Physicians have plenty of reasons why they may want to move to a non-clinical role, but how do they make the move? Society of Physician Entrepreneurs President and CEO Dr. Arlen Meyers explains the 4 Ps of the Pivot: Product, Pipeline, Pitch, & Plan.
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Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together and hear some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.
Michael: Welcome to the Paradigm Shift of Healthcare and thank you for listening. I’m Michael Roberts here today with my co-host Scott Zeitzer. This show is focused on the many ways that healthcare is changing and how the consumerization of healthcare is affecting practices. We talk about this topic on a regular basis of P3 practice marketing, and we invite you to be a part of that conversation here. Today we have a guest back on the show with us to talk about physician entrepreneurship, especially in nonclinical roles. Our guest is Dr. Arlen Meyers. He’s the president and CEO of the Society of Physician Entrepreneurs and a professor emeritus of otolaryngology, dentistry, and engineering at the University of Colorado school of medicine and the Colorado school of public health. Dr. Meyers, thank you for coming back today. We were just talking right before the show that you’ve got a busy day today. So I’m honored that we can get some time in here and get a conversation going.
Let’s jump in and talk. I mean, I’ve seen some of the articles that you’ve posted around this topic, and I’m really interested to kind of hear your thoughts on this because there are a lot of physicians that are kind of in this crossroads of whether they should continue on in the practice, just kind of as usual or whether they should consider some other options. So what are some of those pathways a physician might take toward a nonclinical career or a side?
Dr. Meyers: So I don’t think we really need to go over the why. I mean, we all kind of understand the pressure of COVID and burnout and anxiety and suicide, and just being generally grumpy and unhappy. So moving on from the why then there’s the what. So what do you move on to? And generally the general categories… there’s sort of three general categories that I’ve sort of identified. One is you can change your practice situation, that is continue to see patients, but you’re not going to do it full time. You may be doing a locums. You may be doing some sort of fill in role. You may be covering from someone in another practice, but you’re continuing to see patients, but you’re not doing it the way you did it before, as much as you did it before.
The second part is okay, I don’t want to see patients full time anymore, but I still want to somehow be involved in medicine. And then so that leads to what I would consider roles. Where you are part of the biomedical industrial complex. In other words, you’re doing utilization review, you’re doing utilization management. Maybe you’re doing case reviews, maybe you’re doing medical legal work. Maybe you’re doing something out that facilitates the oil or provides the oil in the system.
And then there’s a third part which is okay, I want to continue to be part of medicine, but I don’t want to have anything to do with the biomedical industrial complex from the standpoint of continuing to see patients or supporting the system, I’m just fed up with it. I don’t want to have anything to do with it. What I want to do instead is pursue what I would call an entrepreneurial side gig, and we can discuss that.
And then the fourth part is, you know what? I’m fed up with everything and anything that has to do with medicine and patients. I want to go out and do something that has nothing to do with medicine. I want to be a TV chef. I want to be a passive real estate investor. I don’t want to be an angel and whatever. So this conversation is about the third one. That is what I would consider to be entrepreneurial side gigs in medicine. So with the ultimate goal of contributing patient and end user value, but you’re just not going to do it seeing 40 a day for the rest of your life.
Scott: Right. It’s really interesting. I’m very close to that 60 mark and a lot of my friends, who are doctors, we’re all having that conversation about “the pivot” and there’s a wide spectrum. You could have somebody who’s much younger thinking about whether or not this is right for them, but it’s all about what’s making you happy at the core. Would you agree with that?
Dr. Meyers: Yeah. And to your point again, I’ve sort of sub categorized the universe in terms of the demographics of the people thinking about this. And I break them up into the young and the restless. That means medical students, residents, fellows, and people who have been in practice five years or less so those are the young and the restless. They have on average $200,000 in medical school debt if they don’t marry someone who also has $200,000 in debt. They have doubts about whether it’s worth it, et cetera, et cetera. Then there’s the middle group, which I call the desperados. These are the folks that are so desperate, but they’re wearing the golden handcuffs. They either overextended themselves. They’re so busy they don’t know where to turn. They had all kinds of issues at home. They bought the second house in veil, et cetera, et cetera, et cetera. So they’re deep into the weeds and it’s pretty hard for them to get out of their golden handcuffs.
And then there’s the final group, which are the old and the grumpy, people like me. And these are people who are generally 60 or over who have either, if they’re on the tail end of this, they started during the golden age of medicine and it’s totally different now. They’re fed up. So those are the three groups and all of them are having doubts. So if this is not unique to people who are 65 and over thinking of retiring. This spans the gamut of physicians in the pipeline.
Scott: Before I get into my next question, I’ve got a good friend of mine and he talks about the pivot. His name is Ira Kirschenbaum, and he always says “You want to still be relevant. You want to do something that really gives you joy and you want to avoid maybe hitting into your retirement funds.” If that’s the pivot for the cranky old men disease or cranky old woman disease in that third demographic. But let’s just assume that people who are listening to us are… they’re there. You know what I mean? They’re saying to themselves you know what? This isn’t for me, no matter what demographic you’re in. What’s your best advice for helping that physician figure out what type of entrepreneurship is right for them?
Dr. Meyers: Right. So what I say is, so first of all, to the previous point… So a couple of tips. One is most people are motivated to follow the map and by map, I mean, M-A-P. What they’re looking for is mastery, autonomy and purpose. That typically is what’s driving people because they don’t get that now. They don’t want to work for the man. They don’t want to be the doc in the gray plaid suit. They’re fed up with the system and they want to regain the mastery of all that clinical experience without somebody telling them what to do. They want to be autonomous or independent because they’re fed up with people telling them what to do and they want to maintain their sense of purpose, which is why they presumably at least to some degree, went into medicine to begin with. So they want to regain that. And oh, by the way, entrepreneurs are happier.
So the point and there’s some debate, but actually it was just a recent article on the Wall Street Journal today, reviewing the literature on are entrepreneurs happy? Headline, yes. Once you get into the weeds there’s some nuances but basically yes, for the reasons I just mentioned. So if you decide or when you decide you’re at that place, okay, I get it. I want to do this, but I have no clue how to do it, what do I do? So I tell people you’re going to need, just like the four Ps of marketing, which I don’t need to tell you guys, product, price, promotion, and place or distribution, you’re going to kind of need the same thing. But in this case, the product is you.
Scott: That’s right.
Dr. Meyers: Not some other product. So if the product is you, you’re going to need the four Ps of the pivot, which is you’re going to need a product, which in this case is you. You’re going to need a pipeline, which in this case is a network or mentors or people that are going to hire you or want to use you for whatever you decide. You’re going to need a pitch. You’re going to need a way to let people know who you are and what you do, why you’re different. It’s a typical value pitch for a new product in front of investors or customers. And you’re going to need a plan. So you’re going to need product, pipeline, pitch, and a plan. And we can talk about each of those and what that means, but that’s fundamentally where you start.
Michael: Yeah, absolutely. It’s something that we’ve been talking about quite a bit with a variety of people that have been on the show. We had somebody come on and talked about helping physicians develop their own personal brand, develop that product and develop that way of getting the attention on a regular basis. There was a lot of conversation about webinars and all these different ways, getting on people’s podcasts, all that kind of stuff.
Dr. Meyers: Right. And to that point, so let’s just talk a little bit about these four elements and maybe fill in some things. So in terms of the product, there’s two basic pieces of advice. I mean, there’s a lot to this, but the basic advice is number one, and I might have mentioned this before in a previous interview, but you want to make this personal but don’t take it personally. You have to do something that really trips your trigger. This has to be something inside you that says, this is really what I want to do, it’s really how I want to create some purpose or meaning in my life and I’m good at it. And I want to do that. So you have to kind of figure that out. But you don’t take it personally because in the business world, and when you’re trying to do this, you’re going to fail.
So you experiment, you try stuff, see if you like this thing, you don’t like that thing and you don’t make a big deal out of it, you just get up and you do something else. So make it personal, don’t take it personal. Number two and the problem that a lot of docs have with this is what got you here, won’t get you there. So the letters after your name, all the murkity murk, all the awards, all the stuff hanging on your wall, all the diplomas, all the stuff that really doesn’t make any difference. So what you have to do then is change your mindset from a clinical mindset to an entrepreneurial mindset, and you have to develop the knowledge, skills, abilities, and competencies to then take the entrepreneurial journey in a nonclinical career.
Scott: I agree with that doc. And the old school set of, hey, I got my degree and I’m just going to hang my shingle outside and it just happens, right? Those days I think honestly are ending and are over. And I really do believe that that point you made about having I guess maybe the fifth P, passion for what this is because if you do have a passion for what you think might be that right pathway for you, then you don’t worry about being knocked down every now and then. I always tell people, because I sold for quite a while and I guess I’m still a salesperson being an entrepreneur, is that if you’re a good salesperson, you have to get yelled at for about 10 minutes, walk out of the room and say, “Wow, what was wrong with that guy?” And again, that goes back to that passion part, if you really believe that what you’re doing is something that really excites you and it does make it easier to prove your point to talk about what makes sense to you.
Dr. Meyers: That’s easier said than done.
Scott: It really is.
Dr. Meyers: We can talk about this till we’re green in the face but the reality is you don’t know that until you try to go out and find it. And the only way you’re going to go out and find it is to experiment. So for example, let’s say you decide that you want to start a company as a physician entrepreneur, that’s a long road. And that’s filled with a lot of landmines and a lot of disappointment and heartache. So you kind of have to understand that’s the road you’re going to go through. On the other hand, if you want to be an advisor, if you want to be a consultant, if you want to be a chief medical officer of a technology company that takes its own pathway and you have no idea what that’s like. I’m not talking about a chief medical officer or a VP for medical affairs at a hospital, with the MD, MBAs in the corner office because they don’t want to patients anymore.
I’m talking about CMOs or advisors to startups, scale ups, and in some instances grown ups like Google or Apple or Facebook or the enumerable number of retail entities that are getting into healthcare. So you just don’t know what that’s like. So the only way you’re going to do to find out is to try it. Now you could say, well, that’s easy. How do I find somebody who’s going to hire me if I don’t have any experience and how do I get the experience? It’s like that old catch 22. How do I get the job if I don’t have experience and how do I get the experience if I don’t have a job? Well, that’s where the personal brand comes in and networking, which is the pipeline. So you have to have a network of people. And I’m not just talking about 30,000 people on a LinkedIn site or sort of people that you know on your LinkedIn profile, I’m talking about people that really can help you where you have developed a relationship with these folks.
And oh, by the way, most doctors have such thin networks and they’re not cultivated. So another point develop the networks before you need them. And I mean develop them, don’t just build them. So that when it comes time to say, “Look, I’m thinking of making this transition, can you help me connect to a decision maker, connect to a person that is in a role that I want to be in?” And it starts with informational interviews. This happens to me a lot. I’m fortunate that it does. I mean, I’m lucky that I can do this. People call me up and they say, “Arlen, I got the lecture. I heard what you said, I’m convinced, I want to do this. Can you help me connect to someone that will help me understand what I’m thinking about doing?”
I’ll give you an example. Yesterday, I had coffee in a coffee shop with a person who thinks they want to start a nonprofit to grow intents and purposes, find ways to deliver medication or prescription drugs to people who can’t afford them.
Dr. Meyers: Social purpose, good idea. There are lots of folks that need drugs and they can’t get them.
Dr. Meyers: So sounds like a good idea, right? He is clueless about social entrepreneurship. He has absolutely no idea what that means. So I said to him, let me give you an idea. Why don’t I connect you to a friend of mine who has run a nonprofit for 10 years? In fact, I used to be on the board and I just want you to spend a day in the life of her place so that you understand what you’re thinking about doing. You need a job preview. And she said, great. I mean, I know this person forever. I’ve done some stuff with her and we’re friends. So I said, “Would you do me a favor and just let this guy hang around with you for a couple of hours to see what it’s about?” But you have to have those kinds of connections. You just can’t call them up on the phone and say I’m going to drop in. That’s what I’m saying.
P3 Pro Tip
Hey, Michael here with your P3 pro tip for the week.
What do you do when your practice receives a negative review online? You may be tempted to ignore it or try to get it taken down. But if it’s a legitimate review, there may be an opportunity to respond. While you can’t discuss specific details in a public response to the review, you can post a response asking the patient to contact your office and see if you can resolve the issue. This can help to lessen the impact of the negative review in two ways.
