Physicians working at the coal face of medicine are painfully aware of these problems. Still, they often realize that the traditional physician-scientist role does not afford the means to address them. Instead, physicians often find themselves overloaded by mundane and time-consuming bureaucratic tasks. Despite all the remarkable scientific advances, expectations for discovering meaning in the medical profession and careers seem mostly unfulfilled.
Start with why
An increasing number of entrepreneurs and investors are considering health technology as a lucrative and meaningful area. However, because of its complexity and deep roots in science, the health and care space requires deep subject matter expertise that calls for a new breed of Digital Health Doctors. While the demand for this role is rapidly rising, it is still unclear what competencies this novel type of doctor should bring. It is essential for physicians who have the talent and drive to transform the system to realize they have a responsibility to use their capacities to embrace the challenges that others may not be able to identify or cope with.
If you consider a switch, avoid falling prey to the so-called "sunk cost fallacy," thinking that the X years you have spent developing your clinical expertise means you should continue as a clinician. It would help if you also realize that it is irresponsible to stay because you are potentially blocking a space for a more committed and passionate colleague who truly enjoys delivering care at the coal face.
Recalibrate for Impact
Developing health technology can be a chance to channel your frustrations and use more of your skills to improve the system, deliver hope, and create tangible positive outcomes. Innovation and entrepreneurship are the Digital Health Doctors' rebellion against the inefficiencies and inequalities inherent in a system that has done some good but still has a long way to go before it can be significant.
Doctors can be quick to assume that they already possess the skills needed for a Digital Health career due to their training and experience. Here are some reasons why you should critically reflect on your actual talents:
- We all are susceptible to the overconfidence effect in which our subjective confidence in our ability is more significant than our objective performance.
- The training we received might not have taught us well. A recent study conducted to assess the statistical literacy at Charité Berlin showed that, on average, only half of the students and three-quarters of the teachers answered all questions correctly. Another study suggests that experts tend to overestimate the transferability of their expertise to other fields.
- The more experience we gain, the more we entrench ourselves in a certain way of viewing the world. Expertise is a two-edged sword; it often comes with blinders.
Your n=1 experience isn't that valuable
Many clinicians feel that their clinical skills and experience are so precious that this is all they need to transition into a lucrative digital health career. It turns out that your subject matter expertise is more or less a commodity. Successful entrepreneurs don't rely solely on the anecdotes and opinions of a single individual. Instead, they conduct qualitative user research with various insiders and prospective customers (often, these people are willing to share their insights for free) to get a robust understanding of the multiple realities that typically co-exist. Then, they combine these insights from rigorous interviews and observations with user analytics and systematic desk research. That's the secret sauce to getting a robust foundation of evidence on which to build products on – it is not by relying solely on your expertise (read: "your biased views").
Also, most start-ups endorse agile principles, which include frequent pivots in strategy and focus. Your special clinical knowledge might be relevant initially, but pivots might make subject matter expertise in other fields more relevant. For example, maybe your start-up launched in hip osteoarthritis suddenly realizes that the tool is much more suitable for prostate cancer patients. How is your orthopedics residency going to add significant value now? Lastly, start-ups usually require the full-time attention of its key members; working clinically part-time is rarely feasible.
So what matters?
In our experience, health innovation teams value the following three types of skills in a Digital Health Doctor:
- Higher cognitive skills:literacy in evidence-based practices, critical thinking, the ability to process complex medical information, and a deep understanding of the benefits and risks of clinical interventions.
- Social and emotional skills: an ability to communicate to representatives of all societal strata, being able to conduct user research at eye-level with fellow doctors, understanding the medical culture and way of reasoning, and an ability to adapt to changing environments quickly.
- Technical skills:hypothesis-driven decision making, scientific research, systematic reviews, data analysis.
At a macro level, there is a desire to enable "cross-pollination" through cognitive diversity. Cross-pollination, the mixing together of "disparate ideas, people, and technologies from different disciplines," is considered to be a crucial ingredient of innovation. The deliberate combination of diverse outside views becomes an opportunity to uncover unknown unknowns.
How to make the transition from clinical medicine to digital health
Unfortunately, medical school does not prepare today's doctors for the digital future, nor present, of health & care. You have to create your own curriculum. To make the transition, we recommend that would-be Digital Health Doctors put themselves regularly in uncomfortable environments outside of their clinical work.
In order to accelerate learning, there are various valuable courses available online that fit into a busy clinical schedule, e.g., on design thinking, user experience design, data science, behavioral economics, or agile management. One of the authors even obtained additional Master's degrees in Public Health and Public Policy, studied and worked internationally in a total of five different languages before gradually starting to advise health start-ups or giving talks at conferences on digital health. After leaving the bedside entirely to pursue a career in digital health technology management, he enrolled in a postgraduate entrepreneurship program at the University of Cambridge. "Continuing Medical Education" is just as relevant for Digital Health Doctors.
Medical school does not prepare today's doctors for the digital future
Equally important as building the knowledge base is deliberately working on expanding your network. It is plausible to meet inspiring individuals lacking direction and expertise that you can provide simply by attending start-up meet-ups. To test the waters, aiming to obtain advisory board roles in start-ups is an excellent first step.
Leaping out of a safe and reasonably predictable clinical career into entrepreneurship is risky. Whatever outside experience or training you can obtain before making that leap will improve your understanding of your preparedness level. More importantly, a broader reservoir of experiences well beyond clinical medicine helps you overcome status quo bias and develop the ability to combine lateral thinking with in-depth analyses.
There is a high prize behind tall walls
Technologies are increasingly shaping our personal lives and our clinical working environments. Doctors moving into entrepreneurial careers or joining start-ups can give clinicians a stronger representation in innovation processes, ensuring that they hybridize their skill set. Individuals who succeed in medicine share many traits with successful entrepreneurs: both are hard-working, willing to make sacrifices, and intelligent. However, doctors will likely need to learn new skills and unlearn dysfunctional thinking patterns. Before you embark on this journey, you should ask yourself if entrepreneurship is for you. Despite its charm and social prestige, entrepreneurship is a high-risk endeavor. Entrepreneurs and their team of innovators must be prepared to face an ocean of rejection, expect failure as the most likely outcome, and continuously seek new opportunities in a highly uncertain environment.
Authors: Sven Jungmann MD, MSc, MPP, Co-Founder of FoundersLane Health, Berlin, Germany; Advisory Board Member at Spring, Munich, Germany. Ali Ciğer, MBA, Commercial Director at Pfizer, Berlin, Germany. Anant Jani, MS, PhD Nuffield Department of Primary Care Health Sciences, Oxford Martin School, University of Oxford, Oxford, Great Britain.
