Dr. Parekh interviewed by Orthopreneur Magazine about the business of orthopedics
Think Like an Innovator: Tips from a Surgeon Entrepreneur
Selene G. Parekh, M.D., partner at the North Carolina Orthopaedic Clinic and Associate Professor of Orthopaedic Surgery at Duke University, saw the value in educating fellow surgeons, residents and medical students on the business aspects of medicine to improve healthcare.
Dr. Parekh took a year off from medical school to earn his MBA, during which time he learned to expand his approach and seek innovative solutions. He completed a Healthcare Entrepreneurship Fellowship, learning how ideas progressed from concepts to marketing and product launches.
During his residency, Dr. Parekh saw that his co-residents, as well as physicians and medical students, did not understand the language of business. This led him to develop the “Business of Orthopaedics” conference, which addressed practice management, product development and entrepreneurship, as well as personal financial management, leadership and negotiations.
After several years, Parekh found that it became difficult for industry to support the meeting because it was not a traditional medical meeting format, and so he transitioned materials from the “Business of Orthopaedics” into the residency-training program at UNC. He has continued to educate the residents in business at Duke on a monthly or every–other–month basis.
In his academic pursuits and throughout his career, Parekh learned that he could directly impact patient outcomes through product development and efficiency. He is currently working on the implementation of new technologies into his surgeries to both improve care and educate his peers and students.
Dr. Parekh spoke to ORTHOPRENEUR®, sharing what he has learned about innovation and the interdependency of medicine and business.
ORTHOPRENEUR: How do you apply your business education into your career as an orthopaedic surgeon? What are some innovative products you’re currently working on?
Parekh: Aside from becoming an orthopaedic surgeon, getting an MBA was the next best thing I did. It really trains you to think out of the box. As a surgeon, when you’re in the operating room and you’re frustrated with a certain instrument or technique, you’re constantly thinking about new ways of doing things and new ideas for products, implants or instrumentation.
I’ve gotten involved with product development with multiple companies in the orthopaedic world. In my everyday practice, I am constantly thinking about clinic efficiency, OR efficiency and looking for ways to run my practice more efficiently. I think about patient satisfaction. I think about wait times and flows. These are concepts from organizational management in business school that I’m applying to my everyday life.
I’ve been involved with the development of foot and ankle plates and screws. I’ve been involved with a plate that is made by OrthoHelix (now Tornier), and I am helping to develop plating technologies for some other companies, as well. I’m also currently involved with the development of a total ankle replacement plate.
I’ve also started to be involved with IT and software companies for product development, and thinking about ways to use technology as a platform to improve care for patients. I’ve been an early adopter for Google Glass and thinking out of the box for ways to integrate Google Glass into OR efficiencies and have the ability to broadcast surgeries to educate medical students, residents and other surgeons around the world.
I think that wearable technologies is one of the biggest things revolutionizing medicine and setting the tone for the next 50 to 100 years. Google Glass is only one of those devices. Others like smart clothing, smart necklaces and smart watches will monitor different biologic functions to allow us, as physicians, to take better care of patients. We’re only on the tip of the iceberg with some of these smart watches on the market. The smart clothing and smart clock could look at body temperature, heart rate, electrocardiogram (EKG) monitoring and pressure point monitoring. I think that this is really going to change how we manage patients. It will allow patients to become more responsible for their own healthcare and allow us to remotely monitor patients more effectively. It’s coming to reality
ORTHOPRENEUR: How do you overcome the challenges involved with developing products?
Parekh: I think the biggest challenge for orthopaedic surgeons is that we all have ideas; we just don’t necessarily know how to pitch and market that idea to see that it’s commercialized. It’s a learning curve.
When you have an idea, the first thing you need to do before you do anything else is sketch something. You need to have a good thought process on the product: how it would work and how it could be implanted, if it’s an implantable product. Then, try to protect your intellectual property. That can be as simple as drawing it on paper, dating it and getting it notarized. Secondly, formally get through the patent application process. This is really dependent on the surgeon. Once you decide which way you want to go, the next step is to decide whether you want to do this on your own or want to go to industry to see if an industry partner can help develop this idea for you. More often than not, a lot of surgeons go to industry. As you approach industry, a Nondisclosure Agreement is critical. You need to be able to protect your idea so that once it’s disclosed, the industry partner does not develop the product idea without your involvement.
The next process after that is deciding on an agreement, whether that be royalties, licensing or hourly consulting rates. Then, developing the product and being part of the product development team, which usually includes surgeons, engineers and marketing people. The sales team takes over once the product is developed. It’s a process. I think most surgeons have ideas, but many don’t know what to do with those ideas and that’s kind of the big picture way to do it.
ORTHOPRENEUR: Please tell us more about the lessons you’ve learned throughout your career.
Parekh: First and foremost, medicine is now business. I keep learning that every day that I’m in practice. You’re constantly being forced to think about dollars and cents and how it affects patients, your practice and hospitals. That’s something that ten or 15 years ago, surgeons didn’t need to think about.
Second, you always want to think outside of your usual zones and look for ways to continue to be better. If I’m getting frustrated, even with a surgery, with my EMR or even with the way that communication happens between patients or physicians and patients, then I’m probably not the only one who has that frustration. For me, business school taught me that where I see the most frustration is where there is the most opportunity for innovation.
Innovation for me has become an integral part of both my personal life and academic career. Medical students, in general, aren’t thought to be innovators. I think that if you train yourself to continue to think in innovative ways and think of ways to do things in a better way, you can train yourself to become an innovator.
ORTHOPRENEUR: What do you mean by train yourself to think innovatively? What recommendations do you have for surgeons on how to think more creatively?
Parekh: In medical school, we’re taught to memorize a lot of the information and we take things as fact. No one is necessarily teaching you along the way to challenge ideas, to think outside of the box and think about why you’re doing things the way you are. The perfect time to do that is during those times when you’re the most frustrated. That’s usually the place where innovation can occur.
You want to start asking yourself, “Am I just going to keep doing things the way I always do them or are there ways that I can do things more efficiently?” Train yourself to start thinking outside of the norm. Not all out of the box ideas are worth pursuing, but if you start training yourself to think that way, then it becomes second nature. That’s when the creativity comes out.
ORTHOPRENEUR: What advice do you have for entrepreneurial-minded surgeons like yourself, who are trying to create new technologies and bring their ideas to life?
Parekh: The first thing is, never get discouraged. If you are an innovator, you’re usually the first to do things. In medicine, the gut reaction to new things is, “Oh, you can’t do that,” or “No, we’re worried about privacy or cost issues.”
For innovators and entrepreneurs in medicine: you can’t get discouraged. You have to keep working at it, keep innovating and look for ways to work around current limitations.
I’ve implemented into my practice what Google calls Explorers of Google Glass. But, there were a lot of concerns from the institution about HIPPA issues.
I was one of the first to force institutions to think about mobile technologies outside of cell phones, and ways that we can change old policies with the new policies that make mobile technologies an integral part of healthcare delivery. You have to think about policies, regulations and obviously the innovation, and you can’t get discouraged. You just have to push forward.
The other thing I recommend for all entrepreneurs is to look outside of yourself and your immediate environment for expertise to help you. Whether that is expertise in engineering, software or venture capital, don’t be afraid to reach out and seek experts to help you innovate. Just like we learn in business school, you need to have a team to really work together to look for solutions. The same thing happens for the surgeon entrepreneur. At some point, you have to have smart minds working with you to help you get where you want to be. The team approach is important.
Selene G. Parekh, M.D., MBA has been a partner at the North Carolina Orthopaedic Clinic and Associate Professor of Orthopaedic Surgery at Duke University since 2009. Previously, he was a surgeon at the University of North Carolina, where he served as the foot and ankle consultant to the athletic department and taught medical students and residents. He received his medical degree and MBA from Boston University and completed his residency and a one-year Healthcare Entrepreneurship Fellowship at the University of Pennsylvania. Dr. Parekh is dedicated to teaching medical students the importance of business in healthcare and diving into new technologies to improve patient outcomes.