Radiologists log lower rates of entrepreneurship compared to other physician specialists

Radiologists have lower rates of entrepreneurship when compared to other physician specialties, a trend that persists across all different types of business, according to an analysis published in JAMA Network Open.

U.S. healthcare, with its high costs and inefficiencies, is ripe for disruption. And who better to launch a new PACS or artificial intelligence software than a radiologist? Wanting to explore this topic, one MD researcher pinpointed all companies founded by Massachusetts physicians between 1960 and 2017.

Out of 34,770 doctors holding a medical license at the end of that range, 6,494 (or 19.2%) started at least one business, noted Wesley Greenblatt, MD, a PhD candidate with the Massachusetts Institute of Technology. And of 2,154 radiologists included in the analysis, 277 (or 12.9%) started their own venture. Using internal medicine as the “neutral” reference point to compare other specialties, radiologists had lower rates of establishing companies across all business types in the analysis.

“I can’t say for certain why radiologists have lower rates of entrepreneurship. It is very likely that multiple factors are at play,” Greenblatt, who is also a staff physician at Boston Children’s and part-time instructor at Harvard Medical School, told Radiology Business by email. “While you might think that radiology’s typically strong remuneration and attractive work-life balance might mean otherwise, the opportunity cost of a radiologist spending time on entrepreneurship is high. Specialties which might be similar on this dimension, such as dermatology and ophthalmology, are much more entrepreneurial,” he added later.

Other reasons for this lower rate could include culture, professional values, peer influence (physicians may be likelier to pursue opening a business if their colleagues are as well), and market opportunities, he added. Radiology notched lower odds of entrepreneurship in domains including clinical practice (odds ratio of 0.598), public interest (0.308), biotechnology (0.475) and medical business (0.449). Across the study’s entire physician sample, 66% of doc startups operated in clinical practice, real estate or practice management. Another 7.4% were in public interest (i.e., advocacy or philanthropy), while 18.5% were labeled as “other business pursuits.”

All told, among Massachusetts physicians who founded at least one company between 1960 and 2017, 4.3% were radiologists. Rads dabbled in a wide variety of interests, according to Greenblatt. Many related to medicine, such as augmented reality to facilitate surgery, interventional radiology catheters, an app to deliver imaging educational materials, and enterprise software for pathology labs. Meanwhile, other rad-led ventures had little to do with the specialty, ranging from advocacy groups for same-sex couples to a yoga studio, selling athletic gear or even operating a bakery.

While some may assume that physician entrepreneurs are mostly young, Greenblatt pegged the average age at about 46. He speculated that this was likely because seasoned docs have more clinical experience, professional contacts, access to capital and managerial experience. One key takeaway from the analysis, he added, is that entrepreneurship can be taught, and radiology leaders should work to cultivate this mindset and culture among their peers.

“Medicine is a fantastic platform to pursue entrepreneurship,” he told Radiology Business. “Physicians have deep expertise which can inform their work, and successful healthcare startups can go on to make a real difference in the lives of our patients. Given that many innovation-driven startups ultimately fail, the relative job security and flexibility of medicine offers a great platform to help manage the risks of experimenting with entrepreneurship,” he added.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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