RX Podcast_Arlen Meyers: Audio automatically transcribed by Sonix

RX Podcast_Arlen Meyers: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody and welcome to another edition of Entrepreneur RX, where we help health care professionals own their future.

John Shufeldt:
Hello Everybody and welcome back to Entrepreneur RX. I'm your host, John Shufeldt, and with me, today is a gentleman I've had the honor to learn about and get to know this last year, Dr. Arlen Meyers. Dr. Meyers started SOPE, which is a society of physician entrepreneurs. He is an ear, nose, and throat surgeon, and an MBA and has been a great leader and voice in the physician entrepreneurial community. Arlen, welcome.

Arlen Meyers:
Thanks, John. Thanks for having me on.

John Shufeldt:
I really appreciate it, you are the preeminent physician entrepreneur in the country who thought about starting this organization to help other physician entrepreneurs. So before we talk about that, can we go into your background a little bit? Go back and start in med school and,

Arlen Meyers:
Yeah, sure.

John Shufeldt:
And get people caught up.

Arlen Meyers:
So I grew up in inner-city Philly, I went to school at a small, liberal arts college in central Pennsylvania, Dickinson College, and then I went to med school at Jeff. I did my residency in ear, nose, and throat surgery at the University of Pennsylvania, and then I got recruited to the University of Colorado to be an assistant professor and basically start my academic career. So I was a pretty typical doctor, I mean, medical student, you know, like no gaps and you just kind of heads down and you wind up being a doctor and going to Colorado. So I did that as an academic surgeon, pretty much, well, that was my first career. So that lasted about 40 years and during that time, I was involved, as most academics are, in research and development. Now, back in the day, commercialization was not part of the mission. Research and development was and certainly publication but this issue of commercializing stuff out of a university really is a relatively recent, like 1980's vital kind of thing. So tech transfer, commercialization, spin-outs, all that, was relatively new, but I was interested in that kind of stuff, and myself and several other people on a team, short story, invented a gadget that optically detects cancer in the mouth because I'm an ear, nose, and throat surgeon and oral cancer was my specialty and all that. So and then we attempted to commercialize it, like, but as just like everybody else, I mean, I was clueless about, OK, this is kind of interesting but now what do I do? Because I don't know how to do this. Nobody taught me how to do it and I don't know anything about patents and money and all this other stuff. And so I went down this road kind of groping my way through trying to figure it out on my own, like I would reach out to people, and how do I do this? I had a friend who was a patent attorney, and what do I do? Anyway, so a long of the short of it is we eventually developed this thing, patented it, did all the business you have to do as you're well aware to get it out but what I learned from that, and it was painful, that experience was very painful and wasted a lot of time and it was frustrating and etc, etc. So what that experience taught me was, number one, every doctor thinks they have a good idea. Number two, most of those ideas are not good ideas. I mean, they may be a good idea, but that's all it is, an idea. It's certainly not an invention. It's certainly not an innovation. It's an idea. And maybe you reduce it to practice and make it into something but that doesn't mean anybody really wants to buy it or use this. Number three, even if I had a good idea, I wouldn't know what to do with it. I don't know what I'm supposed to do with this thing in terms of commercializing or getting it to a patient. And the final point nobody was going to teach me how to do it. It wasn't being offered in medical schools, certainly, it wasn't being offered by specialty society. Nobody was interested in teaching biomedical, clinical and innovation, and entrepreneurship. Nobody. So I said to myself, You know what, this isn't right, so I'm going to do it. So I got together a bunch of folks and we created the society of physician entrepreneurs to do it. Now that was, so essentially the Society of Physician Entrepreneurs is a virtual society. We don't have buildings, we don't have high-paid execs, including me, we don't have a whole lot of infrastructure, it's a virtual society that is a global, it's an international, non-profit 501(c)(3)-(c)(6), biomedical and clinical innovation and entrepreneurship network, and our mission is to help our members get their ideas to patients so that they don't have to go through what I went through.

John Shufeldt:
Wow. How, what year was that?