First, the public response shows other potential patients that your practice is committed to resolving issues whenever possible. Second, if you are able to resolve the issue for the patient, they may be willing to edit or take down the negative review. While this customer service focus may be a different approach for your practice, it can go a long way toward patient retention and getting good word of mouth in the community.
Michael: If you’re just joining us, this is the Paradigm Shift of Healthcare. I’m Michael Roberts here today with Scott Zeitzer and we’re talking with Dr. Arlen Meyers about what nonclinical roles for physician entrepreneurs could look like.
Scott: Yeah, what mentorship, friendship and true connection, I think is really critical. You said it very well, it’s not a bunch of LinkedIn people. I mean, look, I got a lot of people connected to me on LinkedIn and I know some of them, some of them are just in my area, that kind of thing. But that’s a big difference between picking up the phone and saying I’m trying to figure out X and how do you get that done? And I can’t tell everybody how important that is even if you’re not thinking of changing careers, becoming an entrepreneur, whatever. Arlen, I think you’d agree with me, even if you’re going in every day and you’re happy seeing patients, et cetera, take a step back every now and then and just try to figure out who you’re interacting with. And who you can bond with and who you can learn from because you’ll overall become a better doctor, a better entrepreneur, a better human.
Dr. Meyers: Another tip and advice I give people is that when you’re going down this road, you should create a personal advisory board. Just like if you’re a CEO and you have a board of directors, you just identify three or four people that you so-called, know, like, and trust and you take them to lunch once a month. You say, here’s what I’m thinking. What do you think? And just see what happens. And you pick them because you think they can connect you to somebody or their wise, or they’ve been there before, or they do what you’re thinking of doing or whatever. But I think that’s a good tip too. And then there’s some people, there’s some doctors that are linked out and they just intentionally will not use LinkedIn. And I say, “Why?” And they say, “I don’t do that. I don’t believe in this. I don’t believe it.” So I said, okay, you’re cutting your nose off to spite your face.
The other interesting thing, and it gets back to this young and the restless. There are a lot of medical students now, more and more medical students that are really thinking twice about A, do I want to go to medical school? B, do I want to finish medical school? C, do I want to do a residency after I finish medical school? And we’re seeing medical students dropping out or graduating with an MD and then not doing a residency because they want to go to work for a startup, particularly in Silicon Valley or whatever. And I tell them, it’s called physician entrepreneur for a reason. When you graduate medical school, you have MD after your name. Technically you’re a doctor. You’re not a physician. You haven’t seen really patients. You don’t understand what the domain is about.
So from the standpoint of working for a startup, A, you don’t know what you’re doing. You don’t know anything about medicine, let alone business, unless you had some experience prior to going to medical school. And it’s simply not fair. And the people that hire you, they’re not smart either about doing this because now this person really can’t contribute value to their company. So it’s the blind leading the blind. It’s just a really bad, but that’s what they do. Now, the counter to that is, “You know what? You can tell me all you want Meyers, I’m not listening to you yet. I see all my friends making 300 grand working for Google coming out of business school. I’m doing it.” Okay, great. I also think therefore medical school should understand the reality that that’s what’s going on and accommodate that need. Do I think it’s a good idea? No, but it’s a market opportunity.
Scott: I will say this over and over. I’ve talked about this with lots of different docs out there over the course of this podcast conversation we’ve having about the need for medical schools to start embracing this change. They have not embraced it. They don’t talk of the business side of medicine. They don’t talk about preparing these young people for the new changes. I don’t understand other than momentum and their lack of knowledge in this area, it’s a real sore point I think for a lot of doctors and residency programs.
Dr. Meyers: Right. So actually that’s a good point, but many of us, including myself, are treating academentia. That’s what they call that.
Michael: I like that.
Scott: I like that.
Dr. Meyers: It’s actually not my term, a friend of mine called it so.
Scott: I still like it.
Dr. Meyers: Yeah, it’s cute. But the point is what we’re seeing and I’m very involved in reforming medical education to this point and I want to… we can talk about it on another show.
Dr. Meyers: But the point is, things are changing. They are definitely changing. And medical schools, new medical schools are totally rewriting their curriculum. They’re including data literacy, business of medicine, entrepreneurship, and innovation, you name it, all the stuff that everybody is bitching about saying, how come they didn’t teach me at medical school? They’re teaching it now. So just the short headline is things are changing and actually they’re changing fairly quickly. So we have this conversation in three years, this is going to be a moot point.
