Whey we need medical practice entrepreneurs, not managers

Take a look at the course catalog of the medical schools in the US or the ACGME competencies following residency training and it is unlikely you will find a mandatory course or competency with the learning objective of teaching attendees physician entrepreneurship i.e. how to run a private practice profitably using a viable business model, how to add value as an employed physician intrapreneur, how to be a social entrepreneur or how to get an idea, invention or discovery to patients. 

At best, those dwindling number of graduates interested in private practice are forced to take week -end "practice management" seminars or courses at their national specialty society meetings. Many focus on the IT- mandate- to- get- paid of the week by highly trained specialists, but, in many instances, they are offered by the blind leading the blind.

"Practice management" is an archaic, out-dated term that limits the scope of what 21st Century physicians need to know and know how to do to serve the needs of their communities of patients, while making a fair profit doing it. While operations management is important, instead, the future belongs to those who add user defined value through innovation. In other words, medical societies,medical schools and graduate resident education programs should offer mandatory courses, and require demonstrating competencies, in medical practice entrepreneurship, not practice management. 

The purpose of these courses is to offer the knowledge, skills and attitudes necessary to thrive in the contemporary and rapidly changing medical landscape at a sustainable and scalable profit. At a minimum,courses should include:

1. Revenue Cycle Management including coding, billing and collecting

2. Human Resources

3. Digital Health 

4. Innovation,Entrepreneurship and Intrapreneurship

5. Marketing

6. Personal Financial Planning

7. Basic Accounting and Financial Statements

8. Operations Management

9. The legal and regulatory environment of health 

10. Comparative health care systems and alternative delivery channels

11. Value proposition design

12. Business model design

It is extremely unlikely that medical schools will offer these courses. Consequently, doing so will devolve to other independent or non-profits who embrace biomedical and health innovation and entrepreneurship education as part of their mission.

Here are some reasons why they should offer biomedical and clinical innovation and entrepreneurship education and training:

1. Employed physicians are expected to add more and more value as intrapreneurs
2. More and more doctors want side gigs but don't have the knowledge, skills, abilities and competencies to add value.
3. There are many ways to create patient defined value other than starting a company or seeing 20 patients a day.
4. Innovation requires involving end users early to be successful
5. As we migrate from paying for volume to paying for value, we should teach doctors how to create it.
6. Doctors are interested in social enterprise and social entrepreneurship
7. Doctors are interested in alternative non-clinical career development
8. We need more leaderpreneurs
9. Every doctor has a great idea. Unfortunately, few have an entrepreneurial mindset, know what to do next with their idea and are unlikely to be taught what to do with it in medical school or residency.
10. It is a way to recruit new members and generate dues revenue.
11. Members need guidance when it comes to policies and procedures for working with biopharma, medtech and digital health companies
12. The demographics and psychographics of the medical workforce has changed and they are struggling to adapt to the new world of work
13. Both the American College of Cardiology and the American Gastroenterological Association are investing in startups.

Here are 10 reasons why practicing medicine using a viable business model should be an ACGME competency.

Moving from medical practice management to medical practice entrepreneurship takes changing your mindset and not letting what got you to where you are now to where you want to go or what impact you want to make.

The sooner we move forward, the sooner doctors will have the ammunition they need to re-empower themselves, bend the private practice participation and cost curve, and add value to a system badly in need of it.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@ArlenMD and Co-editor of Digital Health EntrepreneurshipStp