What's the Secret to a Successful Healthcare Startup?

[00:00:00] Jared: Hello everyone and welcome to the Med Design Podcast where we highlight the journeys of medical innovators. This week we have Dr. Arlen Meyers with us. Dr. Meyers has been a physician for over 40 years in the field of otolaryngology. He's been a professor at the University of Colorado for upwards of four decades as well.

He's the president and founder of the Society of Physician Entrepreneurs or SOAP, as many of you know. Dr. Meyers is someone that's really been there and done that in the world of medicine and entrepreneurship and basically everything in between. He's a thought leader and has a track record knowing emerging trends in medicine and business.

If you haven't kept update with his writings, I highly suggest you do so cuz he is really helped so many physicians excel in business at every level. We're real excited to have him on and learn from his experience. As a result of listening in today, we're really hoping that you feel more educated about how to start as a physician entrepreneur, what a career looks like in this field as represented by Dr. Meyers and his experience, also some really cool details about what SOAP and Med Design are up to. So let's just get us started. Welcome Dr. Meyers. We're happy to have you on with us.

[00:01:02] Arlen: Oh, thanks very much. Thanks for inviting me. It's always fun to be on these programs.

[00:01:08] Jared: Yeah. We're happy to have you here. Let's talk about physicians for a little bit. Something that comes up a lot for us.

We talk about this statistic where 90% of startups fail, right? And, more recently, the highest reason for failure was like, what? 42% of those startups had no market need in the first place. That's entirely preventable to some degree.

But what we're really curious of is why do physician entrepreneurs fail? And what are some of those factors that are more easily preventable that they could probably overcome.

[00:01:42] Arlen: So before I answer that question, I just wanna mention to the audience that if you have a question, ask it and we'll try to answer it when you ask it, rather than wait till the end.

Because our experience with this is you're here to learn. You have specific questions you want answered. So we're pleased to do that. So again, thanks for inviting me. So the answer to your question is first of all, most of the information out there indicates that the reasons why startups fail, and this is different than why startups fail to scale. That's a different webinar. So this one is about why will your startup fail? And the answer generally is because you make a product that nobody wants to buy. In other words, lack of product market fit. And secondly, you don't have a viable business model. In other words, you can't make it up in volume if everything you sell loses a nickel.

So you have to have a business model at the end of the day that basically generates more than you spent. It's that simple. Creating the model is not simple. And we've seen a lot of examples of failed business models and that's why you see people keep churning them. And incidentally whatever you come up with as a business model, it's just a wild guess.

And you don't know that what you're gonna do is gonna actually work and make money. So you have to test it. So that's a take home. So you gotta test whatever it is you are thinking. It's a wild ass guess when you put it on a business model canvas or any of that. Sure, you go out and you talk to people, you validate it, you try to, but you know as well as I do, what people say is not what they do.

So they're gonna tell you, oh, it's a great idea. Go out and go for it. You go for it. You go broke, so you have to test it. Now I would add a third one. And that is even if you create product market fit, in other words you make something people wanna buy. And even if you have a viable business model, the third reason is you don't have a team that can execute.

They screw it up. And when you are pitching to investors, the only thing they want to know is, do you have a team? Okay. What's the problem you're trying to solve? How are you gonna solve it in 30 seconds, in fifth grade, English? Tell me a story. How are you gonna solve this person's problem?

I get it. The next thing they want to know is who's on your team? Can they execute this experience, background, subject matter expertise, diversity, et cetera, et cetera, et cetera. And then the last question for the advisor or the investor's gonna be, why should I trust you with 2 million dollars in my money and the presentation is going to communicate that.

Are you an idiot? Do you know nothing about what you're talking about? Are you arrogant? Are your communication skills worthless? Why would I give you 2 million dollars of my money or somebody else's money that they have given me to invest in their behalf? So that's the answer to the question. Big picture.

Now, second point. So why is it that white coats and I would enlarge the conversation to white coats? Biomedical engineers, graduate scientists, doctors, any kind of sick care professional, anybody in a white coat who's trying to get an idea to a patient. What is unique or different about why they fail? Mindset. The short answer is mindset.

The clinical scientific mindset is different than the entrepreneurial mindset, and unfortunately, we don't teach that in any graduate science or bioengineering program with a couple of exceptions. Because recently, I'm sure you're familiar with many biodesign programs throughout the country. More and more, and some of us are involved with integrating this into medical school education.

Some people are under the mistaken notion that if they get an MBA that's gonna make a difference. It isn't. It's about mindset. And the reason I just mentioned the result is you have to come down off the mountain. You are not the smartest person in the room because of all those initials after your name.

You don't know what you don't know about business just because you're a fourth year medical student with an MD about to graduate and you think I'm gonna be an advisor to Google in Santa Clara. No, you're not. You don't know anything about medicine, let alone business. So you have to understand what this is about.

