Category Archives: Entrepreneurship

Everyone hates to fail, why do you?

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Everyone hates to fail, why do you?

GUEST POST from Janet Sernack

If you have ever had a significant setback, made a serious mistake, or failed at completing an important task, you will have experienced some kind of deep emotional and visceral, largely unconscious, negative, reactive response to it.

By becoming passively or aggressively externally defensive and blaming and punishing others for the outcome, or by withdrawing internally, and attributing self-blame and self-punishment for what may have happened.

Everyone hates to fail because either type of reactive response stings and causes discomfort, dissonance, sorrow, suffering, and pain since you are feeling ashamed, judged, and shamed by yourself and by others. We need to re-think how we approach and digest failure, to scale and leverage it as one of our 21st-century superpowers.

Sabotaging your chances of success

According to a recent article in Psychology Today, this reactive response triggers your avoidance motivation, which then often exceeds your motivation to succeed!

Describing that the fear of failure causes us to then unconsciously sabotage our chances of success, as well as our ability to cultivate and manifest the superpowers necessary to thrive in the 21st century.

Self-doubt settles us into a denying the need to experiment, and a reluctance, full of excuses, to experiment further with adopting, iterating, and testing new and novel ideas. Or in taking smart risks, that help you connect, explore and discover and design opportunities for making important and necessary, personal and professional changes.

Pivot and adapt to disruptive events

Yet, our ability to experiment, test, validate and iterate creative ideas is critical to surviving and thriving through the current decade of both disruption and transformation – which more of us are viewing as a series of relentless, continuous, and exponential changes, requiring unlearning and radically new learning processes.

In a 2021 Deloitte survey of 2,260 private – and public-sector CXOs in 21 countries, 60% of the respondents said that they believe disruptions like those seen in 2020 will continue. The resulting challenge is underscored by another of the survey’s findings:

Seventy percent of the CXOs do not have complete confidence in their organisation’s ability to pivot and adapt to disruptive events.

This confidence can be developed by re-thinking how we approach and digest failure, to scale and leverage it as a 21st-century superpower.

Developing 21st-century superpowers

Here are the four key superpowers, to be supported by digital technologies:

  • Nimbleness: The ability to quickly pivot and move. (“We used to do this, and now we do that.”)
  • Scalability: The ability to rapidly shift capacity and service levels. (“We used to serve x customers; we now serve 100x customers.”)
  • Stability: The ability to maintain operational excellence under pressure. (“We will persist despite the challenges.”)
  • Optionality: The ability to acquire new capabilities through external collaboration. (“Our ecosystem of partners allows us to do things we couldn’t do previously do.”)

Rethinking our fears of failure

None of these 21st-century superpowers can be developed without experimentation and collaboration.

Where you are able to self-regulate your fears of making mistakes and failure, by becoming a smart risk-taker who willingly, stretches the envelope and steps outside of your safety and comfort zones.

This helps maximise your potential and ability to learn and develop in the growth zone, where we stop self-sabotaging our chances of adapting and learning, succeeding, and growing in an uncertain and unstable world.

Everyone hates to fail because it’s hard to self-regulate the basic emotions of disappointment, anger and frustration, and deep shame. Resulting from and the distorted thinking patterns that accompany failure, often immobilising you which results in an unwillingness and inability to disrupt yourself and take intelligent actions.

Slow down to rethink, respond, regroup, play and thrive

It all starts with leading, teaching, mentoring, and coaching people to slow down, to learn, and appreciate the value of taking “time-out” for retreat and reflection.

At ImagineNation, in last week’s blog, we described how this involves developing regular reflective practices, where people can pay deep attention, and learn how to master these basic emotions and unresourceful thought patterns. How this allows them to be playful and experimental in developing new mindsets, rethinking habits, and resourceful emotional states, which are foundational for developing 21st-century superpowers.

Failure can become valued as a process and resource for effecting significant human-centric change, deepening learning, and improving your future fitness.

Consequences of avoiding failure

According to the same article in Psychology today – “shame is a psychologically toxic emotion because instead of feeling bad about our actions (guilt) or our efforts (regret) shame makes us feel who we are”.

By getting to the core of your egos, your identities, your self-esteem, and your feelings of emotional well-being and resourceful thinking habits.

Because everyone hates to fail, we all unconsciously seek ways of mitigating the implications of a potential failure – “for example, by buying unnecessary new clothes for a job interview instead of reading up on the company – which allows us to use the excuse, “I just didn’t have time to fully prepare.”

