers and technology promoters should better address the complexity of AI and understand the systemic challenges raised by its implementation in healthcare organizations and systems.

ORGANIZATIONAL INNOVATION READINESS

Improvement readiness is not the same as innovation readiness.

Giffford Pinchot, who originated the term “intrapreneur”, has suggested that you rate your organization in several domains to see whether your innovation future looks bright or bleek:

  1. Transmission of vision and strategic intent
  2. Tolerance for risk, failure and mistakes
  3. Support for intrapreneurs
  4. Managers who support innovation
  5. Empowered cross functional teams
  6. Decision making by the doers
  7. Discretionary time to innovate
  8. Attention on the new, not the now
  9. Self- selection
  10. No early hand offs to managers
  11. Internal boundary crossing
  12. Strong organizational culture of support
  13. Focus on customers
  14. Choice of internal suppliers
  15. Measurement of innovation
  16. Transparency and truth
  17. Good treatment of people
  18. Ethical and professional
  19. Swinging for singles, not home runs
  20. Robust external open networks

If you ask a sample of people to rate these in your company on a scale of 1-10, don’t be surprised if the average equals somewhere between 2-4. Few organizations, you see, are truly innovative or have a truly innovative culture. Most don’t even think about how to bridge the now with the new, let alone measure it.

Do a cultural audit. Creating a culture of innovation must include SALT and PRICES

AND

  • Process
  • Recognition
  • Incentives
  • Champions
  • Encouragement
  • Structure

Here is a rubrick that might help get you started

Learn from companies in other industries who transformed. Here are some tips from Levi Strauss.

DIGTAL/AI TRANSFORMATION

Develop and deploy the 6Ps:

  1. Problem seeking
  2. Problem solving
  3. People
  4. Platform/infrastructure
  5. Process/Project management
  6. Performance indicators that meet clinical, operational and business objectives and achieve the quintuple aims.

Here are some sickeare digital transformation tips.

The path to the end of the rainbow is filled with good intentions and lots of shiny new objects. Stay focused, use your moral compass to guide you and follow the yellow brick road.

Image Credit: Pixabay

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Forming Good Entrepreneurial Habits

Going from Said to Done

Forming Good Entrepreneurial Habits

GUEST POST from Arlen Meyers, M.D.

Are you trying to change and practice entrepreneurial habits? Science can help and here’s how.

As you progress in your career, it often gets harder to ask for help in reaching your goals and staying accountable to yourself to achieve them. If you’ve reached a career plateau, this author recommends three strategies to hold yourself accountable to your goals:

  • Enlist an accountability partner
  • Go public in declaring and sharing goals
  • Change your environment

Here are some new entrepreneurial habits that might contribute to your success and change your innovator’s DNA gene expression:

1. Put 5 books on your nightstand that you read for 30 minutes before going to bed. William Osler suggested it for doctors but it should work for entrepreneurs, too. Yes, you can read 50 books a year. The new twist on the concept is the 5 hour rule.

2. Subscribe to 5 newsletters completely outside of your field to find new sources of innovation and inspiration. Most true innovation rarely comes from inside.

3. Write 500 words about anything, anywhere every day. It can be in a journal. It can be on a Pulse post, It can be an evolving book or it can simply be on your iPad. Perhaps the biggest gap in my formal education was in writing. The only way to overcome that deficit is to discipline yourself to practice, practice, practice.

4. Invite at least one person every day to join your linkedin network who you think you can help.

5. Practice random acts of kindness when someone asks you to do them a favor that does not compromise your integrity. It’s good for your karmic bank account.

6. Watch children play every now and then. Like Jobs said at Stanford, be playful and stay hungry.

7. Use vacations as a way to create new habits. Change the rewards and cut yourself some slack instead of practicing incessant self denial. Productivity decreases when you reach a certain numbers of hours of work in a day. Try to do more in less time by eliminating unproductive distractions, overconnectedness or finding when your creative, imaginative biorhythm kicks in. Aim to work 20 hours a week.

8. Set goals with your spouse.

9. Have a fun fund. Not an emergency fund. Not a retirement fund, A fun fund you use to reward new and constructive behaviors. Don’t make it too small or too large. Just enough.

10. When your inner voice says no, create a space between the stimulus and your response. Say yes more often and try new things. Say no more often to things and people that are not aligned with your goals.

11. Train your brain to have patience and leave more time for Type 2 thinking (slow) instead of Type 1(fast) that leads to bad decisions based on intuition and bias.

12. Think positively to act positively. Here are 10 ways to do it

13. Keep a daily log of your small accomplishments each day and congratulate yourself. Nothing succeeds like success, not matter how small.

14. See things differently. Great creators, innovators, and entrepreneurs look at the world in ways that are different from how many of us look at things. This is why they see opportunities that other people miss.

15. Move from self-awareness to self-improvement

16. Join communities that a have employees set aside time for work that is important but not urgent. We call this proactive time or pro-time.re different from one another. Balance generalism with specialized focus.

17. Set aside time for work that is important but not urgent.

18. Practice gratitude.

19. Prune

20. Practice the power of negative entrepreneurship

21. Learn something new every day

22. Do something that scares you every day

23.Make these 6 practices a habit

Changing your morning routine might help. Mine includes reading, thinking and writing articles like this one.

Take advantage of the science of happiness by doing these four things.

Here are 5 more habits to future-proof your brain.

There are no short-cuts along the entrepreneurial journey. There are only habits that take time, repetition and the motivation to develop. You should focus on a few critical behaviors that have:

Implementation criteria include:

  • Actionability: Are people able to perform the behavior?
  • Degree of visibility: Can people see others performing the behavior?
  • Measurability: Can you measure (preferably objectively) whether people are performing the behavior?
  • Speed of results: Can people performing the behavior deliver results in the short term?
  • Ease of implementation: Given the current organizational environment, how easy/difficult will it be for people to perform the new behavior?

Some of these principles apply to organizations as well. When it comes to turning strategy to action, pay attention to this check list

Here are some ways to turn insight into execution by rewiring your brain and your team’s too.

These new habits will probably take several months to create. Here are some tips, backed by research, for forming new healthy habits.

Part of surgical training involves creating patterns of behavior that are habit forming. While, on the one hand, it helps to standardize care, it also can lead to making Type 1 and Type 2 technology adoption errors and faulty diagnostic thinking because it precludes other possibilities. The same applies to entrepreneurs.

Try to avoid what your basal ganglia is telling you to do when it makes sense. Like the man says, you’ll like how you feel. But, like they say, innovation and entrepreneurship is much easier said than done. Habits will set you free.

Image credits: Pixabay

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Mentors Advise and Sponsors Invest

Mentors Advise and Sponsors Invest

GUEST POST from Arlen Meyers

Whether you are a physician entrepreneur or intrapreneur, the primary thing that matters is that you can recruit people to help you and find the assets you need to be successful.

In the initial stages of your career, one of the most important things you can do is build relationships that will have a significant impact on your life over time. These five relationships can accelerate your path to a promotion, increase your visibility within an organization, and stretch you beyond your comfort zone into to the leader you aspire to be.

  • Mentor: A mentor can help you broaden your functional expertise, grow your emotional intelligence, and learn your company’s unwritten rules.
  • Sponsor: While mentors give you advice and perspective, sponsors advocate on your behalf and in some cases, directly present you with career advancement opportunities.
  • Partner: A partner is an ally or peer who can serve as a sounding board to broaden your perspective. This relationship is fueled by trust, a shared drive to succeed, and the recognition that you can do better together.
  • Competitor: Competition between peers is inevitable. And, when used correctly, it leads to improved performance, breakthrough ideas, and greater drive to get things done.
  • Mentee: Becoming a mentor will teach you how to bring out the best in others, recognize their strength, give feedback, and coach. In turn, it will push you to be better and to strive for more.

For workers just starting their careers, remote setups come with significant challenges, according to journalists Anne Helen Petersen and Charlie Warzel. While companies adapted to get work done virtually, in-person policies such as mentorship programs and networking events did not always make the transition, leaving new employees feeling adrift. When the authors asked early-career workers what resources they’d most benefit from, many wanted a “clearly delineated mentor who — crucially — was not also their supervisor or in charge of evaluating their performance.”

There’s an old African proverb that says, “It takes a village to raise a child.” The idea here is that young people need to interact with and build relationships with a variety of people to grow up well-versed and thrive. This can also be applied to the workplace, specifically to early career professionals.

In the initial stages of your career, one of the most important things you can do is build a village of your own. We’re not talking about a college network, LinkedIn friends, or the people who you met one time at a conference. We’re referring to the relationships that will have a significant impact on your life over time — ones that can accelerate your path to a promotion, increase your visibility within an organization, and stretch you beyond your comfort zone into to the leader you aspire to be.

Throughout our careers as executive coaches, we’ve seen success manifest as a result of these connections. In fact, there are five relationships that we believe are key to anyone’s professional growth. Think of them as your personal board of directors. It will take time to build meaningful relationships with each, so you better start NOW.

1. The Mentor

When a more experienced person teaches someone new, the knowledge transfer that takes place is unparalleled. Some of the most successful people ever have mentors to thank (in part) for their careers. Treasury Secretary Larry Summers mentored Facebook COO Sheryl Sandberg. Author and poet Maya Angelou mentored Oprah Winfrey, and music legend Ray Charles mentored the equally talented Quincy Jones.

Think of a mentor as the north star that will keep you on track when you’re feeling lost at work. They are the one person inside (or outside) of your organization who you can turn to for guidance — whether you are looking to expand your industry knowledge, navigate a difficult conversation, listen to feedback on a project, or get some encouragement when times are tough. They are reliable, wise, and most importantly, honest. Mentorship is all about having challenging conversations that help increase your self-awareness and help you grow both personally and professionally.

Great mentors are often proven leaders who have navigated corporate politics and advanced their career within an organization or industry that aligns with your longer-term goals. To find one, think about someone whose path you deeply admire but is still within reach, someone who may actually respond to your email or LinkedIn message. A potential mentor has to be open to forming a professional relationship with you because, more often than not, they’re pressed for time and mentoring takes effort.

Once you’ve identified a potential mentor, reach out to them in writing. Don’t start with “Would you be my mentor?” These kind of bonds form slowly after you’ve both had a chance to interact and build trust. Instead, share one or two things you admire about their work, and explain why you’re contacting them in the first place. You might say, “I attended the digital conference last week and was intrigued by your talk on what makes content go viral. I’m new to this field, and I’m interested in specializing in video production. I’d love to hear your career story and how you got here. Would it be possible for us to have a quick video chat sometime within the next couple of weeks so I can learn more?”

After your initial meeting, take the time to engage with them regularly — potentially quarterly or bimonthly — updating them on your projects, progress, and achievements. This will help you develop a reputation as someone who can manage stakeholders and deliver what you set out to do. Building a strong personal brand by displaying your competence, experience, and positive attitude is an effective way to attract the interest of powerful people at your company. Potential mentors will want to advise someone who is already on an upward trajectory.

2. The Sponsor

While mentors give you advice and perspective, sponsors advocate on your behalf, and in some cases, directly present you with career advancement opportunities. They play a role in the “behind closed doors” conversations that you may not be included in, and can support your boss in advocating for you in front of other members of the leadership team.

Morgan Stanley’s Managing Director Carla Harris gets it right in her TED Talk. “A mentor, frankly, is a nice-to-have,” she says, “but you can survive a long time in your career without one. You are not going to ascend in any organization without a sponsor.”

Research backs her up. A junior manager with a sponsor is 21% more likely to climb up the career ladder than someone in the same position without one. The global think tank and advisory group Coqual even devised the phrase the “sponsor effect” to describe how high power is transferred in the workplace. Their research found that “one in four white men in the middle ranks of workplaces have sponsorship, but only one in eight women and just one in 20 minorities have them,” indicating opportunities for greater sponsorship among gender and diverse groups for advancement.

To find a sponsor, you need to begin by showing people in your organization that you’re someone worth advocating for. This means you must be great at what you do — and your work must be visible.

Start by thinking about what unique skills, cultural knowledge, or generational life experiences you can share with your organization that will add value to their mission and help them reach outstanding goals. For example, if you work at an agency that is looking to bring innovative advertising offerings to their clients, your manager might be interested in learning more about emerging video-sharing networks like TikTok or live-streaming platforms like Twitch. If you have first-hand experience with these technologies, then offer to host a zoom “brown bag” lunch to share your knowledge.

Sponsors, like mentors, are in high demand and difficult to recruit. But if you develop a standout reputation, they might end up coming to you. Alternatively, you may be able to ask your mentor to make an introduction or reach out yourself for an introductory chat over coffee. Whatever you do, the first time you meet with a potential sponsor, be sure to enter the conversation with a purpose. Ask them questions about their career path, work, passions, and goals. Then, share your own. You want to build a foundation of good intention and rapport.

3. The Partner

A partnership is a mutually beneficial peer relationship. It is fueled by trust, a shared drive to succeed, and the recognition that you can do better together. Your partner is an ally who can serve as a sounding board to broaden your perspective, a collaborator to tackle problems with, and a connector that can help you build out your personal brand and expand your network.

Your partner is not always your work BFF. This relationship is more transactional. You each have an explicit intent to elevate yourselves by elevating each other.

One powerful example of a partnership can be observed through the women in President Obama’s administration. They used an “amplification” strategy to support one another and make their collective voices heard. When a woman made a key point during a meeting, the other women would repeat it, giving credit to its author.

Simply put, finding a partner is similar to finding a co-founder — look for someone whose personality and work ethic complement your own. You want a person who will fill the gaps in your working style. For instance, if you are more of an introvert who avoids public speaking, look for a partner who enjoys presenting and will promote your shared projects when doing so. If you are a strategic, big-picture person who doesn’t thrive with the details, look for a partner who is strong in analytics and operations.

It’s also important to choose a partner, such as a peer or cross-functional team-member, who are working towards the same outcome as you.

A good first step towards building this relationship is becoming an advocate for other people’s work. Pay attention to who reciprocates your enthusiasm. They may be a good candidate for the role. Ultimately, what makes a partnership work is the idea that you two will be more successful together.

4. The Competitor

The business world is full of rivalries: Steve Jobs vs. Bill Gates. Jeff Bezos vs. Elon Musk. Indra Nooyi vs. Irene Rosenfeld. Some of these rivalries have resulted in amazing breakthroughs.

Competition can be healthy if it’s focused on achieving results (a win-win) rather than battling for resources (a win-lose). When used correctly, it can serve as a motivation to hone and improve your skills and lead to improved performance, breakthrough ideas, and a greater drive to get things done.

Your competitor could be your ally or even your partner. Imagine that you and a peer come up with two great ideas for executing a project. You know that both of you have the potential to think up unique and separately effective solutions. Instead of butting heads and trying to choose one over the other, how might the end result look if you collaborated and came up with something that’s much more effective and valuable?

That’s what competitors can do. The idea is to win, not win over.

Remember that competitive relationships show up naturally at work. As Dr. Stephen Covey states in his business classic The 7 Habits of Highly Effective People, a win-win attitude possesses three vital character traits; integrity, maturity, and abundance mentality. So, choose your competitor after evaluating these traits. Once you have identified a potential competitor in your company, schedule a one-on-one meeting. One way to entice them to work with you, instead of against you, is to have a vulnerable conversation. Be sure to tell them you admire them professionally and consider them a formidable peer. Then, share your aspirations, ask them about their goals, and figure out if there are ways you can help each other succeed.

5. The Mentee

Physics Nobel Prize winner and Cal Tech Professor Richard Feynman coined the phrase, “If you want to master something, teach it.” Most of us have been teachers at some point in our lives. Whether we’re teaching our friends how to play a card game, our kids how to ride a bike, or our classmates how to better understand a difficult concept. No matter the situation, assuming the role of the teacher helps you gain greater clarity of a subject by breaking it down into simple steps, or by articulating a complex problem in a more understandable way.

At work, having a mentee serves this purpose — it allows you to be the teacher. Whether you help onboard an intern or assist a new colleague in navigating the specifics of a project they’ve been assigned, you learn more by teaching more.

Becoming a mentor also helps hone important soft skills that every leader should have: strong communication, creativity, and empathy. Employers are looking to groom leaders who can provide clear direction, be innovative problem solvers, and who have emotional intelligence. As a mentor, you are a leader and role model. You learn to bring out the best in others, recognize their strengths, give feedback, and coach. Thus, this role will push you to be better and to strive for more.

Seek out these opportunities internally by looking for interns or new employees that may need help settling in. You can also do this externally by mentoring in affinity organizations such as your alma mater or a non-profit. That said, if done at work, being a mentor will give you more visibility and help build up that good reputation we discussed.

Sometimes forming these relationships will happen randomly and without effort. But you can accomplish so much more if you are open and intentional about it. So, don’t leave things to chance. As the Roman philosopher Seneca puts it, “Luck is what happens when preparation meets opportunity.”

Some will be teachers to educate you. Some will be coaches who teach you a skill. Some will be mentors who help you develop as a person.

Mentoring can be a challenge as workers and students are more diversified.

Some of those people will be advisors who offer guidance about how to grow your company.. Some will be mentors who typically develop a more meaningful and deeper relationship that has a more lasting impact. Here are some dos and don’ts about mentoring. One is if you are terrible at relationships, don’t volunteer to be one. Stick with being a thought or key opinion leader or role model. It will save both you and your mentees a lot of disappointment.

But, most need not mentors, coaches or advisors, but rather sponsors who not only give you advice and support, but invest in you and your ideas with the expectation, like all investors, that they will get some defined, measurable return.

The ROI does not need to be just money, although generating revenue via a new program or offering helps. Other valuable deliverables are innovative ways to move forward the mission, a tool to recruit new students or employees, a way to motivate or retain existing employees, faculty to students or something that improves the customer experience.

Take the case of Dr. Smith, who was a highly regarded specialist in her field, hired to “change how we do things around here”. During the interview process, everyone expressed support and said all the right things. It worked. Unfortunately, when Dr. Smith arrived 8 months later, many in leadership positions had left or had been fired, Dr. Smith had a hard time finding someone willing to support her change agenda and, instead, was left being subsumed by the status quotidiens and an unsupportive department chairman.

