Episode 94: Physician Entrepreneurship & Training

Come learn with Dr. Arlen Meyers, president and CEO of the Society of Physician Entrepreneurs, as he shares how today’s healthcare professionals can bring their ideas to life. Physician entrepreneurs are vital to medical innovation, yet the road is filled with obstacles ranging from internal culture to a lack of business training in medical school. Learn how Dr. Meyers directs healthcare professionals to overcome these challenges, and why he believes that entrepreneurship is a tool to restore the joy in medicine.

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Full Transcript

Announcer: It’s time to think differently about healthcare. But how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together, and here are some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the “Paradigm Shift of Healthcare” and thank you for listening. I’m Michael Roberts here today with my co-host Scott Zeitzer. This show is focused on the many ways healthcare is changing and how the consumerization of healthcare’s affecting practices. And we talk about this topic on a regular basis at p3practicemarketing.com and we invite you to be a part of that conversation.

Today we’re talking about why physicians should be taught about entrepreneurship, and our guest is Dr. Arlen Meyers. He’s the President and CEO of the Society of Physician Entrepreneurs and a professor emeritus of many things. I’m not gonna even get into all the different things out of fear of saying them incorrectly.

Scott: Otolaryngology. See there? And engineering. What kind of engineering, doc?

Dr. Meyers: It’s biomedical engineering and I can get into the weeds but basically, we invented a gadget.

Scott: Okay. I’m a biomedical engineer by training [crosstalk 00:01:29]. So yeah. I had to ask.

Dr. Meyers: Well, I don’t…yeah, I just play one on TV. I’m not an engineer.

Michael: It’s like, “Oh, no. I’m quickly gonna be excluded from this conversation.” Because I have no degree or nothing in that side of things. So, Dr. Meyers, thank you so much for coming on the show. We’ve already been talking some before we started recording just about the difference in medical practice management versus medical practice entrepreneurship and how transformative the thinking of entrepreneurship really needs to be instead of just squeezing more efficiency out of something. Really rethinking a whole model. It’s really interesting that you bring that up because we’ve actually been in conversation with somebody that is actually going through that process of thinking how he wants to set up his practice. And he has a lot of ideals and it’s not copy the model of everybody else. It’s what can I do to really come at it from a different way.

As we’re jumping into the conversation, can you just give us a quick two-minute rundown of your background and particularly how you become invested…interested in the concept of physician entrepreneurship?

Dr. Meyers: So, the short version is I spent 40 years as a clinical surgeon at the University of Colorado and I still am. I don’t practice medicine anymore. And in the course of that, myself and several other people invented a gadget. So, I’m an ear, nose and throat surgeon. My subspecialty was oral cancer. And we invented a gadget that optically detects cancer. That led to a realization of fundamentally three things. One, that everybody in a white coat thinks they have a good idea. Two, they don’t. Most of it…I mean, it may be a basic science. You know, there’s nothing against basic science but in terms of commercializing or actually getting it in the hands of a patient, it’s probably not a good idea. And third, even if it were a good idea, they wouldn’t know what to do with it because you’re not taught at medical school or anything else you get when you’re trying to get into medical school. And including me, when it happened to me. And fourth, no one was gonna teach you.

So that’s why we created the Society of Physician Entrepreneurs and that’s why I decided to kinda make a mid-career pivot, the mid meaning in my 60s, to pursue healthcare innovation and entrepreneurship at a different level.

Michael: That’s great. So, you’ve got this Society of Physician Entrepreneurs. What is it that the Society does to really help further these goals and how has does it really, like, encourage the physicians to go down that path?

Dr. Meyers: So, the problems that we’re trying to solve are the ones that I just listed. So therefore, the Society of Physician Entrepreneurs is a nonprofit, international biomedical and clinical innovation and entrepreneurship network. Our mission is to help our members get their ideas to patients, and we do that through an international chapter network that provides education, resources, networks, mentors, experience, peer to peer support and nonclinical career guidance. And I believe…you know, you never say you’re the best or the biggest or the largest or whatever but it’s a pretty big network and we’ve been doing this now for about 10 years. So, we’ve gotten to be a fair size and, you know, it’s taken us about 10 or 11 years to be famous overnight.

Scott: Yeah, it’s something that really needs to be done. I’ve got one son who’s in medical school right now and it’s basically the same way he…probably you were taught, I’m guessing.

Dr. Meyers: Exactly. Right. Things are changing. And we’re trying to be part of that initiative and we’re very involved in changing. We’re trying to change medical education.

Scott: Yeah, I think it’s important but I kinda wanted to get your angle on that. I know I speak to a lot of surgeons, and when they’re just getting started, none of them have any real background, any idea about what the business of medicine is. And they’re so frustrated by the lack of information that they’ve been provided. These are all very bright people. They were top of their class, you know. They had to get As to get into med school.

Dr. Meyers: Yeah. So, we’re changing that. And I can give you several examples actually of medical schools, both osteopathic and allopathic. There are about 200 medical schools in the country. Very, very few of them teach the business of medicine, innovation, entrepreneurship, data science, etc., etc., etc. And I’m part of a group that is changing that. So, there’s several…we’re beginning to see cracks in the armor. We’re beginning to see…

Scott: I’m happy to hear that. I really am.

Dr. Meyers: Yeah, we’re beginning to see several schools…and I can give you several examples, including my school, the University of Colorado, where for the first time… Now I’ve been at this for a while and actually I’m scheduled to teach an elective, which is a start, it’s not mandatory, to first year medical students in healthcare innovation and entrepreneurship.

Scott: I kinda wanted to get everybody caught up. You shared a Klaus Schwab’s set of recommendations for the fourth industrial revolution, and I wanted to go through that with you. So, the first one was focus on systems instead of technologies. Let’s kinda dive into that.

Dr. Meyers: All right. So sick care, and I call it sick care because we’re spending about 4 trillion, and 96% of that is on taking care of sick people. So, we don’t have a healthcare system. We have a sick care, sick, sick care system of systems. And it masquerades as a healthcare system.

Scott: You’re right.

Dr. Meyers: But it’s not a healthcare system. And guess what? The OECD ranks us last in industrialized countries out of 12 in terms of healthcare systems for that reason when it…it’s inequitable, you get care if you have money. Now the interesting thing is that a similar group that ranks global entrepreneurship environments ranks us first. So, the question is, if we’re so good at entrepreneurship, how come our system sucks? And that’s one of the issues that we’re trying to tack…and there’s…I have several reasons. But one of them is because we don’t adopt an entrepreneurial mindset to medicine. It’s a culture of conformity. It’s not a culture of creativity.

Scott: There’s no doubt about that. I made mention again, though, that you went to med school, I am guessing, quite a bit earlier than my son who’s in med school now. And it’s a very similar setup, you know. It’s like, “Hey, man. You know, the first couple of years you’re gonna learn the basics. Then you’re gonna go follow some people around for a couple of years. Then you’re gonna go do your residency program and see one, do one, teach one.” Right?

Dr. Meyers: Right. There are several fundamental flaws with the present medical school business model.

Scott: Oh, yeah.

Dr. Meyers: And one of them is who and how we accept medical students. And the second is the toxic culture of medical education, which discourages creativity, innovation, imagination. It’s a culture of conformity. Now, by its nature, it is risk averse. And that’s okay. We’re talking about people. But it’s cruel and unusual punishment to say we’re gonna pay you for value, doctor, but we’re not gonna teach you how to create it.

Scott: Right. Yeah, it’s a very, very valid point. You know, one of the things was…mentioned in this by Klaus was a focus on key values as a feature of new technologies rather than a bug. I wanted you to talk a little bit about that because that’s kind of a…I found that to be a really good point.

Dr. Meyers: So, a couple of points. And these are just my opinions. A nation’s healthcare system is a reflection of its values. So, you can’t compare the healthcare system of England, France, Germany, Singapore, Japan with the United States because their values are different than the United States. Number two, the values issue comes up a lot in artificial intelligence, and this gets into the fourth industrial revolution. It’s like the biggest buzzword now. And what are we gonna do with artificial intelligence? Well, there’s a lot of conversation about the future of work, the future of the impact of the technology just like human beings.

Scott: Yeah.

Dr. Meyers: The future of security, confidentiality, replacing people, hacking, you name it. That’s a…ethics, professionalism. That’s a conversation about values. So, you have to set the guardrails, and that’s what’s going on at this very moment. People are trying to figure out what should be in the AI code of ethics. And we don’t know. Eventually we’ll get there. It won’t be the final word but we’re trying to figure that out. And what should patients know about an AI patient bill of rights? That reflects values. So, we have to have that conversation. It’s not about the technology. It’s about its impact on society.

Scott: Right, and how it’s used.

Dr. Meyers: And how it’s used. Great.

Scott: Yeah. Yeah. I agree wholeheartedly. Michael had and I had mentioned to you before we got on that there’s a surgeon who is just starting a practice for the very first time and he’s…like, he wants to do it differently but he doesn’t know how to do it differently. And, you know, I will be pointing him to this conversation and the Society as a whole. He’s very interested in that. And you mentioned a little bit and I had these conversations with a lot of our surgeons that we work with about value versus volume. And you had mentioned, like…and I always talk about this. Like, when…in the old days, you put your shingle out and you just kinda put your head down and you just have this huge volume of people because people really just needed you. And now, you know, there’s a lot of data out there about who you are, what you’re about, how you’re processing and rightfully so, and how we interpret that data and how a physician can take advantage of that and help their patients better. Because it’s not just about outflanking somebody. It’s about how do you take better care of your patients.

Dr. Meyers: Right. The problem with that, though, is at this stage of the game, everybody’s talking up value-based care. The reality is the large majority of docs get paid on fee for service.

Scott: Yep.

Dr. Meyers: So, while you’ve gotta make a living doing fee for service, everybody’s ramming value down your throat. So, the question is how do you balance the transition? How do you…I mean, I think most of us are understanding that gradually this is gonna happen but what do you do in the meantime? Because you’ve gotta make a living from fee for service.

Scott: Right.

Dr. Meyers: So, I call this one foot in the boat and one foot on the dock, and I mean the dock, and how do you negotiate that water, number one, through medical practice entrepreneurship? Number two, as you know better than…I mean, I, you know…the vast majority of medical students now have no interest in going into private practice. Zero. Now I think actually that’s gonna change because I think people are sorta figuring, “Well, you know, I tried working for the man and that didn’t work out so well.”

Scott: Yeah, yeah.

Dr. Meyers: The problem is, they didn’t have any training or experience in private practice after they worked for this enormous integrated delivery network, and seven years out now, they’re deciding, “I quit. I’m gonna go into private practice but I have no clue.” And actually…and I’m interested in your piece but it seems to me that actually there’s a backlash and that people who were in employed physician positions like myself…I mean, I did that for most of my career, are now figuring, “No. Grass is greener. I’m bailing. I’m going into private practice,” or, “I’m going into a nonclinical career.”

Scott: Yeah.

Dr. Meyers: And that’s a whole other line of conversation.

Scott: It really is and it could be an entire conversation out of that.

Scott: Whenever a surgeon comes to me…because we deal mostly with orthopedic, spine, and neurosurgeons, and they tell me like, “Hey, man. I’m gonna work for blah, blah, blah.” Whoever that is, right, some large hospital, etc. I always tell them that, “Your name is your brand and protect it.” Because three years later you might be going, “This is the best decision I ever made in my life. I don’t wanna worry about how I get patients. All I wanna do is see patients, take good care of them, and go home and hug my kids.” Nothing wrong with that. That’s awesome. The other side of the coin is that, as with most surgeons, and I say this with love because most of my surgeons are some of my best friends, surgeons tend to have fairly large egos and you need them. You have a scalpel in your hand.

And after a year or two of being told exactly what to do, how to do it, and when to do it with no explanations as to why, it kinda rubs a lot of surgeons the wrong way. And now we come back to what you were saying. It’s like, “Okay, they wanna go back on their own.” And I know a lot of surgeons who are going back and they’re getting MBAs, they’re taking some courses. I know some of the…because the med schools aren’t doing it. I’m happy to hear that you’re working with med schools to get that done, but there are post-med school, residency, etc., ways to get some more information through societies, etc., that I think it’s critical that people need to get some baseline tools on how to, you know, run a business.

Dr. Meyers: You know, the key issue…actually, education is the least important part of learning how to do this. You can do it on nights and weekends, you can download stuff like this, you can…you don’t have to get an MBA. In fact, it’s a whole another conversation but I think MD MBAs and MBAs are stupid. But that’s a whole another…

Scott: And you have one.

Dr. Meyers: And I…well, not only that, I helped create the MD MBA program at Colorado. So, there’s nothing worse than a reformed sinner. So, I’m saying that the biggest problem that I see is, number one, what got you to where you are won’t get you to where you wanna go when it comes to entrepreneurship. I don’t care how many letters you have after your… And number two, you have to come down off the mountain. You simply don’t know what you don’t know when it comes to medical practice entrepreneurship. You don’t have the knowledge, skills, abilities, and competencies. The clinical mindset is very different than the entrepreneurial mindset. So, you need to kind of, like, be more humble and accept the fact that you need to learn how to do this. And you need to change your mindset. That’s the single biggest important thing. Innovation starts with mindset.

Michael: That was one of the interesting things I found in one of the articles that we were reviewing and prepped for this. You had mentioned that one of the key differences is the ability for the entrepreneurial physician to spot new problems and to spot different kinds of problems than the physician that’s just kind of going through and just…and finishing out the day. You know, kind of relating that back to some of what we dug into with the fourth industrial revolution. So, here’s a physician that’s aware. Now this physician has his mind or…his or her mind open to, “Hey, I need to spot these new problems and go solve these things.”

Dr. Meyers: Right.

Michael: What do they do in a small practice to take advantage of this fourth industrial revolution to really change things?

Dr. Meyers: Well, again, it starts with being a problem seeker, not a problem solver. That’s part of the entrepreneurial mindset. That’s part of design thinking. That’s part of understanding the stakeholder because… And, again, let me just mention that a big misconception is that, in my view again, that entrepreneurship is not just about creating a company. My definition of entrepreneurship is the pursuit of opportunity under volatile, uncertain conflicts and ambiguous so-called [inaudible 00:17:59] conditions. But the important part is the goal is to create stakeholder or user-defined value through the deployment of innovation using a viable or what I call a vast business model.

One way to do that is to create a company. You’re a technopreneur. That’s what I did when I did the gadget thing, but there’s a million other ways to do this. So, if you’re in private practice, it starts with understanding who is your customer. That could be a number of people, family members, patients, you know, payers, the whole list of the Ps, of the stakeholders. So, you have to understand what is their problem you’re trying to solve. It’s not graduate last in your class, hang a shingle, show up, and get paid for effort. That’s the old model. The new model is you are starting a startup and we’re calling it a private practice. Now let’s look at this differently. That’s what I’m saying.

Michael: Yeah. We were talking about this very much from…just to kinda go down this path of what you’re talking about in terms of you don’t necessarily have to start a new company. We’ve talked some about really focusing on the small practice, but what room for entrepreneurship is there in the large health system for the physician that’s in that spot?

Dr. Meyers: There’s an enormous opportunity, and it’s called intrapreneurship. So, you are an employed physician, and for the reasons we mentioned, because more and more doctors are employed than independent, and it’s continuing to grow. Frankly, I think it’s gonna flatten out, like I said, but that’s another conversation. So, if you are an employed physician, I don’t care whether it’s for the Mayo Clinic or the university of whatever or some other organization, as an intrapreneur, by definition, you are an employed physician and you are being paid in part to add value to your organization. It’s one of the stakeholders. And oh, by the way, if you don’t do that, they’ll fire you. And I don’t care whether you’re tenured. If you don’t make the numbers and add value, you’re gone. Nobody has job security.

Michael: Yeah.

Dr. Meyers: Especially during COVID. And guess what? You know, people are quitting because they’re rethinking the whole… I don’t care whether it’s restaurants, retail, or healthcare. People are rethinking the whole business. So that’s what you have to do as an intrapreneur. Now, again, we can get into a whole conversation about the differences between outside entrepreneurship and intrapreneurship, but the headline is intrapreneurship, in my view, is actually harder than outside entrepreneurship because not only do you have to deal with all the entrepreneurship issues, getting an idea to a patient or a stakeholder but you have to deal with the culture, the internal culture that will stomp you like a grape as soon as they detect anything that is disruptive. And they will call you a disruptive physician. It’s not that you’re disruptive and you’re pissing patients off or you’re throwing stuff at the scrub nurse. You’re trying to disrupt the business model and they’re getting paid to keep it exactly the way it is. That’s the hard part. So, there’s all kinds of intrapreneurship survival skills, guerilla tactics, political savvy, all kinds of stuff. And that’s part of the education we’re trying to include in the medical school curriculum.

Michael: And I will say that as we’re talking for our listeners here that, you know, you find Dr. Meyers online, find him on LinkedIn is where I found him first, and there’s just a ton of materials that you’ve already contributed to these very ideas and really explored them in depth. We’ve had the opportunity to talk with a number of physicians that are redefining things and they are in a variety of settings. And so, I really like this concept of really bringing out the core component is problem seeking, not problem solving. I love that because that level of creativity and that level of…it’s not even necessarily, like, creativity. I think it’s just awareness and it’s the ability to observe and really drill in. So, I think people get scared of terms like creativity, sometimes. And so, if somebody hears that, they go, “Well, I’m not that.” But we can all be observant, for sure.

Dr. Meyers: Right. Well, they’re not scared of it. They’re just smart. Like, medical students, when you interview them or premeds, when you interview them to get into medical school, the last thing in the world they’re gonna tell you is, “I don’t wanna be a doctor. I just wanna get the MD to get credibility. I wanna start a biotech company or a blank. And I have no intention of seeing patients.” You really think a person’s gonna tell you that? No. Any creative is gonna hide it. And I tell people, in this world, until it significantly changes, innovate your heart out. Just don’t tell anybody you’re doing it.