And to me, I think those are the biggest faults. They're just arrogant and they have this attitude of exceptionalism. And the third reason is they are problem solvers, not problem seekers. Which is the reason you guys are in business, because you teach people design thinking. You teach people how to be a problem seeker and understand the customer, empathy, all the steps of design thinking. What you think about your solution is totally irrelevant. So that's a long answer to your question, but that's what I think. I'm sticking to my story.

[00:07:11] Jared: You also brought up a vocabulary word for a lot of folks. I think not everyone is fully familiar with the term sick care, right?

So maybe you can go sick care a little bit. Then also just talking about entrepreneurship in general, how do you define it and why the heck should physicians get involved in it?

[00:07:26] Arlen: So the US I don't need to tell anyone in this audience, whether you're a provider or a patient or you've had family members.

I don't need to tell anyone in this audience that when you get involved in the experience of interacting with the US sick care system is horrible. Generally. Sure there are exceptions, but in general, if someone hands you another clipboard for the same information, the sixth time you're gonna kill yourself.

So it's just ridiculous. Now I just wrote an article about, "Are patients customers?", and actually it was interesting because it got the most hits of almost anything I've written in 15 years. So it's a very sensitive question, but the answer and the reason I call it sick care is. So for the right to go to the bonus round, how much money do we the taxpayers spend on taking care of people with illness in the United States?

Any guesses?

So the answer is 4.3 trillion. Oh dear. And it's funny because people can't, it's hard to get your head around what 4.3 trillion looks like, but actually some funny guys said, if I stack dollar bills from New York City and put 4.3 trillion of them, it reaches the moon. That's

That's how much money we're talking about. The bad news is, we're the worst country of developed countries in the world when it comes to rating our system. And 96% of the 4.3 trillion is spent taking care of sick people. So the bottom line is what the politicians and the pundits and everybody calls a healthcare system is not a healthcare system.

It masquerades as a healthcare system, and what it's hiding is we have a totally dysfunctional sick care system of systems. It's not one system. It is the va, it's university hospitals, it's safety net hospitals, it's community hospitals, it's government run hospitals, et cetera, et cetera, et cetera.

And every doctor on this call knows that working in those hospitals is totally different. Each one is totally different culture, different mission, different attitude, different, et cetera, et cetera, et cetera. And I've worked in pretty much most of them. So I can tell you that it's a very dysfunctional, sick care system and that's why I call it a sick care system of systems that is very sick.

Now the good news is there's lots of opportunity to fix it, and that's why we're on this call.

[00:10:32] Ty: It's a problem rich environment. My God. Yeah. Yeah, there's lots of opportunities for disruption. I do want to get to Dr. Harvey Castro's question. And this is, it looks like it's a comment going back to the value of teams. And as, as you were talking, I was reminded of a quote from Nassim Taleb where he says, you want to bet on the jockey, not the horse.

Which speaks to the skill of the team that's driving versus the specific technology that they're pursuing. But Dr. Castro's point was if the team is not strong, would be careful with investing. Doctors are wired differently and healthcare reinforces it. Many physicians feel they know more than they typically do in medicine.

[00:11:08] Arlen: And then the question becomes, so thanks for that. Harvey is a SOAP member and he and I have work together. I don't plant these people in the audience, so just so you know to ask question, but keep 'em coming. So how do you pick the jockey? And what's a good jockey? And is that in fact true. You hear that all the time.

And I think the idea is that the person that is on a startup team, or a scale up or leading, or CEO, whatever, they come in with a certain pedigree, they have a certain background, all the inputs. But when the rubber meets the road, it's about adaptability. So it's not about what you did in the past.

It's about do you have the knowledge, skills, abilities, and competencies to adapt in a VUCA environment? V u c a volatile, uncertain, complex, ambiguous. So when the blank hits the fan, what are you gonna do? How are you gonna adapt to that? Because it will. Inevitably you're gonna fail. How many times have you failed?

How long is your failure resume? What did you do? And basically, the failure resume, has two parts to it. One, what'd you learn. Two, what was the silver lining? And if you don't analyze that and take responsibility for it. You've totally wasted your time. You haven't learned anything, so I pushed back a little bit about this bet on the jockey and not on the horse, because how the hell do you know?

And you tell me how do you measure someone's adaptability? And you can say past performance is an indicator future performance. I don't think so. And the typical example is a lot of startups think they need to put a hood ornament in their website. So what's that mean? It means you get somebody who is a very well respected high profile, CEO, of a mega billion dollar medical device company.

To be an advisor to your startup, and you put that person on, and I'm not that person, but I have been approached and probably some people in the audience have. We want you to be an advisor. You have some brand equity people know who you are, blah, blah, blah, blah, blah. So we want your picture on our website.

We're not gonna ask you to do very much. We just want your picture on the website. It's like a influencer. And I call those people hood ornaments. Now some hood ornaments get paid a lot of money just to have your picture on the website. Sure do. And it's up to you. It's up to you as an advisor whether that's something you want to do.

But in general, most folks wanna actually accomplish something and contribute to something, so you have to make up your own mind. So if you get Mr. Big stuff or Mrs. Big stuff on your website who ran a multi-billion dollar medical device company to work with your startup, their headset is very d the first thing they're gonna do is who gets the coffee around here.

How do I change the toner in the copy machine? How come I don't have a parking space? I mean it, it's ridiculous. So you have to find the right culture. And the right person, and if you get someone in MedTech and you're a biopharma company, that's a problem too. So again I think this business and how do you pick the jockey is more complicated than it seems.

[00:14:41] Ty: Yeah, I've got a theory about this that you've got like the different stages of the enterprise. You need different jockeys so to speak, because the skillset that you know, takes you from zero to one is very different than the skillset it takes to go out and raise investor money, which is different than the skillset of then like a sales growth.

Like how do you grow the enterprise. And so the jockey you need at each stage of development for some of these healthcare enterprises varies as you go. So I wanted to jump in with some comments and questions that have popped up. One is a question of what are the pros and cons of pursuing a new venture as a founder or CMO?

So chief Medical Officer, when your early career and have a stable six figure income. Is it a reasonable expectation to do so while keeping your position career, given the VC market possible, drying up a funding and startup market post Covid, what would you do if you know that what you know now? But we're 32 years old, so this is Dr. Meyers at 32 years old.

[00:15:40] Arlen: So I get that question asked a lot. Okay? And so here's my answer. First of all as the environment has changed in terms of the demand. So is it a good idea for startups? Now, let's just confine this to startups. We could put this in the context of startups, scale-ups and grownups.

And each of those companies at a different stage of development have different requirements in terms of what they want someone to do. Advisor, consultant, chief medical officer, member of the board management team, hood ornament, you name it. So number one is, you have to understand, again, problem seeking, not problem solving.

Mr. Google, what is your problem that you think as me, I can help you solve? So you have to have clear expectations about what they're asking you to do, and we can have a whole long conversation about what most of them ask you to do. But let's just confine this to startups. So is it a med tech company? Is it biopharma?

Is it digital health? Is it FinTech? Is it education tech? Now, what is it? Each place is different. So that's number one you have to understand and where you're gonna pick your spot. Now get to the question. What would I do if I were a 32 year old medical student, resident, fellow, whatever. And I work with these folks day in and day out.

I teach at medical schools, health administration programs, graduate schools, all this stuff. So I'm talking to these folks day in and day out. So here's my advice. Number one, don't take my advice. It's what I think is irrelevant. It's, you have to listen to your inner voice.

You will uncover the advice, but if you're willing to ignore my advice, , then here's my advice. And my advice is first of all you have to do a personal professional development plan, and I've written an article that calls the six Rs of career transition. The first R is reflection and we can put the LinkedIn thing on the, in the chat, but the first is reflection.

Where are you now? Where do would you want to go? How would you want to get there? It's a strategic plan, so you start with assessing a whole number of factors of yourself, not the least of which are, do I have an entrepreneurial mindset? And each one of these topics I'm listing has a pretty long, deep in the weeds explanation.

So I'm just trying to hit the high points. Do I have an entrepreneurial mindset? Do I have the knowledge, skills, abilities and competencies to satisfy the requirements of what someone asking me to work for them? Or I want to do it myself, like you wanna start my own company? That kind of thing. And essentially it comes down to.

Mindset, means, and motivation. So I'm a big fan of, every doctor learns pneumonics. That's how we get through medical school. So you gotta have all these tricks to memorize all this nonsense. So this one's the 3 Ms, you gotta have mindset, you have to have the means that is the resources to do whatever it is you're thinking about doing.

Not the least of which is money. So to the question, and I always get asked this, wait a minute, I'm making $800,000 a year as a neurosurgeon. I want to be an advisor to a company and I wanna make $800,000 a year. It's not gonna happen. Number one, it's ridiculous. Number two, you should be thankful you're making $800,000 a year as a neurosurgeon, cuz you're making more than 0.1% of the people in the world.

And number three, you're just not gonna get paid that much. It's just unreasonable. But doctors don't listen. They say wait a minute I'm worth it. I got all these initials after my name. I just went to school for a gazillion years. The reason is that the compensation model in industry is different than the compensation model in clinical care. Doctors have a great gig. You show up, you do whatever you're gonna do. It doesn't matter whether it works or not. You submit a bill that is so convoluted and opaque, nobody can tell what the hell you did, and you say a prayer and hope somebody pays you. You get paid for effort. When you go to work for industry.

No, that's not how we do business. If you go to work for a VC like I do, I advise to vc, they have a totally different revenue model. We're not gonna pay, you're gonna get the. Most people don't know what a carry is. It's not important. The point is that you get paid differently and often it's paid for performance.