For intrapreneurs, engaged employees trying to act like entrepreneurs adding value to their organizations, finding sponsors can sometimes be more difficult than finding angels or more typical investors in companies. If you are an intrapreneur looking for a sponsor, here are ten tips:

  1. Pick your spot carefully. Be sure you work on a problem that is important, not just interesting. Important means it’s something that the sponsor might want to see happen. Interesting is something that just piques your interest.
  2. Use an effective pickup line. Craft a value proposition that covers the bases and tells the story to hook potential sponsors and in no uncertain terms makes clear what’s in it for them if they give you their support and you are successful.
  3. Network before you have to. Build connections and relationships early and develop them. It starts when you are thinking of applying for a new job and need to build a potential support system at the new place.
  4. Don’t just focus on those above you in the food chain. Colleagues, coworkers and friends can be great sources of support as you move your project forward.
  5. Test a little, learn a lot. Do a pilot project or experiment to test your proof of concept. Use the results to sell your ideas to sponsors.
  6. Be careful about asking for forgiveness instead of permission .
  7. Practice intrapreneurial survival skills.
  8. Build your bench strength to go to when your sponsor gets cold feet, gets fired, moves on or retires.
  9. Think impact, scalability and sustainability. Create and validate a business model that will assure growth, sustainability and impact and that can be executed with some high level of assuredness.
  10. Think short term. While your vision might be to create something that will have long-term transformational impact, the sponsor will usually answer to someone or some thing that expects to see some immediate return on investment or signals that the effort is successful.

Getting buy in for your ideas from a manager or administrator in your organization is tough. They have conflicting claims on their time and resources and are forever doing the political calculus when it comes to placing bets. But, like most people, they buy emotionally and justify rationally and , at least at some level, they do the cost-benefit to factor in what’s in it for them and the organization. Be sure you have a good answer when you ask someone to sponsor you.

Image credits: Pixabay

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What Entrepreneurship Education Really Teaches Us

What Entrepreneurship Education Really Teaches Us

It’s been 100 years since Harvard Business School began using the case study method. Beyond teaching specific subject matter, the case study method excels in instilling meta-skills in students. This article explains the importance of seven such skills: preparation, discernment, bias recognition, judgement, collaboration, curiosity, and self-confidence.

Now, project-based learning has emerged as another experiential learning model.

Some educators define meta-skills as a group of long-lasting abilities that allow someone to learn new things more quickly.

I have been teaching biomedical and clinical innovation and entrepreneurship for several years now and my students have told me they learned much more than how to start a company or launch an organizational initiative, In fact, we start every course with defining entrepreneurship as the pursuit of opportunity under volatile, uncertain, complex and ambiguous conditions (VUCA) with the goal of creating stakeholder defined value through the deployment of innovation using a VAST business model to achieve the quintuple aims.

Here is what I learned teaching entrepreneurship to 1st year medical students at the University of Colorado School of Medicine.

Knowledge is what you know. Skills are things you learn how to do. Abilities are your natural talents. Competencies are what you need to know how to do to accomplish a given goal. Meta-KSAs are the things that you know, learn and do that are transferable.

Here is a list entrepreneurial virtues and competencies.

Other entrepreneurial meta-KSAs you will learn about are:

  1. Failure
  2. Selling things, including yourself
  3. Stories
  4. Fear
  5. Emotions
  6. Empathy
  7. Pattern recognition
  8. Testing and experimenting
  9. Data generation and analysis
  10. Resilience and perseverance
  11. Mindset
  12. Questioning

Entrepreneurship education and training is more about learning life skills that are used to create value, not just companies. We should start teaching it in pre-school. The longer we wait, the harder it is to learn and apply the meta-KSAs. It is unlikely that the Facebook version of Meta will be as helpful.

Image credit: Pixabay

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The ABCDEs of Technology Adoption

The ABCDEs of Technology Adoption

GUEST POST from Arlen Meyers, M.D.

Every day, doctors have to make daily decisions about whether or not to adopt a new technology and add it their clinical armamentarium, either replacing or supplementing what they do. In doing so, they run the risk of making a Type 1 or a Type 2 adoption error.

Epistemology is a branch of philosophy generally concerned with the nature of knowledge. It asks questions such as ‘How do we know?’ and ‘What is meaningful knowledge?’. Understanding what it means to have knowledge in a particular area—and the contexts and warrants that shape knowledge—has been a fundamental quest for centuries.

Data Information Knowledge Wisdom Pyramid

In Plato’s Theaetetus, knowledge is defined as the intersection of truth and belief, where knowledge cannot be claimed if something is true but not believed or believed but not true. Using an example from neonatal intensive care, this paper adapts Plato’s definition of the concept ‘knowledge’ and applies it to the field of quality improvement in order to explore and understand where current tensions may lie for both practitioners and decision makers. To increase the uptake of effective interventions, not only does there need to be scientific evidence, there also needs to be an understanding of how people’s beliefs are changed in order to increase adoption more rapidly.

Only 18% of clinical recommendations are evidence based. There are significant variations in care from one doctor to the next. Physicians practicing in the same geographic area (and even health system) often provide vastly different levels of care during identical clinical situations, including some concerning variations, according to a new analysis.

Clinical and policy experts assessed care strategies used by more than 8,500 doctors across five municipal areas in the U.S., keying in on whether they utilized well-established, evidence-backed guidelines. They found significant differences between physicians, including some working in the same specialty and hospital.

The study results were published Jan. 28 in JAMA Health Forum.

One practice difference the authors found surprising was in arthroscopic knee surgery rates. In these cases, the top 20% of surgeons performed surgery on 2%-3% of their patients, while the bottom 20% chose this invasive option for 26%-31% of patients with the same condition being treated in the same city.

The question is why?

There’s an old joke that there are two ways everyone sees the world: those that see it as a 2×2 matrix and those that don’t.

Type 1 Type 2 Errors Kris Martin

A type 1 error occurs when they make a “false positive” error and use or do something that is not justified by the evidence. Type 2 errors, on the other hand are “false negatives” where the practitioner rejects or does not do something that represents best evidence practice.

The most recent example is the campaign to get doctors to stop prescribing low value interventions and tests. The Choosing Wisely campaign, which launched five years ago, hasn’t curbed the widespread use of low-value services even as physicians and health systems make big investments in the effort, a new report found.

The analysis, released  in Health Affairs, said a decrease in unnecessary healthcare services “appear to be slow in moving” since the campaign was formed in 2012. The report found that recent research shows only small decreases in care for certain low-value services and even increases for some low-value services.

The reasons why American doctors keep doing expensive procedures that don’t work are many. The proportion of medical procedures unsupported by evidence may be nearly half. In addition, misuse of cannabis, supplements, neutriceuticals and vitamins are rampant.

