The entrepreneurial v the clinical mindset

Innovation starts with the right mindset. For that reason, doctors with a clinical mindset have some characteristics that are entrepreneurial keys. However, there are many more entrepreneurial mindset traits they lack.

So, if you are a sick care professional, like a doctor, nurse, pharmacist, dentist or allied health professional interested in entrepreneurship or a non-clinical career pivot, then you not only have to change your mind about things, you will have to change your mindset as well.

The 14 scales measured by the second (and final) version of the Entrepreneurial Mindset Profile (EMP).

Personality Scales

Independence: The desire to work with a high degree of independence (e.g., I’m uncomfortable when expected to follow others’ rules.)

Preference for Limited Structure: A preference for tasks and situations with little formal structure (e.g., I find it boring to work on clearly structured tasks.)

Nonconformity: A preference for acting in unique ways; an interest in being perceived as unique (e.g., I like to stand out from the crowd.)

Risk Acceptance: A willingness to pursue an idea or a desired goal even when the probability of succeeding is low (e.g., I’m willing to take a certain amount of risk to achieve real success.)

Action Orientation: A tendency to show initiative, make decisions quickly, and feel impatient for results (e.g., I tend to make decisions quickly.)

Passion: A tendency to experience one’s work as exciting and enjoyable rather than tedious and draining (e.g., I’m passionate about the work that I do.)

Need to Achieve: The desire to achieve at a high level (e.g., I want to be the best at what I do.)

Skill Scales

Future Focus: The ability to think beyond the immediate situation and plan for the future (e.g., I’m focused on the long term.)

Idea Generation: The ability to generate multiple and novel ideas, and to find multiple approaches for achieving goals (e.g., Sometimes the ideas just bubble out of me.)

Execution: The ability to turn ideas into actionable plans; the ability to implement ideas well (e.g., I have a reputation for being able to take an idea and make it work.)

Self-Confidence: A general belief in one’s ability to leverage skills and talents to achieve important goals (e.g., I am a self-confident person.)

Optimism: The ability to maintain a generally positive attitude about various aspects of one’s life and the world (e.g., Even when things aren’t going well, I look on the bright side.)

Persistence: The ability to bounce back quickly from disappointment, and to remain persistent in the face of setbacks (e.g., I do not give up easily.)

Interpersonal Sensitivity: A high level of sensitivity to and concern for the well-being of those with whom one works (e.g., I’m sensitive to others’ feelings.)

Undergraduates are accepted to medical school, in part, on their mindsets, which, given the list above, is counter to the the culture of clinical training. So, doctors who want to practice their entrepreneurial mindset will have a conflict of consciousness.

What is a “mindset”? Experts vary, but, fundamentally, is it how and why we think about things the way we do and how we interpret the world. We use mental models, that, unlike most personality traits, are malleable, not fixed, and that drive our emotions and behavior. 

Mental models are created by the internal conversations we have with ourselves and, those conversations, psychologists claim, create feelings that drive behavior. Negative thoughts drive negative behavior and vice versa. In other works, you will become what you think.

Given how entrepreneurs and biomedical professionals evolve in their careers, there are some similarities between the two mindsets.

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However, there are some fundamental differences too, like different:

  1. Cultures
  2. Personality traits
  3. Set of professional norms and ethics
  4. Knowledge, skills, abilities and competencies
  5. Problem solvers v problem seekers
  6. Customer centered v paternalistic
  7. Networks
  8. Perceptions of user defined value
  9. Incentives and payment systems
  10. How they use or waste resources
  11. Business models
  12. Rules,legal and regulatory environment
  13. Ways they look for innovation: one in the New England Journal, the other in the Wall Street Journal

Mindset is but one of many entrepreneurial competencies you will need to succeed. Others include:

Opportunity recognition pertains to one’s ability to scan and search for new information, connect the dots between incidents that appear to be unrelated with limited cues, and recognize patterns or ideas that suggest potential opportunities in the myriad cues or signals that they receive (Baron, 2006).

Conveying a compelling vision/seeing the future reflects an individual’s proclivity for effective communication where he or she can translate his or her vision into condensed, clear, and intriguing messages to important stakeholders (Chen, Yao, & Kotha 2009).

Ability to maintain focus yet adapt speaks to the entrepreneurial experience. This ccan include considerable ambiguity and uncertainty, significant obstacles, ongoing emergence of new opportunities, and continuous change in circumstances (Morris et al., 2012). The entrepreneur must continuously adapt, change, modify, and switch while maintaining a self-regulated focus in the midst of volatile conditions (Haynie & Shepherd, 2009)

Resilience captures the cognitive tendency of an individual to cope with stressful, adverse, and devastating situations, to be able to recover from failures, and to constructively sustain his or her efforts to pursue goals. In reality, successful entrepreneurs are not easily beaten by distress or rejections. Instead, they are able to remain or resume a calm state of mind, to tactically frame and analyze problems, dig into the root cause of failures, and to search for ways to get back on track again (Sinclair & Wallston, 2004).

