GUEST POST from Arlen Meyers

Physician entrepreneurship is the pursuit of opportunity by doctors and other health professionals under VUCA (volatile, uncertain, complex and ambiguous) conditions. The goal is to create user/patient/stakeholder defined value through the design, development, testing, deployment and harvesting of biomedical and clinical innovation using a VAST business model. Unfortunately, in my view, only about 1% of doctors and biomedical scientists have an entrepreneurial mindset and there are several misperceptions about those that do.

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

1. They are egotistical, self centered and greedy. Some might be , but most are generally interested in moving forward biomedical innovation to help patients and leverage their skills. Most physician entrepreneurs practice the belief that you can do well by doing good. They try to be compassionate capitalists , resolving the ethics of medicine with the ethics of business.
2. They are mostly 24-35 year old techies. In terms of medical education, people that age are just completing their residencies and just starting to practice independently. A few dabble in entrepreneurial ventures during undergraduate, medical school or residency, but most have their hands full with medical training and have little time, money or energy for anything else. In addition, many physicians start their entrepreneurial careers later in life as part of a portfolio career or an encore career after retirement from clinical practice. There are three main demographics.
3. Physician entrepreneurs have an inherent conflict of interest that makes them all suspect. All physicians, particularly those in private practice billing fee for service, have a conflict of interest and always have throughout the history of medicine. The world has become more complicated, further clouding the air. The idea is to declare, manage, mitigate or eliminate conflicts of interest, not ignore them.
4. Physician entrepreneurs have to quit the practice of medicine. In fact, there are many ways clinicians can practice entrepreneurship, adding value at a profit, by engaging in part time or transitional activities. The decision to engage in physician entrepreneurship should not be and either/or decision, but an “and” decision. There are many kinds of physician entrepreneurs and almost every doctor has the potential to create user defined value at some stage of their career. In fact, the ACGME should make practicing medicine using a viable business model a 7th competency.
5. Most physician entrepreneurs are millionaires. Like other entrepreneurs, most will fail if they create a new venture. In fact, most doctors make mid to high six figure salaries and the opportunity cost of pursuing an entrepreneurial venture is a barrier to participation.
6. Doctors think that the business of medicine is as important as the practice of medicine. In fact, most medical schools don’t teach it and very few medical students and postgraduate trainees learn it. Doctors learn it when they have to after graduation as a simple matter of survival
7. Entrepreneurship is about creating businesses. No it is not. Rather, it is about creating user defined value through the deployment of innovation and there are many ways to do that, including , but not limited to creating a business. For example, there are independent professional service providers (private practitioners), social entrepreneurs, intrapreneurs-employed physicians trying to act like entrepreneurs, physician investors and physician service providers. They all are trying to get ideas to patients or help someone who is. Doctors who say, “I didn’t go into medicine to be an entrepreneur” i.e. learn medical practice entrepreneurship, are misguided, partly due to the messaging of the academic and biomedical industrial complex that medicine is just about taking care of patients.
8. Innovation is the same as practice management. Practice management is like any other operations management function. It is done to maximize outputs/unit input. Innovation is done to create the future. For those in clinical practice, we should be emphasizing medical practice entrepreneurship and intrapreneurship.
9. You need a certain personality to be a physician entrepreneur. Most research indicates almost anyone can be creative, imaginative or innovative with the right coaching. Innovation starts with a mindset. Unlike personality traits, a mindset is malleable.
10. Things are staying the same. Quite the contrary. There are many in diverse educational, training, coaching and organizational ecosystems that are doing extraordinary things despite big obstacles to change how we do biomedical and health innovation and entrepreneurship.
11. Physicians are better entrepreneurs than anyone else. I doubt it. While it is true that end users are market perceivers, very few are technopreneurs, business developers, story tellers, score keepers or money finders that are necessary skill positions on the startup team
12. Physician entrepreneurs play nice with others. No they don’t. Here’s why.
13. It’s a “good old boys” network. About half of medical students are women. Yes, it is still true that minorities are underrepresented. Here are the numbers about women in medicine. My experience is that women physicians are just as entrepreneurial as men. Immigrants are more entrepreneurial.
14. Doctors make lousy business people. Here are some reasons why doctors have the potential to make great businesspeople or entrepreneurs. No, doctors are not lousy business people. Don’t be fooled by the cynics.
15. Doctors who don’t see patients are not “real doctors” . In fact, in my experience, the vast numbers of physicians who stop seeing patients continue to do things that benefit patients. In many instances, with much bigger impact on much larger numbers of patients that they did when they were seeing 40 patients a day working for the Man.

Here are some other facts about entrepreneurs that might surprise you.

Our sickcare system of systems is sick and the prescribed treatment needs to be multimodality therapy. One treatment is biomedical, digital health, care delivery and process innovation. Physician entrepreneurs will play an increasingly important role in making sure that the patient takes their medicine. Taking care of business is an essential part of taking care of patients. If doctors don’t care of business, they have no business practicing medicine.

Image credit: Pixabay

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