It is easy to be cynical about the present state of sick care affairs. We see the negatives like doctors leaving practice prematurely, high rates of burn out and physician suicide, national political polarization, and, of course, all things EMR.

However, when you take the long view and dig a little deeper, several trends might put a smile on your face:

1. Medical students and residents are demanding ways to get involved in sick care innovation and entrepreneurship and to make medical education faster and cheaper. Medical schools and graduate medical education program leaders are gradually yielding to their demands. Here is a letter I recently received as an example:

I am currently a first year resident in internal medicine. My attending recommended I contact you to learn more about ways to begin initiating a career in physician entrepreneurship and healthcare innovation as a a resident.

As a quick background, I've been very interested in applying machine learning/advanced data analysis methods to the personalization of care. Previously I obtained a master's at Stanford in probabilistic analysis and worked in finance at BlackRock (after attending undergrad at Wharton) and at various startups in the Silicon Valley before medical school. I've been fascinated by the movement to design healthcare systems bridging personalized care with advanced data-processing methods, from Watson-derived diagnostic methods to remote monitoring of chronic illness states. My personal career aspiration is to become a physician entrepreneur involved in the re-shaping of healthcare delivery. I'm seeking mentorship. If you're at all able to meet or further discuss on the phone a potential project I could be involved with, I'd love to do so. Thanks for your help and looking forward to chatting!" These arrive with gratifying increasing frequency and I usually give them this advice.

2. Sick care is more and more open to outside in innovation and reverse innovation.

3. EMR change and interoperability is getting closer and closer.

4. End users are increasingly skeptical about shiny new objects and requiring clinical validation before they recommend them, particularly in digital health.

5. Regulators are hurrying to create an environment that balances safety and efficacy without stifling innovation.

6. Interprofessional biomedical entrepreneurship is coalescing.

7. Sick care innovation districts and ecosystems are evolving.

8. Patient entrepreneurship is growing.

9. Investments in sickcare innovation are hot, albeit geographically isolated to three states.

10. Medical school applications are at an all time high. It is, in many ways, the best of times and the worst of times.

11. Sick care is agonizingly migrating to health care and recognizing the impact of social determinants.

12. Barriers to sick care diversity and inclusion are gradually falling.

When you measure public health and medical advances, more good things have happened to people in the last 100 years than the preceding 300,000. Smile. It's contagious.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs.