Why Doctors Become Entrepreneurs
The world looks different when you’re 18 and when you’re 30 – in some cases because your perspective has evolved, other times because the world has changed. Men and women drawn to careers in medicine while in high school or college are finding that when they emerge on the other side, things aren’t quite what they expected.
Typically, this is portrayed as the (well-worn) “Narrative of Disillusionment” – i.e. idealistic youth drawn to help people discover the practice of medicine is more rushed/bureaucratic/corporate/burdensome than they were expecting, and now are searching for new opportunities. While there’s a measure of truth to this arc, I’m not sure how different it is from any other career choice, which tend to be attractive in the abstract (A prosecutor! A screenwriter! A journalist!), perhaps less so when you’re actually doing it.
My hunch is that many of the physicians who leave medicine do so not because the negative externalities have become so bad, but rather because the range of potentially appealing alternatives has become so good.
A recent NPR blog focused on Bay area physicians leaving medicine to become entrepreneurs has sparked considerable dialog on social media. My sense is that many physicians are attracted to entrepreneurship not to escape medicine, but to deliver on their perception of medicine’s promise. Frontline providers, as Aenor Sawyer of UCSF’s Center for Digital Health Innovation frequently emphasizes, offer vital insights into where the existing system may not be working, and where innovation is sorely needed.
I view entrepreneurship as reflecting the translational impulse in perhaps its rawest form – a desire to apply a new technology, approach, or way of thinking to a thorny problem, and deliver an impactful solution, as evidenced by real traction in the marketplace. Entrepreneurship obviously isn’t the only expression of translation, nor the only way to envision translational success, but for many, it’s a compelling approach, and real-world adoption a compelling metric.
At the same time, I’m struck by how many career paths are available to physicians that involve neither entrepreneurship nor clinical practice. I am just returning from a genomics policy meeting in Washington DC, organized by the standards organization HL7, and I was struck by the diversity of roles represented by some of the physician speakers and panelists.
Of course, practitioners were represented, as were doctors working at emerging companies.But physicians in a range of other roles were also present – docs who work in government; docs who work for health-IT companies ; for EHR companies; and for consultancies.
The point is, during training, physicians contemplate what seem like a very narrow series of choices – do you want to go into private practice (boo, hiss) or become an academic physician or physician-scientist (yay!). A few strays might even join a pharma company (quelle horreur!).
With the popular ascent of entrepreneurship, starting a new company or joining an emerging one has become as another defensible alternative (at least in some circles).
Yet the breadth of options available to physicians is almost certainly broader than is typically contemplated, and includes roles in government, non-profits, and range of industries – reflecting the broad and increasingly apparent need for healthcare expertise. (The question of exactly how much medical training is required to attain this expertise is always contentious, and is left as an exercise to the reader.)
Medical schools and residency programs would do well to recognize, acknowledge and enlighten trainees about the diversity of career paths that are now available, avenues of personal development that, in effect, offer the possibility of allowing each of us to perform at the top of our own license.
David Shaywitz, M.D., is the chief medical officer of DNANexus, a company based in Mountain View that is pushing the use of genomic medicine through a variety of platforms. A version of this article originally appeared at The Health Care Blog.
