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The Creative-Clinical Culture Clash


Doctors get a lot of mixed messages. They're encouraged to think outside the box, but often penalized when they do so.

Practice Management, Physician Entrepreneurship,

Here is how someone recently responded to one of my posts entitled "Where are all the entrepreneurial doctors?"

“Entrepreneurial medical doctors are anomalies. Medical schools, medical training programs, medical boards and authorities, medical communities, medical doctors and patients themselves weed out any doctor who has entrepreneurial spirit or tendency. People expect doctors to be rich but demonize doctors who make a lot of money. Ironic but true.”

The comment highlights a clinical creative culture clash that pits the medical establishment talkers against the walkers, those that say one thing but do another. No wonder so many doctors are not buying into the "innovation thing." There is conflict, cognitive dissonance, and confusion in the ranks.

Here are some of the mixed messages:

1. Adhere to standards and comply with rules but be creative and know how to do the work-around

2. Be disruptive (business) but don't be disruptive (clinical)

3. Make money but don't make too much

4. Toe the line but lead the revolution

5. Accept when we drop your reimbursement because we screwed up the actuarial insurance risk and just bend over when we raise the salary of the CEO

6. Take out lots of loans to go through medical school but don't blame us because someone moved the cheese

7. Be imaginative, creative, and innovative. Just don't tell anyone you are doing it.

8. Never tell the truth about your non-clinical career intentions at a medical school interview

9. Work with industry but don't work with industry

10. Be entrepreneurial but don't expect us to acknowledge or reward your efforts with too much money or promotion and tenure credit.

Now, do you understand? Still want to do that "entrepreneurial thing" or just spend more time with your family and friends?

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Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice