Finding Your Intrapreneur

I’m not a big fan of buzz words, but when I ran across this one--intrapreneur—I was intrigued.  As organizations have grown larger, intrapreneurs—persons within a company who promote innovation within the organization—have become the new movers and shakers, and company executives are on the hunt for this new type of employee, for people who can lead on important internal issues and, where possible, effect internal change that’s positive and, in many cases, ground-breaking.
In my work with new docs, especially those coming right out of residency or fellowship, I tend to see three distinct types.  There’s the new physician that just wants to practice medicine, and not be bothered by operational issues.  There’s the new doc that is only interested in those operational matters that have a direct impact on his or her bottom line.  Finally, and more rarely, there’s the intrapreueur, the one that looks at a bigger picture of healthcare and is looking analytically at their practice, the group’s practice, and the immediate healthcare environment, finding ways to make very productive changes that benefit their practice, group, patients, and hospital.
As the business of medicine grows more complex, and undergoes rapid change, it’s almost impossible for one physician to cover all the bases.  I have always suggested to my clients that they look at their practices as multi-faceted entities, and that they break down the most important pieces—contracting, HR, patient satisfaction, hospital integration, etc.—into silos, assigning responsibility for each.  Spread the responsibilities, hopefully matching each silo to the interests of the physician.  This helps create strong group leaders.   Even the smallest groups should bifurcate responsibilities and set a schedule for reporting meetings as well as a mechanism to deal with urgent matters. 
Of course, having a good administrator to help coordinate all of this can be crucial (and should be part of any job description for this position).
What typically happens is the intrapreneurs rise to the occasion.  They search for a better way to do things, and do not look at this responsibility as just non-reimbursable burden. These are the folks that will be leaders in your group practice in the years ahead.  They are the guys that read the literature, keep up with what’s going on in medicine, and understand the concepts of “Best Practice” as they apply to medical practices. Typically, they often become leaders within their hospitals or surgery centers as well.
I also suggest to my clients that they amend the interview process when hiring new docs.   They need to ask questions designed to help identify the intrapreneurs, as well as those new hires who just want to come to work.  For those who want to get involved, groups need to find a way to reward them for their extra effort. 
Consideration might be made to add a certain level of operational responsibility into the wording of employment agreements—maybe even for all new hires. Group culture should be amended to require all new hires to understand that they are expected to be integrated both clinically and operationally, with tasks in the latter category designed to get them involved in the operations and business.  Start small, expand as the talents and interests of the new hire begins to surface.  You may have more intrapreneurs in your practice than you know. –Tom Ellis