The Sick Care Entrepreneur's Guide to 2019

If you are are a physician entrepreneur, 2019 will be another year of opportunity. In order to create user defined value through the discovery, development and deployment of innovation, you will need to continue lifelong learning, find the resources, build robust internal and external networks, work with mentors and mentees, get peer to peer support and continue working on your personal and professional talent development plan. You will also need a lot of luck.

Here are five trends that are sources of innovation.

In case you were too hung over or stoned to make this class in B school (they don' teach this stuff in health professional or graduate schools), here are Drucker's 7 sources of innovation:

1. The Unexpected
2. The Incongruity
3. Process Need
4. Industry and Market Structure Change
5. Demographics
6. Changes in Perception, Meaning, and Mood
7. New Knowledge

Here are some articles from this year that might help you find your way:

1. How to be a physician entrepreneur despite your MBA I graduated Jefferson Medical College in 1972. I graduated with an MBA from the University of Colorado in 1984. Given my interests in biomedical and clinical innovation and entrepreneurship, it seemed like a good idea at the time. So much so, in fact, that I led the initiative on campus to create our own MD/MBA program. Over half of US medical schools now offer the dual degree programs.
   
   
2. The pros and cons of medical experience. Medical education is an apprenticeship and has been so for thousands of years. It is unlikely to change in the near future. Consequently, the model reveres the teacher and places obligations to the student, even by taking an oath.

3. How do I know whether my surgeon is doing unnecessary surgery? Unnecessary surgery is a big problem. Here is an article that describes the problem and its size.The fact is that any doctor has a fiduciary responsibility to do what’s right for the patient. However, as long as proceduralists (not just surgeons) get paid to do procedures (regardless of FFS or bundled payment), there will be an inherent conflict of interest. I don’t think it will ever be eliminated, but there are steps we can take to mitigate it.

4. How to create more physician pharma-technopreneurs Most physician entrepreneurs, particularly those still in clinical practice, are more interested in devices, digital health and care channel, process and model improvement or innovation. For the drug industry, that is a problem since there are many exciting opportunities.. Given the escalating costs and decrease in new drug research productivity, we need to do a better job of getting physician entrepreneurs engaged in the early stages of drug discovery, development and commercialization.

5. Virtuous entrepreneurship The evolution of the cyberintelligence driven economy-the fourth industrial revolution-is forcing everyone, including entrepreneurs, to answer some tough questions.

6. Barriers to digital health physician entrepreneurship It seems that almost everyone who has anything to do with sick care is trying to innovate, move the needle, disrupt, create game changers and win the 4th industrial revolution. It could be a case of too many cooks spoiling the broth.

7. Rookie entrepreneur mindset mistakes. Innovation starts with the right mindset. Doctors who are considering a side gig or an alternative non-clinical career, have a hard time getting their heads around the entrepreneurial mindset. There is a difference between the clinical mindset and the entrepreneurial mindset.

8. How to fake it 'till you make it. The overwhelming number of doctors, engineers and scientists don't have an entrepreneurial mindset. What's more, when they have an idea, they don't know what to do with it since they will not learn those competencies in their formal training. They just don't know how to innovate their way out of our sick care mess.

9. The myth of patient consumerism The newest mantra in sick care is patient empowerment to make them effective consumers of care. The underlying assumption seems to be that by giving them the information they need, patients will make sick care decisions, and even health care decisions, that are not only in their own best interests, but, in so doing, in the interests of the society at large. Doctors are being asked to do the same thing. Unfortunately, it is virtually impossible to serve three or four masters. The problem is that asking patients to shop for care does not work.

10. Digital health: Stop frying doctors. Another survey showed that doctors are burning out in big numbers, but that some specialties are worse than others. The survey asked about the prevalence of burnout factors and how they affect physicians’ lives. Overall, 42 percent of respondents were burned out—down from 51 percent last year—and 15 percent admitted to experiencing either clinical or colloquial forms of depression.

11. Side gig doctors These days more and more doctors have a side hustle, whether it be a way to earn more money, recovering from a disability, disciplinary action, disqualification, disaster or divorce, or as a pathway to exiting clinical medicine altogether. There are many side gig possibilities.

12. How to pick a residency if you are interested in entrepreneurship Applying for and being accepted to a residency after medical school is a complex, important decision. There are several factors to consider including the reputation of the place, the likelihood you will be accepted, the culture, whether it is a "good fit", your performance in medical school,where you went to medical school and undergrad, bias,whether you are applying as a couple, the local cost of living, and, the location and lifestyle amenities it offers and how much it pays.

13. So, if patients are customers, how do you sell to them? Consumerization of sick care is on everyone's lips. I think patient consumerism, i.e. the belief that if given the right information, patient-consumers will make smart sick care choices based on value , is a myth.

14. Why do people still say doctors are lousy business people Despite the many doctors creating user defined value through the deployment of innovation, people still insist doctors are lousy business people. 

15. Data competency is the new black Many are predicting the jobs of the future, how to robot proof your kids and what knowledge, skills, abilities and competencies will be key to avoid your white coat getting the pink slip. Communication, creativity, complex problem solving and collaboration are usually on the list. Now we need to add another “C”: healthcare data competency

Here are some other stocking stuffers:

1. Advice to a medical student entrepreneur Congratulations on your recent graduation. I'm sure you are thrilled to start medical school in August and are looking forward to taking a break this summer.
   
   
2. Advice to a premed Thank you for inviting me to address your graduating class. I know it's hot out there sitting in those folding chairs and the pot is kicking in, so I'll keep this short.
   
   
3. The five phases of physician entrepreneurship development Physician entrepreneurship describes the pursuit of opportunity under conditions of uncertainty using scarce resources with the goal of creating significant multiples of user defined value through the deployment and harvesting of biomedical and care innovation. Clinicians are becoming interested for many reasons and they characteristically go through defined stages of their physician entrepreneurship career progression.
   
   
4. Fundamentals of edupreneurship Entrepreneurship means many things to many people. Perhaps the biggest misconception is that entrepreneurship refers, exclusively, to starting businesses. In fact, if we use the definition that entrepreneurship is the pursuit of opportunity with scarce or uncontrolled resources with the goal of creating user defined value through the deployment of innovation, then it means much more. In fact, there are many ways to innovate and create user defined value, whether it be in sick care or education, other than taking care of patients, starting a business or teaching students.
   
   
5. A boomer's guide to teaching millennials My parents were traditionalists. I'm a boomer. I work with a lot of Gen-Xers. I teach a lot of millennials. We are all trying to understand each other and adapt to how we teach and learn.
   
   
6. Posts on Innovation Excellence
   
   

Happy New Year and good luck.

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