Are you a hedgehog or a fox?

Twenty years ago, Jim Collins wrote a popular business book, Good to Great. In it, he described the defining characteristics of great companies and the executives that led them.. He wrote about eggs, flywheels, hedgehogs, foxes and people in bus seats.

He invited you to “Picture two animals: a fox and a hedgehog. Which are you? An ancient Greek parable distinguishes between foxes, which know many small things, and hedgehogs, which know one big thing. All good-to-great leaders, it turns out, are hedgehogs. They know how to simplify a complex world into a single, organizing idea—the kind of basic principle that unifies, organizes, and guides all decisions. That’s not to say hedgehogs are simplistic. Like great thinkers, who take complexities and boil them down into simple, yet profound, ideas (Adam Smith and the invisible hand, Darwin and evolution), leaders of good-to-great companies develop a Hedgehog Concept that is simple but that reflects penetrating insight and deep understanding.”

These authors tracked the long-term fortunes of the 50 companies lauded in the seminal business books, like Good to Great, of the past three decades. What did they find? Take greatness with a grain of salt—even the greatest answer to trends and forces.

David Epstein wrote Range: Why Generalists Triumph in a Specialized World about one year ago. In a world that has been transformed by volatility, uncertainty, complexity and ambiguity, the foxes rule the roost , the hedgehogs being the exception, like Tiger Woods, musical prodigies, surgeons, and, of course, chess players.

In fact, Epstein claims “Charles Darwin must have been one of the most curious and actively open-minded human beings in history”. Like they say, all history is revisionist.

By my definition, entrepreneurs pursue opportunity under VUCA conditions. The I-shaped mindset , while useful, has been displaced by the need for a T-shaped one, i.e. broad knowledge with areas of more shallow expertise in any particular area. Epstein goes on to describe late bloomers, polymaths, outside- in thinkers, people who think horizontally, not vertically, and those with a growth mindset and challenges our traditional notions of “follow your dream” and “pick and stick” early, when, in fact, you probably don’t know what you don’t know and will only find your spot when you experience it. Drop out docs are learning that after years of education and training and are just accepting the sunk costs.

So, what has changed and what should you do as a physician entrepreneur?

1. Adapt to the differences between a “kind” learning environment and a “wicked” learning environment.
2. Change your mindset
3. Think outside-in, not just inside out
4. Change your fixed mindset to a growth mindset
5. Practice and develop entrepreneurial habits
6. Embrace diversity of thought and people
7. Learn to play nice with other hedgehogs and foxes
8. Experiment with jobs, interests and careers
9. Learn the difference between the clinical mindset and the entrepreneurial one
10. Develop the entrepreneurial knowledge, skills, attitudes and competencies required to go from clinically good to entrepreneurially great
11. Challenge claims that AI can easily solve wicked problems
12. Challenge deep domain experts when they make predictions, particularly about the future
13. Stop following your passion
14. Don’t confuse passion with anger
15. Know when to pull the plug

Does your 4 year old really need to learn to code? Why do we make college students declare a major? How should we recruit and develop the doctor persona in 2025?

Here are some thoughts on developing entrepreneurial grads

We all know the world has changed. But, like frogs in slowly boiling water, we have not recognized the evolution of the 4th industrial revolution and its relentless impact. Rather we have be been scalded by COVID, and , that too shall pass. Then what? Will you curl back up into your ball?

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs