The 21st century is not like the previous eras in human history. The Industrial revolution was a boon to mankind as much as the science of hygiene and preventive medicine. The previous century provided the gateway to the virtual marketplace, the online platform for the instantaneous trade of goods and services, at a click of a plastic key, free from geographic boundaries. The digital biosphere is intricately maintained and promoted by millions of connected buyers and customers, who can often switch roles faster than the speed of thought. The new digital economy has created the well known gig economy, the ability to sell highly specialised niche services at an affordable price to a worldwide market.
This freedom from strictly governed societal roles that used to exist during the time of mass corporatisation of industries has given people the chance to earn a sustainable livelihood using digital tools and crafted services. There is no better time to be a digital entrepreneur than this new century as access to information via democratised technology is now widely available. No longer do people have to be defined by the teachings of an institution, and nothing else, and also work in industries that claim to be in need of such highly educated professionals.
Even as the 4th Industrial Revolution, AI and other ultra specialised phenomena sweep the globe, human resources management has not aligned its core strategies to help give skilled individuals a chance to a decent earned livelihood. The Health sector is perhaps the worst organised and poorly optimised industry till date. Although rapid strides in public health activities has greatly expanded our lifespans, which is directly correlated with increased global GDP and ofcourse rising out of poverty, there is a pandemic of societal injustice to healthcare professionals.
If you are a doctor reading this, or have a doctor associate in your social circle, you know very well the difficult tasks that we have agreed to take on as part of a lifelong investment in caring for our human brethren. We sacrificed almost an entire decade of our productive lives to learn about the frailty of the human condition. We spent countless hours in memorising diseases and dosages, fine-tuning delicate movements in deliveries, bone setting, suturing, palpation and performing various surgical intervention, and let us not forget the mentally exhausting act of continuous medical education by way of highly standardised examinations. Continuously spending expensive resources on the rapid acquisitions of domestic and foreign degrees. In the hopes of being translated into the possibility of a fulfilling and prosperous lifelong career.
If you are reading this article, you and I have now realised the harsh reality of this charade.
Like me you too have successfully completed many years of rigorous military doctrine style training and have amassed a collection of degrees and other abbreviations that we can hang on the walls of our empty practices, or added to the end of our not-so-significant names. Many of you may have asked your seniors by now about how we can ‘growth-hack’ our careers to atleast make ends meet. Surely there is some secret method to earn more money, without taking up even more debt for the next degree? Your seniors would say not to obsess over money as the medical career is a noble/humble pursuit to help heal our fellow neighbor.
Some would perhaps recommend that you close down your private chamber and join a large corporate medical organisation
If you are already in a massive hospital, then maybe you should resign and start your own practice
Have you considered moving abroad to work in a massive hospital or private practice in that country?
The frustrating circle of the same advice from almost retired physicians, who are well versed in the norms of a bygone era, often demotivates the healthcare professional from leading a purposeful life and puts a great strain on the quality of their long term career motives. Many have resigned to the fate that one must intentionally lead a humble but debt-ridden lifestyle, when their peers from other professions have greatly advanced their financial stability.
This professional wealth inequality is unfairly normalised and accepted as part of the medical creed.
All practicing physicians keep trying year on year to slowly work extra hours, work extra shifts and maybe take even more roles to atleast earn that extra dollar. The physician profession is a strange outlier in that it takes so many years before the right societal value is given to the coveted consultant.
In Bangladesh there is a horrifying deficiency of adequately skilled specialists in the public and private sector. With a WHO white paper research highlighting a ratio of at least 1 Doctors to 1650 Patients (1:1650) in the urban setting atleast, it is no wonder that the vast majority of people who can afford international medical tourism can avail such specialised healthcare services abroad, but at great personal cost due to the high out-of-pocket healthcare financing that is prevalent in the region. From this statistic, one would assume that specialists and consultants have an inherent economic advantage - with such high patient population demand and limited supply of specialists, surely private practitioners can charge a modest consultation fee and be on the path financial stability and wealth creation?
The Medical career is truly a noble journey. We strive to heal the sick of all ages and walks of life. The Doctor wishes to be the guiding example to a better wellbeing. Except our own.
From medical school to medical training, we are taught the minute intricacies of the human body. The complex metabolic and biochemical dynamics of pharmaceuticals. The brutal but necessary surgical interventions to ease the suffering or cure the illness. But what of having enough savings to buy a house? How can we apply for tax breaks? What kind of investment or retirement scheme could help us ease into future transitions of our aging lives? When will you afford to take a holiday without the corporate sponsorship of Big Pharma?
As a profession, Doctors are financially illiterate.
It is not that the mind that is molded by medicine is not capable of calculating economics, in fact this deficiency of the basic fundamentals of managing ones own accounts (book-keeping) and risk calculating ones available resources for future investments, simply is far too mundane. In certain social settings, it may even be considered taboo and uncouth that a medical professional would even bring out the topic of money. It is quite alright for lawyers, engineers, stockbrokers and the like to openly talk about their wealth creation strategies. But not Doctors. The medical profession is far too noble to discuss such shallow desires. But ironically everyone assumes that the Doctor will pick up the cheque out of the kindness of their hearts and empty wallets.
Perhaps this self-censorship and self-ignorance is the reason why the heaviest burden of debt is carried after medical graduation, postgraduation, residency placement, licensing practices and the other chains of obstacle. Perhaps placed by non-medical bureaucrats and tenured senior physicians, to enforce the gross supply-demand imbalance in their favor.
I can personally attest to atleast 8 ways to go broke as a Doctor. As mentioned, I too have accumulated a vast number of expensive degrees and debt as well. I too have invested heavily in private medical education, postgraduate medical degrees, postgraduate training courses and let us not forget the true sin of financial illiteracy - mass consumerism driven out of frustration and societal expectations.
Everyone assumes and expects that a Doctor would have a nice car, nice clothes, nice spouse and nice trips abroad. But on the other hand, what kind of doctor would not earn enough to lead a lavish life and not charge any money at all?
The Burning Questions of Business
Not all physicians are ready to accept this status quo. In fact I personally know of many who had left medicine within days of graduating, perhaps you do too. Many recent medical graduates have the luxury of a family-owned business which they can simply take over, some may even have married up and taken on household duties instead and a brave few gathered some funds after a few years afterwards to start or invest in some kind of venture. Every night after that decision had been made, I am certain that these questions had come up in their minds:
So what options are available for medical professionals to earn a little bit more?
What kind of business can one get into that has the least financial risk?
How far can I go in business when all I have is an MBBS medical degree?
Not to criticise the decisions to start a business venture or simple invest as a shareholder in an establishment. But in reality it really is not that simple to completely leave medicine. In any form, whether it be become a lecturer, examiner, medical scholar, medical newscaster or anything remotely connected to the health sector. After all that hard, even if you do make some decent money, somehow or the other you may face a deep yearning for making a meaningful impact as per your medical knowledge. Call it an association with the familiarity of your past life experience or some kind of professional Stolkholm syndrome, once a doctor always a doctor, even if you had just opened a restaurant or a boutique.
Once a Doctor, always a Doctor....even in Business
After all that hard work to complete your medical degree and qualifications, after that tough conversation with your family, friends and peers to quit medicine to a start a passion project, fail at it and then become a second wheel to joint venture with someone who is ofcourse more financially literate than you, how can you leverage your passion for impactful healthcare, maybe some innovation as well, into something that you can atleast tell yourself in the mirror and say -
‘Maybe I am no longer practicing medicine, I am still a doctor but also something more’
Physician Entrepreneurship 101
My personal journey into entrepreneurship was anything but planned. It was indeed all chaos, I had paid the price of being a novice entrepreneur (or wantepreneur) in money, time and reputation. But this is a price that all amateurs must pay, whether in business or in medicine. You cannot master the intubation, cannulation, neonatal resuscitation, kasai procedure and the other assorted high value skills, without botched attempts in the first few patients that you would be tasked with taking care of. Such is life where we must take painful and humiliating risks, in order to master an art.
Business is a science of trade, but entrepreneurship is an artform with money
Business and entrepreneurship are related but different in key themes. Classical business caters to an established need in a marketplace, with defined pricing and customers, and with historically pre existing (often crowded) sellers. To be an entrepreneur means to create a demand for an innovation (product, process, pricing, purpose), orientate the marketplace, calibrate the price points and actually survive long enough to make some returns on investments (ROI). The digital ecosystem has provided a unique opportunity to create digital innovations which can be rapidly designed, iterated, tested, sold and resold at the click of a button.
The 21st century is indeed the era that belongs to the Digital Entrepreneur.
Physician entrepreneurship, or healthcare entrepreneurship, is an enterprise business just like any other fancy startup. There is a defined problem in a set market, with customers with high probability of being attracted to a solution with the right value proposition, a scalable distribution channel and business model that guarantees flawless revenue streams. And money in the bank of course.
The sole difference being that a medical professional is at the cornerstone of every decision making process. The Doctor has correctly identified a defined healthcare/healthsector problem, there is a medical solution that can be replicated, quality and safety maintained, easily sourced and produced on a mass scale, and the most crucial aspect is that this Doctor is the ambassador to its innovation.
Authority in the Market
Building consumer trust and authenticity in an innovation is the truest manifestation of proper branding. The way a product speaks to the customer about its value is a core process in creating a loyal user base. In healthcare nothing is more crucial in the doctor-patient conversation than trust. Trust in skills capacity above all else. Patients judge the capacity of a doctor based on their internal and external skill sets. The external branding process is relatively easy - clean white coat, spectacles, middle-aged and a wall adorned with foreign degrees. The internal characteristics of a trusted healthcare professional is based on the degree of their soft skills (patient communication, empathy, complex decision making process and emotional intelligence).
A healthcare innovation is more in need of internal branding since the consumer and the producer are not always in the same room, let alone platform (eg. healthcare apps). People may have a defined health problem, maybe they can afford this solution as it provides the right solution but a scalable/loyal financial transaction may not occur, simply because there is a trust deficiency.
The characteristics of a founder or the business executive speaks to the brand as much as any press release or marketing campaign. If a healthcare entrepreneur is not directly connected or associated with the health sector, the customer cannot form the right mental processes to put their lives, or their loved ones to a concept that is clearly a revenue-generating machine (like all successful businesses).
And here lies the value of being a Physician Entrepreneur. As a medical professional, you have the intimate and inherent knowledge that can directly communicate with the wider audience about a concept. The assurance of a Doctor on the health-giving properties of a medicine, instrument, prosthesis, gadget, app or whatever is worth the entire fees accumulated in that doctor’s medical training. The word of an industry representative (expert) is the foundation of creating an authority in the marketplace. A voice to believe in, a face to trust in.
The word of an industry expert is the foundation of creating an authority in the marketplace. A voice to believe in, a face to trust in.
Much can be said about the need for being a business person. Not only for much needed solutions, but also as a potential job creator. Global youth unemployment is the new threat to sustainable development for every nation. In healthcare there is also a rapidly expanding population of unemployed medical graduates, highest rates affecting women, new graduated and also foreign-skilled doctors. There is a culture of impunity in providing substandard work to high skilled doctors in all sectors, either due to incompetent lobbying or as is the case, financial illiteracy does not allow for leveraging the right networks and rescources.
Physician entrepreneurship may in fact be a guiding tool to help highly motivated and dedicated healthcare professionals to create sustainable and gainful employment, even wealth generation not just for oneself but for their comrades as well. The entrepreneur is an artist at creating a canvas of opportunities. The high income skills involved with negotiating, leveraging, learning a new skill, unlearning a false belief, attaining a growth mindset and managing risks and money - are multiplied in effect to the brave physician who wants to be defined more than a degree.
The physician entrepreneur population is itself a minority within a minority. There are so many challenges beyond the obvious that we become complacent out of fear. Fear of the unknown. Fear of being inadequate/incompetent. Fear of doing it alone.
But you are not alone.
We are in this together.
When you are truly ready to accept that a better life awaits. When you know you have a much deeper purpose in life. Do one thing right and that can set you up for future success and prosperity.
What is that one thing?
Get yourself a mentor. Someone who has done it all, seen it all and probably failed in the same ways that you might.
Contact me so that we can have an impactful conversation about leading your life and career in a new direction. A parallel career path to medicine, that will reward you for your efforts.
Free from injustice
Free from politics
Free from doubt
Let us create a set of conversations that will help guide you to the right entrepreneurial path.
If you want to know more about my journey into entrepreneurship,
grab a copy of my first self-published book:
THE VIOS VALUES (available on Amazon)
where I describe in detail my transformation into healthcare leadership, physician entrepreneurship, the various mistakes and learnings I have had in my previous ventures (which you should avoid!) and the makings of a truly innovative health-tech startup - VIOS