Arlen Meyers:
The idea, and it's an interesting creation story, but it's going to, the long and the short of it is, the answer to your question is the idea took shape probably in 2007-2008. We fooled around with it, as you well know, trying to figure it out, it for three years or whatever, and then once we, we incubated it in the American Academy of Otolaryngology-Head Neck Surgery, actually, and then we spun it out as a freestanding, separate, non-specialty society in 2001. So now we're 10 years into it.

John Shufeldt:
So 2011.

Arlen Meyers:
I mean, 2011. Yes.

John Shufeldt:
OK. So and then, when in, when in that process, did you go back and get an MBA?

Arlen Meyers:
So I went to graduate school, I went to business school in 1982. Now, in those days, yeah, that's the reaction most people get.

John Shufeldt:
Wow, you were ahead of, were you ahead of the time?

Arlen Meyers:
Exactly. So I was kind of ahead of the curve. In fact, I was the only doctor and only health professional in the class, and everybody kind of looked at me cross-eyed, like, what are you doing? And I graduated in, you know, two years and then I graduated in '84. Now, at that time, actually, I was in private practice. I've had a fairly eclectic career like you, and I, I've been all over the place, various practice arrangements but at one point I was in private practice. I worked for a group one time, I worked for Kaiser, actually for a little bit, I had my own practice, etc, etc., but for the large majority of my career, I've been an academic physician. And so I graduated in '84, and since that time, I've sort of been interested in the business of medicine and entrepreneurship, and so that's how all this wound up.

John Shufeldt:
Well, I was in grad school in '93 to '95, and, and I was like, you were out of the, you were 10 years before me, you must have really, you, you were like a dinosaurs' era for innovative, and that's really cool.

Arlen Meyers:
And not only that. Take the story one step further. I felt so convinced that somehow, someway, doctors needed to understand the business of medicine, including entrepreneurship but I actually was part of a group that created the combined MD-MBA program at Colorado. Now that was in the early 90s, and I think we were like the sixth combined MD-MBA program in the country because when I went to school wasn't a combined, I was in practice and I, I went to, like a lot of folks do now, but it was not a combined MD-MBA program. So fast forward, there's roughly two hundred medical schools in the United States, about a hundred and seventy-something allopathic and thirty-three or thirty-four osteopathic and over a half, if not 60% of them have combined MD-MBA programs now. Now, to me, actually, that's the bad news, because people always ask, why should I get an MBA? And I'd be interested in what you think. I'll tell you what I think, I think it's a total waste of time and particularly for those that are interested in entrepreneurship, I just think it's a total waste of time. Now, far be it for me to discourage anyone from getting more education. I mean, I'm the poster child and you are for like multiple degrees after our name and just constant learning and getting more stuff. That's not the message I'm giving to 16-year-olds watching it. The message I'm giving is that in this day and age, I don't think medical students should have to spend more than they're already spending, the average over two hundred thousand dollars in debt, to go to business school to learn how to practice the business of medicine. First of all, they don't teach it. They teach stuff that has nothing, in most instances, are there schools that focus on entrepreneurship? Yes. Are there schools that have a focus on physician entrepreneurs or physician executives? Yes. But by and large, the vast majority do not focus on biomedical or clinical innovation and entrepreneurship. And I don't think they should, I don't think you should have to go to business school to learn this stuff. You should learn it in medical school and residency. So I'm trying to make MD-MBA programs for entrepreneurship obsolete.

John Shufeldt:
Yeah, that's interesting. You know, I think back in the day you did it, and I think even when I did it, you know, when I did it, computers were just starting to get involved. Laptops were anyway, and I had one in about 1990, and I was clearly ahead of the curve, at least in my peer group, not for the rest of the people, and, you know, now with the access information, you do not need to go to formal schooling to get the information you need to be an entrepreneur. It's all over the web. You wrote a forward to, a book. I do thank you for doing that, but it was basically business 101 for physicians. I totally agree with you. However, I think a lot of is, I think if you're going to go into a physician leadership position in a hospital having that MBA or MHA is probably a smart thing to do because it's some street cred and you're dealing with hospital administrators who don't think much of your, of your business skills to begin with and so are leadership skills. So I think for that, for those people, but I agree with you 100% that if you want to be a physician innovator, there are easier paths than spending two years in a classroom.

