The New Academic Medical Triple Threat

I go to several medical conferences and Grand Rounds during the week to keep up on latest advances and new thinking in medicine. Inevitably, the moderator will introduce the speaker incanting, "Dr. ____ is the ultimate example of the triple threat. She is an exemplary clinician, an excellent teacher, and has just received multimillion-dollar funding to continue her award winning research".

Unfortunately, the game has changed and we need a new offensive coordinator.

Instead of research, teaching and patient care, we should be recruiting for leadership, entrepreneurship and innovation. But, before we can, the search committees need to understand the differences between one and the other.

Leadership is the process of providing vision, direction and inspiration.

Entrepreneurship is the pursuit of opportunity with scarce, uncontrolled resources with the goal of the creating user defined value through the deployment of innovation.

Innovation is the process of creating something new or using it in a new way that results in at least 10x the customer defined value when compared to the competitive offering.

What the moderator failed to say was that traditional triple threats are a vanishing breed. NIH funding is dropping and science is getting more and more complex and specialized and increasingly un-fundable for those who don't dedicate their careers to it full time. Teaching is an increasingly unfunded mandate and state support is nowhere to be found. Clinicians are the academic cash cows and drive the other 2 wheels.

But, reimbursements are dropping and academic docs are feeling the same pressures to produce as their non-academic colleagues in the community. Just like them, if they don't make the numbers, they are benched.

College or NFL mobile quarterbacks who can audible at the scrimmage line, are a running threat in or out of the pocket and can throw for 300 yards per game are a regular part of Saturday and Sunday afternoons. Academic medicine needs a new playbook as well and people in the skill positions who can execute.

Of course, the other option is to just fire the coach.