The State of Sickcare Entrepreneurship
Physician entrepreneurship has changed from a curiosity to becoming mainstream in 5 short years. Defined as physicians pursuing opportunity with scarce resources and conditions of uncertainty with the goal of creating user define value through the deployment of biomedical and clinical innovation, we are starting to see some trends and fault lines forming.
1. The phenomenon affects all physician demographics including the young and the restless (in training or in practice less than 5 years) , the desperados (in the prime of their professional careers (6-40 years in practice) and the old and the grumpy (arbitrarily over 65) but looking to rewire, not retire, pursuing encore careers.
2.International bioentrepreneurship education programs are evolving and offering various levels of training and platforms. MD/MBA programs , while still being offered, are being displaced by more specific, sick care relevant, market driven offerings that teach moreclinically relevant, market driven knowledge, skills and attitudes. They are growing because almost every health system in the world is challenged with getting better outcomes for less cost. More medical schools are offering education in innovation, entrepreneurship and design thinking.
3. More medical students are electing to forgo residencies to work with industry or create their own companies. While ultimately a personal decision, some think it is an encouraging sign while others question the wisdom of that pathway. After all, it’s called physician entrepreneur for a reason. The market for physician entrepreneurs, either as advisors, founders or employees, particularly in digital health companies, is starting to plateau. Part of the reason is that while the number of startups is increasing, fewer become scale ups that hire people.
4. Digital health is getting most of the attention. Unfortunately, it has yet to demonstrate it can deliver most of the value.
5. Academic medical centers have searched and replaced “research” with “innovation” in their marketing literature and branding communications. Listen to this for some stories about how they are doing.
6. Sickcare employment has dropped for the first time in 10 years. Reading the tea leaves is always hazardous to your health, but some feel the era of “rightsizing” has started as we wean ourselves from inefficient, wasteful, costly medical and business practices. In addition, with the migration of care to non-hospital settings, integrated delivery systems are shedding unprofitable parts and that translates into fewer employed physicians.
7. Consolidation of hospitals and insurance companies are making it harder to innovate and creating hostilities between the administrators,third party intermediaries and the grunts in the trenches. Mergers and acquisitions have moved from horizontal to vertical.
8. Physician employment is plateauing, but significant intrapreneurial barriers persist.
9. People are finally beginning to abandon the notion that doctors are lousy business people. Even doctors are starting to believe the contrary about themselves.
11. Value based care is driving the necessity for advanced information technologies, like artificial intelligence, do help determine quality and costs and improve productivity
12. Immigration policy is interfering with entrepreneurship
13. International medical graduates who are US citizens are seeing physician entrepreneurship as a viable alternative career pathway, particularly that 50% who do not match into a US residency
14. COI rules are interfering with physician-industry collaboration and new product development
15. Sick care data scientists are in sort supply unless you live on the US coasts
16. Women make up more than 50% of medical school students. However, fewer woman than men stay in the clinical workforce, mostly to take care of family members or find a non-clinical job after burning out.
17. Sources of early seed stage money have changed, altering the all aspects of biomedical and clinical startups.
18. Accelerators and incubators continue to evolve as part of their inevitable life cycles
19. AI, robotics, cloud storage, blockchain and mobile devices are having a bigger impact on digital health design, development and launch
20. Many digital health products and services are encountering significant resistance crossing the chasm to widespread adoption.
21. Regulatory and reimbursement rules are shaping the future of new products and services.
22. Burnout continues to claim more and more victims who looking for alternative non-clinical career possibilities
23. Community based innovation networks and ecosystems continue to grow and evolve
24. Medical schools continue to ignore the importance of entrepreneurship and digital health and data science education and training
25. Graduate bioscience and medical school education is in desperate need of reform
26. Outsiders, Google, Apple and Microsoft and the three amigos-Berkshire,JP Morgan and Amedzon- are trying to change the game and then scale it to others.
Physician entrepreneurship continues to evolve before our eyes. If things go according to plan, physician entrepreneurs will be more and more involved in the innovation supply chain at earlier stages helping others innovate our way out of the sick care mess. If things don’t go that way, we’ll just have lots more people with lots more letters after their names sitting in the corner office of the Innovation Center. Smart medicine has already attracted a lot of smart money. Let’s see if it attracts the smart doctors and students.
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