Interview On Biomedical Entrepreneurism

Here's an interview with Arlen D Meyers MD from Kings College London.

I embedded them in this post but they automatically play on load so I've opted to provide just the links below. As you may well know, Dr. Meyers is one of Freelance MDs writers. You can read all of Dr. Meyers posts here.

• Video 1
• Video 2

Cluster Theory: Geography Is Destiny

Geography is destiny, particularly when it comes to biomedical innovation.

The Kauffman Foundation and the Information Technology and Innovation Foundation have released The 2010 State New Economy Index, which tracks state performance on 26 indicators divided into five categories: knowledge jobs; globalization; economic dynamism; transformation to a digital economy; and technological innovation capacity. Most of the states have improved, with Massachussetts taking home the trophy.

Clusters are formal and informal geographically circumscribed networks that link participants with similar interests. Silicon Valley for IT, New York and London for finance, Hollywood for entertainment are examples. Bioclusters, linking inventors and researchers, service providers, industry representatives and public agencies, have erupted in every state in the US and most major industrialized countries. Their growth is driven by economic development, jobs and revenue for the regions that spawn them. If you are interested in bioentrepreneurship, follow Meyers Law: go where the innovation is. In most instances, that will be a cluster close to a major research university, populated with creatives and linked by an entrepreneurial ecosytem that provides money to early stage companies.

Harvard Business School Professor Michael Porter, one of the founders of cluster theory, defines a cluster as “a concentration of companies and industries in a geographic region which are interconnected by the markets they serve and the products they produce.” This nexus of acitivity is associated with high performance economies and regions. They are where the action is and that's where you should be if biomedical innovation is in your future.

If you want to act, go to Hollywood. If you want to hit it big in financial services, spend some time on Wall Street. If you want to learn biomedical innovation, pick a place with a proven track record of creating great companies and management alumni and hitch your wagon to a local star.

Turning Stumbling Blocks Into Stepping Stones

By Yvonne Thornton, MD

Since the age of eight, I have wanted to be an obstetrician, delivering babies. Being an author was not in my consciousness as a young woman. However, the journey to write a book came from my mother’s request to write a book about our family. The seed was innocently planted when I was an OB/GYN resident, during a conversation with my mother. She told me that all she wanted was to have our story told in a book that would be in the library. She wanted to let the world know that with education, focus and determination, how her little “nappy-headed” daughters from the housing projects became successful independent women of whom she was so proud. When my mother told me her request, I was somewhat taken aback because I wasn’t a writer. I delivered babies for a living. I told her that I had little time to sleep much less to write a book. However, after she died, my mother’s wish became my quest, my obsession, my new goal in life.

I had the story. I just needed someone with the right skill and temperament to help me write my story.  It wasn’t easy. It took me 18 years to find a collaborative writer and get my first book published!!  I searched for years to find the right person who had substance, writing talent and an insight about the struggles of my parents. Writer after writer came and went. Either they wanted an enormous amount of money to help me write a book or their writing skills and temperament were not suited to write the kind of book I wanted written. One day, I saw a reference in The New York Times to the American Society of Journalists and Authors and its Dial-a-Writer service. Dorothy Beach, who ran the service, put me in touch with one writer who had too many assignments to take on another, a second writer who wanted a year’s salary in advance, and a third writer who said she wasn’t interested in writing a book but thought the Reader’s Digest might want to run an article about the family. That writer was Jo Coudert. Ironically, Jo Coudert had authored my husband’s favorite book, Advice from a Failure.

I had finally found the writer I knew could do justice to my parents’ story, but she wasn’t interested. I was relentless. Once or twice a year for the next five years, I would call Jo to ask if she might possibly change her mind about writing the Thornton story as a book. Jo was as resolute as I was persistent. However, after several years of convincing her to help me, she finally capitulated.

Jo and I began meeting all day every Saturday, Jo making notes and taping, while I retold the story of the ditchdigger’s daughters: how we were born and grew and were molded into becoming successes by a father who labored at two jobs and a mother who cleaned houses. With the book outline and representative chapters in hand, our literary agent approached many publishers. To our chagrin, no one wanted to publish the book. The publishers said it wasn’t marketable because the book had no conflict. But persistence does prevail and a small publishing house in New York did take a chance and The Ditchdigger’s Daughters was published in 1995. The book has never been out of print, was condensed by the Reader’s Digest, translated into 19 languages and was adapted into an award-winning telefilm for cable television.

My new memoir, SOMETHING TO PROVE takes a closer look at my nuclear family, my struggles and the life lessons I have learned throughout my years as a physician, a wife, a mother and a woman. This second memoir continues the saga of my journey in medicine and was written to serve as a roadmap for young professional women who need to balance their careers with managing a household and raising children.  The book takes a sharp look at the hierarchy of academic medicine, misogyny and racial prejudice in the working world. But more than just telling my story, SOMETHING TO PROVE speaks to women, young and old, of all races and socio-economic status, giving them dynamic messages of empowerment, and the courage to face the pitfalls that so often pop up along their own personal roads to success. With each chapter opening with the wise sayings of my father, I try to be faithful to the memory of my parents; in that the inspiring lessons they taught me would not stop with me, but would touch the lives of my children and all those I have touched. 

