Innovation vs. Entrepreneurship in Academic Medicine: It's Not "Either Or," It's "And And And"!

In our quest to make innovation and entrepreneurship a natural and expected academic behavior to accelerate great ideas toward patient impact, we need to talk about barriers that make it difficult for innovators in university-based Academic Medical Centers (AMCs) to engage. I have received feedback both internally and externally (including some outright flack) regarding combining the terms.

A good bit of this has come from traditionalists inside the AMC. For example, many academic scientists feel they are innovating by virtue of making fundamental discoveries, but think of this activity as completely separate and distinct from entrepreneurship. Indeed, they do not feel compelled to think about the transition of this new knowledge into anything other than an outward-facing communication to the world of science (read: publication) or perhaps another grant. Others feel they are producing new knowledge that is innovative and inherently distributive (can be provided broadly to others in many forms to make a difference) but feel they are not entrepreneurs because they have not commercialized that knowledge as a product. In essence, within the university setting, “entrepreneurship” is often separated from “innovation” and many flat out disdain the association of the two.  In fact….Michigan Medicine recently updated its mission statement.  Some of us tried to influence the Research aspect of this mission statement by suggesting that our visionary research will be empowered by creating a culture of high-risk innovators with an entrepreneurial spirit that transforms biomedical discoveries into products and policies with real-world impact. Sounds exciting and something that the public and industry would resonate with…right?  Uh….well apparently this gave some of the committee heartburn and was deemed too much too fast because some thought our basic scientists would not identify with it.  What a bummer! 

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Even from outside the university, I have heard from traditionalists in industry (including the startup world and large biotech) who reinforce a lot of this as they, too, see a definitive difference between “innovation” and “entrepreneurship” and suggest that innovators should stay in their own swim lane and do what they do best and allow entrepreneurs to do the same. In short, this reinforces the above notion that the two are necessarily separate, making many innovators within the AMC feel uncomfortable identifying as entrepreneurs. I think this is shortsighted, propagates stereotypes, and produces unnecessary, and even harmful, cultural barriers, especially within the basic sciences.

To be certain, there are differences between hardcore innovators and hardcore entrepreneurs and by and large, there is merit to the argument that those who can do both well are really, really rare (like the Golden Tabby Tiger and Javan Rhino, but not as rare as unicorns).  After all, there can be a difference between great chefs and great restaurateurs, actors and directors, musicians and producers, etc.  There are a few that are great at both: Emeril Lagasse is both a renowned chef and restaurateur (I’ve eaten at all of his New Orleans restaurants – 5 stars), Clint Eastwood is both a great actor and director (I almost named my son Dirty Harry).

In fact, I would submit that if you are a successful basic medical scientist, clinician scientist, medical educator or other researcher motivated by the importance of fundamental discovery, developing new scientific techniques or innovative ways to educate, you are in most cases already engaged in entrepreneurial behaviors! You want your new discovery, newly developed technique, new curriculum, new book, new policy, etc., adopted by others. You have journals, grants, scientific and educational venues, etc., to help you propagate and share your new discovery and message. Some of you are even monetizing these discoveries in the form of promotion and tenure (getting pay raises and job security), notoriety, and awards (travel and presentations), and in getting more grants and resources to let you do more of what you love.

Well, that’s exactly what entrepreneurs want and do as well. Entrepreneurs want discoveries and inventions to be propagated to the masses, in this case through commercial use.

In the AMC, if innovation is like your mom who says to you when your were a kid, “Dream my child, dream big, change the world with your big ideas,” then entrepreneurship is like your dad three years after you have graduated from college and says, “Hey, kid, you can’t just live in the basement all of your life – use those ideas and do something, will ya?” Entrepreneurship is the transition of your innovation into something that propagates and brings continued, sustained value.  

In the end, innovation needs entrepreneurship.

Innovation that does not couple itself with entrepreneurship (at least in spirit) doesn’t make a lot of sense. It would be a practice that is divorced from reality. It would be like making the discovery and then saying, “I am not going to publish or present it.” It’s the same for those developing innovative teaching techniques, policies, or clinical care processes. Truth be told, these discoveries and techniques are products! Your research, discoveries and innovations are platforms for building your professional credibility that will be leveraged for bigger things. There is really no difference in the world of industry where entrepreneurs succeed or fail based on the products they are commercializing.  So in essence, Promotion and Tenure (see previous blogs) is perhaps one of the most entrepreneurial concepts in academia.

So the bottom line is this: You don’t have to call yourself an entrepreneur – you can just say that you have the entrepreneurial spirit (it will be our little secret). I just hope that you take a moment every now and then to think about how you could accelerate the impact of your new research discovery by thinking of it in terms of how it could impact patients sooner as a potential product.  

Hardcore entrepreneurs outside of the AMC would also do well to cede a little ground regarding the definitions of innovation and entrepreneurship. I think the best entrepreneurs are those who understand the process of innovation and even though they are many times not responsible for the idea itself, they encourage and create a culture that promotes continued innovation. Such understanding is essential in making innovation and entrepreneurship a natural and expected academic behavior and a force multiplier for improving human health.

As you may recall in one of my previous blogs…the field of emergency medicine and critical care (my tribe) has little to offer to save your life compared to 30 years ago.  MCIRCC is taking a new approach to change this by developing a culture of high-risk, high-reward innovation that is linked to entrepreneurship and commercialization.  To paraphrase Einstein….the definition of insanity is doing the same thing over and over and expecting a different results!  Let’s try something new shall we!

Kate Murphy