Benefits of embracing failure

Rather than succumbing to the notion that everyone hates to fail, it is much more useful to develop healthier ways of embracing and flowing with it which might:

  • Motivate you to reflect deeply to consider and deliberate as to what might be the most intelligent and brave actions to take under the range of circumstances you find yourself in.
  • Inspire you to risk-taking those intelligent actions through developing sound risk anticipation, management, and mitigation strategies that help boost your confidence.
  • Commit to doing just a bit more, in inventive ways that add value to the quality of people’s lives as well to your customer’s experience of your product or service.
  • Encourage you to access your multiple and collective intelligence, be more courageous, compassionate, and creative in co-sensing, co-discovering, co-designing, and co-creating innovative solutions to complex problems.
  • Enable you to learn from others, and harness people’s collective intelligence to adapt and grow, through teaming, in ways that serve the common good.

Tips for rethinking and self-regulating fears of failure

A few tips to support you to rethink, respond, regroup and thrive that we will explore more deeply, through real-life stories and examples, in our next two ImagineNation™ blog posts (November and December):

  1. Be willing to redefine and reframe failure as what it means in your unique context, review past failures and see if you can find benefits that resulted from them.
  2. Set approach goals and not avoidance goals to view failure as a challenge that can be mastered.
  3. Control the controllable by intentionally managing your mindsets, shifting any negative perspective, and unpacking distortion and generalisations about failures and their negative consequences.
  4. Imagine yourself doing well, achieving your goals by composing and painting a picture or image of a desirable and compelling future success.
  5. Develop healthy self-compassion for when you do mess up, make mistakes and fail, by being kind and understanding, and empathic to your won humanness.
  6. Focus on every experience, no matter what it brings is an opportunity for deep learning and creative and inventive change.

Rather than living in a world where everyone hates to fail, why not adopt the rethink, respond, regroup, thrive pattern, be future-fit and develop your set of 21st-century superpowers in the face of the acute disruption of COVID-19?

Where it is expected that the business environment, over the next three to five years, will be the most exciting and innovative period that many of us may learn from and experience in our lifetimes?

Want to know why you might have a fear of failure?

Participate in our online research study “Ten Signs you may have a fear of failure” which we adapted from the article “10 Signs That You Might Have Fear of Failure… and 2 ways to overcome it and succeed” by Guy Winch Ph.D. in Psychology Today. Click here to access the survey.

We will happily share the results and findings with you if you leave your name and email address on the form provided. By sharing these details, you will also qualify for a complimentary 30 minute one on one online innovation coaching session, with one of our global professionally certified coaches to help you overcome your own anxieties and fears about failure and develop your 21st-century superpowers.

Join our next free “Making Innovation a Habit” masterclass to re-engage 2022!

Our 90-minute masterclass and creative conversation will help you develop your post-Covid-19 re-engagement strategy.  It’s on Thursday, 10th February at 6.30 pm Sydney and Melbourne, 8.30 pm Auckland, 3.30 pm Singapore, 11.30 am Abu Dhabi and 8.30 am Berlin. Find out more.

Image credit: Unsplash

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Sickcare Culture of Conformity versus a Culture of Creativity

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Sickcare Culture of Conformity versus a Culture of Creativity

GUEST POST from Arlen Meyers

Sickcare is a culture of conformity and competition. Premeds know it. Medical students and residents learn it. But, once they graduate, they are told they will be paid for value. Unfortunately, few will teach them how to do it and reconcile the culture of conformity and competition with an innovative culture of creativity, collaboration and interprofessional communication.

We should be thankful that we are starting to see some cracks in the armor.

Here are some ways to balance the two mindsets:

  1. Start with higher education reform  To prepare students for a post-Covid future, colleges and universities need to double down on preparing them for digital jobs. But even teaching platform skills aren’t enough. Few employers are interested in hiring candidates who’ve just completed a training program, they’re looking for relevant work experience. The good news is that there are two promising models for colleges to go beyond the traditional career services function to provide students with relevant digital training and work experience.
  2. Overcome the fallacies about creativity. To avoid premature closure, teams should arrive at an “almost final” decision and then intentionally delay action in favor of additional incubation time. During this time, everyone should commit to thinking about the problem and sharing their ideas. If the team can’t find a better approach during the incubation period, they should proceed with their original solution. Leaders can improve group creativity by paying close attention to how ideas are discussed in diverse group settings. They should encourage team members to build on each other’s ideas instead of pushing individual ideas. This doesn’t mean that ideas should be accepted blindly when they contain flaws; instead, they should approach ideas with an open mind to acknowledge useful aspects and improve weaknesses using plussing or the similar “yes, but, and” approach. To promote more creative ideas, leaders should utilize simple tools to capture individual ideas before they are opened to the whole group. Group discussions should be conducted asynchronously, where team members look at each other’s ideas and use them to refine and create new ideas. If done remotely, leaders should find other ways to bring the team together to bond and build trust with each other
  3. Teach creativity and entrepreneurship in medical school and residencies. Here is something so you don’t have to do reinvent the wheel.
  4. Rethink how we recruit and accept medical students Medical education is not alone, as noted in a recent HBR article describing how Goldman Sachs changed how they recruited new hires. Perhaps it is time for medical schools to adopt three new ways of recruiting and accepting medical students.
  5. Give medical students the opportunity to get experience working in a more creative culture as part of an internship or rotation.

6.Train the trainers. Provide faculty with the knowledge, skills, abilties and competencies they need to integrate creativity, innovation and entrepreneurship as part of their basic science and clinical rotations. But, what should an introduction to entrepreneurship teaching and learning include for basic science and clinical faculty who do not have innovation and entrepreneurship domain expertise include?

The learning objective of the module should be to know how to integrate healthcare innovation and entrepreneurship topics into basic science courses and clinical rotations by challenging students with case based, problem based and project based learning in real world settings and applications to help them perfect sickcare entrepreneurial knowledge, skills, attitudes and competencies.

7. Let medical students and residents take a gap year to learn how to create and sell something. Over half of medical schools already have an arrangement whereby students can take a one year leave of absence. But they call it something other than a gap year. They call it getting an MBA. Or, offer them a fellowship in entrepreneurship and innovation.

8. Close the doctor-data scientist digital divide to create a more cooperative culture of data analytics creativity.

9. Hire leaderpreneurs to become department chairs and deans. Rethink the triple threat.

10. Give medical students and residents an exit ramp. The next phase of medical school education reform is in progress. One question medical educators and Deans will have to address is, “What business are we in?” Are you in the business of graduating doctors who will only take care of patients directly, or, are you in the business of creating opportunities for graduates to pursue biomedical careers of their choice, including non-clinical careers that do not involve seeing patients face to face for a significant part of their working life? Patients are not the only stakeholders that have a dog in the sickcare hunt.

11. Teach philanthropreneurship Philanthropreneurship has four elements. First, the driving force must be a passion to make life better for others, especially those who are underprivileged. Second, there has to be an element of giving, whether this is in terms of money or time. Third, there needs to be creativity, the envisioning of novel approaches to solving problems. And finally, philanthropreneurship requires leadership and strategic thinking– directing, organizing, and influencing the efforts of others.

12. Destroy your innovation silos Sick care badly needs innovation if it is to become healthcare . Yet, it’s questionable whether it can be fixed from inside. Despite the popularity of open innovation and community based, participatory innovation networks, healthcare organizations and doctors seem to shun outside ideas and collaboration and are perceived as arrogant know-it-alls, stuck in the ivory tower or healthcare city , when it comes to knowing what’s best for patients. They have a silo mindset that blocks collaboration with other stakeholders in the innovation supply chain. The challenge for most organizations is to create and engage stakeholders.

Innovation starts with mindset. The clinical mindset is different from the entrepreneurial mindset and the ethics of medicine are different from the ethics of business. We need to give experience, educate and train doctors who can reconcile the two. Thankfully, it is starting to happen and it will make better doctors.

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Are doctors wasting their time on entrepreneurship?

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Are doctors wasting their time on entrepreneurship?

GUEST POST from Arlen Meyers

Medical students, residents and practitioners around the world are getting more and more interested in entrepreneurship for many reasons. With that, some are questioning the wisdom of doctors bothering themselves with “the business of medicine” , innovation and entrepreneurship given how difficult it is for most doctors to maintain state of the art medical skills, cope with a constantly challenging regulatory environment and keep up with the explosion of medical knowledge. One fundamental question that challenges every doctor is how to reconcile the ethics of medicine with the ethics of business where they practice.

The idea that we are living in an entrepreneurial age, experiencing rapid disruptive technological innovation on a scale amounting to a new “industrial revolution” is a pervasive modern myth. Scholars have written academic papers extolling the coming of the “entrepreneurial economy”. Policymakers and investors have pumped massive amounts of funding into start-up ecosystems and innovation. Business schools, universities and schools have moved entrepreneurship into their core curricula.

The only problem is that the West’s golden entrepreneurial and innovation age is behind it. Since the 1980s entrepreneurship, innovation and, more generally, business dynamics, have been steadily declining—particularly so in the US. As economist Tyler Cowen has found: “These days Americans are less likely to switch jobs, less likely to move around the country, and, on a given day, less likely to go outside the house at all […] the economy is more ossified, more controlled, and growing at lower rates.”

For all the entrepreneurship cheerleading of the last 15 years, the Great Recession accelerated an already alarming decline in new business formation in this country. In the United States, our rates of entrepreneurship have been declining for decades, and those new firms that have been created are employing fewer and fewer people. Meanwhile, techno-oligopolies continue to increase.

After remaining remarkably consistent for decades, the number of new businesses launched in the United States peaked in 2006 and then began a precipitous decline – a decline accelerated by the Great Recession. From 2002 to 2006, the economy produced an average of 524,000 new employer firms each year. Since 2009, however, the number of new business launched annually has dropped to about 400,000, meaning the United States currently faces a startup deficit of 100,000 new firms every year – and a million missing startups since 2009.

COVID has had a significant impact on entrepreneurship. Here is another take on the effect of COVID on entrepreneurship. But, entrepreneurship by necessity has its dark side.

Research suggests that over the past two decades, the number of high-value startups has declined, sparking significant debate over what’s causing the drop, how to fix it, and whether or not it’s a problem that needs fixing. Here are six reasons why that might be true:

  • Theory 1: Entrepreneurs are motivated more by the lifestyle than by viable business ideas

  • Theory 2: Tougher regulation is hurting high-growth companies

  • Theory 3: Big businesses have changed the way they operate

  • Theory 4: Entrepreneurs lack the right training

  • Theory 5: The gig economy is affecting would-be entrepreneurs’ experience

  • Theory 6: The problem is a measurement issue

Here is the tale of the tape:

  • In 1980, 15% of all U.S. firms had been created the year before. In 2011, that share had been halved, according to census data.
  • In 1997, for the first time in this country’s history, more Americans worked at companies with 250 or more employees. The gap has steadily grown since, aside from a notable blip in the early 2000s. The biggest single percentage increase was between 2007 and 2008, as the Great Recession took hold.
  • Three-quarters of U.S. incorporations that we do have issue no payroll, mostly for the self-employed.
  • Though our outsized venture capital market means we have a high share of iconic, rocket-ship growth companies, the United States is lagging other rich country peers in the crucial middle category: new, growing, innovative companies trying to bring efficiencies to industries that may last.

Part of the problem derives from some misconceptions and differences in our interpretations of physician entrepreneurship:

  1. Each doctor has his or her definition of physician entrepreneurship, value and innovation

  2. Physician entrepreneurs play many different roles creating user defined value

  3. Those roles depend on whether they are medical practice entrepreneurs, social entrepreneurs, technopreneurs, intrapreneurs, educational entrepreneurs, physician service providers or investors

  4. Innovation ecosystems vary from one domain e.g. digital health to another, like biopharma

  5. There are vast international cultural, social and political systems differences that help or hinder physician entrepreneurship.

  6. Rules drive ecosystems. Rules variation around the world often reflects the values of a given citizenry at a given point in time. While health system problems are universal (cost, access, quality, changing demographics, supply, demand, equity), the solutions vary tremendously.

  7. Creating value and wealth is but one step. Sharing the wealth that results, justice and equity are separate issues that can either raise the overall standard of a health system in a given country or drive another wedge between the haves and have nots. It also determines how physician entrepreneurs are perceived as either ruthless, greedy profiteers or instruments of social justice and improvement.

  8. The gaps between how younger generations and older rulers see the world are widening (e.g China and somewhat reflected by Sanders supporters in the US elections) The “dream” constantly evolves from financial security to higher levels of needs like democracy, international connectedness and security and a better life for families and children.

  9. Regardless of which way physicians choose to pursue entrepreneurship, it takes teamwork and the involvement of many different participants with varying skill sets. Each contributes something different.

  10. Biomedical entrepreneurship is a marathon relay race. As such, any team is only as strong as its weakest link.

  11. Few health professionals have an entrepreneurial mindset, in large part because of how they are chosen and the lack of bioentrepreneurial education and training in their programs.

  12. Politics, ego and greed get in the way of substantive change in the US sickcare system of systems.

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

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

If you thought getting a side gig or pursuing a non-clinical career was Plan B but now realize the grass really isn’t that much greener, maybe it’s time for Plan C.

The underlying assumption behind creating incentives for early involvement of physicians in entrepreneurship is that it will improve outcomes and company success. However, we lack the data that validates that assumption.

Doctors are wasting their time typing into EMRs, complying with administrivia, being on hold to get prior authorization, and answering unnecessary phone calls from patients that could be avoided with proper engagement and education. If anything, they are not spending enough time creating user defined value through the deployment of innovation.

At its core, though, we need to change the rules about measuring quality, clearing products, paying to things, providing equitable access and insurance coverage, and eliminating waste and administrivia cost, and narrowing inequitable value sharing. Otherwise, we are just parading shiny new objects.

We need to fix sickcare USA before we decide how or whether we change how we fund it. Otherwise, we will be just wasting more and more money.

We need to do a better job of measuring the input, output and impact of physician entrepreneurship including not just creating new companies, but interventions in medical practice entrepreneurship, social entrepreneurship, intrapreneurship, edupreneurship and other non-commercial roles as well.

International biomedical entrepreneurship will continue to grow With that, however, will be more challenges to use the results to make patients, systems and societies better. By doing good, physician entrepreneurs can do well, but there are formidable headwinds preventing them from doing so. Unless we have evidence to the contrary, the null hypothesis is physician entrepreneurship is a waste and , in retrospect, just sounded like a good idea at the time. I hope the results prove me wrong.