About the author: Dr. Thornton is a double Board-certified perinatal consultant in obstetrics, gynecology and maternal-fetal medicine. She is a Clinical Professor of Obstetrics and Gynecology. Dr. Thornton blogs at PagingDrThornton.com

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The Physician Entrepreneur's Christmas Reading List

Recommended holliday reading for physician entrepreneurs.

Sir William Osler, one of the fathers of American medical education, ennumerated in "Aequanimitas" several classics that every doctor should keep on his (or her) nightstand and suggested reading parts of them for 30 minutes every night.

In that vein, now that the holiday season is upon us, I thought I'd recommend a few book ideas to put on your gift list, some classics, some recent, to help you or others along the bioentrepreneurial path to success. While not Seneca, Plato or other classicists, they certainly contain more than enough wisdom for many sleepless nights.

So here are the fabulous five:

1. Peter Drucker: Innovation and Entrepreneurship
2. Guy Kawasaki: The Art of the Start
3. Steven Johnson: Where do good ideas come from?
4. Robert Sutton: The No Asshole Rule
5. Timothy Ferriss: The 4 Hour Workweek

Like any good entrepreneur, you should rent, or buy used, and get as much as you can for free. Watch your cash. The total bill on Amazon is $55.82. The postage is free.

Sweet dreams and Happy Holidays.

Preparing for Boards

Sitting on a Board of Directors takes an experienced hand, but has its perks.

A very long time ago, I can remember walking into the Palmer House in Chicago to take my board examination administered by the American Board of Otolaryngology and Ophthalmology...yes, that's how long ago it was when both boards were combined. Remember EENT's? Fresh out of my residency, with my first academic job slot already secured, I confidently blasted through the written exams and suffered through the orals. On the return flight home, I had no clue whether I'd have to face the agony of defeat, head mirror in hand, humiliated in front of my peers, or return the victorious warrior, endowed by my creator with the necessary credentials to live happily ever after. Fortunately, I passed and, a few months later joyously hung my Board certificate on the wall like a flashy hood ornament.

Several years later, I entered my first Board of Directors meeting as a newly appointed independent board member of a medical device startup company. If only it were as easy as going to Chicago.

As I thought about it, I came to realize that preparing for specialty boards or serving on a company board involves a similar pathway. The first step is basic education. Like going to grand rounds, journal clubs, temporal bone labs and faculty presentations, you will need to learn the "basic science" of how companies are structured, the fiduciary roles of board members, the rules and physiology governing how they work and your role in participating. There are several good sources for this information including the National Association of Corporate Directors and the Corporate Director's guidebook.

The second part, like getting progressive clinical responsibility in your residency, is applying your knowlege to taking care of patients, or, in this instance, the business and its shareholders. The practice of boardsmanship can be honed just like clinical skills. It takes practice, hopefully in an environment that provides you with increasing levels of participation under the watchful eyes of experienced mentors and practitioners. Just like residency, start with the simple cases. Volunteer to join committees of your medical society, particularly, in these days of Sarbanes-Oxley, the Audit Committee. Participate in not-for-profits. Serve as a member of a scientific advisory or business advisory board before taking on the "big cases" or complicated revisions.

Them, at first, listen, don't talk. Be sensitive to what is not said, not what is said. Be sure you know when to fold them if you observe bad behavior or ethical lapses. Come to meetings prepared and don't be afraid to TACTFULLY tell truth to authority.

I was one of the lucky ones who was grandfathered out of having to retake my board exam every 10 years. However, that certainly has not relieved me of the responsiblity for the last step in medical/business boards , life-long learning. The rules of corporate governance change with every Congress and it is your reponsibility as a board member to be current and aware. In addition, like malpractice insurance and liability , CYA when it comes to your personal and business liability while serving on a board. Sometimes, particularly as your assets grow, you will have more to lose than to gain.

Serving on business or scientific advisory boards or boards of directors is a gratifying experience that will challenge and energize you. You'll make great contacts with other board members, develope life-long friendships and build your credibility.

Oh, and another thing. Most of the time the food is better than what they served at the Palmer House.

Jumping The Track From Clinical Practice To Industry

For physicians looking for non-clinical careers, it's a different world.

An increasing number of physicians are considering non-clinical careers. Some may have discovered they can no longer sustain their purpose and passion through a clinical practice. Others may feel trapped and simply want a change. Many would prefer to build on their background and experience—and continue to serve patients—but in a different way. For those up to the challenge, a career in either the medical device or pharmaceutical industries could be viable option. 

