Barriers to clinical entrepreneurship

1. Arlen Meyers, MD, MBA
Society of Physician Entrepreneurs

2. 1. Lack of entrepreneurial mindset
 The size of the challenge, not the size of the kingdom
 The new direction is the challenge, not the destination
 Make the present model obsolete
 Problem seeker, not problem solver
 Questions not answers
 Work from the challenge backward,
not capability forward

3. 2. A highly regulated ecosystem
 Differs around the world
 In US, shifting from FFS to value based

4. 3. A lack of patient awareness
 Low health IQ
 Low insurance IQ
 Bad consumers of care
 Bad judges of quality
 Lack of transparent information to make choices

5. 4.Vested interests
 There is nothing more difficult to take in hand, more
perilous to conduct, or more uncertain in its success,
than to take the lead in the introduction of a new order
of things. For the reformer has enemies in all those who
profit by the old order, and only lukewarm defenders in
all those who would profit by the new order, this
lukewarmness arising partly from fear of their
adversaries … and partly from the incredulity of
mankind, who do not truly believe in anything new
until they have had actual experience of it.
 — Niccolo Machiavelli

6. 5. Consolidation
 BIG MEDICINE v small medicine
 Public systems v private systems
 Market power
 Threats to private practice

7. 6. Mass eCare
 Scaling digital health adoption
 Digital health gaps

8. 7.Finding leaderpreneurs
 Knowledge technicians are dead and replaceable
 Managers are not leaders
 Leaders are not necessarily entrepreneurs
 Entrepreneurs are not necessarily innovators

9. 8. Finding early seed sage capital
 Changing financing models
 Money, like people and technology, go where they are
treated best

10. 9. Generational changes
 Risk aversion
 Generational stereotyping is stupid

11. 10. Defining and measuring value
 The perceived difference in the mind of the user
between the tangible and intangible benefits-the
tangible and intangible costs when compared to other
offerings
 Changing value factors
 Convenience
 Speed
 Experience
 Service
 Price

13. 11. Education and training
 Reform medical and PhD and postdoc bioscience
education and training
 Culture highly resistant to change

14. 12. Ecosystem Integration
 Integration into innovation ecosystems to provide
networks, mentors, and experiential learning
 Career development opportunities

15. 13.Fear of physician entrepreneurs
 Defining medical entrepreneurship
 Conflict of interest
 Money before mission

16. Academic-industry barriers
 Anti-entrepreneurial policies and procedures
 Lack of an entrepreneurial culture
 Regulations
 Poor networks

17. Solutions
 Upside down organizational structure
 Revised platforms and processes of care with
innovative business models; systems of systems
 The right people in the right jobs of the future
 Changing rules that drive ecosystems that drive
business models that catalyze innovation
 Education reform to include bioentrepreneurship
 Better business environment

18. Solutions
 International knowledge transfer programs
 SoPE Sao Paulo chapter
 More early stage capital
 Remove uncertainty
 Open national
innovation:public/private/finance/academic