Image credit: Pixabay

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Teaching to Win the 4th Industrial Revolution

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Teaching to Win the 4th Industrial Revolution

GUEST POST from Arlen Meyers

The Coronapocalypse is forcing us to rethink who, how and what we teach. Regardless of how we do it, college students don’t learn much and the teacher experience is eroding.

Many not for profits are directing their efforts to provide equitable access to public education. However, putting more students in a broken, dysfunctional system won’t yield the outcomes and impact we want. Instead, the very structure and process of education will need to change if we are to provide students with the knowledge, skills, abilities and competencies they need for jobs that have yet to be created.

What’s more, unless we address the gender social and cultural stereotypes, the 4IR could make gender inequity worse, not better.

Companies like Infosys still hire lots of engineers. But today, Ravi Kumar, the Infosys president, is not looking just for “problem solvers,’’ he says, but “problem-finders,’’ people with diverse interests — art, literature, science, anthropology — who can identify things that people want before people even know they want them.

If for nothing else than the future of your children, take 12 minutes to watch this:

If you agree, then thriving in the 4th industrial revolution will require nothing short of restructuring public education at all levels, not just k-12. Even doctors will need to change how they educate their young. How many things can you do with a paperclip?

One goal should be to create entrepreneurial schools and universities, and by that I don’t mean teaching children how to start businesses. Instead, creating the entrepreneurial mindset is about the pursuit of opportunity with scarce resources with the goal of creating user defined value through the deployment of innovation. Creating a successful business in but one of many ways to do that.

Here are 10 different ways to encourage youth entrepreneurship. The same techniques might apply to graduate students as well.

Other learning objectives and curriculum themes are emerging:

  1. Encouraging private, public and academic collaboration to define market based competencies
  2. Teaching horizontally, not vertically, in limiting smokestack domains
  3. Developing soft skills that are in high demand
  4. Experience cultural competence, diversity and inclusion
  5. Alternative pathways for teacher training and development
  6. Job searching techniques that are state of the art
  7. Mandatory experiential learning opportunities
  8. Developing and testing alternative intelligence measures
  9. Replacing memorization with creative problem solving, problem seeking and divergent thinking.
  10. Hiring for creativity and finding and supporting educational reform champions
  11. Like sick care, recognizing and addressing the socioeconomic determinants of academic failure, like housing, illness, disability and nutrition.
  12. Rehabilitating the brand image of teachers
  13. Teaching STEAMpathIE and rethink STEM as BMETALS
  14. Preparing students for the jobs of the future that have not yet been created.
  15. Teach them how to work in and manage virtual international teams.

Here’s another short list:

  1. public speaking
  2.  writing well
  3. storytelling (see 1-2)
  4. critical thinking (not cynicism)
  5. good manners
  6. active listening (hear with your eyes)
  7. networking (trust and giving)
  8. good customer service
  9. how to sell
  10. to fight against entitlement

Curriculum redesign for medical students and residents will need to include:

  1. Data literacy
  2. Interprofessional bioentrepreneurship
  3. Digital health policies and practice
  4. Care coordination between the medical team and the patient care circle
  5. Cost-effectiveness analysis
  6. The pharmaceutical value chain and drug pricing
  7. Customer service
  8. Ethics and professionalism
  9. Personal financial literacy and planning
  10. Nutrition

Here is how automation will affect economies around the world.

Here are some recommendations to Promote digital education and workforce development

“As AI applications accelerate across many sectors, it is vital that we reimagine our educational institutions for a world where AI will be ubiquitous and students need a different kind of training than they currently receive. Right now, many students do not receive instruction in the kinds of skills that will be needed in an AI-dominated landscape. For example, there currently are shortages of data scientists, computer scientists, engineers, coders, and platform developers. These are skills that are in short supply; unless our educational system generates more people with these capabilities, it will limit AI development.”

Our economy and standard of living hinges on meeting these wicked challenges. But, like medicine, government and other risk-averse and sclerotic industries, the resistance to change will be substantial. Only bottom-up pressure led by creative, courageous innovators who teach what they practice, in collaboration with non-profits and government agencies, will remove the obstacles in our path. Many of those obstacles are in the classroom next door or the corner office or the halls of government.

Image credit: Pixabay

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Myths About Physician Entrepreneurs

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Myths About Physician Entrepreneurs

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.

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Lean Startup Methodology

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Building a Business with Minimal Waste

Lean Startup Methodology - Building a Business with Minimal Waste

GUEST POST from Chateau G Pato

In today’s competitive business landscape, achieving success requires more than just a great idea.
Entrepreneurs need a systematic approach to quickly identify what works and what doesn’t, all while minimizing waste.
Enter the Lean Startup Methodology – a revolutionary approach that involves building a business by experimenting, iterating, and validating with minimal resources.

