Category Archives: Healthcare

The Gilded Age of SickTech

The Sicktech Gilded Age

GUEST POST from Arlen Meyers, M.D.

The WSJ reported that Twitter Inc. TWTR 5.66% accepted Elon Musk’s bid to take over the company and go private, a deal that would give the world’s richest person control over the social-media network where he is also among its most influential users.

The $44 billion deal marks the close of a dramatic courtship and a change of heart at Twitter, where many executives and board members initially opposed Mr. Musk’s takeover approach. The deal has polarized Twitter employees, users and regulators over the power tech giants wield in determining the parameters of discourse on the internet and how those companies enforce their rules.

In response, the NYT reminded us that two years ago, the economists Emmanuel Saez and Gabriel Zucman published a statistic that you don’t normally see. It was the share of wealth owned by the richest 0.00001 percent of Americans.

That tiny slice represented only 18 households, Saez and Zucman estimated. Each one had an average net worth of about $66 billion in 2020. Together, the share of national wealth owned by the group had risen by a factor of nearly 10 since 1982.

Wealth inequality in the US is rising with fewer and fewer owning more and more. As digital health consolidates and unicorns become as common as dandelions on your lawn this time of year, should we fear the Sicktech Gilded Age? What are the concerns?

  1. Will these technologies cause more problems than they solve?
  2. With wealth comes power. What will that mean for equitable access?
  3. What will be the impact on the business of medicine?
  4. Will profits precede patient interests more than they are now?
  5. What will be the impact of private equity on medical practice?
  6. How should we educate and train health professionals to work in the Sickcare Gilded Age?
  7. How will sickcare entrepreneurs respond?
  8. What will be the backlash from the sickcare workforce? Labor actions and strikes?
  9. How much more will the prices of sickcare rise as inflation eats away at household spending?
  10. Will technobarons be able to transform sickcare into healthcare?
  11. Will there be a Luddite backlash? The past is prologue.
  12. What will be the impact of sickcare technologies on society?

Or, will there the bubble pop and we will start seeing more “cram downs”? Do you trust sickcare technobarons to do the right thing?

We will have to wait and see whether Mr. Musk can unleash the value of Twitter or whether sickcare barons can do the same. Many other billionaires have failed trying.

Image Credit: Pixabay

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19 Things Physician Entrepreneurs Don’t Get About Sales and Marketing

19 Things Physician Entrepreneurs Don't Get About Sales and Marketing

GUEST POST from Arlen Meyers, M.D.

Many biomedical and health marketing and sales people ask about tips and techniques on how to sell to doctors. But, very few doctors or physician entrepreneurs have much interest in how to market and sell to patients and other customers. The conventional wisdom goes that they are “too busy” or “don’t have the time” and that they are trained to take care of patients, not take care of business.

I disagree, as I’ve explained in many other posts. However, sales is not in the medical school course catalog.

During a pandemic, that is not an option. Here is what you need to know about digital marketing now.

Here are some social media strategies you should use in the post-pandemic world.

Do you know how to rank #1 on Google?

Ogilvy, one of the most respected marketing firms globally, has recognized this shift by stating that the traditional “4 Ps of Marketing” are out and the 4 Es are in.  

  • Experience is more important than Product
  • Everywhere (Omnichannel) is now Place
  • Exchanges outweigh Price
  • Evangelism is more valuable than Promotion

Here is the job description for a social media manager for Microsoft:


  • Design and execute a slate of rich social media strategies that resonate with our diverse and global audience and drive its implementation across our key campaign moments.
  • Define social media priorities, set goals and targets, aligning with audience insights. Proactively identify areas of optimization, set best practices, and communicate these across teams.
  • Partner across MSR Labs, Campaign Marketing, Community Engagement, Comms, Editorial, and Web/Media Production to support opportunities for rich scientific storytelling.
  • Serves as a trusted advisor to senior leaders through strong communication and influencing skills.
  • Creates and presents business reports that outline impact driven and provides recommendations based on outcomes.
  • Ability to focus on business priorities and create boundaries to ensure successful project completion.
  • Work with the paid social media team to execute and deliver on overall campaign KPIs.
  • Continuously improve on results by capturing and analyzing the appropriate social data/metrics, insights, and best practices, and then work with marketing managers to execute on those KPIs and leading indicators.