Interdisciplinary teamwork and collaboration refers to the ability of individuals to form partnerships with a team of professionally diverse individuals in a participatory, collaborative, and coordinated approach to share decisionmaking around issues as the means to achieving improved health outcomes (Orchard & Curran, 2003).

Assessing the feasibility of an opportunity emphasizes the need for innovators to make evaluations or judgments on whether emerging information or changes would lead to viable opportunities with profit potential (McMullen & Shepherd, 2006).

Self-Efficacy/Confidence relates to an entrepreneur’s self-confidence and selfassurance about his or her ability to take on challenges, to perform certain set of tasks as needed or expected, and to control processes, contingencies, or consequences in the entrepreneurial pursuit (Bandura, 1997; Baron & Markman, 2005; Tierney & Farmer, 2002). 

Building and using networks concerns one’s ability to establish, maintain, and structure his or her contact network(s) in ways that foster relationships, enhance access to opportunities and/or resources, and potentially lead to realization of his or her objectives (Aldrich, 1999).

Tenacity/Perseverance refers to the extent to which entrepreneurs are committed to seeing their vision through, to endure the long journey to carry out venture creation, to work fervently despite challenges or adversity, to maintain interests, and persist with efforts in achieving goals (Duckworth & Quinn 2009; Hmieleski & Corbett, 2006).

Understanding of healthcare systems entails having a firm grasp of the various components of the health system and an understanding of the major issues faced by the stakeholders.

Resource leveraging/Bootstrapping describes the need to overcome resource constraints by leveraging resources from others. It also reflects a tendency for innovators to demonstrate an inclination towards effectual rather than causal reasoning in bringing together unique resource combinations (Greene &Brown, 1997; Honig, 2001; Politis, Winborg, & Dahlstrand, 2011).

Creative problem solving/Imaginativeness is characterized by Schumpeter (1942), who posited that creative destruction plays a key role in the innovation process. Innovators who start something are engaged in a process of creative imagination in which opportunities are exploited by continuously combining resources in new ways (Kirzner, 1973; Chiles, Bluedorn, & Gupta, 2007).

Design thinking is a human-centered, prototype-driven process for innovation that can be applied to product, service, and business design. It is the process of questioning, observing, and experimenting, so that you can become better equipped to capture valuable information and develop new business ideas. It requires experimentation in order to understand how things work, to test new business ideas or different approaches, and to look for valuable insights that may emerge in the process (Brown, 2008).

Guerrilla skills is a label adapted from a warfare context, describing approaches that center on clever ways to take advantage of one’s surroundings, do more with less, to rely upon unconventional tactics, and to utilize resources not recognized by others in accomplishing tasks within entrepreneurial firms (Schindehutte, Morris & Pitt, 2008).

Risk management/mitigation involves the systematic monitoring, assessing, hedging, transferring, and/or exploiting multifaceted risks encountered as an innovation initiative unfolds. Risk-aversive attitudes discourage individuals from innovative activities (Cramera et al., 2002), while successful entrepreneurs are willing to first recognize and bear the uncertainty or risk needed to take entrepreneurial actions, and are able to manage risk rather than simply trying to avoid risk (McMullen & Shepherd, 2006).

Cross disciplinary knowledge refers to an understanding of the connections, interrelations, and interactions between different fields of knowledge (Mosseri, 2006).

Change management is the ability to understand and manage driving forces, visions, and processes that fuel large-scale transformation (Kottler, 2011).

Information management is the collection and management of information from one or more sources and the distribution of that information to one or more audiences.

Behavioral economics refers to an understanding of psychological, social, cognitive, and emotional factors on the economic decisions of individuals and institutions, and the consequences for market prices, returns, and resource allocation (Lin, 2012). It is the understanding that drives decision making.

Leadership There is a strong link between leadership and innovation

Mindset Innovation starts with the right mindset

In my view, about 1% of doctors, engineers and scientists live at the intersection of the two circles.

Consequently, many health professionals struggle to make the transition to a combined clinical entrepreneurial mindset from a pure clinical mindset. Likewise, here are 10 reasons why non-sick care entrepreneurs stumble along the life science innovation roadmap.

Achieving success as a biomedical or sick care entrepreneur requires resetting your mind, not just changing it. Doing so takes time, mental discipline, knowledge, practice, self-improvement, experience, study and coaching… sort of like your residency training. Except, in most instances, it will take more than four years since old habits don’t die quickly.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@ArlenMD and Co-editor of Digital Health Entrepreneurship