Scott: I’m very happy to hear that. And I’ve got a son, let’s say he’s in his second year of medical school and it’s pretty much old school setup. I’m gently having that conversation with him about whatever you pick, be passionate about it. And it isn’t a different conversation as I start to talk to a lot of younger people. It used to be like, I’m going to be a surgeon because that’s the thing I’m going to do. And a lot of people saying I’m not doing five years.
Dr. Meyers: Okay. So I want to be sure that the listeners get this. So product, pipeline, pitch, plan.
Dr. Meyers: So the pitch is how do you sell yourself in terms of putting it together in the value proposition. And the last point is the plan. So you need a personal and professional development plan because I said before, what got you here is not going to get you there. So you have to say, “Where am I now?” Where do I want to go possibly, because you don’t know where you want to go. You just pick something and kiss a lot of frogs and the how are you going to get there means you’re going to have to have education, resources, networks, mentors, experience, peer support, and nonclinical career guidance. And you should create like the autobiography of Benjamin Franklin, he had seven virtues and he practiced one every day, you need to do the same thing in your personal and professional development plan.
Work on your networks on Monday, identify resources on Tuesday, learn something on Wednesday, but you have to have a plan. And finally just like when you get divorced, it generally psychologists tell us, it takes three years to get over that. You are divorcing yourself in this role, you are literally divorcing your persona as a doctor seeing patients.
Scott: That’s right.
Dr. Meyers: And you have to get over that, but it will take years. It is not something you can do in three months. And what that means is you have to be not just emotionally, but financially prepared with some runway because I can’t tell you how many times people say, “I’m fed up with being a neurosurgeon. I’m making $800,000 a year, I want to be an entrepreneur so help me find a job where I can make $800,000 a year, but not see patients.”
Scott: Yeah. Hey doc, help me do that too, okay?
Dr. Meyers: Hey, I wish I could find a gig. You tell me, I’m going to I wish I had that gig. But that’s the reality. That’s just the way it is, that’s what I’m trying to give people a heads up about. Just face the reality of what you’re looking at and deal with it.
Michael: Absolutely. One last question before we wrap up today, I love this plan that we’re kind of talking through. I love these four Ps that we’re talking through. If somebody’s ready, they’re getting there, they’re kind of working themselves up to start jumping to this next thing, what types of nonclinical or side gigs have you seen that were particularly successful? And I realize this is very dependent upon who’s engaging with it and all that kind of stuff, but what are you seeing for people right now?
Dr. Meyers: So what I’m seeing mostly, and most of the interest is in digital health. So people want to somehow get involved in some aspect of digital health. So whether that’s, like I said, an advisor, a consultant, a chief medical officer, a member of the management team, sometimes they serve on a board of directors. So some sort of engagement role in a startup, a scale up or a grown up, that’s number one. So that’s the large majority of the kinds of things that I see.
Other people are going into professional service side gigs like physician coaching. I mean, burnout coaches is a growth industry. I mean, it seems like every day there’s another doctor that tells their story. Typically, it’s an ER doc or a primary care doc or some awful frontline situation, COVID burnout, they can’t… I recovered and there’s nothing worse than a reform center. So they now become the coach and they become… And there’s all these coaching credentials and all this other business. Frankly, I think there are too many coaches. I think there are too many chefs in the kitchen, but that’s just my own. And then there’s people that are pursuing other things like writing or authoring or they’re creating podcasts or stuff you’re experts in.
Michael: Dr. Meyers, thank you so much. We’ll have all your contact info on the show notes, but definitely on LinkedIn where I definitely follow everything that you post there. So thanks so much.
Scott: You and me both, yeah.
Dr. Meyers: Thanks for having me.
Scott: [crosstalk 00:27:14] Thank you.
Michael: Our pleasure. Have a great week.
Dr. Meyers: And you too. See you next time.
Announcer: Thanks again for tuning to the Paradigm Shift of Healthcare. This program is brought to you by Health Connective, custom marketing solutions for med tech and pharma. Subscribe on Apple Podcasts, Google Play, or anywhere you listen to podcasts.