The new physician triple threat roles, holes and goals

COVID, technology, and sick care corporatization, consolidation and unfettered capitalism have driven the emergence of the new triple threat doctor as clinician-technologist-entrepreneur.

Medical schools and graduate education residency programs are not producing them, so talent does what is always does. It goes where it is treated best.

There are seven generations in the work force pipeline:

1. Greatest Generation: Born 1901-1924
2. Silent Generation: Born 1925-1945
3. Baby Boomers: Born 1946-1964
4. Generation X: Born 1965-1980
5. Millennials: Born 1981-1996
6. Generation Z: Born 1997-2012
7. Generation Alpha: Born 2013-2025

The average age of a medical student is 24.

Each generation has its own persona, characteristics, and mindset.

Here is the doctor persona 2025:

1. They will be chosen differently
2. They will be educated and trained differently
3. They will be measured more intensely than they are now particularly for competencies
4. They will be employed by different employers. A hospital or health system employed about 25% of U.S. physicians in 2012. That percentage nearly doubled to 44% in 2018.
5. They will be paid differently
6. They will be more data driven
7. They will be disintermediated for some jobs and substituted for some by others
8. They will work in different sick care and health care ecosystems
9. They will evolve from being knowledge technicians to strategic thinkers
10. More will have an entrepreneurial mindset
11. They will demand more personalized solutions for lifelong learning, clinical decision support and dissemination and implementation of new technologies
12. In some instances, they will become commoditized and therefore challenged to differentiate themselves
13. They will require the knowledge, skills, abilities and competencies to win the 4th industrial revolution and they will use new adult learning technologies to learn and practice them
14. They will work in interprofessional teams, not as individuals, taking care of patients and their care community
15. They will work under the coordination of a global cybernervous system
16. Primary care will be unbundled
17. They will work as part of the gig economy
18. They will be more data literate
19. They will have shorter clinical careers
20. They will be working more in non-clinical careers
21. The physician workforce will include more women who will have different practice patterns and productivity
22. Physicians over 65 will delay retirement
23. The physician experience will eclipse the focus on the patient experience
24. The innovating economy will take center stage and leave a gap in geriatrics
25. Community health workers will be more important stakeholders as part of the patient team as social determinants overwhelm clinicians
26. Medical societies and medical meetings will become less relevant and virtualized
27. They will work in jobs that have not yet been created.
28. The pace of change and the innovation imperative will cause more doctors to shift to the left of the technology adoption curve.
29. Most doctors will continue to "buy" emotionally and justify rationally.
30. Doctors will struggle to learn and unlearn the hidden curriculum.
31. They will be more risk averse, less entrepreneurial and burdened with debt
32. The changing role of the academic physician as AMCs change their business models.
33. How would Medicare for All change the physician workforce?

34. Their expertise will be questioned

35. They will want you to educate and engage them differently.

36. They hate email

37. They will continue to do side hustles after they graduate.

38. Some women in America have publicly proclaimed that they are distancing themselves from men, abstaining from sex or going “boy sober.” Nearly 70 percent of breakups of heterosexual marriages in the United States are initiated by the wife.

39. Many doctors now get to medical school by taking the road less traveled and have more diverse backgrounds and life experiences than previous generations.

40. They will earn less inflation and tax adjusted income than previous generations and have more financial insecurity

Every society in the world has the same problem: Addressing the increasing demand for care with limited resources. Here are the drivers of international physician entrepreneurship.

They also want different roles, holes, and goals other than directly taking care of patients.

ROLES

Roles have to do with which position you will play on the startup, scaleup or grown up team or during your career. Is it a problem seeker, a problem solver, a money finder, a business builder, a customer finder, a scorekeeper, a legal eagle, a people connector or some other role that your title may or may not completely convey? If you are considering being an advisor e.g. can you deliver these M's?

The pathway to participation in biomedical and clinical innovation is different depending on where you are where you are and where you want to go and depends on whether you approach it from a business, clinical or technology perspective. Unfortunately, many think doctors are terrible business people, doctors think business people are terrible doctors and technologists are from Venus and doctors are from Mars.

HOLES

Holes have to do with which problems you want to solve not just in your organization, but where you have personal knowledge, skills, attitude and competency gaps as well. What are the expectations?

GOALS

Goals have to do with your personal and organizational key performance indicators, objectives and key results.

The new triple threats are replacing or supplementing their clinical roles holes, and goals with non-clinical ones. They are:

Founders: Startup entrepreneurs pursuing opportunities to get their ideas to patients.

Funders: VCs, angel investors and other entrepreneurial finance executives

Finders: Those looking for non-clinical jobs or working as intermediaries between job seekers and potential clients

Fixers: Clinical champion intrapreneurs or those working to fix the US sick, sick care system of systems from the outside

The seven generations of the sick care pipeline are deciding whether to persevere, pivot, or punt. The pipeline is leaking.

.More than 11,200 Americans will turn 65 every day — or over 4.1 million each year — from 2024 through 2027, according to estimates from the Retirement Income Institute at the Alliance for Lifetime Income.

We can't wait that long. Our next chance for change is Tuesday, November 3, 2026.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack