An Ask-the-Expert Conversation with Lyle Berkowitz, MD, FACP, FHIMSS and Alan Pitt, MD
Physicians understand better than almost anyone what their patients’ needs are, as well as the healthcare industry’s limitations in meeting those needs. Today, those limitations can often be met through the innovative development and application of technology, but is that a role that physicians can and should be undertaking? And what are the opportunities for the physician as innovator, both within large, establish health care organizations and in entrepreneurial ventures?
At the ATA’s recent EDGE18 Forum, Drs. Lyle Berkowitz and Alan Pittfacilitated a dynamic Ask-the-Expert Power Breakfast on the topic of “physicians as innovators.” For those who missed this provocative discussion, we’ve brought Alan and Lyle together again to address their key points in an online Q&A.
ATA: How can physicians innovate within a large organization?
Lyle Berkowitz: You need a balanced portfolio of innovations, from singles to home runs. Some small hits can get you recognition and respect, which will give you the time and ability to go after the big stuff. And not every innovation has to be completely new and over-the-top. It’s fine to borrow ideas from other health systems and other industries.
For example, we ran an innovation contest at Northwestern Memorial (in Chicago) for small ideas that could improve the patient experience and I got to take the first look at any tech-based ideas. One was for more phone chargers in the ER because they kept getting stolen. I didn’t want to provide more chargers to get stolen, but at a conference I found an 80-pound kiosk that charges 10 phones at a time and I bought two on the spot. The patients in the ER loved it. Imagine how horrible it must be in this day and age to have your phone battery run out in the ER. Simple project, big win. There are other case studies in a book I edited a few years ago called “Innovating with Information Technologies in Healthcare” at www.TheHealingEdge.org.
To be innovative within large organizations, I tell people to use the ABCs: hire A-plus people, have a Bias for action (do something — you can learn a lot by failing small, failing fast, and failing cheap), and be constantly Curious — always asking, “how can we do better?”
That first item — hiring great people — is a really important skill-set. My best advice is to have people who are good at this and research how to get better. I recommend www.recruitrockstars.com.
ATA: What about those physicians who are thinking about becoming an entrepreneur?
Alan Pitt: When most people hear of an entrepreneur they generally think of a 23-year-old with a hot new tech startup willing to risk it all. Of course, at 23 there isn’t much of a risk. You have time to rebuild from several failed startups. However, at 23 you haven’t had time to build a network and you haven’t learned an industry.
At 53, you have a different set of problems. You’re accomplished. You’ve made mistakes. You know your industry and people know you. However, you are likely risk-adverse. You don’t have the time to risk it all and rebuild.
Let’s say you have a great idea. You’d probably like to make some money, even if it’s not a lot, but maybe it’s mostly about finding purpose in your life. There are ways to go about that. Most experienced physicians aren’t going to be good CEOs, but there are three key elements to make a viable business: entrepreneur, investor, and expert. I advise physicians to take on the expert role and find experienced professionals for the other key roles.
Lyle Berkowitz: If you are really passionate about something, then you need to decide how you’re going to approach it. One is to find a business-minded person to take your idea and run with it, letting you take the role of part-time Chief Medical Officer. This gives you a higher chance of success, but you will have less control and own less equity. The other option is to go all in and become CEO and dedicate yourself full time, but don’t pretend you can be a CEO and still do any reasonable amount of practice. This approach gives you more control and equity, but at a considerably higher risk of failure (docs are rarely good CEOs) and can have a huge impact on your immediate income. I suggest that you start small, such as volunteering as an advisor to various startups. This is a low-pressure, fun way to learn, and it lets you keep your day job.
ATA: What are the intersections between telemedicine and physician entrepreneurship?
Alan Pitt: We need to change our thinking to accelerate the adoption of telemedicine. The only real way to do that is to figure out what medicine needs. Entrepreneurship offers insights from people who are in the system who can help guide the construction of businesses and technology that are really needed. I don’t think about it as telemedicine. It’s about medical collaboration and ultimately about reassurance, for patients, their families, and for less-experienced providers. If I can provide reassurance, I can provide lower-cost, higher-quality care.
I believe healthcare is selling the wrong product. We’re selling drugs and devices, but what the patient wants is relationships. Physician entrepreneurship allows us to redesign the solution, either inside or outside the hospital. I cover a lot of these issues in my blog at http://healthcarepittstop.com/.
Lyle Berkowitz: Telemedicine really does represent the next frontier in health care. Like the gold rush of the early 1850s and the Internet boom of the late 1990s, there will be some big winners and a lot of small folks having fun trying. This represents one of those rare times in health care where physicians can truly innovate and disrupt our system. Patients are demanding easier, cheaper, faster access and large organizations are very slow to move. But physicians have the ability to move their practices online and serve more people than ever before. This is a true Blockbuster vs. Netflix moment for health care. The difference is that the need for health care is so great that there will likely be all winners and no losers! As doctors learn how to both automate and virtualize health care, this will provide amazing access to more people across the nation, while freeing up office visits for the more complex patients who do need to be seen in person. In other words, we won’t have a shortage of physicians if we start using technology to make them more efficient.
Lyle Berkowitz, MD, FACP, FHIMSS is Chief Medical Officer and EVP of Product for MDLIVE, as well as President of the MDLIVE Medical Group, one of the largest virtual primary care groups in the nation. For much of the past 20 years, Dr. Berkowitz helped lead IT and Innovation at Northwestern Medicine and has additionally helped start and manage multiple healthcare IT companies in that time frame. You can find him at www.DrLyle.com and @DrLyleMD.
Alan Pitt, MD is an attending physician and professor at the Barrow Neurological Institute in Phoenix. He is the former Chief Medical Officer for Avizia, now part of American Well. He continues to advise Healthcare startups in the data analytics, AI and telehealth space. You can find him at http://healthcarepittstop.com/.