Understanding Lean Startup Methodology

The Lean Startup Methodology, coined by Eric Ries in his seminal book “The Lean Startup,” is based on the principles of lean manufacturing.
It emphasizes the importance of creating a Minimum Viable Product (MVP), validated learning, rapid iteration, and pivoting based on customer feedback.
This approach allows startups to validate their business ideas quickly and efficiently, reducing the risk of investing time and money into unproven concepts.

Case Studies

Case Study 1: Dropbox

One of the most well-known examples of the Lean Startup Methodology in action is Dropbox. Before investing heavily in product development, Dropbox’s founders aimed to validate their idea: a simple-to-use file-sharing service.
Instead of building a fully-featured product, they started with a short video demonstrating the core functionality of Dropbox. This MVP helped them gauge interest and gather valuable feedback from potential users.

The video went viral on various tech forums and social media platforms, quickly securing thousands of sign-ups for the beta version of Dropbox. By using this minimally viable form of validation, Dropbox managed to refine its product with minimal waste and significant user input.
Today, Dropbox is a multi-billion dollar company, and it all started with a simple MVP and a clear focus on validated learning.

Case Study 2: Zappos

Zappos, now one of the largest online shoe and clothing retailers, also adopted a Lean Startup approach in its early days. Rather than investing in a large inventory upfront, founder Nick Swinmurn started with a simple website that displayed photos of shoes.
Whenever a customer placed an order, Swinmurn would personally go to local shoe stores to buy the shoes and ship them directly to the customer.

This MVP allowed Zappos to validate the demand for online shoe shopping without the risk and expense of holding inventory. It also provided valuable insights into customer preferences and buying behavior, allowing Zappos to fine-tune their business model.
The information and insights gained during this MVP phase were critical in building the foundation for Zappos’ subsequent growth and success.

Conclusion

The Lean Startup Methodology offers a powerful framework for building a business with minimal waste. By focusing on validated learning, creating MVPs, and iterating based on customer feedback, entrepreneurs can quickly determine the viability of their ideas and pivot as needed.
The examples of Dropbox and Zappos illustrate how this approach can lead to tremendous success when executed correctly.

As you embark on your entrepreneurial journey, remember that the key to success is not just having a great idea, but also having the ability to learn, adapt, and evolve with minimal waste. The Lean Startup Methodology provides the tools and mindset needed to achieve this goal.

SPECIAL BONUS: The very best change planners use a visual, collaborative approach to create their deliverables. A methodology and tools like those in Change Planning Toolkit™ can empower anyone to become great change planners themselves.

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Should intrapreneurs really ask for forgiveness and not permission?

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Should intrapreneurs really ask for forgiveness and not permission?

GUEST POST from Arlen Meyers

Intrapreneurs are employees trying to act like entrepreneurs, i.e. pursuing opportunity in their organizations with scarce resources with the goal of creating user defined value through the deployment of innovation. Many run into a brick wall.

The intrapreneur’s Ten Commandments include:

  1. Remember, it is easier to ask for forgiveness than for permission.

  2. Do any job that needs to make your project work, regardless of your job description.

  3. Come to work each day willing to be fired.

  4. Recruit a strong team.

  5. Ask for advice before resources.

  6. Forget pride of authorship, spread credit wisely

  7. When you bend the rules, keep the best interests of the company and its customers in mind.

  8. Honor your sponsors

  9. Underpromise and overdeliver

  10. Be true to your goals, but realistic about ways to achieve them.

We’ve heard #1 a lot and it has become part of the lore of intrapreneurship and organizational behavior. But, is it really a good idea? It depends, and here are some reasons why:

  1. Every organization, hospital and university has a culture of risk. Some cut you some slack. Some don’t.

  2. It depends on the risk involved. Andrew Gove of Intel advised to ask for foregiveness, but don’t drill holes below the water line.

  3. Sometimes, it ‘s better to keep what you are doing secret so as not to expose your idea too soon to the organizational immune system or people who are out to torpedo your success.

  4. It takes a while to get your idea ready for prime time and validate assumptions. Better to fail early and off the radar than flop big.

  5. Getting the resources you need will require imagination and political savvy. Sometimes that requires stealth and cunning.

  6. Most organizations have archaic systems for prioritizing innovation or a new product portfolio. Asking for permission just puts you in dysfunctional queue.

  7. Better to deliver your idea with as much value added as possible.

  8. You are not the only one with the responsibility of moving your idea forward. Think about your team members and sponsors who have their necks out too.

  9. One swallow does not a summer make. Even if you roll out a successful idea, people are going to want to know what you have done for them lately. Better to have a pipeline of products in development before launch. Platforms are more attractive than products.

  10. Building sustainability takes time and is sometimes done better off the radar. Once you have a successful internal venture, people will come to you to take credit.

Getting “escalated” is not pretty. Here are some ways to manage it.

There are two kinds of innovators. Permission seekers start with the rules, create ecosystems that conform to them, create business models that are new or different and that foster innovation. Forgiveness seekers, do the same, but in reverse. They use technologies that have reached a coherence tipping point to create business models and ecosystems and then drive to change the rules to allow them to scale.

There is a lot to recommend stealth innovation. Beware of making too much noise and make it low impact at the beginning. Don’t use words, like “center”, “institute” or “innovation” that are likely to mobilize hostiles with competing interests. Practice digipreneur guerilla tactics. Watch out for snipers.

Arming yourself with anti-radar technology is usually a smart move. However, if you get shot down over enemy territory it might be hard to find you and you will be placing your search and rescue team members in jeopardy. Think twice before flying over hostile territory without a survival plan.

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Encouraging a Risk-Taking Mindset in Your Organization

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Encouraging a Risk-Taking Mindset in Your Organization

GUEST POST from Art Inteligencia

The rapid pace of change in today’s business environment demands agility and a willingness to take risks. However, fostering a risk-taking mindset in an organization is easier said than done. It requires deliberate strategy, clear communication, and a supportive culture. Here, we’ll explore practical steps to encourage this mindset by examining two case studies from companies that have successfully navigated this transformation, while building an entrepreneurial mindset in their employees.

Case Study 1: 3M

Overview

3M, a global innovation company, is often cited as a model for fostering a risk-taking culture. Known for its wide range of products and significant number of patents, 3M has embedded risk-taking in its corporate DNA.

Actions Taken

  • 15% Rule: 3M encourages its employees to spend 15% of their work time on ideas of their choosing. This policy gives employees the freedom to explore and experiment without the immediate pressure of delivering results.
  • Cross-Functional Teams: By forming cross-functional teams, 3M brings diverse perspectives together, promoting creative solutions and informed risk-taking.
  • Learning from Failure: 3M celebrates both successes and learnings from failures. They hold ‘failure parties’ to dissect what went wrong and how it can be avoided in the future, thereby destigmatizing failure.

Results

3M’s risk-taking culture has led to products like Post-it Notes and Scotch Tape, revolutionizing the stationery market. Their approach demonstrates that calculated risks, backed by support and learning, can lead to groundbreaking innovations.

Case Study 2: Google

Overview

Google, a pioneer in the tech industry, is another example of a company that thrives on a risk-taking ethos. Their rapid expansion into a variety of tech-related fields is a testament to their willingness to venture into the unknown.

Actions Taken

  • Psychological Safety: Google places high importance on creating environments where employees feel safe to take risks. Project Aristotle highlighted psychological safety as a key component of their high-performing teams.
  • Dedicated Innovation Labs: Google runs innovation labs like X (formerly Google X), which are dedicated to ‘moonshot’ projects with high risk and high reward.
  • Clear Metrics: For each experimental project, Google sets clear milestones and metrics, allowing for informed go/no-go decisions rather than arbitrary cuts based on gut feeling.

Results

Google’s approach to risk-taking has birthed revolutionary products like Google Search, Gmail, and self-driving car technology. By emphasizing psychological safety and creating dedicated spaces for risk, Google continues to lead in innovation.

Key Takeaways

From these case studies, we can extract several key practices that any organization can implement to foster a risk-taking mindset:

  • Encourage Time for Exploration: Allocate time for employees to work on passion projects and explore new ideas.
  • Promote Cross-Functional Collaboration: Bring together diverse teams to fuel innovative thinking.
  • Create a Safe Environment for Failure: Celebrate learnings from failures to reduce the stigma and fear associated with taking risks.
  • Set Clear Metrics and Milestones: Provide clarity on what success looks like to make informed decisions.
  • Support from Leadership: Ensure that leaders actively support and model risk-taking behavior.

By embedding these practices into the fabric of your organization, you can create a dynamic environment where innovation thrives, and calculated risks lead to transformative successes.

Bottom line: Futurology is not fortune telling. Futurists use a scientific approach to create their deliverables, but a methodology and tools like those in FutureHacking™ can empower anyone to engage in futurology themselves.

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Being Too Focused on the Test is Dangerous

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Being Too Focused on the Test is Dangerous

GUEST POST from Arlen Meyers

Like most premeds, I got into medical school, mostly, because I am good at taking standardized tests, I can memorize lots of information , I had some cultural and economic advantages and I knew what to say to interviewers who did not know how to interview. It certainly was not about my being creative or imaginative.

Fortunately, for this generation, that is gradually changing.

As more and more medical educators try to reform the structure, process , goals, learning objectives and outcomes of medical undergraduate and post-graduate education, they run into some recurring questions:

  1. How do we find the right people to teach new subjects?

  2. How do we find the time to teach all of this new information when we are already constrained by the explosive growth of new basic science and clinical information?

