Why Most Good Ideas Go Down the Drain

Every doctor I know has a lot of good ideas. Few see the light of day, let alone the color of money. While there is much written about creativity, creating new ideas, and capturing your creativity, whether it be on an Etch-a-Sketch Pad or your iPad, most ideas that come to you in the shower go down the drain.

An idea is something that sticks in your head or piles up in your Evernote file. An invention, discovery, or new process is an idea reduced to practice that may or may not have any user defined value. An innovation is something new or something old done in a new way that creates a user-defined multiple of value when compared to the existing status quo or competitive offering. Solutions looking for a problem is tinkering. Small increments are improvements. Big increments can create entirely new markets.

Moving an idea to an invention, discovery or new process, let alone making it innovative, is a formidable challenge and there are several reasons why it does not happen, either by a person or an organization:

1. It's hard. It's much easier to just leave the status quo alone and deal with the consequences. Bending over is easier and takes less work than racing forward.

2. It takes an entrepreneurial mindset to think in terms of how to pursue an opportunity.

3. It requires, among other things, certain knowledge, skills, and attitudes that are different than technical skills.

4. It requires much more than education. You must have also have motivation, drive, personality traits, networks, mentors, and experiential learning, hopefully under the guidance of those with wisdom and experience.

5. It's not your job. You have enough to worry about trying to make a living coping with the regulators, bureaucrats, politicians, and difficult customers/patients as it is, without having to worry about creating value and transferring it. I mean, after all, how are you supposed to keep up your standard of living while wasting time on the new when you can just work harder on the now? Better to just complain and try to keep your head above water.

6. The switching costs are high when you move from being a technician to an entrepreneur or innovator.

7. The land of innovation is very hostile territory. Cultures are primed to snuff it out. Managers feed on it.

8. Innovating is a constant conflict between control and chaos. There are very few places you can go to get a degree in getting your arms around serendipity.

9. The doers are not admitted to their chosen profession because they are creative. In the case of medicine, they are chosen because they are good at memorizing facts and regurgitating them on standardized tests. They are creative, however, when it comes to gaming the admissions systems and telling the interviewers exactly what they want to hear, so maybe there is a ray of hope.

10. It is very hard to do the right thing when it comes to physician entrepreneurship. The ethics and culture of medicine is very different from the ethics and culture of business. The 2 can be reconciled, but it takes a lot of whispering from our better angels to make it happen.

The fact is, for most people and organizations, coming up with good ideas is an amusing parlor game. What's more, counting the 3 x 5 cards in the suggestion box gives the Chief Innovation Officer something to do until she's replaced by an intelligent machine in the cloud that will put her on the street. But, she's too busy to think about that now.