Impressions from São Paulo

I recently had the privilege to participate in the First Medical Entrepreneurship conference in São Paulo, Brazil (thanks to my friend Filipe Sousa for being my host).

The timing and attendance at the meeting was reflective of growing interest in biomedical entrepreneurship around the world and was attend by a diverse group, including health professionals at all levels of training, practitioners, digital health entrepreneurs, representatives of hospitals systems and investors. Here are some impressions:

1. I was approached several times by medical students and trainees who were already disenchanted with their career choice and looking for answers and advice.

2. While there is political upheaval, rising debt and sluggish growth of the Brazilian economy, many in attendance were enthusiastic about the opportunities to get Brazilian sick care and the economy back on track.

3. Brazil has the second largest private health insured population in the world.

4. Most doctors work for either the public hospitals, private clinics or a combination of both. There is a long history of physician entrepreneurship, particularly in medical practice entrepreneurship and, recently, digital health.

5. Brazil has the second largest number of medical schools in the world, behind India. Some are private that are deemed to be of marginal quality.

6. Those that can send their kids to private elementary schools so they can be competitive on entrance exams to public medical schools. Student debt does not seem to be much of an issue, certainly not as large as it is the US.

7. Like all global health systems, rising costs and the present business model is unsustainable.

8. Ambulatory surgical centers as partnerships with private doctors are seen as a way to potentially reduce the burden of surgical costs (40% of the tab in Brazil) while at the same time generating revenue for owners

9. Most felt it is much too hard to create a business in Brazil compared to other countries in the world. Red tape and corruption seems to be pervasive, and, as you would expect, the smart money has figured out how to do the end around.

10. Those in attendance seemed to have a favorable impression of entrepreneurs and entrepreneurship and were eager to get the education, resources, networks, mentors and work experience to build portfolio careers or add value as a practicing doctor.

I came away optimistic about the future of physician entrepreneurship, not just in Brazil, but in Latin America as well. Sure, the bank employees were on strike and I agreed, like any guest, that I wouldn't talk about Brazilian politicians if my hosts did not talk about American ones. We both followed the rules and came away with more mutual understanding that revolved around one basic commonality. We both had championship football/futbol teams. Bom dia.