Arlen Meyers:
So to follow up on that, first of all, I totally, I agree with what you're saying. You've got to get street cred, but you've got to question why. So if you are going to business school, let's, MD-MBA program, you go after med school or before med school, I don't care. But basically, my view is that those programs and programs like ours, they still exist, basically provide connections, credibility, credentials, and content in that order, and statistically, the research indicates that the value of a Harvard MBA is your roommate who now is the governor of Ohio. All the content these days, you and I are, and people like us, are producing this stuff every day on the internet, and there's no excuse for not learning whatever you want to learn on the internet. You don't need to be there to get the content. The real value is in the connections and the network and the conversation that goes on like we're having, and arguably, it's not as good as face-to-face, I think most of us admit that, but it's OK. So, and second point, if you're getting an MBA so that you can get out of practice because you're fed up and you want to be an administrator and get a six figure salary in a corner office, you've got to ask yourself, why are we doing this? We need more health administrators like a whole one ahead. I don't care whether they're doctors or whether they're physicians, you know, hospital executives or any of that business. And my third point is that I think these programs in health administration, and I teach in a faculty of health administration at our business school. I guess if they're watching this, they're going to fire me but point is, first of all, it's not health care, it's sick care, and secondly, we need more administrators like a whole one ahead, sort of call it health care administration, I think it's a totally obsolete term and they really, they, the health administration infrastructure, the education infrastructure really needs to rethink how they're doing things and what is the purpose of the program. The same applies, incidentally to PhD programs and MD-PhD programs. They just really need to rethink why they're doing what they're doing.

John Shufeldt:
Yeah, I think, I, I, include, I think, a lot of folks and I encourage people if they want to go into leadership to go ahead and get an MBA, but I'm definitely with you in the sense that is it really necessary if you want to be a health care innovator? The answer is no, and as far as a hospital administrator, yeah, there's plenty of those around, and do they add value? Well, we can debate it all day.

Arlen Meyers:
And as far as MD-MBAs are concerned, despite best intentions and some effort, we don't know what value MD-MBAs add to the system because there's no data and as I said, these programs have been around since the early '90s. So we're talking about a long time. A lot of medical schools, probably on the average of five to six hundred MD-MBAs being graduated every year at an exorbitant cost. You better work, you're looking at another two hundred thousand dollars for an MBA or Harvard, you know, the main schools, let alone the smaller ones. So the question is, where's the beat? What's the cost-benefit? Where's the value add? What do these folks add to their already over two hundred thousand dollars in debt as an average medical student?

John Shufeldt:
Well, not only that, it's so, you know, Mayo has an MD/JD program and the MBA program, and I talked to those folks quite a bit. I think the hard part and, and I didn't do that, I, like you went, I go back about every 10 years, I think it adds a lot more to the program when you're out a few years and you have some, you have a little bit of historical background to say, yeah, this now makes a lot of sense, or now I can make this, rationalize it. But while in medical school, I couldn't have imagined doing that in medical school, because, you know, you get out, you do a residency, well, all that information you gained through your JD or MBA are way in the past, and now you're out, you're just, you know, you got to question why, why do they take two years for law school or a year for an MBA while in medical school? ... all the cost.

Arlen Meyers:
And I think part of it is our fault, by our fault, I mean, academic faculty and mentors and sort of key opinion leaders like yourself and people that are sort of out there doing this stuff. I think it's our obligation to set medical students and those that are interested in MD-MBAs straight, and here's the deal, I don't think our messaging is very good. I think that in fact, we're encouraging erroneously people to get degrees that really don't add value, that costs a lot of money, and don't help the system. Last I saw my health insurance premium didn't go down.

John Shufeldt:
Yeah, very true ... based medicine, we haven't found it yet.

Arlen Meyers:
Right, so where's the value? And the other criticism I have is the business schools see us as cash cows, us, meaning doctors. We're smart, we don't have to take G-Mets, we add diversity to the cohort, we'll do whatever you tell us to do and get high grades, we'll spend whatever you tell us to spend to get pretty initials and the business school and a lot of places is the cash cow of the university. I just don't think it, it makes sense and then we get into this whole thing of the higher ED model and that's a whole nother conversation but, so I think, so what's the answer? In my view, I think we should be teaching this and we are teaching this stuff to medical students and to residents and to practicing physicians as continuing medical education and lifelong learning. You shouldn't have to go to business school to learn and prosper practicing the business of medicine.