Evidence-based practice is held as the gold standard in patient care, yet research suggests it takes hospitals and clinics about 17 years to adopt a practice or treatment after the first systematic evidence shows it helps patients. Here are some ways to speed the adoption of evidence based care.

Unfortunately, there are many reasons why there are barriers to adoption and penetration of new technologies that can result in these errors. I call them the ABCDEs of technology adoption:

Attitudes: While the evidence may point one way, there is an attitude about whether the evidence pertains to a particular patient or is a reflection of a general bias against “cook book medicine”

Biased Behavior: We’re all creatures of habit and they are hard to change. Particularly for surgeons, the switching costs of adopting a new technology and running the risk of exposure to complications, lawsuits and hassles simply isn’t worth the effort. Doctors suffer from conformation bias, thinking that what they do works, so why change?

Here are the most common psychological biasesHere are many more.

Why do you use or buy what you do? Here is a introduction to behavioral economics.

Cognition: Doctors may be unaware of a changing standard, guideline or recommendation, given the enormous amount of information produced on a daily basis, or might have an incomplete understanding of the literature. Some may simply feel the guidelines are wrong or do not apply to a particular patient or clinical situation and just reject them outright. In addition, cognitive biases and personality traits (aversion to risk or ambiguity) may lead to diagnostic inaccuracies and medical errors resulting in mismanagement or inadequate utilization of resources. Overconfidence, the anchoring effect, information and availability bias, and tolerance to risk may be associated with diagnostic inaccuracies or suboptimal management.

In addition,  there is a critical misunderstanding of what information randomized trials provide us and how health care providers should respond to the important information that these trials contain.

  • Has this trend been studied?
  • If so, who conducted the study?
  • Was it somebody who may make money based on study results?
  • Did the study include a control group?
  • What population did they use to test this trend?

Do you know how to read the medical literature?

Denial: Doctors sometimes deny that their results are suboptimal and in need of improvement, based on “the last case”. More commonly, they are unwilling or unable to track short term and long term outcomes to see if their results conform to standards.

Emotions: Perhaps the strongest motivator, fear of reprisals or malpractice suits, greed driving the use of inappropriate technologies that drive revenue, the need for peer acceptance to “do what everyone else is doing” or ego driving the opposite need to be on the cutting edge and winning the medical technology arms race or create a perceived marketing competitive advantage. In other words, peer pressure and social contagion is present in medicine as much as anywhere else. “Let’s do this test, just in case” is a frequent refrain from both patients and doctors, when in fact, the results of the treatment or test will have little or no impact on the outcome. It is driven by a combination of fear, the moral hazard and bias.

Here are some common customer fears when it comes to adopting a new product or technology and how to overcome them.

 Although investment in start-ups is significant, complex barriers to implementing change and innovation remain.

These “unnecessary” barriers, which vary from complicated funding structure to emotional attitudes towards healthcare, have resulted in the uneven advancement of medical technologies – to the detriment of patients in different sectors.

Economics: What is the opportunity cost of my time and expertise and what is the best way for me to optimize it? What are the incentive to change what I’m doing?

Here are three insights as to why physicians are still skeptical about using wearable technology to monitor patients’ health:

  1. Data access. Clinicians aren’t interested in using wearables if data from the devices isn’t connected to their organization’s EHR. Only 10 percent of physicians said they have integrated data from patient wearables, leaving clinicians unable to access the data or having to enter it manually.
  2. Data accuracy. Some physicians do not trust data from consumer wearable devices; for example, the FDA and other global regulators have cleared a smartwatch application that can alert patients who have already been diagnosed with atrial fibrillation when they are experiencing episodes. However, the capability is less useful as a mass screening tool and has generated many false positive results.
  3. User error and anxiety. If a wearable device is not worn correctly, it may generate inaccurate results. Some who use wearables to monitor their health can also become too focused on vitals such as heart rhythm and pulse rate, which can cause anxiety-induced physical reactions that mimic conditions such as atrial fibrillation.

The past 600 years of human history help explain why humans often oppose new technologies and why that pattern of opposition continues to this day. Calestous Juma, a professor in Harvard University’s Kennedy School of Government, explores this phenomenon in his latest book, “Innovation and Its Enemies: Why People Resist New Technologies.”

Here are the key takeaways.

Research indicates that doctors make these kinds errors frequently(http://ecp.acponline.org/sepoct01/pilson.pdf). Moreover, we are witnessing the development of digital health technologies like medical mobile apps, most of which are not clinically validated. So, how should a clinician decide when to adopt new technology? How much evidence is sufficient for an unsophisticated physician to begin adopting or applying a technological innovation for patient care? How do you strike a balance between innovation and evidence from a patient safety and quality standpoint?

Changing patient behavior has been described as the “next frontier”. To make that happen, we will need to change doctor behavior as well.Some interventions work but passive interventions don’t.

Here are some suggestions:

  1. Recognize, that like most customers, surgeons buy emotionally and justify rationally.
  2. Surgeons should be introspective about how and when they adopt new technologies and try to minimize Type 1 and Type 2 errors
  3. While an initial step is to be sure that surgeons are aware of new information that might drive an adoption decision, research indicates that simply presenting them with that information does not change behavior.
  4. Doctors should be skeptical about digital health technologies that might be technically and commercially validated, but not clinically validated.
  5. Doctors will have to resolve the conflict between best evidence and personalized medicine. We face the opportunity to individualize care yet are faced with the challenges of delivering mass customized care when it is becoming increasingly commoditized.
  6. Technology adoption, diffusion and sustainability vary depending on the product offering like drugs, devices, digital health products, care delivery innovation or business process innnovation.
  7. Doctors often have nothing to do with choosing which technology is adopted or, more importantly, paid for by a third party.
  8. Doctors, particularly those that are employed, have to concern themselves more and more with making the numbers, which involves implicitly or covertly rationing care, as irrational as it may be.
  9. Conflicts of interest hide, in some instances, the motivation for technology adoption.
  10. Doctors have high switching costs when it comes to including something new in their therapeutic armamentarium.
  11. In most instances, dissemination and implementation has more to do with leading change than the technology. Consequently it is best to get buy in from clinicians early, define a clear unmet need, have internal champions and leadership from the C-suite.
  12. Adoption and penetration happens in organizations when there is a match between the values and skills of intrapreneurs and organizational innovation readiness as demonstrated by teams that are willing to pull the oars in the same direction.
  13. Here are some ways to to change doctor prescribing habits to conform to evidence based medicine

The job doctors want virtual care technologists to do is that they want you to give them a QWILT: quality, workflow efficiencies,income, protection from liability and giving them more time spend with patients (face to face, since, in most instances, that’s how they get paid) Increasingly, they also want to spend more time “off the clock”, instead of being overburdened with EMR pajama time and answering non-urgent emails or patient portal messages.

