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We sit down with Carrie Atcheson, a board-certified anesthesiologist and co-founder of Business Mindset MD, to explore the transformative potential of physician-led innovation in health care. We delve into how the acquisition of physician practices and surgery centers by major corporations like UnitedHealth Group is reshaping patient care, and the role of physician leadership in driving this change. Carrie shares insights on balancing profitability with high-value care, integrating health care services, and the opportunities for simplifying patient experiences through IT solutions. We also discuss the growing importance of home-based primary care and the challenges of engaging physicians in meaningful leadership roles.

Carrie Atcheson is a board-certified anesthesiologist and co-founder of Business Mindset MD.

She discusses the KevinMD article, “How do we get a critical mass of women physician innovators?”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Carrie Atcheson. She’s an anesthesiologist and co-founder of Business Mindset MD. Today’s KevinMD article is “How do we get a critical mass of women physician innovators?” Carrie, welcome to the show.

Carrie Atcheson: Thank you so much, Kevin. I appreciate the opportunity.

Kevin Pho: So let’s start by briefly sharing your story and journey.

Carrie Atcheson: Sure thing. So as you said, I’m an anesthesiologist. I’m currently at the University of Alabama at Birmingham, and I’m a working wife and mom, and just in my heart a gender equity advocate.

If you knew one thing about me today, you’d know that I got to spend the morning advocating for female physicians at the state level. I’m here in Montgomery, Alabama today, which is our state capital. And I also just had, I was sharing a little bit with you before we started, I just had the opportunity to meet the Reverend Jesse Jackson, because he was here today having celebrated Juneteenth here in Montgomery.

And if anybody ever wants to come for sort of a historical event that you will never forget, come on down here to Alabama, in Montgomery, for the Juneteenth celebration. Just a beautiful mix of history and culture, and the Equal Justice Initiative really does it up right here.

But he said something that I think kind of pertains to our conversation today. One of the other folks who was attending the celebration said to him, you know, I’ve been doing this work for 50 years. And he said, well, what are you doing today? And just that question of, like, OK, so things are done, you’ve got things planned, but what are you doing today? I don’t know, it just was really powerful for me. So that’s what I’d share with you today.

Kevin Pho: What about your advocacy efforts? Tell me some of the challenges that you’re advocating to overcome as it relates to women physicians.

Carrie Atcheson: That’s such a great question. So here in Alabama we are about 25 percent of physicians. And so we’re facing a recruitment challenge, getting physicians to come and be physicians here, serve here. And we’re facing an additional challenge of recruiting physicians to rural areas.

So things that we look at are, how to make conditions optimal for physicians to practice in rural areas, how to expand so that our rural hospitals can survive and pay their physicians, and also how to support especially early and mid-career physicians as they are trying to launch their careers here. And so those are some of the biggest challenges that we face.

And then there’s the additional layer of legislative challenges. We were surprised, not surprised, to have Senate Bill 129 passed this year, that essentially made it against state policy for a state-run institution to have a diversity, equity, and inclusion program. And so we are figuring out how to do the work of creating great workplaces and great teams sort of without the usual tools. And so that’s part of our challenge.

Kevin Pho: How did you get involved with physician advocacy? And maybe for those physicians who may be listening to you today, how can they get involved?

Carrie Atcheson: Oh yeah, absolutely. So I think that getting involved with your state medical association or your state specialty board is a fantastic place to start. I’ve been involved with organizations in every state I’ve been in, from New York to Oregon to here, and I have gotten an incredible amount of collaboration, mentorship, opportunities, and just connection to what’s going on in my community from that involvement. And so that’s sort of my entree into advocacy work, and it’s where I’m continuing to put my efforts.

Kevin Pho: All right. Let’s talk about your KevinMD article, “How do we get a critical mass of women physician innovators?” For those that didn’t get a chance to read your article, tell us what it’s about.

Carrie Atcheson: Absolutely. So I’m kind of a business nerd, so I kind of watch Silicon Valley and Wall Street with similar interest and analysis to the way people sort of watch gowns at the Met Gala, I think.