John Shufeldt:
Yeah, I would agree with that. So let's switch things for a sec, let's talk about SOPE. So I was fortunate enough to get connected with you and work on this Phoenix chapter of SOPE, albeit going slowly but starting to pick up some speed. Tell folks how extensive is SOPE now and what are some of the great things that you and the SOPE community have done to further these physician entrepreneurs?

Arlen Meyers:
Right. So as I said, our mission is to help members get their ideas to patients, and we do that through this global chapter network. I tell people we're sort of a cross between Rotary and Match.com. So we have this little chap, you know, this nonprofit chap. We don't have the little sign outside the border of your town that we meet every Tuesday at nine o'clock in the church but it's a similar concept and, and we're a dating service. So the idea is we provide through this chapter network and thank you very much for helping us do this, education, resources, networks, mentors, experience, peer-to-peer support, and non-clinical career guidance. That's what you get when you join SOPE. And to me, and based on the experience that I just mentioned, it's really about just connecting dots and finding the right person who can help you get to the next step. So I tell people, so when you ask me, well what has SOPE done? We haven't done anything. We just make dates, you make babies. But in the course of making the dates, we partially can take credit for whatever favorable outcome has happened. So can I take credit for some person that's a member and, you know, discovers some drop-dead drug or creates an outrageous device or, you know, all the digital health stuff? Of course not, I didn't do that. All we're doing is providing the platform and it's up to the individual, like everything you get out of it is what you put into it and the more you engage, the more likely you are to be successful. The more shots you take on goal, the more you score.

John Shufeldt:
Totally. What advice would you have now for someone in medical school who wants, who has these burning ideas? So let me give a quick example, there's a male medical student kid, I think he might have scored the highest score in the country on the MCAT. I mean, he just crushed it, he goes to Mayo and has this idea, and he approached me with that and I said, that's a pretty cool idea, it's not applicable for the emergency department. The idea was basically before a patient came in, you got to take a look at their credit history, but also their litigiousness history. Have they .seen physicians before? And I said, for me in the emergency department, everybody ... some of my colleagues, probably not going to help. But if I was a, for example, a plastic surgeon, yeah, that might help. I may want to know if she's suited or he's suited over the ... previous position. He was so committed to this idea, he dropped on medical school, and I, what I adviced, whatever you do, do not drop on a medical school. Medical schools' a golden ticket. You can pursue this at the same time, but don't drop out. What, what advice would you give these medical students and residents on these great ideas?