While monetary incentives and behavioral “nudges” both have their strengths, neither of them is sufficient to reliably change clinician behavior and improve the quality of their care. Sometimes nudging helps. Organizational culture, while diverse and complex, provides another important lens to understand why clinicians are practicing in a certain way and to put forth more comprehensive, long-term solutions.

The public shares some culpability. Americans often seem to prefer more care than less. But a lot of it still comes from physicians, and from our inability to stop when the evidence tells us to. Professional organizations and others that issue such guidelines also seem better at telling physicians about new practices than about abandoning old ones.

Medicine has a lot to learn from the consumer products industry when it comes to using the power of brands to change behavior. Some are using personal information technologies to give bespoke information to individual patients, much like Amazon suggesting what books to buy based your preferences. We need to do the same thing for doctors.

Like most consumer electronics customers, doctors will almost always get more joy from technology the longer they wait for it to mature. Cutting-edge gadgets can invoke awe and temptation, but being an early adopter involves risk, and the downsides usually outweigh the benefits.

There are many barriers to the adoption and penetration of medical technologies. The history of medicine is full of examples, like the stethoscope, that took decades before they were widely adopted. Hopefully, with additional insights and data, it won’t take us that long.

Image credits: Pixabay, ResearchGate.net, Kris Martin

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Innovation Theater – How to Fake It ‘Till You Make It

Innovation Theater - How to Fake It 'Till You Make It

GUEST POST from Arlen Meyers

The overwhelming number of doctors, engineers and scientists don’t have an entrepreneurial mindset. What’s more, when they have an idea, they don’t know what to do with it since they will not learn those competencies in their formal training. They just don’t know how to innovate their way out of our sick care mess.

But, that hasn’t stopped lots of them from trying, include non-sick care entrepreneurs. They just improvise.

Now that Elizabeth Holmes has been convicted, many are commenting on the pros and cons of the “fake it ’till you make it” ethos of entrepreneurs and Silicon Valley. But, is this really a black and white issue? Is it true that “You have no business being something you are not, or doing something without proving your worth.” I venture to say many of us, including me, have done something that was not a good fit and we have all tried things when we simple did not know what we did not know.

Here’s how to fake it when you don’t know what you are doing or you forgot your lines:

  1. Avoid these wannapreneur rookie mistakes.
  2. If you are a female, find a male wing man so someone will invest in your product
  3. Surround yourself with people who are way above your pay grade at lots of Meetups
  4. Practice Therantology
  5. When you inevitably fail, make a big deal out of it and about how much you learned from your mistakes and include them on your Linked profile. Rinse. Repeat
  6. Wear a fleece vest with your company logo
  7. Plead ignorance about how hard it is to get anybody in sick care to change and the long sales cycles.
  8. Be sure you have lots of hood ornaments (doctors with fancy titles) on your advisory board prominently posted on your website
  9. Hire a virtual assistant that answers all of your calls and says that she/he will not be able to immediately connect you because you are in an investor meeting
  10. Get your co-working space guy to allow you to use more space than you are actually paying for when people come for meetings. Bribe interns with pizza to come and look busy.
  11. Forget being your authentic self. “You are generally better off coming across as likable, which will generally require some effort, restraint, and attention to what others expect and want to see. Seeming authentic in the process is the cherry on top of the cake, but it requires a fair amount of faking.”
  12. Try being a good rebel even if you are a bad one.
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During these times, we are supposed to wear a mask. Most of us wear a mask all the time to hide our insecurities or avoid being outed as an imposter or physician wannapreneur, so none of this should be new to you.

 In a follow-up to their February 2021 article challenging the commonly understood definition of imposter syndrome, authors Ruchika Tulshyan and Jodi-Ann Burey offer actionable steps managers can take to end imposter syndrome in their organizations. Doing so will require work at both the interpersonal and organizational levels, and success will depend in part on gathering data and implementing real mechanisms for accountability. The authors call on managers to stop calling natural, human tendencies of self-doubt, hesitation, and lack of confidence “imposter syndrome.” Those who want women to lend their full talents and expertise must question the culture at work — not their confidence at work.

These things come with practice. But, since you are part of innovation theater, practice your lines, be sure you are wearing the right costume and that the stage is set properly. Break a leg.

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Finding the Right Physician Advisor for a Healthcare Startup

Finding the Right Physician Advisor for a Healthcare Startup

GUEST POST from Arlen Meyers

It has never been easier to create a sickcare startup, particularly in digital health. Part of that process requires that founders find the right players to be on the team. In many instances, that will involve finding physician advisors or consultants.

But, how do you find the right physician advisors?

Here are some tips:

  1. Clearly define the optimal candidate by writing a job description that includes the knowledge, skills, attitudes and competencies you want. Are you looking for someone with an entrepreneurial mindset or someone with just domain expertise? One expert suggests that they should be able to communicate a deep understanding of their domain effectively and understand the context of both their organizations and those they work with. Moreover, emotional competence is essential to developing strong interpersonal skills and succeeding in any workplace. Professionals should also strive to be effective teachers and build a large network of human connections. Finally, possessing an ethical compass will be important as algorithm-driven machines begin to make morally weighted decisions.
  2. Look for past experience and results
  3. Decide how much and what kind of compensation you are prepared to offer, either in cash, equity or both
  4. Make it clear how long you want to engage your advisor. Is it for one hour or one year or more? Or, maybe it’s best to try before you buy and hire for a renewable three-month term.
  5. Clearly define your expectations, deliverables and timelines and how you will measure the results. What roles, holes and goals do you want your advisor to fill?
  6. Solicit candidates using networks, social media channels, word of mouth referrals or responses to a call to action on your website or other marketing collateral
  7. Screen candidates using the criteria you have defined
  8. Decide whether you want someone to fill a business or clinical advisory position. Finding a clinical business advisor is difficult since few doctors or other healthcare professionals have both a clinical and entrepreneurial mindset and the knowledge, skills, abilities and competencies to help you achieve your next critical success endpoints.
  9. Agree on whether you are hiring for periodic strategic input or more tactical, hands-on execution.
  10. Interview candidates to see if they comply with your requirements and whether they are the right fit
  11. Negotiate an agreement
  12. Execute an advisory services agreement that defines the terms and conditions of the relationship

Finding the right physician advisors is an important part of recruiting your startup team. Don’t hire someone simply because of the initials after their name.