Required Qualifications:

  • 5+ years of practical experience in a global enterprise social media environment or global agency in the field of social media.
  • Experience in the use of social media platforms (Facebook, Instagram, LinkedIn, Reddit, TikTok, Twitter, Twitch, YouTube, or Club House, etc.).

Preferred Qualifications:

  • Bachelor’s Degree
  • Exceptional formal and colloquial communications skills.
  • Ability to collaborate effectively within a team and across organizational and team boundaries.
  • Ability to manage complex projects in a fast-changing environment.
  • Proven track record for new, innovative approaches, and smart risk taking.
  • Understanding and natural curiosity of evolving social media trends.
  • Experience with tools like Sprinklr, Opal, Excel, and Power BI.
  • Positive attitude, detail and customer oriented along with strong multitasking and organizational acumen.

Here are 10 things docs don’t seem to understand about healthcare sales and marketing:

1. That they are different. Said another way, the marketing team figures out the strategy. The sales team executes the battle plan. Marketing serves the interests of the buyer. Sales serves the interests of the seller.

2. That they are complementary and have to be aligned

3. That the sales plan should not be an afterthought when building the business model canvas or business plan for a new venture.

4. That branding is not sales and marketing and that B2B marketing is different than B2C marketing.

5. That the Internet and social media have revolutionized how they both are done.

6. That service after the sale is just as important as selling the product and that they need to pay attention to the aftermarket.

7. That they don’t need to worry about any of this because they work for someone else who does it or they are busy enough.

8. That they should just outsource sales and marketing to someone else and just see patients.

9. That they can just depend on word or mouth referrals. It used to be docs played golf with their friends, but they now work on Wednesdays .

10. That all they need to do is hang a shingle to be successful because they have been reading about the shortage of doctors.

11. If you are a physician entrepreneur selling to doctors, you will relate to these tips on how to sell to doctors.

12. Every customer segment in sickcare requires a different value proposition, marketing and distribution/sales strategy. The 4Ps can rapidly become the 8, 16 or 24 Ps.

13. They actually believe they are the best and that “there is no competition”. Maybe it’s time for you to step back and create a competitive analysis matrix.

14. AI, changes in social media and VR/AR are rapidly changing how marketers are building their brands, engaging customers and driving sales and lead conversion.

15. There is a big difference between vanity numbers at the top of the funnel or prospect funnel and people who are ready, willing and able to buy (about 3% of the people you contact). Here’s a way to tell the difference

16. The difference and practice of segmentation, targeting and positioning

17. These ten most effective marketing techniques are a diverse group of online and offline strategies. Each technique is most effective when it is working in concert with the others.

18. When to hire a marketer

19. Consultative sales is more about leadership than sales

Most importantly, they don’t understand that branding a service is different from branding a product. That’s, in part, why they are losing patients to non-MDs.

Most entrepreneurs, including doctors, are still stuck in the spray and pray marketing mindset instead of inbound model. The idea is , instead of you finding patients and customers, help them find you.

What’s more, they don’t understand sales operations . The main function of the sales operations team is to smooth the sales process—reduce any friction and incorporate itself to the organization so as to ensure the execution of the sales strategy.

The basic building blocks of medical practice online marketing include building a website, having an search engine optimization (SEO) plan, using social media and managing your online reputation.

Hospital strategy and marketing officers, particularly those who have been recruited from consumer goods and service industries, stare in amazement at board meetings trying to understand why their docs won’t wear the sneakers and compete with the guys down the street. They fail to understand the culture of medical education and the profession that fundamentally places institutional affiliation and engagement way down the totem pole compared to peer acceptance and cooperation.

Another problem occurs when non-sick care entrepreneurs want to hire doctors as advisors, when, in fact, they want them to be salespeople to hospitals and other doctors on commission. The fact is that , in most instances, doctors lack sales knowledge, skills, abilities and competencies to do the job.

The main reason most doctors are not sales and marketing savvy is that they never had to be and they don’t want to be. But, times have changed. Maybe with an attitude adjustment, they’ll be able to get in a quick 18 holes after all.

Image Credit: Unsplash

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How to Balance a Culture of Conformity with Creativity in Medicine

How to Balance a Culture of Conformity with Creativity in Medicine

GUEST POST from Arlen Meyers, M.D.

Medicine, by its nature, is a culture of conformity. We are trained to do no harm, be risk averse, and conform to the standard of care. We follow “best practices” i.e. what everyone else is doing, and are encouraged to follow evidence based guidelines. Medical students are chosen by their ability to score highly on standardized tests and check off the requisite boxes in their application. They know what to say in interviews…over and over again. Physicians have to pass standardized tests to get a license and be board certified to practice and maintain certification.

Now that medicine has become corporatized and more and more doctors in grey flannel suits are working for the man, things have worsened.

Successful innovation and entrepreneurship, on the other hand, encourages a culture of creativity. Now that students, trainees and clinicians are getting more and more interested in physician entrepreneurship and the business of medicine, how do we encourage and balance the two cultures?

  1. Encourage cognitive diversity, not just demographic diversity, in decision making
  2. Don’t penalize failure. Showcase it instead.
  3. Create ambidextrous organizational departments and units that can plan for not just the now, but the next and new as well.
  4. Use evidence based techniques for ideation and creative problem solving. Here are 3 to get you started.
  5. Recruit, hire, develop and promote for creativity
  6. Create psychologically safe spaces to say things
  7. Forget brainstorming
  8. Hire leaderpreneurs who can drive cultural change
  9. Know the difference between good rebels and bad rebels
  10. Don’t confuse disruptive doctors with disruptive doctors
  11. Learn to resolve the conflict between the ethics of medicine and the ethics of business

Sometimes thinking outside of the box will get you in trouble. Other times, not doing so will box you in. You decide.

Image credit: 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.


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

Before you start, prepare yourself with these things:


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.


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 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.


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.


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.


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


  • 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.


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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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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Top 100 Innovation and Transformation Articles of 2021

Top 100 Innovation and Transformation Articles of 2021

2021 marked the re-birth of my original Blogging Innovation blog as a new blog called Human-Centered Change and Innovation.

Many of you may know that Blogging Innovation grew into the world’s most popular global innovation community before being re-branded as and being ultimately sold to

Thanks to an outpouring of support I’ve ignited the fuse of this new multiple author blog around the topics of human-centered change, innovation, transformation and design.

I feel blessed that the global innovation and change professional communities have responded with a growing roster of contributing authors and more than 15,000 newsletter subscribers.

To celebrate we’ve pulled together the Top 100 Innovation and Transformation Articles of 2021 from our archive of over 700 articles on these topics.

We do some other rankings too.

We just published the Top 40 Innovation Bloggers of 2021 and as the volume of this blog grows we may bring back a monthly ranking to complement this annual one.

But enough delay, here are the 100 most popular innovation and transformation posts of 2021.

Did your favorite make the cut?

1. All Leadership is Change Leadership – by Randy Pennington

2. Next Generation Loyalty – Part One – by Braden Kelley

3. Visual Project Charter™ – 35″ x 56″ (Poster Size) and JPG for Online Whiteboarding – by Braden Kelley

4. Where Do Innovation Strategies Usually Go Wrong? – by Jesse Nieminen

5. Black Friday Shows No Loyalty – by Braden Kelley

6. The Fail Fast Fallacy – by Rachel Audige

7. Top 40 Innovation Bloggers of 2020 – by Braden Kelley

8. What is Human-Centered Change? – by Braden Kelley

9. 10 Clever Ways to Stop Ideation Bullies from Hogging Your Brainstorming Sessions – by Howard Tiersky

10. 50 Cognitive Biases Reference – Free Download – by Braden Kelley

11. Free Customer Experience Maturity Assessment – by Braden Kelley

12. The Human-Centered Change Methodology – by Braden Kelley

13. Innovation vs. Invention vs. Creativity – by Braden Kelley

14. America Drops Out of the Ten Most Innovative Countries – by Braden Kelley

15. The One Movie All Electric Car Designers Should Watch – by Braden Kelley

16. Nine Innovation Roles – by Braden Kelley

17. No Regret Decisions: The First Steps of Leading through Hyper-Change – by Phil Buckley

18. Free Innovation Maturity Assessment – by Braden Kelley

19. Myths About Physician Entrepreneurs – by Arlen Meyers

20. Human-Centered Change – Free Tools – by Braden Kelley

21. The Five Keys to Successful Change – by Braden Kelley

22. Discipline Has a Role in Innovation – by Jesse Nieminen

23. Advances in the Management of Worthless Meeting Syndrome – by Arlen Meyers

24. 550 Quote Posters – by Braden Kelley

25. The Jobs-to-be-Done Playbook – by Braden Kelley

26. We Need a More Biological View of Technology – by Greg Satell

27. Free Human-Centered Change Tools – by Braden Kelley

28. Stoking Your Innovation Bonfire – by Braden Kelley

29. The Pyramid of Results, Motivation and Ability – by Braden Kelley

30. Experience Thinking – The Next Evolution for Design Thinking – by Anthony Mills

Build a common language of innovation on your team

31. Scaling Innovation – The What, Why, and How – by Jesse Nieminen

32. Charting Change – by Braden Kelley

33. The Experiment Canvas™ – 35″ x 56″ (Poster Size) – by Braden Kelley

34. To Change the World You Must First Learn Something About It – by Greg Satell

35. Digital Transformation Virtual Office Hours – Session One – by Braden Kelley

36. Lead Innovation, Don’t Manage It – by Arlen Meyers

37. Are doctors wasting their time on entrepreneurship? – by Arlen Meyers

38. What is design thinking? – EPISODE FIVE – Ask the Consultant – by Braden Kelley

39. Zoom Tutorial – Amazing New PowerPoint Background Feature – by Braden Kelley

40. COVID-19 Presents an Opportunity to Create an Innovation Culture – by Pete Foley

41. Increasing Organizational Agility – by Braden Kelley

42. Innovation Requires Going Fast, Slow and Meta – by Greg Satell

43. Remote Project Management – The Visual Project Charter™ – by Braden Kelley

44. Is innovation everyone’s job? – by Braden Kelley

45. What is your level of Innovation Maturity? – by Braden Kelley

46. Flaws in the Crawl Walk Run Methodology – by Braden Kelley

47. Innovation Teams Do Not Innovate – by Janet Sernack

48. We’re Disrupting People Instead of Industries Now – by Greg Satell

49. Don’t Forget to Innovate the Customer Experience – by Braden Kelley

50. Change Management Needs to Change – by Greg Satell

Accelerate your change and transformation success

51. Everyone hates to fail, why do you? – by Janet Sernack

52. Going with the Flow – by John Bessant

53. Can You Be TOO Strategic? – by Howard Tiersky

54. Competing in a New Era of Innovation – by Greg Satell

55. Fast Company is Wrong – by Braden Kelley

56. A New Age Of Innovation and Our Next Steps – by Greg Satell

57. Avoid the Addition Bias – by Paul Sloane

58. Visualizing Project Planning Success – by Braden Kelley

59. Innovation Ecosystems and Information Rheology – by Arlen Meyers

60. Rise of the Evangelist – by Braden Kelley

61. Creating 21st Century Transformational Learning – by Janet Sernack

62. Re-Skilling and Upskilling People & Teams – by Janet Sernack

63. Creating a Movement that Drives Transformational Change – by Braden Kelley

64. How to Scale Your Culture – by Arlen Meyers

65. A Trigger Strategy for Driving Radical, Transformational Change – by Greg Satell

66. Human-Centered Innovation Toolkit – by Braden Kelley

67. You Must Play and Experiment to Create and Innovate – by Janet Sernack

68. Managing Both the Present and the Future – by Janet Sernack

69. Why Change Failure Occurs – by Greg Satell

70. Developing a Future-Fitness Focus – by Janet Sernack

71. Using Intuition to Drive Innovation Success – by Braden Kelley

72. The Academic Intrapreneur Dossier – by Arlen Meyers

73. The Rise of Employee Relationship Management (ERM) – by Braden Kelley

74. An Example of Successful Alchemy – by John Bessant

75. The Dreaded Perfect Entrepreneur – by Arlen Meyers

76. Should intrapreneurs really ask for forgiveness and not permission? – by Arlen Meyers

77. Don’t Stop Thinking About Tomorrow – by Robert B. Tucker

78. Importance of Long-Term Innovation – by Greg Satell

79. Co-creating Future-fit Organizations – by Janet Sernack

80. What you should learn from the Google Health failure – by Arlen Meyers

Get the Change Planning Toolkit

81. Teaching to Win the 4th Industrial Revolution – by Arlen Meyers

82. Catalysing Change Through Innovation Teams – by Janet Sernack

83. Innovation and the Scientific Method – by Jesse Nieminen

84. Being Too Focused on the Test is Dangerous – by Arlen Meyers

85. Architecting the Organization for Change – by Braden Kelley

86. Healthcare Jugaad Innovation of a 17-Year-Old – by Braden Kelley

87. New Capability Mapping Tools for Business Architects – by Braden Kelley

88. How can I create continuous innovation in my organization? – EPISODE TWO – Ask the Consultant – by Braden Kelley

89. Thank You for Your Thinkers50 Nominations – by Braden Kelley

90. Preparing for Organizational Transformation in a Post-COVID World – by Greg Satell

91. Why Change is Hard – by Braden Kelley

92. Building a Better Change Communication Plan – by Braden Kelley

93. What is digital transformation? – EPISODE THREE – Ask the Consultant – by Braden Kelley

94. ACMP Standard for Change Management® Visualization – 35″ x 56″ (Poster Size) – Association of Change Management Professionals – by Braden Kelley

95. Borrow an Idea from a Different Field – by Paul Sloane

96. How to Go From Nail It to Scale It – by Arlen Meyers

97. Innovation in the time of Covid – Satisfycing Organizations – by Pete Foley

98. Sickcare Culture of Conformity versus a Culture of Creativity – by Arlen Meyers

99. Start 2021 with a Free Innovation Audit (Now in Portuguese or English) – by Braden Kelley

100. Outsmarting Those Who Want to Kill Change – by Greg Satell

Curious which article just missed the cut? Well, here it is just for fun:

101. Why so much medical technoskepticism? – by Arlen Meyers

These are the Top 100 innovation and transformation articles of 2021 based on the number of page views. If your favorite Human-Centered Change & Innovation article didn’t make the cut, then send a tweet to @innovate and maybe we’ll consider doing a People’s Choice List for 2021.

If you’re not familiar with Human-Centered Change & Innovation, we publish 1-5 new articles every week focused on human-centered change, innovation, transformation and design insights from our roster of contributing authors and ad hoc submissions from community members. Get the articles right in your Facebook feed or on Twitter or LinkedIn too!

Editor’s Note: Human-Centered Change & Innovation is open to contributions from any and all the innovation & transformation professionals out there (practitioners, professors, researchers, consultants, authors, etc.) who have a valuable insight to share with everyone for the greater good. If you’d like to contribute, contact us.

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Why So Much Innoflation?

Why So Much Innoflation?

GUEST POST from Arlen Meyers

Inflation is all over the news and at your kitchen table. In case you cut all those economics classes, inflation happens when too much money chases too few goods. It’s happening now because of COVID variations in consumer demand, government stimulus, some fed actions and supply chain glitches. Who knew? The Goldilocks economy describes when prices are not too high, but not too low. Instead, they are just right to stimulate the growth of the economy and the standard of living.

In the midst of all this, we have been seeing a simultaneous rise in sickcare innoflation (i.e. too many overfunded startups and companies creating too few valuable products and services that don’t scale). What’s the answer?

  1. Rethink hospital-based care innovation centers
  2. Create more scalerators and euthanators instead of accelerators
  3. Involve healthcare professionals with the appropriate knowledge, skills, abilities and competencies with an entrepreneurial mindset early in the startup and product development lifecycle.
  4. Change the rules and regulations
  5. Build better ecosystems
  6. Change medical education and training
  7. Fix how we disseminate and implement sickcare solutions and make them equitably accessible.
  8. Close innovation silos
  9. Teach physician entrepreneurs how to play nice with others
  10. Change how we recruit, develop and promote sick care system of system leaders

Building back better will just get us to where we used to be. Instead, we need to create the future better to get us where we want to go. Not too much. Not too little. Just right.

Image credit: Pixabay

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Sickcare Culture of Conformity versus a Culture of Creativity

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?

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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Being Too Focused on the Test is Dangerous

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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