So when Fortune magazine came out with a piece about the vertical integration in UnitedHealthcare and in CVS and the other companies that are sort of creating their own chain of insurance, clinics, pharmacies, and ancillary services, and when they featured the two female CEOs, I was really fascinated, and really wanted to ask that question of, what does this mean for us as physicians?

And I think if we’re listening really carefully, it means opportunity for us. I talked a little bit in the article about health IT, and I just learned yesterday that UAB has created a master of science in artificial intelligence degree, one of the first in the country. And so I’m really excited about the physician scientists that are going to be coming out of these programs. There are problems to solve, and we are really good problem solvers.

Kevin Pho: You mentioned at the beginning the phenomenon of vertical integration, like you have these CVSs, pharmaceutical companies, you have health insurance companies, they’re getting into the clinical space. So you mentioned that there are opportunities for physicians. What are some of those opportunities?

Carrie Atcheson: Oh, so I really think that there is always an opportunity for physicians to build something. So I think that we see the problems and the opportunities not only in clinical situations, but also in business situations and in operations situations. We see the problems very clearly. And so I think if we can start thinking clearly about the solutions, then we can create things that solve some of these problems.

And what was really interesting to me is that UnitedHealthcare and CVS are finding those physicians who are creating private practices, micro practices, local practices that are solving those problems, that are creating bridge programs for assisted living, they’re creating population specific clinics that are sort of concentrated on serving one particular population, for example people with diabetes. And they’re buying them or funding them. And so they’re seeing us creating those solutions.

Kevin Pho: So can you give us an example of where a physician perhaps got involved with one of these entities that’s not a traditional medical practice? It could be hypothetical or even a real world example or story where they moved the needle.

Carrie Atcheson: Yeah, absolutely. So I actually think of a colleague of mine, Dr. Britney Anderson. So she is a family physician who practices here in Alabama, in Demopolis, and she started her own direct primary care in the town near where she grew up.

And she is sort of deeply serving this community with wraparound services they don’t always get access to, and also kind of trying to create not only a service, or the person to call when you need a physical or you need to go get your mammogram, but it’s also a person who helps you sort of create wellness. So that opportunity to create community wellness I think is there, and it’s there for each of us in a really unique way that only we can do based on who we are and where we came from.

Kevin Pho: I talk to a lot of physicians, as you could imagine, on this podcast, and they write on KevinMD, and there is a lot of, to be frank, complaining, certainly about the state of medicine today. So tell us why it’s important for these physicians to engage in some of these innovative ideas, to be outside the box and try to solve these problems directly, that they may not necessarily be exposed to in traditional medical training.

Carrie Atcheson: Yeah, I think that first of all, I totally get it. There’s something about us as physicians in our medical training that, it’s like, you know, sharks can’t breathe if they’re not moving, like we can’t breathe if we’re complaining.

But taking that complaining and operationalizing it, making it into data, and then using it productively to solve a problem, that’s the other side of the coin of complaining, is you taking that problem you’re complaining about and figuring out how to solve it.

And I think that the reason that we need to do that as physicians is not just because it makes the world a better place, that is very true and a laudable goal, but it’s also because it makes us happier. Like, if we are solving a problem, if we are sort of fulfilling something that only we can do, it gives us joy, it gives us passion, gets us out of bed in the morning. And so I think there’s an altruistic reason, and we’re all sort of at heart altruists coming into this field, but there’s also a self-based reason, where it makes your days better when you’re solving problems.

Kevin Pho: So you have that perspective of a business mindset, you’re literally the co-founder of a site called Business Mindset MD. Not every physician sees things through that lens, however. So there’s always that perception that physicians are terrible at business. And how can we be involved from a business aspect to take advantage of some of these opportunities that you mentioned?

Carrie Atcheson: It’s such a great question. And I think the answer is, we really live in the internet age, and we also live in the age where most specialized information is a phone call, a direct message, or an internet search away.

So if you see a problem in your community that you feel like needs fixing, if you want to start a business, the Small Business Administration is out there for you, your state medical society is out there for you, there’s dozens of physicians who already own practices who would love to talk to you about their stories and their travails. And there are groups like our group, Business Mindset MD, who offer that kind of education.

