What is an Entrepreneur?

Stanley Feld M.D.,FACP,MACE

“There are various definitions of an “entrepreneur.” An entrepreneur can be defined as a decision-maker whose entire role arises out of his alertness to hitherto unnoticed opportunities.”

“Entrepreneur is sometimes mistakenly equated with “opportunist”. An entrepreneur may be considered one who creates an opportunity rather than merely exploits it. Sometimes the distinction is difficult to make. A role of the entrepreneur is to generate innovation or mobilize resources to address inefficiencies in the marketplace.”

Additionally, an entrepreneur in our knowledge based economy is a person who can see patterns that elude others. He acts on the patterns he visualizes to create opportunities no one thought existed.

Warren Buffet has a long history of success is discovering behavioral or cultural patterns and investing in them. My guess is the discovery of various evolving patterns in society is not made through a process of intensive study of endless data. It is made through a process of considering data and then visualizing the trends and patterns of the present time. Once visualized the entrepreneur has the courage to act and follow through.

There are many examples of entrepreneurs in our society. Some are beneficial to the common good and others take advantage of society.

Rick Scott and Steve Case have taken the lead with in-store clinics. I have predicted that they will sell out long before the in-store clinics fail. CEO’s of hospital systems have been entrepreneurs taking advantage of the holes in the DRG system. They are afraid that the government will finally close the holes in the DRG system.

KKR and HCA have been entrepreneurs taking advantage of the defects in hospital reimbursement. They have visualized that the sum of the parts of the gigantic proprietary hospital system are more valuable than the whole hospital system. They will benefit through divesting hospitals at society’s expense in a free country.

The healthcare insurance industry has been entrepreneurial in taking advantage of the leverage it has in negotiating physician fees and healthcare insurance premiums. They are trying to figure out how to appease the consumer without losing any of their power.

Some physicians have left the traditional healthcare system and opened concierge practices. Some physicians have been entrepreneurs in opening preventive health clinics and spas that have attracted wealthy patients to get fit. Most add no value to the care of patients in my view.

On close inspection none of these entrepreneurial ventures have been undertaken for the public good even though they have discovered patterns in society that lead to successful business undertakings.

How can the healthcare system promote innovation and entrepreneurship to reform the healthcare system for the consumer’s benefit while maintaining freedom of choice for patients and intellectual freedom for physicians. Both freedom of choice for patients and intellectual freedom for pysicians have been severely hampered in the last 35 years. The impingement on these freedoms by restrictions imposed by rules, regulations, and system advantage to secondary stakeholders have led to the mess we are currently encountering.

I believe the mess is a result of the influence various stakeholders’ vested interests have on the political system. I also believe the time has come for the consumer as the most important stakeholder in the healthcare system to demand that the politicians hear them. The politicians need to stop listening to and acting on the vested interests of secondary stakeholders who control the system presently.

This is going to take the will of the people to be informed and express their vested interest. I believe we are getting there and being heard. We still have a couple of problems. It is going to take a Google-like entrepreneur to help the consumer solve the existing problems in the healthcare system.