If someone asks me, Arlen, I want to hire you to help us raise money, for example, that's a common, it's a common theme. The startup says to the doctor, you know, a lot of people who are neurosurgeons, we have a neurosurgical problem. We want you to ask your friends. And talk to your people about how would you mind talking I want to introduce you to the chief integration officer, et cetera, et cetera, et cetera. I want you to help us break through the gatekeepers and make the warm introduction so we can sell, so we can market, so we can raise money, so we can pilot, fill in the blanks and I say, great, how much are you gonna pay me?

I charge $5,000 a month. Just picking a number. There's different revenue models, but mine is a retainer, so I'm gonna represent your interest in my network and you're gonna pay me $5,000 a month. And you know what they're gonna say? No, we're not gonna do that. Number one. We're not sure you're gonna deliver.

So you want me to take the risk? You don't want to take the risk. Number two, we don't have the money. Yes, you do. You're just not willing to pay it because you don't trust that I can deliver. So all these things sort it. That's what I'm saying. When you get into this, you have to think of that. To go back to the original question, what would I do then?

Had I know what I know now? I would focus on education, access to resources, networks, mentors, experience, peer support, and nonclinical career guidance. That's where you start. Then you can start thinking about, gee, do I really want to do this? 95% of MedTech startups are gonna fail, so meanwhile, you're being offered options.

Guess what? They're worthless if the company doesn't ever do anything in the market. How do you learn this stuff? Experience. It's a 70 20 10 rule. 70% of what people learn as adults is derived from experience. 20% is derived from who you know. 10% is derived from what you learn in school. Bottom line, don't let school get in the way of your education.

That's such a great sentiment. Cause you should. Yeah. And it applies to MBAs. It applies to all this garbage that people are selling to doctors that won't make a difference. Your majoring in minors like my wife used to say.

It doesn't make sense. So don't do it. That's what I would do. And I didn't do that. And I'll tell you a very brief short story cause people say how'd you get to where you are now? What happened to you? Tell us your story. Yeah. Brief story. I was an academic surgeon at the University of Colorado.

I guess I still am. It's like being a Marine. You never, I get rid of it. So during my tenure, myself and a couple other folks invented a gadget that optically detects cancer in the mouth. Pretty good idea, I thought. But you know what? What I think is worthless. So long story short, I was clueless. I knew nothing about how to get an idea to a patient.

I knew how to do research and make papers and do to academic stick, but I really didn't understand any of this. So what I do, so I start asking around well, is there someone in school that can teach me it? Like in the medical school. They couldn't spell entrepreneurship, let alone teach it in those days. There was no, the ecosystem was underdeveloped at best.

I couldn't find people to gimme the time of day. The emphasis was on. You're here to take care of patients and chalk up RVUs don't bother us with this silly business stuff. The tech transfer office was in those days, graciously saying, dysfunctional. Now it's much better. It's actually one of the best in the country.

But in those days, tech transfer was a mess, so I couldn't go to anybody. I was lost, and so what happened? I got angry and the moral of, and that's why I'm doing what I'm doing now, because I didn't think that was right. I don't think it's right. Now to threaten doctors with value-based payment and not teaching them how to create value.

It's cruel and unusual punishment. So what I said to myself was, this isn't right. I'm pissed off. I guess I'm gonna have to fix it, not me, I mean with other people. So that's how we created the Society of Physician Entrepreneurs Bottom line and this answers the question that was previously asked. I'm 32 years old, where do I put my stake in the ground?

You make it personal, but you don't take it personal. That's what the motivation and the incentive comes from. You have to have something that makes you so angry or pissed off or passionate or karma or I don't care what you called it, grit. If something is pissing you off and you can't fix it, then don't do it. That's how I wound up doing this.

So that's your entrepreneurship story. So you weren't like somebody that was having little side businesses here and there, and you just wanted to take it to the next level. Like it came from pure passion and aggression towards changing the industry.

Yeah, you have to make it personal now. When I say don't take it personally, guess what? You're gonna fail so you don't take it person. You give up on the idea when the appropriate time happens, you pick yourself up, you wipe yourself off, and you do it all over again. You don't give up on yourself. You give up on the idea, and as long as you have that itch, then keep doing it.

When you lose the itch, you should stop doing it.

Because you're just wasting, you're just wasting your time. And other people, it's really hard to know when to persevere versus when it's time to move on to your next thing because

you've but there are signals. There are triggers. I mean it's like dating in two minutes, this is not gonna work. It's like doing rotations in medical school. I tell people I knew in five minutes I didn't want to be an obgyn doctor after I delivered my first baby. I just it was not a good fit. It just didn't work. And you can sense that. Now you have to have the courage to admit it because you could find yourself in some sticky situations where, darling, I've given up my clinical practice and the House of Veil and the trip to part of Valarta and the Maserati because I'm gonna do a start up and I've taken all this money and I've put into it, but guess what?

