Physician social and public health entrepreneurship

Physician entrepreneurs are medical professionals who pursue opportunities under conditions of volatility, uncertainty, complexity and ambiguity (VUCA) with the goal of creating stakeholder defined value through the deployment of innovation using a VAST business model.

Some physician entrepreneurs do that by starting a company, running a practice or being an employed intrapreneur. Others do it by creating a non-profit enterprise to improve the human condition, like helping to solve food insecurity, homelessness or disparate global health outcomes. There is certainly no shortage of problems to solve. The UN has a few suggestions.

Social entrepreneurs play the role of change agents in the social sector by (1) adopting a mission to create and sustain social value (not just private value); (2) recognizing and relentlessly pursuing new opportunities to serve that mission; (3) engaging in a process of continuous innovation, adaptation, and learning; (4) acting boldly without being limited by resources currently in hand; and (5) exhibiting a heightened sense of accountability to the constituencies served and for the outcomes created.

According to Goffman (1974, p. 10), social frameworks involve a set of rules which may be clearly explicated (such as in his example of a game of Checkers) or are developed more subconsciously and built up over time. Goffman's main interest was in how such frameworks preserve social harmony. However, he also outlined a variety of tactics that deviant actors use to manipulate how people see and understand events. Goffman's work has inspired scholars across several disciplines. Notably, social movement theorists have extended Goffman's work to develop the dynamic concept of framing as: “the generation of interpretive frameworks that not only differ from existing ones but that may also challenge them".. As such, social entrepreneurs can be seen as being engaged in the production and maintenance of new systems of meaning. These “collective action frameworks” are action-oriented sets of beliefs aimed at mobilizing collective action.

There are three “core framing tasks” which together constitute the collective action framework: “diagnostic framing” “prognostic framing,” and “motivational framing.” Diagnostic framing involves identifying what the problem is, and what or who is to blame. Prognostic framing involves specifying a potential solution according to the ideologies and values of the movement. Motivational framing “provides a ‘call to arms’ for engaging in ameliorative collective action” ; for example, warning of the consequences of failing to act.?Goffman's main interest was in how such frameworks preserve social harmony. However, he also outlined a variety of tactics that deviant actors use to manipulate how people see and understand events. Goffman's work has inspired scholars across several disciplines. Notably, social movement theorists have extended Goffman's work to develop the dynamic concept of framing as: “the generation of interpretive frameworks that not only differ from existing ones but that may also challenge them”. As such, social entrepreneurs can be seen as being engaged in the production and maintenance of new systems of meaning. These “collective action frameworks” are action-oriented sets of beliefs aimed at mobilizing collective action.

There are three “core framing tasks” which together constitute the collective action framework: “diagnostic framing” “prognostic framing,” and “motivational framing.” Diagnostic framing involves identifying what the problem?is, and what or who is to?blame. Prognostic framing involves specifying a potential solution according to the ideologies and values of the movement. Motivational framing “provides a ‘call to arms’ for engaging in ameliorative collective action”; for example, warning of the consequences of failing to act.?

Patagonia will now be run by a nonprofit foundation. The shift generated a lot of headlines, but?outside of the U.S. this form of ownership is not new. “Shareholder foundations” have quietly prospered for decades in continental Europe, particularly in Denmark where a quarter of the largest 100 firms are foundation-owned, including the three largest firms in the country: Carlsberg, Maersk, and Novo Nordisk. These authors’ analysis of these firms suggests they can succeed as businesses, and that the arrangement helps simplify some of the tradeoffs that for-profit companies typically face when considering social responsibility.

Here are some tips if you are considering creating a non-profit entity:

1. Be sure you have a compelling value proposition that differentiates you from all the rest trying to solve the same problem or doing it in a way that no one else is doing.
2. Start with the "why", not the what and the how
3. Be sure you have a mission-driven business model canvas with valid assumptions
4. Build a strong community
5. Celebrate the beneficiaries, members, funders and donors, not your organization
6. Excel at branding, marketing and telling your story that speaks to the heart, not the head. Here is how to create a brilliant LinkedIn profile as a social entrepreneur
7. Make it personal but don't take it personally
8. Have a robust IT infrastructure that will support your CRM, communications, membership and fundraising efforts
9. Stay lean
10. Here's how to build a 30,000 member Linkedin group
11. Non-profit does not mean no profit. Run it like any other business
12. Focus on outcomes and impact and key results
13. Pick the right IRS defined non-profit organizational entity
14. Pick the right members for your board and clarify expectations

15. Build lasting partnerships and collaborations

16. Decide whether you should be for-profit or not-for-profit

Given all the controversy OpenAI has generated as a capital-intensive startup founded as a nonprofit, one might think AI-focused founders today would opt to avoid that governance structure.

However, the number of nonprofit AI-focused startups is growing at a fast clip. Nonprofit accelerator Fast Forward said that this year more than a third of applicants for its latest class were AI companies. They’re applying technology in areas including education, healthcare, and critical infrastructure.

The debate about whether globalization is dead is raging. Regardless of your view, we all now appreciate the nexus between public health, education and business and, given the liklihood that we have not seen the last of pandemics, how we should reset our thinking about the future of economic prosperity, US global competitiveness and equitable access to opportunity around the world. Pubic health social entrepreneurship is a tool to accomplish that end.

Here is a framework for education and practice of public health entrepreneurship and intrapreneurship.

Some think that the main difference between a for profit and non profit is where you find money. For profits seek investors. Not for profits seek donors, grantors and contractors.

Many nonprofits have big and important missions, but most are under-resourced. Of the 1.5 million in the United States, 65% have budgets under $500,000. The domestic violence shelter, the food pantry, the local free clinic — these groups are typically run on shoestring budgets with volunteer staff. Here are more ideas about how to keep your non-profit afloat.

Stay focused on the 7Ms: mission, members, money, mindset and model, marketing and meaning.

Here is what happens when one non-profit collides with another.

Some might argue that what worked for Frances Hesselbein in a nonprofit organization (The Girl Scouts) would not work in an organization in which performance is bottom-line oriented. Her bottom-line was always “changed lives.”?

Physician social entrepreneurs are making a difference around the world, particularly during turbulent times. You can too.

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