  3. How do we make sure that our students and residents pass the tests required to graduate and get board certified so that they can practice and so that the education and training programs get accredited? In other words, how do we practice educational ambidexterity

  4. Should we change how and who we admit?

  5. How do we bridge the now, with the next with the new?

The latest trend in management theory is what’s called organizational ambidexterity. It’s the social scientists take on being a switch hitter, and is defined as an organization’s ability to be aligned and efficient in its management of today’s business demands while simultaneously being adaptive to changes in the environment. In other words, being able to simultaneously lead the now, the new and the next. Some describe it as bimodal people management.

While some are very vocal about eliminating standardized tests, it is unlikely they will be eliminated. The rate of growth of scientific and clinical information will increase. New faculty develoment is always a challenge. So, what are some answers?

  1. Faculty development programs that are people-centric and expand their knowledge, skills, abilities and competencies about introducing and integrating new subjects into their existing subject matter expertise. Engage the champions, build innovation teams around them, set the standards and goals then get out of their way. Identify the skeptics and either convert them or just let them do what they do best now. Sabateurs should be quickly exposed and “rehabilitated”.

  2. Recruit, develop, promote and reward for skills, like innovation, entrepreneurship , data analytics and artificial intelligence

  3. Create interdisciplinary and cross functional teaching teams

  4. Encourage industry collaboration

  5. Decrease, don’t increase, lecture time and give students the flexibility to learn when and how they do it best.

  6. Focus on competencies, while at the same time making it clear to students what they will be tested on to practice medicine

  7. Reform the standardized test and maintenance of certification process

  8. In the age of search, teach students how to learn, not what to memorize. Take advantage of how students learn, not how you think they learn.

  9. Accelerate up the hierarchy of learning from recall to interpretation to problem solving to creativity

  10. Take small steps in integrating the new subjects into the traditional four year/three year curriculum

  11. Test new ideas and incorporate the results into the next iteration

  12. Encourage students to be prosumers (producer/consumers) and help you build the product

  13. Rethink how and who you admit to medical school. In one recently opened school, 75% of the first year class have engineering or computer science degrees.

  14. Integrate and continue to build medical school education with post-graduate education and training

  15. Change and define GME required competencies and accreditation standards to meet contemporary needs.

Here are themes/motifs that are becoming part and parcel of the practice of medicine and are incrementally being intergrated into the medical school curriculum:

Some new schools are leapfrogging the old ways and launching entirely new curriculum maps from the start.

We should strive for educational ambidexterity and evolve from teaching and learning to the test and forgetting about all the rest.

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How to Scale Your Culture

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How to Scale Your Culture

GUEST POST from Arlen Meyers

Facebook, Apple, Boeing, McDonald’s and Starbucks are not the only high profile companies that have lost their way as they just got bigger and bigger. Experts and pundits will offer many reasons, some organizational and some more personal about the CEO and the leadership team. Just read the transcripts and review the videos of Congressional hearings about companies breaking bad as they are conducted, seemingly, on a more regular basis. Or, you can see the highlight reel on 60 Minutes or YouTube.

Most would agree, though, that a main cause of a company loosing its bearings during explosive growth is a loss of culture. The term “company culture” is something of a nebulous concept, but most culture professionals can agree on the very basics of a definition. In short, company culture is defined as a shared set of values, goals, attitudes and practices that make up an organization. How an organization goes about crafting its own culture is totally up to them .

In other words, culture is mostly about “how we do things around here”.

The US “healthcare” system is actually a dysfunctional sickcare system of systems masquerading as a healthcare system that includes academic medical centers, community hospitals, government hospitals and other health service organizations. Recent entrants include retailers, online vendors and pharmaceutical companies.

I have worked in many of these kinds of organizations. They all have a unique culture. Working in a VA hospital is much different than working in a for profit community integrated delivery network. In fact, one of the main causes of failed mergers, acquisitions or hospital consolidations is “cultural mismatch”.

The average tenure of a hospital CEO is 5.6 years with a median of 3.6 years. Very few (3.4%) had continuous tenure of 20+ years. Half (51%) had previously been a CEO at another hospital. First-time CEOs were often (57%) promoted from within their organizations.

So, how do you scale culture when the music stops for one CEO and starts for another as consolidation relentlessly surges forward?

Here is an anthology of culture continuity hacks:

  1. Forbes
  2. Harvard Business Review
  3. Bob
  4. 15five
  5. Inc
  6. What about scaling culture during the pandemic?

Some have observed that company culture is a reflection of the founder or leader. But, once the founder goes, pong, pool and picnics will only get you so far. Instead, many will get lost in the wilderness next to where you are holding your koombaya event including your investors and bankers.

I once worked with a Dean who remarked, “The problem is that we have no soul”

Rounding up stakeholders and getting them back to base camp is not something you will learn in scaling school ,medical school or your health adminstration degree program. 

Not learning how to scale culture, however, is career suicide.

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