The Corporate Frailty Syndrome

The Corporate Frailty Syndrome

In medicine, frailty is theoretically defined as a clinically recognisable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is comprised. 

In the absence of a gold standard, frailty has been operationally defined as meeting three out of five phenotypic criteria indicating compromised energetics: low grip strength, low energy, slowed waking speed, low physical activity, and/or unintentional weight loss . A pre-frail stage, in which one or two criteria are present, identifies a subset at high risk of progressing to frailty. Various adaptations of Fried’s clinical phenotype have emerged in the literature, which were often motivated by available measures in specific studies rather than meaningful conceptual differences.

Patients who are frail before surgery are more likely to have serious complications and mortality afterward and increased costs of care, suggesting that frailty should be factored into risk calculations before surgery.

Consequently, surgeons develop clinical judgement when doing patient selection for surgery. Whether to operate is as important, if not more, than how to operate.

In several ways, organisations and companies are like patients. When they are sick, some interventions , like change management, digitisation, leadership development and innovation initiatives are high risk if the company is frail.

Corporate frailty, is as yet undefined, but might include:

  1. Unexplained revenue or market share loss.
  2. Exhaustion manifested by employee burnout or innovation fatigue.
  3. Low physical activity with resulting under-productivity, waste, or complacency.
  4. Slowness in seeing potential threats or opportunities or inability to respond to environmental and business model threats.
  5. Weakness in the C suite, lack of market power or other parts of their competitive strategy They just can't get a grip.
  6. Sarcopenia i.e lack of muscle strength.
  7. Small energy reserves.
  8. Inability to withstand stressors, no matter how minor.
  9. Failure to scale.
  10. Multiple system failure.

Like frail patients, operating on a sick business when it is frail is associated with complications and higher rates of mortality and patient selection is key to favorable outcomes. Pre-habilitation is a necessary requirement before taking them to the OR. Structure eats culture for lunch.

Arlen Meyers, MD, MBAs is the President and CEO of the Society of Physician Entrepreneurs on Twitter@ArlenMD.

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  • Leo Potts

    Well explained thank you

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Arlen Meyers, MD, MBA

Former Contributor

Arlen Meyers, MD, MBA is a professor emeritus of otolaryngology, dentistry, and engineering at the University of Colorado School of Medicine and the Colorado School of Public Health and President and CEO of the Society of Physician Entrepreneurs at He has created several medical device and digital health companies. His primary research centers around biomedical and health innovation and entrepreneurship and life science technology commercialization. He consults for and speaks to companies, governments, colleges and universities around the world who need his expertise and contacts in the areas of bio entrepreneurship, bioscience, healthcare, healthcare IT, medical tourism -- nationally and internationally, new product development, product design, and financing new ventures. He is a former Harvard-Macy fellow and In 2010, he completed a Fulbright at Kings Business, the commercialization office of technology transfer at Kings College in London. He recently published "Building the Case for Biotechnology." "Optical Detection of Cancer", and " The Life Science Innovation Roadmap". He is also an associate editor of the Journal of Commercial Biotechnology and Technology Transfer and Entrepreneurship and Editor-in-Chief of Medscape. In addition, He is a faculty member at the University of Colorado Denver Graduate School where he teaches Biomedical Entrepreneurship and is an iCorps participant, trainer and industry mentor. He is the Chief Medical Officer at and and Chairman of the Board at GlobalMindED at, a non-profit at risk student success network. He is honored to be named by Modern Healthcare as one of the 50 Most Influential Physician Executives of 2011 and nominated in 2012 and Best Doctors 2013.

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