Image credits: Pixabay

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What Innovators Can Learn From the Spectacular Rise and Crash of Theranos

Including its CEO Elizabeth Holmes

What Innovators Can Learn From the Spectacular Rise and Crash of Theranos

Last week in a Silicon Valley courtroom, Theranos founder and CEO Elizabeth Holmes was convicted on four counts of fraud in connection with the failed blood-testing company she founded in 2003. The Stanford dropout will soon be sentenced to up to 20 years in prison. She joins a long list of convicted fakers that includes Bernie Madoff, Jeff Skilling, John DeLorean, and many others.

For most observers, the question now is how Holmes got so far, so fast. But for innovators everywhere, I want to focus on a different question: what can we learn from this case study of innovation gone bad?

As an innovation author and trainer to corporate America, I see this as a tragedy for future startups, and the field of innovation.

From the beginning, I followed the amazing rise and spectacular fall of Theranos. At its zenith, the firm soared to a $9 billion valuation. When articles appeared on Elizabeth’s achievements, I was dazzled. Here was a young woman who’d had the gall to drop out of college and start a company that promised to change the game in healthcare.

Theranos invented the nanotainer, which collected blood through a simple, painless finger prick. Several drops of blood could then be tested by another Theranos invention, the Edison. Capable, according to company literature, of performing “hundreds” of separate tests, from standard cholesterol checks to AIDs and leukemia. “The results are faster, more accurate, and far cheaper than conventional methods,” crowed Wired Magazine in a 2014 cover story.

If only it were so. As the 18-week trial revealed, it was all smoke and mirrors.

The Edison was never able to perform any blood tests reliably. But instead of coming clean, Holmes chose to double down and lawyer up. In the book Bad Blood, Wall Street Journal reporter John Carreyrou detailed how Holmes went extreme. She harassed, threatened, and tried to silence internal whistleblowers. Carreyrou was pilloried before the Theranos staff and threatened by Holmes’ attorney and company stakeholder David Boies. Yet his damaging reporting led to Theranos’ unraveling. He carefully documented how Holmes and COO Ramesh “Sunny” Balwani resorted to using conventional test equipment behind the scenes, while pretending to patients and investors that Edison had performed the work.

As the story of Theranos now fades into history, what can be learned from this rare, behind-the-scenes insight into the amazing rise and fall of a startup that might guide the innovation efforts of others? What did Holmes get right, and where did she go wrong?

Innovators need to believe in themselves and think big, and they need self-discipline. Holmes had these attributes in spades. As a journal she kept revealed during the trial, Holmes kept up a grueling personal development regimen: “4 a.m. rise. Thank God, exercise, meditation, prayer. Eat breakfast Eat breakfast of whey and banana. Get to office by 6:45.”

Young and inexperienced in business, she apparently disciplined herself to speak in a deep and unemotional voice to make her seem older and more credible. She wore turtleneck sweaters to subliminally get people to think she might just be the second coming of Steve Jobs, her hero.

She made mentors of people like Larry Ellison and big-name investors like Tim Draper, who in turn helped convince big-name investors like the DeVoss family, the Cox family of Atlanta, and Rupert Murdock, who lost $125 million in the collapse.

Holmes’ was ultra-tough on herself to keep upping her game: “I am never a minute late,” she wrote in one entry. “I show no excitement. [I am] ALL ABOUT BUSINESS. I am not impulsive. I know the outcome of every encounter. I do not hesitate. I constantly make decisions and change them as needed. I speak rarely. I call bullshit immediately.”

Yet the one person she failed to call it on was herself.

And once she edged down that path with little lies, little deceptions, she got trapped into telling bigger and bigger lies. “Our equipment is already in use by the U.S. military on battlefields,” she promised would-be investors. It wasn’t. She was particularly good at establishing credibility, and somehow managed to charm such luminaries as Henry Kissinger, George Shultz, and James Mattis to serve on her board of directors, along with not a single scientist nor medical doctor who might have red-flagged problems with the Edison. (It is amazing that General Mattis apparently didn’t bother to check out the false claim that the military was already piloting the product on battlefields).

Holmes knew how to deflect when her offering proved vulnerable. Every good sales professional knows to “overcome objections.” But whenever visitors started asking her questions that were too close to the Big Lie (the product had major flaws), she aggressively pushed back with, “don’t ask us to reveal trade secrets.” While this shut them up, it did not solve her problem.

Another tool of innovators trying to build the buy-in for their ideas is to use the “fear of losing out” technique. There’s nothing unethical about it, unless you misrepresent facts. This strategy worked well for Holmes – at least for awhile. She used it successfully to secure big contracts, and big investments.

But the lie that did her in was a false attempt to demonstrate credibility. Before the jury, she admitted adding the logos of drug companies Pfizer and Schering-Plough to a marketing pitch to Walgreen Drugstores, at the time considering partnering with Theranos to install instant blood-testing centers in its 9,000 retail locations.

Final lesson to innovators: use creativity to make your case, but don’t fudge even on the smallest details. What Elizabeth did with the logos became a charge of wire fraud and was said to be the smoking gun that all jurors agreed on should send her to prison.

This article originally appeared in Forbes
Image credit: Wikimedia Commons

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Problem Seeking 101

Problem Seeking 101 Charles Kettering

GUEST POST from Arlen Meyers

When federal agencies in charge of protecting Americans’ health recommended that there should be a pause in the administration of the Johnson & Johnson (J&J) COVID-19 vaccine, state health leaders listened and suspended its use. People may experience a mild headache after vaccination. The headaches associated with the blood clot occur one to three weeks after the shot and are more severe.

One expert recommended asking patients, “Is this like headaches you’ve had before? Or is the quality of the headache something that you’ve never experienced before?”

The 12 steps to biomedical innovation starts with being a problem seeker, not a problem solver. Eventually, to be successful, customer problems and solutions need to meld around a VAST business model i.e. one that is not just profitable, but that demonstrates:

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.

Many doctors, scientists and engineers start with solutions looking for a problem. Some find it or, eventually, as their inventions or technology evolves, markets appear to those who have the talent to see them. The more typical model, and one that is more common among the startup community, is to find a problem and devise a solution.

But, how do you pick the IDEAL opportunity given the almost infinite possibilities? Here are some tips:

I Identify the problem: Seeing a problem is an important skill and core competency of savvy entrepreneurs. It typically is the result of personal experience, primary research talking or watching others or secondary research. Whichever problem you pick, look for ones that:

  1. Will make a very big difference in people’s lives if you solve it
  2. Has the potential to be very profitable or create lots of user defined value, typically at least 10x the value compared to existing offerings or the status quo.
  3. Is something that taps into your passion or satisfies your psychic need
  4. Anticipates future customer/stakeholder wants and needs
  5. Has an extremely high level of market pain and frustration, where customers know they have a problem and have unsuccessfully and repeatedly tried to solve it
  6. Has limited barriers to entry
  7. Has the right potential risk-return profile that matches yours
  8. Is not one dominated by incumbents
  9. Is easy to explain and understand
  10. Someone is willing to pay enough for your solution so that you can make it profitably

Where massive success comes – where a good idea becomes great – is when it meets five simple criteria:

  1. It is the first solution to a problem or gap (it is “innovative”)
  2. It is the first WORKING solution to a problem or gap (it is “innovative and effective”)
  3. It is the most affordable, comparable, option for its market (it is “innovativeeffective and affordable”)
  4. It consistently examines its effectiveness and seeks to improve (it is “innovativeeffectiveaffordableand adaptive”)
  5. It is powerful enough to create a loyal following that naturally wants to – and does – share the idea with others (it is “innovativeeffectiveaffordableadaptive and influential”)

How do you find problems worth solving?

  1. 1. Solve a problem that you already face
  2. 2. Observe a problem and solve it
  3. 3. Anticipate a problem and solve it
  4. 4. Create a problem and solve it
  5. 5. You have a personal stake in solving it
  6. 6. The 3 W’s: Will customers WANT it, is it WORTH it, can you WIN at it?

Identifying a problem starts with identifying a customer archetype that has it. Beyond guessing, identifying that person and describing their problem can only be done by talking to, working with or observing potential customers.

Doctors call it taking a pain history and documenting the chief pain complaint, the history of the present illness and their past medical history. In other words, talk to people and have them describe:

  1. Where is your pain?
  2. How bad is it?
  3. How long have you had it?
  4. On a scale of 1-10, how would you describe it?
  5. What have you done in the past to make it better?
  6. What makes it better or worse?
  7. What other problems do you have that makes the pain better or worse?
  8. How have you treated it in the past?
  9. Is the pain constant or intermittent?
  10. What would you pay to relieve the pain?

Startup geeks call this process customer discovery by “getting out of the building”. Doctors call it making house calls. Here is the ultimate list of customer discovery/development questions.

Here is a customer interview script.

Remote patient programs , for example, don’t just automatically work out. They have to be carefully planned and developed in order to gain traction and produce results. Most importantly, they have to target the right patients.

D Define and represent the problem

Primary or secondary research should give you some idea about :

  1. Market size
  2. Market growth
  3. The competitive landscape
  4. Where you intend to play
  5. What you see that others don’t.

Once you have done these things, then you can:

E Explore and experiment with possible strategies or solutions and risks involved with each by identifying customer segments and creating a value proposition canvas and a business model canvas

Here’s an into to value proposition design

When you create new value propositions and growth you need to focus on high-value customer jobs. These are not necessarily the most important jobs from your customers’ perspective. They are the most promising jobs from your perspective as a solutions provider. High-value customer jobs are characterized by the following, they are:

  • Important: When customer’s success or failure to get the job done leads to essential gains or extreme pains, respectively. Examples are managing the security risk of an ecommerce website, or designing and implementing the strategy at a company.
  • Tangible: When the pains or gains related to a job can be felt or experienced immediately or often. Examples are traffic during your daily commute, or managing a constantly overflowing email inbox.
  • Unsatisfied: When current value propositions don’t help to relieve pains or create desired gains in a satisfying way. Maybe the desired value proposition doesn’t even exist. Examples are the inexistent cure for hangovers, or calorie-free chocolate.
  • Lucrative: When many people have the job with related pains and gains or when a small number of customers are willing to pay a premium. An example of the former is listening to music on the go. An example of the latter are rare diseases for which customers or insurers are willing to pay a premium.

Here is a list of stakeholders that represent customer segments. But, job title is only one part of creating a customer persona. Here’s what Linkedin Sales Navigator won’t tell you and how to fill the gaps.

If you listen to or watch customers enough, you’ll be surprised at what you’ll discover. Here are some examples.

Don’t send out a questionnaire. Here’s why you need to interview stakeholders to identify their value factors that are most important until you get saturation.

A Act on a selected strategy or solution

L Look back and evaluate

Most businesses fail because 1) they don’t offer the right value proposition-market fit or 2) they don’t have a viable business model. Your business model canvas is anchored on your value proposition. Your value proposition (doing the job the customer wants you to do, removing the pain they have to endure to do it now and offering a product that meets or exceeds customer expectations) starts with understanding your customers. Focusing on your customers or market segments starts with those who touch the problem every day.

Design thinking describes this process i.e. understanding a problem from the customer perspective, putting yourself in their shoes by either interviewing them, watching them or experiencing what they experience. and create a range of solutions that you then design, prototype and test.

Design Thinking Diagram

Customer centered design means you have to learn how to talk to humans.

Before you do all this, though, decide whether the industry or market you decide to tackle is, the words of my friend, Tom Higley, the CEO at www.101010.net, the right founder-opportunity fit. That usually means finding independence, mastery and purpose and scratching all those psychological itches, be they pathological or not.

Perhaps the most powerful problem is one that you make personal but don’t take personally.

Here’s the problem with saying, “Don’t bring me problems, bring me solutions.”

The education pioneer, John Dewey, said, “a problem well-put is half solved”

That happens when you arm yourself initially with the information you get from being a problem seeker, not a problem solver. Even academic scientists are getting the message.

Image credits: MisterInnovation.com, Interaction Design Foundation

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