PIIR to peers

As more and more doctors choose to be employed rather than be in independent practice , and , as intrapreneurship, employees acting with an entrepreneurial mindset, becomes more and more of a competitive advantage, we need to change how we teach employed physician intrapreneurs how to create user defined value through the deployment of biomedical and clinical innovation in their organizations. 

The present model, integrating entrepreneurs and entrepreneurial models, like accelerators, generators, innovation centers and incubators, to include doctors into the ecosystem is slow, cumbersome, inconvenient, not familiar to most doctors, and does not conform to their workflow and schedule demands. Neither does it provide enough of an incentive to participate, given the opportunity costs that have to be incurred to participate in intrapreneurial activities compared to reliable, revenue generating clinical or research activities.

Instead, we need to develop a cadre of PIIRs, Physician Intrapreneurs In Residence, that can act like teachers, mentors and sponsors to those who choose to go down the intrapreneurial path. You might consider them intrapreneurial attendings.

Here are some reasons why it makes sense to work with entrepreneurs-in-residence. Given the small , but growing, number of physician entrepreneurs, most EIRs will be domain experts. Eventually, EIRs will be replaced with PIIRs.

Given the present small numbers of credible physician intrapreneurs and given that only a small percentage of doctors have an entrepreneurial mindset, the challenges are substantial. For those that are considering creating, developing and deploying PIIRs , here are some things to consider and potential barriers. 

1. They need both business and clinical credibility with their peers

2. They need teaching and mentoring skills

3. They need comfort with the clinical and administrative culture

4. They need policies, procedures and C-suite vision and leadership that is aligned with clearly defined strategic innovative priorities

5. They need resources

6. Most employed physicians work for academic, government or private health systems organizations. Each has its own mission and culture and SOPs. Consequently, all PIIRs will need to adapt to the challenges presented to them on the ground and be adept at navigating the unique organizational waters. Academic PIIRs have different challenges and require a somewhat different skill set than others, for example.

7. PIIRs need to engage not just practicing clinicians, but trainees as well, and adapt to their needs and non-entrepreneurial education and training requirements

8. PIIRs need to have a clear understanding of their role and job expectations, particularly concerning who they will report to, their authority and how their role meshes with other innovation team members, like the VP for Business Development, the Chief Innovation Officer, the Chief Medical Officer, the Chief Strategy Officer and others.

9. PIIRs need to have robust internal and external connections to other members of their regional innovation ecosystem and know how to break down firewalls built by their organizations

10. PIIRs need an innovation leadership system that clearly defines expectations to potential innovation champions in the organization and gives them cover to freely reject ideas that are not ready for prime time without resulting resentment or disengagement.

Research shows that  the role of coaching in these programs is very impactful. Coaches serve not only as an experienced guide, helping intrapreneurs to embrace a new way of working, but also as a crucial link to a network of experienced professionals both inside and outside the corporation. ‘

Doctors like working with other doctors. They have confidence in those who are tribal members and are suspicious and distrusting of those who are not. While working with non-sick care entrepreneurs is a viable model in some circumstances, PIIRs are a better fit. Whether they can be more effective remains to be seen.

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