It's not working. So I'm gonna quit. Have that conversation. And good luck with that . And I've had it so it's. It's hard, but it takes courage. It takes getting to know yourself, but you'll know. People don't have to tell you. The problem is you have to have the courage to do it. You know, It's something you should do.

You just have to do it and take a deep breath and take the leap, but you should have plan B. Now, some people, and people do this stuff for two reasons. By stuff, I mean pursue entrepreneurial careers in some way, shape, or form. First reason is because they have to. Second reason is cuz they want to, the have to is I lost my medical license, I suffered a disability, I got a divorce.

There was a death in the family. I have to take care of a family member. I can't do this anymore. I call, you know, all these Ds. Or what we're seeing a lot of are foreign medical graduates coming to the United States and they have to go through this ridiculous rigamarole of taking another residency and a cgf.

They're just not gonna do it, and they are immigrants. Now I have looked at and other people have looked at the social determinants of entrepreneurship. One of the top are immigrant status. If you look at the number of Nobel prize scientists, significant percentage of them are immigrants? If you look at people that are creating stuff in the United States in healthcare, significant percentage of them are immigrants.

Why? In my opinion, and I've asked them, so what? Why is that? First of all, do you agree? Yes. I'm interested in the audience feedback. If you're an immigrant in the audience, if you're doing this stuff, chime in. Put something in the chat. My response or what I heard from him was because we are willing to pretty much risk everything behaviorally, you've already done this, you've already done, you've picked up your family from a place God knows where, and come here thinking you have a more opportunity and you probably do.

To be fair, I mean there's a lot wrong with the United States, but let's face it, we're the number one entrepreneurial ecosystem in the world. Which is a contrast and a behavior, a cognitive dissonance because we have the lowest sick care system in the world. So if we're the best entrepreneurs in the world, unquote, and we're the lousiest sick care system, how come we don't apply it?

And my answer is because the rules are screwed up. And if we're gonna change the system from sick care to healthcare, It starts with changing the rules. Reimbursement. Rules create ecosystems, intellectual property, how we teach people how to do this, how the system is structured, universal coverage, on and on.

Social determinants. On and on. Yeah.

[00:30:26] Ty: Vardhmaan Jain said, I am an immigrant. And he had asked one of the questions earlier and strongly agree, and I said, already a mid-career advisor to a startup that IPOed. So that's, it estimates that observation. Absolutely.

[00:30:40] Arlen: Good. So I'm taking that as. Speaking as a white guy who grew up in the United States. I'm taking that as validation of what I just said. So good.

[00:30:49] Ty: Thanks for your comment. If there is a market for a Y Combinator led by folks like Dr. Meyer for physicians.

[00:30:55] Arlen: Yes. And there's lots, there are many accelerators, incubators, generators, accelerators.

Frankly, I think we need more euthinators. Euthinators are companies or places where terrible ideas go to die. And the best thing that I can do as an advisor is to tell you that your baby is ugly. It should not see the light of day. Pull the plug. Save yourself a lot of heartburn.

Start over. But we got a patent right, which is worthless. Good for you. Yeah. You can put that on the wall of your, with all the other diplomas and plaques that I used to have, that kind of thing. Make sure everybody sees it and all that stuff. It's totally worthless if you don't do anything with it,

[00:31:41] Ty: but I have a credential in becoming an entrepreneur.

[00:31:43] Arlen: Yeah. It adds to my hood ornament profile. And actually I do have a patent. So to go back to the story, we created this gadget, we patented it, it went absolutely nowhere. It's worthless. If and why is another story. But if it doesn't, if it doesn't get out there, what's the point?

And the vast majority of patents never see the light of day.

[00:32:10] Ty: You paid a tax to have a monopoly on a dumb idea.

[00:32:14] Arlen: And not only that, you're paying the fee to maintain the patent but's not doing anything, what's the point.

[00:32:18] Ty: we've got a lot of great questions that are in here. I do want to circle back to a foundational question about entrepreneurship and maybe mindset shift between physician and entrepreneur.

[00:32:29] Arlen: So let's start with what is the definition of entrepreneurship? You ask a million people, you get a million answers. The traditional notion is entrepreneurship is the process of creating a company. I totally disagree with that. So what my definition of entrepreneurship is, and more specifically physician entrepreneurship or sick care, professional entrepreneurship, is as a couple of parts to it.

So bear with me. Number one, it's the pursuit of opportunity. Problem seeking. It's the pursuit of opportunity under volatile, uncertain, complex, ambiguous conditions. You don't know what you don't know. You don't know what's coming down the road next. It's really hard to see around corners. Who knows where the next black swan is, et cetera, et cetera, et cetera.

It's just a very ambiguous, uncertain. Now, the good news is doctors are used to dealing with uncertainty cause that's the world we live in. Tell us what your problem is. I make a diagnosis, I give you a treatment, but I don't know whether the hell, this is absolutely positively what's wrong with you.

We deal under probabilities and conditions of uncertainty and we test our therapies. Take this medicine. Let me know if you can get into the patient portal and you can afford to ask me the question these days, how you're doing? And if it's working, great, it's not working. Let's go back to the drawing board, that kind of thing.

So pursuit of opportunity, uncertain book of conditions. The goal is to create user-defined value. It doesn't make any difference what you think. The only thing that matters is if the dog eats the food. User defined and then value. So what is value? What? What does that mean? Value means the difference in the mind of the person that you are targeting between the tangible percieved.

Not real, perceived, tangible and intangible benefits minus the tangible perceived costs. Anyone in their right mind that does a cost benefit, we all buy emotionally and justify rationally. It's an emotional decision of everything. And the average person will not buy something or do something, if the costs outweigh the benefits.

Now, that's not always absolutely true. There are many circumstances where, for example, we will do things for free because we have a meaning, it adds purpose, we get together, it's connecting. There's a million different reasons why you would do, and I do. I do a lot of free stuff. Serving on boards, giving people advice, doing stuff like this.

Whatever. There's lots of good things. It's fun. Gives you a sense of meaning. Okay, I woke up today, gives me a reason to get up and go to work. So there's lots of reasons for doing that, but in general, most people aren't, are gonna do the cost benefit and they're not gonna buy something where the cost outweigh the benefits.

Okay. So pursuit of opportunity, VUCA conditions, goal of creating user-defined value through the deployment of innovation. So what's innovation? What's the difference between an idea and improvement? An innovation? What's the difference? What is an innovation? And in my view, again, it's a two factor analysis.

So it has to do with. Is it new or something old? Done in a new way. So it's a novelty axis, and then it is a value axis. So if you create something as compared to the status quo or a competitive offering, if in the end the user defines it as valuable. Then it has the potential to be an innovation. So if you're down in the lower left-hand corner, it's not new and it hasn't added anything.

It's a solution looking for a problem. So don't waste your, don't waste your time in the lower left hand corner. So through the deployment of innovation, Using a viable business model. We talked about that before with the goal of achieving in the case of sick care, the quintouple aim. Quality, cost, youth, patient experience, doctor experience, equitable access, and waste, or lack thereof and incidentally, Of the 4.3 trillion, a trillion is wasted.

Think about that. That can buy a whole lot of stuff. In sick care. It's just ridiculous. And every doctor in the room in this call knows why are we spending money on blank? In my case, it was every time I went to the operating room, they had 2000 instruments on the back table and I used five 95% of the time.

So I say I knew what was gonna happen, but it's just wanted to be a pain in the ass kind of things. It's like I said to the nurse, the scrub nurse around the OR, I said, I have an idea. How about if we eliminate, if I tell you the five instruments that I want and you tell the people down at Central Supply and the whole supply chain cause it's an enormous cost to get all that stuff to the OR don't do it, but give me half of what you saved.

I got this kind of, you gotta be kidding. But that's an example.

[00:38:47] Ty: That'd be a value-based incentive, right? You're getting exactly right to the upside of the savings that you're carving out of that trillion dollars. Everybody wins.

[00:38:56] Arlen: Yeah. And then, so the feedback I get is, yeah, that may be the case with you doctor, and you get sort as condescending, doctor.

But if Dr. Jones in the OR next door wants something and it's not here, you know what's gonna happen? I'm gonna get my head cut off. That's what the nurse says. That's because you have competing incentive schemes you've just proposed.

So it's just an example of the and you could just, it's sad.

It's actually really pitiful how much money we waste. You go to a country, you go to a place I've had the good fortune of traveling around the world doing this stuff, including working in hospitals around the world, and it's amazing what surgeons do around the world with such limited resources.

It's just amazing and good for them. We need reverse innovation and learn from that.

[00:39:40] Jared: So I think, we have 15 minutes left. Some things we wanted to talk about. I know Ty, we have an update from Med Design, but first and foremost I wanna talk about SOAP. And so who is it for? What impact has it had? How do you get involved? Give us the whole lowdown.

[00:39:54] Arlen: All right, so here's the pitch. So you heard the story and why we created it. So you heard the why. So the SOAP, the Society of Physician Entrepreneurs affectionately referred to as soap, I tell people I'm a soap salesman. Is a global nonprofit, virtual open, biomedical and clinical innovation, and entrepreneurship network. So that means anybody can join.

It's a nonprofit. And it's virtual. So we don't have an 8 million building in Washington. We don't have a seven figure executive director. We don't have ridiculous dues. We don't have all the stuff that every doctor that pays $800 a year to belong to their medical society does. They're just not adding value in my opinion.

So that's why we did this way. It's a different, it's not your father's medical society or your mother's medical society. It's different. So anybody can join, and our mission is to help our members get their ideas to patients. So we provide, like I said, education, access to resources, networks, mentors, peer support, clinical guidance, experience, et cetera.

What has been the impact? Who knows? I tell people, so they say what have you done? And I say, you know what? I just make dates. I don't make babies. This is just a, this is just a cross between Rotary and match.com. If you need to connect to somebody and get an answer for something, should I kill my idea?

We can connect you to somebody. How do I raise money? What about ip? What about reg affairs? How do I do product development, marketing, et cetera, et cetera. We just connect the dots, and that's why I'm saying it is so important for the 23 year old or the 32 year old medical student to build robust networks now.

Not when you need them. Not when your white coat gets the pink slip and you're saying to yourself, what the heck do I do next? Do that now. That's the single thing I would tell you to do. And don't build networks. If you're looking for innovation, you're not gonna find it at your next medical society meeting.

It can't be fixed from inside. You have, you're gonna find it at the Consumer Electronics Show. You're gonna find it at the next AI meeting. You're gonna find it from aerospace, nano media, et set quantum computing. It's the fourth industrial revolution. You just gotta get out. Yep. And that's the single biggest piece of advice I would give you.

Build networks and just don't build them. Just don't pile 'em up like coins in a piggy bank, manage them. You have to create relationships so when it's time, you can tap on people's goodwill to help you and you can help them like I'm doing with you. Now you have to pass it forward. Absolutely. No one else is gonna do this for you, doctor.

If doctors don't do this for each other, you're screwed. Your employer could care less.

[00:42:58] Jared: Yeah. Talk about paying it forward. Maybe that's a good segue into our maybe new module coming from med Design as well. I know Ty's super excited. He's been working real hard on it.

Know he is excited to share a little bit more too.

[00:43:09] Ty: Yeah. And I guess before I talk about the new module, one, just like how much does it cost to join soap?

[00:43:14] Arlen: Where, so it's cheap. It's 80. It's $80 a year. A year. That's $7 a month. A couple of Starbucks if you're, in the mocha wrap.

Netflix, man. Yeah. Netflix, you got the. That kind of thing. And you go to www.soapnet.org. Now if you do that right now, unfortunately we have to get our website . It's another lesson we have to get our website certification renewed. So you may see an error message, but we're getting it fixed, so don't write me a note and tell me, oh, a website doesn't work.

I know, I get it. We're trying to fix it, so keep an eye on it and I'll put it in the chat. So that you can sign up and then you could, we have chapter meetings. If you want to create your own chapter, you can do that. But basically you're joining a dating service.

[00:44:05] Ty: Awesome and do you have to be a physician to join or is it

[00:44:08] Arlen: No, as I said before, it's an open innovation network and we have about so I'm talking about a hundred, over a hundred thousand people on social media touchpoints.

Around the world. That's incredible. At about half of them, we started in 2011, so it's taken us 12 years to become favorites overnight, but we're not there yet.

[00:44:30] Ty: It's overnight and like 12 years or so.

[00:44:33] Arlen: But actually, we're slightly ahead of the curve because the average medical discovery takes 17 years to become the standard of care.

So actually we're ahead of the curve.

[00:44:44] Ty: You're got what four more years to go.

[00:44:46] Arlen: Five more years to go. Yeah. Yeah. I was six or seven more to go. Good. Yeah.

[00:44:49] Ty: Awesome. And Dr. Myers, you provoked me. When we were talking about this to where you one as we've been talking about what we're doing at Med design, right?

That there needs to be an intro course. And so ever since then I've, I don't know, maybe been, I don't know, like angry or something of I'm just gonna do it. Damn it. So we've got a bad first draft. Then I'm gonna share with everybody that it's an intro course to, we're titling it, it's based on a a writing blog about how to be a better writer.

So it's called the day You got started in Digital Healthcare Innovation. What we're doing is we're offering this course for free, or you can pay what you want. And I just dropped the link in the channel there. We are just getting started with it. And also if you do sign up we'll ask that you put your mailing address down and we'll send you a sketchbook as part of the course.

And so I'd like to send that to you as a gift. That's just one of the components of this. Cause we do believe in, the value of sketching every day, journaling every day as part of the discipline of design and design thinking. So that's gonna be a component of that. So do encourage people to sign up for that.

Then also, the one thing we ask if you do sign up is to give us feedback. It's a bad first draft, but we're gonna improve it over time and build it into a very robust program. Yep. And it's, and you told me this, but how much does it cost. So it's

free for a limited time. And then it's also set up as pay what you want.

Okay? So if you do wanna contribute to it, you're welcome to.

[00:46:18] Arlen: We'll probably wind up offering this at about $70 or so as when we so I want the audience, so thanks for doing that. But I want the audience to realize something from what he just said. Number one. Test your business ideas. He's giving you this for free.

