Editor's Note: Last week we looked at some of the underlying reasons why physician dissatisfaction is the #1 reason that M.D.'s are contemplating leaving medicine or, in some cases, they are actually leaving for other professions. We also looked at some examples where physicians are being taught some of the skills they will need to survive and some examples where physicians have bootstrapped themselves toward success. And, because this subject is so broad and complex, this is the 2nd of a 3 part series.  Enjoy. As always, you can find all my blog posts from 2013 to the present on my website at

The Doctor as an Entrepreneur
In my post from January 24th, "Why Isn't 'Health' Practiced in Healthcare?" I focused on the 3 most common and deleterious character traits of physicians I have noticed over the years. These are:

1. Lack of entrepreneurial spirit;

2. Aversion to conflict and risk; and,

3. Tactical thinking.

This post will drill down on the importance of thinking and acting like an entrepreneur in healthcare today vs. a bureaucrat. By a lack of entrepreneurial spirit I mean simply, that, physicians tend to be more expense oriented than income oriented. This trait can lead to myopia and a focus on preserving scarcity rather than creating abundance; something which is much needed in preserving the autonomy of a medical group.

A Different Business Model
I have been engaged in a consulting relationship with a county medical society in southern Colorado since the fall of 2014; first in strategic planning for 6 months, followed by an in-depth review of one of its professional associations and currently, jumpstarting a charitable foundation to create not only a voice but a personality for this organization in all of the communities in which it serves.

I am getting ahead of myself - let me back up a little and give you a perspective on the state of medical societies in America today. Some have been around since the late 1700's, serving as a professional and unified voice for physicians in legislation, affiliation, credentialing, continuing medical education and they serve as a sounding board for the American Association of Medical Colleges (AAMC) on curriculum matters.

The Decline of Medical Societies in America
Today, with the ever increasing demands placed on physicians and their time, coupled with the "graying" of the baby boomer generation of physicians and the preponderance of the Millennial Generation in the workplace, there has been a sharp decline in membership and interest in medical societies across the US. In my work, I have personally interviewed ( all three generations of physicians in varying locations in the country; i.e., Baby Boomers, Gen X and Gen Y (Millennials) and find that the Gen Y group has a distinctly dubious approach and motivation toward belonging to any association. Unlike their predecessors, they do not feel that they owe it to give back to the profession, nor to leave a legacy, but rather, to not bury themselves in their work to the exclusion of the rest of the things that make life worth living. Actually, I think most of them have a very clear and good perspective on the conundrum of, "Do I work to live or do I live to work?"

The Exception
My client; the El Paso County Medical Society, in Colorado Springs, has a membership base of over 1,000 physicians and 80% market penetration in the largest county in Colorado, populated by 650,000 people. Headed up by a "refugee" alumnus from the American Medical Association (A.M.A.), the CEO, Mike Ware, is forward thinking, passionate, and has the expertise to most likely pull off the reinvention of the new archetype for tomorrow's county medical society. Even better, he has assembled a staff team that feels much the same way he does about doing the best job possible, as a professional association, and, what's more, in alignment with the 2020 strategic plan, he empowers them to go about doing it. He also has an incredible partnership with Frankie Gales, the best COO I have ever worked with, who I am sure could figure out a way to get her entire staff to hell and back without losing anyone in the process.

What's the Secret Sauce?
The magic to bringing all of the success factors together in a synergistic fashion is the synchronicity of the changing demographic in the physician ranks, coupled with a broadened approach to how a medical society could be relevant to today's physician's. Early on in their strategic planning process, I postulated that a county medical society should really be thinking along the lines of becoming a customer service center for doctors if they wanted to avoid irrelevancy in the marketplace. Challenged by my theory, the Board, and the Executive Team took it further beyond what I had envisioned, and came up with a novel approach.

In essence, what they have done is to respond to the Rand Corporation 2013 Study of Physicians in America and what were their most common complaints about being a physician in the 21st Century. From that solid base of information, they have created a suite of consulting services and products that will allow (member) doctors to work at their highest level of licensure, experience, and expertise. It is certainly not as simple as it sounds and, for proprietary reasons, I cannot share the complexity of the metrics that roll-up into a quantifiable plan. I will say this, though; an entrepreneurial spirit, combined with listening to their customers will allow both component medical societies and physicians to survive; an absence of same will mean certain extinction.

The best part of this case history is that it is working! Keep an eye on EPCMS - they are going places, even beyond the confines of Colorado.

Next Week: The Reinvention of a Patient Centered Emergency Department