Are you a "real" physician entrepreneur?

There are many myths and misinformation about physician entrepreneurs. One is that doctors who no longer see patients but instead pursue entrepreneurial opportunities are not "real doctors".

The same applies to doctors who call themselves entrepreneurs but who have not created and sold a company for millions or billions of dollars. They are not "real entrepreneurs", just wannapreneurs.

Here is a comment I recently received:

" I reviewed your LInkedIn profile and you have not created and sold a single company. What right do you have to call yourself an entrepreneur let alone give someone else advice about sick care entrepreneurship?"

Here is my response:

1. Entrepreneurship is the pursuit of opportunity under volatile, uncertain, complex, and ambiguous conditions. The goal of all entrepreneurs, including physician entrepreneurs, is to create user defined value through the deployment of innovation using a VAST business model. In the case of sick care, the goal is to achieve the sextuple aims. Unfortunately, few doctors, scientists or engineers have an entrepreneurial mindset and, due to the shortsightedness of the medical educational establishment, few if any will be taught what to do with an idea in their formal training.
2. 2. Innovation has both a qualitative and quantitative component. It refers to doing something new or something old in a new way that creates user defined value that is a significant multiple of the competitive offering. Sick care sorely needs innovation that is not incremental or sustaining, but rather significantly adds at least 10x the present value to have an impact.
3. 3. Physician entrepreneurship is not the same as private practice nor is it fundamentally about practice management. The increasing rate of employed physicians should not be interpreted, as Prof. Fuchs implies, as decreasing entrepreneurial role of doctors and its consequent impact on medical professionalism. On the contrary, when done properly, it enhances medical professionalism.
4. 4. There are many distinct roles for physician entrepreneurs as small to medium sized business owners, technopreneurs, social entrepreneurs, intrapreneurs i.e. employed physicians acting like entrepreneurs, freelancers and consultants, and physician investors.
5. 5. Employed physicians, whether academic or non-academic, have the potential to be no less entrepreneurial than their colleagues who are in independent practices.
6. 6. While medical educational reform is necessary, expecting medical students to master health economics and population health is an unrealistic expectation. Medical schools need to be part of entrepreneurial universities with the goal of instilling an?entrepreneurial mindset in all graduates, including health professionals. To that end, medical schools and their graduate schools should rethink how they teach and practice technology transfer and commercialization and how they give faculty innovators the tools, incentive, and recognition for the scholarship of innovation they deserve.
7. 7. Physician entrepreneurship enhances medical professionalism, it does not degrade it, as long its practitioners understand and resolve the conflicts between the ethics of medicine and the ethics of business. Violating the patient or public trust by self-dealing or undisclosed conflicts of interest degrades any profession that has a fiduciary relationship with its customers or clients.
8. 8. Physician entrepreneurs create value for patients in many ways other than seeing them face to face for an entire professional career. The upcoming generation of medical students and residents and scientists and engineers in graduate school understand that better than their school's faculty and administrators and they have engaged in bottom-up efforts to fill the gaps in their education and experiences.
9. 9. Every threat to the existing practice of medicine, whether, as noted, it be acute care to chronic care, face to face care to digical care, or corporate care evolving into more patient centered care, represents an opportunity for physician entrepreneurs to help patients by adding value.
10. 10. Every industrialized country is facing the issue of how to provide their citizens with health services with scarce resources. Innovation and entrepreneurship, fostered by rules that catalyze them, will be the solution These days, you can't be a hipster without being a -preneur. They come in all sizes and shapes. Ganjapreneurs sell pot or pot derivatives. Technopreneurs do anything online. And then there are the doctorpreneurs, physician entrepreneurs or medpreneurs. The list gets even more confusing since there are so many different kinds and definitions. Here is a brief lexicon to help understand physician entrepreneurs:
11. 1. Innerpreneurs: Doctors who have the DNA to be great entrepreneurs, but either don't realize it or have had the creativity beat out of them during their medical training. Some have bought into the myth that doctors make lousy business people. Here are 10 reasons why.
12. 2. Entrepreneurs: For the lumpers in the room, a more general description of those who pursue opportunity with scarce resources under conditions of uncertainty with the goal of creating user defined value through the deployment of innovation. They are frequently misunderstood.
13. 3. Intrapreneurs: Employed physicians trying to act like entrepreneurs. They require a special set of survival skills, like political savvy and pursuing opportunities that are not traditional and that require unlearning.
14. 4. Wannapreneurs: Physicians who want to be part of the upside but don't want to contribute or put much skin in the game. Their mantra is "Here's my idea. Just send me the checks" or just appoint them to your advisory board as a hood ornament, put their picture on your website and them give options or a retainer. Here are 10 ways to spot them.
15. 5. Philanthropreneurs: Physicians trying to improve the human condition with active investments, not donations
16. 6. Psychopreneurs: Entrepreneurs with entrepreneurial psychopathology, Here is how to speak to a narcissistic physician entrepreneur.
17. 7. Leaderpreneurs: They lead innovators, not manage innovation systems
18. 8. Ganjapreneurs: Cannabusiness tycoons
19. 9.?Medical student Antsypreneurs: Medical student graduates who forgo taking a residency to go to work for or create their own startup10. APEs: Academic physician entrepreneurs
20. 11. Edupreneurs: Entrepreneurs changing medical school and residency education
21. 12. Non-sick care technopreneurs: Usually someone who is a service provider, technologist or investor, without a previous biomedical background. Here are common reasons why these kinds of entrepreneurs fail.
22. 13. Extrapreneurs: Employed people who are hanging on to their job until they find their next one or get fired and so are doing something entrepreneurial outside of their workplace as a side gig or a potential career pivot. Entrepreneurship is not just about creating a product or companies and exiting for big bucks. The ultimate beneficiaries are patients who benefit from physician entrepreneurs. Responsible physician entrepreneurship, however, requires that we resolve the conflicts between the ethics and culture of business with the ethics and culture of medicine.

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