Arlen Meyers:
Right. So it's a multiple-part question what advice would I give to a medical student concerning physician entrepreneurship and what advice would I give them if they're thinking of dropping out of medical school. So let me take the latter first. So this idea of dropping out of medical school is actually, as you know, becoming more and more common, and, and it goes beyond that. Medical students are dropping out of school like these four, they're finishing school because they're at stoop, but they know the MD after their name is worth something. So they stick it out and they get the MD, but they have no intention of practicing clinical medicine. So they don't do a residency, and then even if they did do a residency, then they have an abbreviated clinical half-life. They're going to practice long enough to pay off their loans, maybe to get their feet wet, figure out where the bathroom is and then they're going to drop out and they're going to do some entrepreneurial thing. So my advice and what I tell them is, it's called physician entrepreneur for a reason, when you graduate medical school, if you graduate medical school, you're a doctor, you're not a physician, you haven't seen anybody, you haven't taken care of, you have no clue what it's like. So you have the credential and it's a two-sided coin, because then what happens is these tech startups figure, we need a doctor on our team. And so they hire someone that just graduated medical school who is clueless as far as how to create value in a business, they just don't add value to the business, and the person that hires them doesn't get what they think they should get. So I think that's, what you're asking me, should you quit medical school and be an entrepreneur and go to work for a digital health startup? No. I agree with you, I think it's a bad idea. But you know what? People don't always take the advice you give them, if you've noticed. particularly people our age that talk to people who are not our age, so they say, well, that's kind of interesting, but you know, you're old and you're a millennial, what do you know? So I'm going to do this. Well, my pitch to medical schools is you can talk till you're green in the face that we are not, you're here to, we're, we accepted you because we thought and you told us at the interview, you wanted to be a doctor, we have a so-called physician work shortage, not only that, if we're a state institution, we have a statutory requirement to produce a certain number of students to take care of the folks in rural Colorado, so we expect you to graduate through a residency and go out and practice medicine. That's what, not what they expect and they're going to stare you in the eyeballs at the interview and they're going to lie to you and they're going to say, oh yeah, I want to do research, I want to take their residence, I want to go to rural Colorado and take care of underserved populations. No, they don't. But they're too smart to tell you that because they won't get admitted if they do, so, because of the reasons I just mentioned. Now there are schools. This is changing, this culture is changing, and in fact, there are some schools that are encouraging that kind of thinking. But you and I both know medicine is a culture of conformity. It is not a culture of creativity, and you get accepted because you conform, you memorize the stuff, you take the tests, you do what we tell you to do, you stay within the guardrails, you're risk-averse and you move on. That is the culture and it's changing but I think if we're really going to move the needle, we're going to have to do a lot more than just change it, like gradually, like incrementally, like we really have to blow it up, turn it upside down. So that's really what my mission is, and missions like mine, like me, that's what I'm trying to do. And in a sense, that's what you're trying to do. We're, we're trying to change it from a sick care system to a health care system, from a fee for service system to a value add or whatever the next bell and whistle happens to be coming down the road. We're trying to provide equitable access, we're trying to eliminate all the disparities. You can't do that with the existing model, in my view, and sick care cannot be fixed from inside, which is why SOPE is an open innovation network.

John Shufeldt:
You know, where it that heading? You know, what's the direction of SOPE? Is whatever the individual SOPE chapters want it to be? What's your vision for SOPE?

Arlen Meyers:
Well, my vision, a lot like, you know, I, I draw the analogy that, that we've, I hope we've created a religion, not a church. So my vision and the future of the Society of Physician Entrepreneurs is to expand the network internationally and grow this mindset. It's a means toward an end. The vision is to close international health outcome disparities through the deployment of innovation and entrepreneurship. The problem is there is an infinite demand for care with finite resources anywhere in the world. So how do you deal with that? I mean, there are various systems of various ways, and our way is a piece of the problem, because it's a wicked problem, is how do we get people to think differently? How do we get them to change their mindset? And that to me, that's the biggest challenge I have, leading this organization is how do you find physicians? And when I say physicians, I don't mean just, it could be nurse practitioners, any health care profession, pharmacy, medicine, dentistry, nursing, public health, you name it. The problem is not enough of these folks have an entrepreneurial mindset and the reason is that's not why they get accepted. So that's, that's our, we're, we're trying to achieve that vision through the deployment of innovation.

John Shufeldt:
Yeah, that's a broad vision and I can not agree with it more obviously but diminishing and reducing health care disparities across boundaries is an amazing goal, and you know, one of the challenges, one is I'm working on in the U.S. is reducing it across state lines and, you know, across sovereign, other sovereigns in the U.S., mainly indigenous lands and I had no idea the disparities that existed on indigenous lands until about six years ago now, when I started working on one and I thought, holy cow, this is 90 minutes from Phoenix and these were huge. I mean, a lot of houses didn't have running water. I intubated the guy who, his CO2 was 100, had sleep apnea, a big, heavyset guy, and he survived and saw him the next week, and I said, you know, why, what happened, why didn't you use, don't you know how to use a CPAP? He was nah, I know how to use it. Does it not fit your face? No, no if it's great. I said, What happened? He's, I don't have electricity, and it was the aha moment of holy crap, there's a lot you don't know, John, about what's going on 90 miles away from where you live.

Arlen Meyers:
And to that point, I mean, some of my thinking has been informed by obviously experience. I spent some time at the Indian reservation with the Indian Health Service in Gallup and in Farmington. I spent some time, one of my, actually my first job was in a city in county, safety-net hospital. So I, I worked in the VA for a while. I've worked in a lot of different health care environments, including, you know, the Gold Coast, where Mrs. Scott Rocks goes at the University Hospital. So I mean, I've been to every sort of extreme and it's informed my thinking in terms of how do we deal with these issues because I don't need to tell you the sick care system takes care of the failure of all the other systems.

John Shufeldt:
Right.

Arlen Meyers:
Revolving door, I don't need to tell you that. So you know, you treat someone, they're homeless, they go on a street, two days later, they're back and it's this revolving door. And so basically, we're just treating the symptom instead of the disease. So it really has to do a lot with social system, social support systems, everybody is now getting all worked up about social determinants, who we've known for 50 years. It's just, so that, it's a wicked system, it's a system of systems and when you squeeze on one part of the balloon, it pops out on another. So that's the challenge. It's a multi-systems engineering problem. It's just not sick care and that's why we have to make it open because we have to be informed by these other industries. I don't care whether it's finance, aerospace, nano, media, technology, you name it, they're all connected.

John Shufeldt:
Yeah, great. OK, final question. What does grit have to do with being a successful entrepreneur or physician entrepreneur? What, what does grit play into that? And how do you develop it if you don't have it?

Arlen Meyers:
So that, that question gets to why are you doing what you're doing, what motivates you, and I think that in order to be successful at this game, as I said, you have to have an entrepreneurial mindset. I also think that you have to be internally motivated. You can't be externally motivated. I don't care how much money you pay me, there's only so much I'm going to do and the literature supports that. I don't care where you are, how much you get paid, money is only gets you so far. So it's not about the money. In some instance, when people say that it is about the money, but people use it, you know how you keep score, the psychological attachment to it, but my point is I tell people, if you want to be successful in physician entrepreneurship or biomedical entrepreneurship, you have to make it personal, but not take it personal. So what I mean by that is if you just look at a bunch of entrepreneurs who have been successful and you start peeling away the onion, usually, not always, but usually deep down inside, there is a personal experience. Now, in my case, it was this business of creating something and not knowing what to do with it, and I couldn't find any help and I got angry, I'm still angry, and that's why I'm doing what I'm doing, I'm pissed off. I don't think it's right. So it could be a child who was sick and nobody could do anything for the child. It could be an experience with the health care system, it was horrible and you're pulling your hair out saying, how come somebody doesn't do something about this? It could be a family member, it could be, you name it but typically, it's a personal thing that's pretty deep in your psyche, it could be satisfying a psyche need. There are an awful lot of entrepreneurs who are psychopaths. They're depressed, they have anxiety, they're ADHD, they're narcissists, there's, they're just not healthy. Maybe psychopath's a little extreme, but they're just not healthy. Now the good news is there are positive aspects to that entrepreneurial personality, and many, many people have admitted it, you know, the Elon Musk's of the world and all these people, that mega entrepreneur superstars, they got issues, and depression, anxiety all that. So you make it personal, but you don't take it personally means you're going to fail. I guarantee you, you will fail, if you do this long enough. So you get up, you shake yourself off, your brush yourself off and you go to the next thing and hopefully you learned, you learned something from your failure. So and if you want to call that grit, fine, call it grit. You want to call it purpose, call it purpose. You want to call it mission, you want to call it your true north, I don't care what you want to call it, all I know is if you don't have that little voice in your head telling you, keep going, you're not going to succeed.

John Shufeldt:
Yeah, I could not agree more and with the little voice, not about the psychopaths so much, but about all the other ones. Arlen, this has been a blast, but how can people find you?

Arlen Meyers:
Well, unless you've been under a rock for the last 10 years, I'm pretty prominent on the internet, so I'm, you know, you can get me on, so if you go to SOPE, it's a www.sopenet S O P E N E T.org or you can get to me on my LinkedIn site for Arlen.Meyers@ucdenver.edu.

John Shufeldt:
Well, thank you so much for being on this, it's been a real joy to see you again, and I know I've learned a lot, I'm sure everybody else does too. So thank you very much.

Arlen Meyers:
Thank you, and thanks a lot for helping us to spread the SOPE community in Phoenix.

John Shufeldt:
It's been a pleasure.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur RX. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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