It's a way to test the idea. This could be awful. It could be like, what am I thinking? You, it's hard to get feedback. It's hard to get people to give you an honest opinion. He's offering you the opportunity, so test your business idea. Number two, there are pros and cons to offering things for free. A freemium business model or a free model is not necessarily the best way to go and comes with pros and cons.

And I will tell you that soap at one point was free. Bad idea. Very bad idea. I won't go into the reasons we can have another webinar, but think very carefully how you price your product. And number three. Have a very clear call to action when you do these sorts of things. Thanks for showing up to our webinar.

Here's a call to action. We want you to do blank, and number four, we are going to offer you an ethical bribe, book, a free book to sign up and give us your feedback. So pay attention to what you just heard and apply that to your business.

[00:47:47] Ty: We're just following your advice here. We probably should straight outta your book.

[00:47:52] Arlen: That's right. Number five, don't take my advice.

This doesn't matter what I think. It matters what the audience thinks.

[00:48:01] Ty: Wonderful. Let's see. So we've got maybe five more minutes left and I think there might be a couple of other questions that sure. Let's get up to 'em. . James asked a question, do you see the most disruptive or useful innovation coming from clinicians? Or from non-clinicians within the system. So we follow says the pathway for career changers from outside the system has a tight gate to switch from business, tech, military, et cetera, to an MD is a years long process, likely with a major paycheck hit, at least in the short term.

So where does disruption disruptive innovation come from in the healthcare space?

[00:48:37] Arlen: Both. So the answer is both. Unfortunately the two major players in the sick care innovation pipeline for too long have been ignored. The doctor and the patient, and it's all about these techies or these med tech people or biomedical engineers or AI data scientists or Prime or Amazon or you name it it's these retail medicine things are all of a sudden informing disruptive unquote innovation.

The fact, my view, You need both. You need market procedures. You need problem solvers. And again, sick care cannot be fixed from inside. In my opinion. I don't think any industry can, that's why you're seeing all these people coming from outside. This is not new. Telemedicine did not happen. The technology of telemedicine did not happen because some genius doctor created it.

It happened from the aerospace and the Moonshot program, NASA. And it's very typical, GPS informing Artificial intelligence did not come from some brilliant doctor. It came from the Navy to identify Russian submarines. And there's many of these stories where outside in informed sick care. I would make the argument that if you look at the history of medicine, there's maybe five major innovations in medicine.

One of 'em was clean water, had nothing to do with technology. It has to do with the cholera epidemic in London. James Snow, maybe Ether anesthesia. Maybe antibiotics or vaccines. There's not a lot of like game changing, oh my God inventions that were created or discovered by doctors. So if you put this thing in perspective, it has to be both.

And it's one of the missions of the society to inform MedTech, biopharma, digital health, et cetera, to engage physicians early on. If anything else, to prevent a failed product 95% of new products fail. So we're here to get in the game now. You can't just raise your hand and say, I want to get in the game.

Like I said, this whole previous conversation, you have to be prepared and have the competencies to add immediate value, time to value. You can't just show up and say, I can help you, and maybe it'll do something in a year and a half. It doesn't work that way. You're being graded on your time to value and how good are you at doing that in solving my problem?

Outstanding. So we're coming up, I think right here at the end, and I do have one, I think just final question for you. It's just really introspective and you have had just a storied career, and so many people have been impacted by your work. And whenever you want to hang it up, like Tom Brady retiring from football.

[00:51:51] Jared: What do you really hope that the impact that you had on people and business and just all the industries that you've worked in, what do you feel like your impact, hope with that?

[00:51:59] Arlen: So there's a famous story. Sir William Osler for those in the fam in the tribe, understand. He was a very famous medical educator, and in fact was one of the fathers of contemporary medical education, as lacking as it is.

And he was a very well respected, he was basically the father of modern medicine. He became the Regis professor at Oxford. He was a big deal. Wrote a lot of stuff. Everybody went to medical school, knew about it. He was like, this humanist. And he wrote a lot of stuff. So they asked him the same question, so if you what do you want on your tombstone.

And he said, teacher. And that is what is on his tombstone. So I am, I'm born and bred to be a teacher if and I can't teach people anything like Socrates, who actually originally said that. So my legacy is about just getting people to think and if that thinking results in change, great. I've done my job.

I've done a lot of stuff and I've thought about this a lot. So my legacy is teaching.

[00:53:04] Jared: That's awesome. I think people have learned a lot already just on this call as well. So yeah, on that note, thank you so much for, taking the time out. I know everyone already in the comments and said so many great things, but we really appreciate learning from you today, Dr. Meyers.

[00:53:17] Arlen: Yeah, it's my fun. It's my pleasure and it's why I do this. It's just fun for me and the trip's my trigger and make it personal, but don't take it personal.

[00:53:24] Ty: You're an inspiration to us and we thank you so thanks. Take care.