Fighting Exasperation: The Physician as Entrepreneur

It seems that every week, there is another opinion piece written by a physician lamenting how the healthcare system has changed—how it doesn’t work, how physicians’ payments are declining, how regulations are driving providers’ practice efficiency, or how others are interfering in the relationship between patient and provider.

But one particular piece written by Dr. Daniel Craviotto, an orthopedic surgeon, resonated quite deeply with me. In the Wall Street Journal, he writes:

“I don't know about other physicians but I am tired—tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way I practice medicine. No other profession would put up with this kind of scrutiny and coercion from outside forces. The legal profession would not. The labor unions would not. We as physicians continue to plod along and take care of our patients while those on the outside continue to intrude and interfere with the practice of medicine.”

I am sure other providers, at one point or another, have felt as exasperated as Dr. Craviotto. Indeed, this is a tumultuous time in healthcare in the United States. The recent election, resulting in the Republican Party gaining control of Congress, has raised the level of uncertainty around health care legislation, and thus our healthcare system. This may mean that provider exasperation may continue, if not worsen. If only there were ways in which providers could channel that exasperation into shaping a better healthcare system.

As a matter-of-fact, there are. Here are just a few:

Get Involved

Yes, providers are extremely busy.  Between clinic, hospital rounds, overnight and weekend on-call responsibilities, it seems impossible to carve out time for non-clinical activities. However, in order for providers to have their voices heard, they need to be active and involved. 

1. One way to accomplish this is to search out leadership positions within the workplace.

Make it glaringly obvious to your colleagues that you’re looking to take on a management role to address the next challenges facing your practice. At the next team meeting discussing such an issue, step forward and volunteer to take the lead in finding a solution. 

Enroll a multidisciplinary group to help you—this will generate a wider perspective on the challenge, and give you more resources than you’d have on your own. In addition, this will be a great opportunity to form relationships across your practice. Most of all, it will allow you to influence and shape the practice of medicine as you see best.

2. A second way to get involved is through advocacy. Lend your voice to influence political, regulatory, economic, or social institutions. Skeptics will cast aside this idea as ineffective—Congress, for example is “controlled” by special interests. However, let me share with you a recent experience that may serve as a template for advocacy activities.

I recently had the honor of representing the Mayo Clinic Cancer Center and the American Association of Cancer Research (AACR) at the Rally for Medical Research in September 2014. The rally brought together approximately 300 medical researchers and providers across many specialties—cancer, ophthalmology, neurology, and liver disease, to name a few—to call upon the nation’s lawmakers to make increased funding for the National Institutes of Health (NIH) a national priority.

By personally visiting with members of Congress, we passionately highlighted how budget cuts at the NIH adversely affected the careers of young researchers and their opportunities. In addition, we discussed how budget cuts negatively affected the pursuit of desperately needed cancer research and clinical trials.

So, what are the lessons learned here? How does one make the greatest impact with advocacy?

First, although one may approach a member of Congress as an individual constituent, advocacy is most successful when it is done though professional organizations such as AACR, and is broad-based with multiple other groups united around the same message.  We didn’t approach Congress for funding specific to cancer. We were asking for more research for ALL of medicine.

Second, there is power in numbers: 300 people representing over 100 organizations—non-profit, for-profit, academic—we all blanketed Capitol Hill on the same day to make the greatest impact possible. 

One note of caution—advocacy is not "one and done.”  Success requires repeated and sustained efforts over many months or years.  Don’t give up on the issues you are advocating for—they’re too important to abandon. 

Another lesson comes from Ryan Panchadsaram, one of the young and brash engineers that was asked by the White House to diagnose and fix the Healthcare.gov website. Ryan was part of the Presidential Innovation Fellows program, and I had the opportunity to hear him speak at Rock Health’s Innovation Summit this year.

His message: government wants to hear when something isn’t working for its people.  However, instead of stopping at identifying the deficiency, propose a solution. There are people within government who truly want to make a positive impact, and they would benefit greatly by hearing from those in the community who are directly affected by the problem and have the expertise to solve it. 

Entrepreneurship

Another way to make a positive impact on the healthcare system is create a solution to a problem that you experience firsthand. It has never been easier to start a company—costs are low, technology such as videoconferencing enables long distance collaboration, and there are many other individuals who want to join forces and affect change on the healthcare system. Finally, because of the shifting landscape in healthcare, the ecosystem is full of opportunity. 

One caveat—most providers do not innately possess the skillset to start a company, establish a pricing model, and sell to customers. Thankfully, there are resources one can turn to address overcoming this deficiency.

Two authors in particular come to mind—whose books are quite valuable for individuals interested in starting their own companies:

1. Eric Ries is an entrepreneur who has written a widely-referenced book entitled The Lean Startup, which describes how newly formed companies can utilize limited resources to efficiently develop and test their product solutions with customers. 
2. Steve Blank is another entrepreneur who has not only written several excellent books on starting a business, but has also taught at Stanford, UCSF, U.C. Berkeley, NYU, and Columbia. His books, The Startup Owner’s Manual and The Four Steps to the Epiphany, delve into the how of building a company around a solution to a problem, establishing a business model, and testing the market demand for the solution. 

There is a lot of exasperation around the state of our healthcare system. Providers have expressed it. Patients have experienced it. We all have stories to share about how the healthcare system could have performed better. However, it’s because we have such opportunities that we have such hope.

So get up. Rise up. Answer the challenges in healthcare with solutions. Get involved.  Take the next opportunity to influence and shape the future of our system. Only then will exasperation turn to satisfaction in a job (and healthcare system) well done.

Mustaqeem Siddiqui, MBA, MD is a practicing clinician in hematology/oncology and an Assistant Professor at the Mayo Clinic—as well as an Entrepreneur Mentor at Rock Health. For more of his expert views and opinions, you can follow him on Twitter @mustaqeemS.

The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.