Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many of us are quite literally surrounded by the four white walls of an exam room most of our lives.

Physicians work hard to treat each patient individually, but this feeling of being trapped in a box is magnified by a growing trend of physicians being employed by large health care organizations, which are managed and governed by non-physician administrators. Some innovation is happening in these organizations, but it is often slow and full of bureaucracy. At the same time, there is a decreasing number of physicians starting a solo practice or joining independent practices where physicians have better chances of implementing innovating ways of providing efficient and cost-effective health care.

And there is another factor at play. Information technology (IT) is rapidly growing in the health care space, so there are increasing possibilities of IT firms managing physicians as well.

Unless physicians decide to equip themselves with certain skill sets, they will continue to find themselves stuck inside the box, working within the constraints set forth by large corporate health care and insurance organizations. Regardless of whether future physicians decide to work in a large health care system or independent practices, they will need to acquire a new set of fundamental skills to succeed in the business of medicine.

Skills needed by medical students and young physicians to set a foundation for success in a new medical landscape, as well as by established physicians who want to pivot to work outside the box in a more innovative environment:

1. Believe in the power of change and evolution. Get out of the comfort zone to make a change you think is important in order to make a difference. Often it is one of the most difficult tasks because of the fear of the unknown and also it is extremely uncomfortable to do things that we are not experts in. However once out of the comfort zone, you’ll discover that staying stuck in the same place is a lot more painful.

2. Believe in the product you’re selling. The concept of marketing yourself, your services and any products you sell, is critical, but only sell things you believe in. The driver for you as a physician to make recommendations to patients should be belief and trust in the product/concept and its ability to make a positive difference in people’s lives. Integrity and honesty should be the sales driver for a physician.

3. Learn how to lead diverse teams. Optimum outcomes are always linked to effective teams, whether small or large. The future of medicine in both the outpatient and inpatient world requires team members from diverse background — both wellness and chronic disease management requires coordination of care by providers from different specialties – dieticians, NPs, PTs, mental health counselors and physicians from different specialties.

4. Stop being a complainer. Doctors, residents, and medical students tend to complain and whine about the things happening around them. But they won’t actually do what it takes to change their lives. Why? Simply because they feel they’ve “invested” so much time, money and effort that they can’t change now. Employed physicians have also lost the autonomy to the corporate world where instead of the physicians, the administrators determine the way to deliver the health care. But will it really get any better if you continue doing something you hate until you retire or drop dead?

5. Understand how to work for yourself. How to start up your own medical practice? Understanding the concept of a business plan, financial modeling, how to acquire funding and legal expertise, understanding compliance with federal and state regulations, understanding the concept of payroll, medical and liability insurances, marketing and networking. Tip: There are many good podcasts about starting up a business. Whether you are starting your own practice or not, it will educate you about how you can optimize your current situation.

6. Explore the concepts of data analytics. Learn how you can use data to help improve processes, patient experience, quality outcomes, value-based practice, leveraging IT in EHR, diagnosis and management of patients and population health.

7. Understand the role of technology in the delivery of health care. Read about trends in artificial intelligence, multiple technology-driven gadgets and tools available to deliver health care with efficiency, even from a remote location. Which tools do you believe are worthy of adoption today?

8. Review the drivers of health care costs. The system is complex, as we all know. It is helpful to have at least a working knowledge of health insurance contracts, direct primary care models other health care models, as well as the lab and pharmaceutical industries. Are there consumer-direct options out there that you can plug in to help your patients save money while also improving their experience?

9. Recognize business risks and how to mitigate them. Physicians are always trained to be risk averse. Fail and fail again in the world of business as you figure out your practice (but still not inpatient evaluation and management!). Know what this feels like, and you won’t fail at the same thing twice. Each “failure” is actually a learning opportunity.

10. Always look for mentors. Physicians tend to have mentors in the field of Medicine. However, it is time now to also find mentors from the world of successful businesses. IT experts, entrepreneurs, business development consultants, marketing and networking professionals, bankers — learn from their stories of success and failure and apply those concepts in the business of medicine to improve your outcomes.

I strongly believe these principles and skills could be and should be taught without sacrificing the clinical training both at the level of medical school and residency training. Introduction of a four-week elective rotation in the 4th year medical school, and similarly, a four-week elective rotation/internship in the business of medicine in the residency training have the potential to make a major impact in the professional lives of young physicians. The return on investment from this training can be anticipated as soon as the physician enters the world of practicing of medicine!

In the meantime, by following these 10 principles, you can begin to think outside the walls of the exam room and make a difference. While it can be a great training ground, do not let working for a large corporate “machine” define your future and the way you practice medicine. Do not be fearful of thinking out of box. You will find a solution to any problem that comes your way if you are passionate about your idea and committed to success.

Danish Siddiqui is an obstetrician-gynecologist.

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