Michael: I like that.

Scott: It’s a very valuable insight. I know that when my son was looking to get into med school, he was very much into looking into what he wanted to do, how he wanted to get it done and thinking a lot of things. But he kinda kept everything inside because he just wanted to get in and he just wanted to talk about, like, how he wanted to be a great doctor and he’s in an osteopathic school. And they were really talking about the need for more family doctors out there, more GPs, etc., and he had a lot of head nodding, etc. And, you know, maybe one day he will be one. I don’t know. But you’re right. It’s designed to get into med school. It’s designed in such a way where you have to conform in order to get in. Creativity is not really looked upon as…on a high level.

Dr. Meyers: So, I call that the hidden intrapreneur.

Scott: There you go. Okay.

Dr. Meyers: And incidentally, to the point, myself and several others are actually working with an osteo…a brand-new whitepaper, white space osteopathic medical school that is being created, and we’re totally rethinking the curriculum to include everything we’ve been talking about.

Scott: That sounds so exciting. It really does.

Michael: Yeah. That’s awesome.

Scott: Yeah. I think it’s one of those things where, you know, we’re talking about lots of different layers here and I do think everybody needs to take a step back. There’s nothing wrong with saying that this country’s healthcare system needs improvement. There are a lot of people like, “Wait. We’re the best.” And all that other stuff. It’s like, “That’s great, man.” And I’m a very, very proud American. That being said, we are not the best. There are some things we do great but there are a lot of things that we could do better, and I’m really happy to see that there are…like you, there are a lot of other people who are looking to figure out how to get that done.

Dr. Meyers: Right. Well, nobody likes to have their baby called ugly. But you know what? It’s part of the entrepreneurial mindset.

Michael: We’re gonna wrap up for today, but, Dr. Meyers, is there anything that you would, like, I guess, leave our listeners with to think about in terms of what next steps could look like for starting down this pathway?

Dr. Meyers: So, I think it’s important…you know, why is this important? Why are we even talking about this?

Michael: Yeah.

Dr. Meyers: And to me there’s kind of three basic…I mean, a whole bunch of reasons but I would highlight three of them. One, I think entrepreneurship makes better doctors. I think…in contrary, I think doctors make better entrepreneurship. You know, you always hear doctors are lousy businesspeople. No, they’re not. That’s a total myth. That’s ridiculous. And we all know doctors who are phenomenal at creating value and are multimillionaires because they’ve done it correctly, ethically. Number two, I think it makes better patients. I think that the patients…if you just look at creative destruction and how it makes better markets, the same thing applies to physician entrepreneurship. Patients get smarter because doctors and physician entrepreneurs are offering transparency in pricing, alternative business models, stuff you can understand, etc., etc., etc. And number three, I think that physician entrepreneurship is a tool to restore the joy in medicine. And I call it the lost tribe of medicine.

Docs are pissed off. I don’t need to tell you. They’re fed up. They’re leaving. They’re not happy. They’re grumpy. And grumpy doctors make grumpy patients and it makes dangerous doctors, statistically. It’s a fact. If you’re unhappy as a doctor, you’re more likely to make bad decisions and technical errors. I know that personally. So, I think it improves or can contribute to the joy of medicine. Whether you’re in clinical practice or whether you’re in a nonclinical career role, it just makes you happier so… And I think that’s a problem we have now that needs to be solved.

Michael: Yeah, so that dissatisfaction, turning that into something and doing something about it instead of just sitting in that spot. So, for everybody that’s listening, this is Dr. Arlen Meyers. Check him out on LinkedIn is where I found him. Also check out the Society of Physician Entrepreneurs. Dr. Meyers, thank you so much for your time today. I really appreciate digging into this. This is definitely a topic that we’re very excited about as well. So, thank you.

Dr. Meyers: Yeah, we’re just…obviously we’re just scratching the surface. We’ll be back to talk some more. I’m happy to do it.

Scott: Awesome. [inaudible 00:27:30]

Michael: We’ll take you up on that. Thank you so much.

Dr. Meyers: All right. Take care.

Announcer: Thanks again for tuning into the “Paradigm Shift of Healthcare.” This program is brought to you by Health Connective, custom marketing solutions for med tech and pharma. Subscribe on Apple Podcasts, Google Play, or anywhere you listen to podcasts.