A career in these industries could be every bit as rewarding and stimulating as the practice of medicine.  In fact, it is possible to touch many more patients through the development and commercialization of medical devices or drug products. The challenge is in managing the transition. 

Physicians who are looking to jump the clinical track will need to fine tune a number of important life skills. Managing the doldrums while still in practice, keeping the dream alive, and sorting things out are all part of the process—as is dealing with set backs. And there will be set backs. But these can be balanced by efforts aimed at experimenting and exploring as well as networking and learning.        

First, consider the need—and what you have to offer. How could you help a company bridge the gap between a clinical problem and its solution? This will help you know where to focus your efforts and how to allocate your limited time and resources. 

Be aware of some common mistakes companies make.  In general, device companies think all the engineering is in the device—and drugs are just something you take off the shelf and put in the reservoir. Pharmaceutical companies think all the science is in the drug product—and devices are so simple, anybody could do it. Unfortunately, both are wrong. With the right background (and change in mind set), physicians could help companies overcome these mistakes. It’s a matter of truly understanding the clinical need and working as part of a team to commercialize the best product to address the problem. 

Clearly, some physicians may be better suited for certain jobs. For instance, an orthopaedic surgeon with a mechanical engineering background could be a good fit for a role in designing and testing a new implant for total joint replacement.  An internist who has been involved in human clinical trials could be a good fit for a position aimed at developing and implementing clinical protocols to meet regulatory expectations.

Second, do your homework. Learn as much as you can about the target companies for your job search—and develop a plan to explore the opportunities that would be the best fit for you.  Do you know where these companies stand in your chosen industry. Revenue and earnings growth is important—but you should know a lot more about these companies. 

What about the company’s social architecture? What do they value? What is their mission or reason for being? What is their vision of the future? How well does the company’s core values fit with yours?  If you and the company are not aligned on this, chances are you will be unhappy in the long run—no matter what you are offered in terms of compensation and benefits.       

What about leadership attributes? How does the company define leadership—and what are they looking for in candidates for employment? Do you have what it takes to meet the company’s expectations in terms of leadership? Have you demonstrated the ability to set the direction and plan for others, build the best team, be a role model, and deliver results?  If not, what can you do to develop the skills necessary for the position you seek?  

And finally, execute your job search. To ensure success, you will need to do three things really well: network, network, and network some more. Tap into your clinical network to understand the commercial needs and the healthcare provider assessment of the leading companies in your chosen industry.

Expand your network to include executives and hiring managers in your target companies.  Find out who you should be talking to learn more about who is hiring or willing to create a position for the right person.

And reach out to a few, well-known and respected executive recruiters in your field. It’s important to plug into people who understand your target companies in your chosen industry. But don’t be fooled by those who claim to know a lot about clinical practice and how physicians can contribute in industry. The fact is, few have placed physicians in these roles—and even fewer truly understand medical devices or the roles physicians can play in areas outside of R&D. There are a few solid performers, such as Korn Ferry, Spencer Stuart, and Heidrick & Struggles. These would be good firms to include in your network.  

Physician Entrepreneurs, MBA's, and anti-MBA's

Does a Physician Entrepreneur need an MBA after their MD?

Once again, in a blog post from the Harvard Business Review, the endless debate about whether entrepreneurs should get an MBA rears its ugly head. The arguments typically fall into the "just do it" camp, as exemplified by a quote in the article "entrepreneurship is a matter of the heart, and education is a matter of the brain. It is difficult to teach a heart" v those in the entrepreneurial education universe who have spent their lives justifying entrepreneurship as a legitimate academic domain.

This debate reminds me of conversations going on now about residency training requirements, duty hours, residency selection criteria (a recent journal article described how a professional management consultant inventoried what first year residents do and then suggested ways to structure interviews to identify and recruit them) and how we provide accelerated levels of education and training. As both a business and medical educator and someone with some experience in starting companies, I come to the same conclusion about nature v nurture: you can teach someone how to do surgery, but you can't teach them how to be a surgeon. I think the same holds true for entrepreneurship. Sure, there are certain behavioral traits and personality qualities that are correlated with entrepreneurial success. However, when it comes to understanding how to get 510(k) FDA approval, or how to read and analyze a term sheet, or how to create a value proposition, feasibility analysis or business plan, I'd rather take the easy road and learn from the mistakes others have made.

Some think entrepreneurs are born, others that they are made, and still others that they are self-made. Like medical students who choose surgery or a surgical subspecialty as a career choice, entrepreneurs who want additional education tend to be remarkably self-selective and successful. Those would-be entrepreneurs with boundless self-confidence, enthusiasm, intelligence and self-awareness will be successful despite their MBA's. However you parse the words, take someone with what it takes, add a first class education and the networks that result, and, in my view, the result is greater than the sum of the parts. There are many ways to the finish line. Just do what trips your trigger.