So we’re doing a panel next month on choosing EMRs, so that people who are going to be making that decision can learn from people who already made that decision. So that expertise exists within our community, and you kind of have to reach out for it, to the places that already exist.

Kevin Pho: What about your colleagues? Do you find that your colleagues are interested as you are in terms of these business aspects, or do you find that some physicians may say, I just want to take care of patients and I just want to leave the business to someone else, and that’s not something that I really want to be bothered with? What’s the environment like among the physicians that you interact with?

Carrie Atcheson: Yeah, I feel like, yes, absolutely there’s always going to be that diversity of perspectives, and honestly, we need each other, right?

So we need people who are very service-minded and who want to come to work and take care of patients, and we need people who are very business-minded and want to have meetings and solve problems. And in my industry, we need people who want to run our preop clinic, who want to wrestle these interesting problems that complex patients have.

So I think my answer is the team, right? Like, we all have different perspectives, and if we can all figure out how to get everybody’s perspective functioning in the right way, so that they can be a good part of the team, then we’re all winning.

Kevin Pho: So if physicians are interested in getting into that physician innovator space, where can they start getting that information? You mentioned podcasts and the internet. Do they need to get an MBA degree? So tell us some first steps that they could start with if they want to get into that space.

Carrie Atcheson: I love this question, because I think as physicians we tend so deeply to overtrain ourselves. So you absolutely can get an MBA, and an MBA is going to give you not only some of the know-how that you’re going to need, but it’s going to give you a network that you can lean back on. And I think that’s one of the biggest assets of any kind of program that you’re going to do, is it’s going to give you a network.

So I think if you’re evaluating a program, whether it’s an MBA, a master of public health and health policy and administration, which is what I did, an MPA, master of policy and administration or public administration, or some other graduate degree, or any sort of private program like Business Mindset MD or another coaching program, you want to also evaluate what kind of network it’s going to give you, what kind of support it’s going to give you going forward. Because the people who you’re going to encounter in that program, they’re going to be your colleagues and your mentors going forward. So it’s not just about that year, two years, three years that you’re completing that program, it’s about what kind of network and mentors it’s giving you going forward.

But I think the best place to start is actually free courses. So there’s so many free courses on the internet. I really like Arlan Hamilton’s courses that she does. And for those of you who don’t know, she’s a venture capitalist, is sort of first-generation wealth, she came up with very little and has built a network that’s very inclusive and concentrates on funding businesses of women of color, people of color, and women. And so she teaches some business courses that are on her YouTube channel, and I think that’s a great place to start.

Kevin Pho: You mentioned the importance of the network and how that could be as important as the education itself. So give us an example or a story of how that network helped a particular physician really make a difference in that innovator space. What would that look like in real life?

Carrie Atcheson: Oh, that’s such a good question. I think that I will use a personal story. So my college roommate, we happen to go to medical school together, and we ended up overlapping on the west coast at one point. We’ve always stayed in touch.

And as she had transitioned out of corporate medicine, clinical practice, academics, and was looking to transition into direct primary care, when this was happening we sort of realized, like, oh hey, we are moving through some of the same spaces right now, we’re talking about some of the same things, we’re building our businesses together. And so we ended up as accountability partners.

So we would meet and make sure that we were both doing all the things that we needed to do, we’d brainstorm about what the next thing to do was. And we’re still meeting three years later. So I think that gives you an example of how those networks, you never know how you’re going to use them.

Kevin Pho: We’re talking to Carrie Atcheson. She’s an anesthesiologist and co-founder of Business Mindset MD. Today’s KevinMD article is “How do we get a critical mass of women physician innovators?” Carrie, we’ll end with some of your take-home messages that you want to leave with the KevinMD audience.

Carrie Atcheson: Thank you so much. I’m so glad we all got to talk today, and it’s really nice to meet you.

I think that what I really want more than anything is for people to stay in medicine. And so whatever we have to do, whether it is taking a sabbatical, taking a break, reorganizing our lives, reaching out for support, reaching out to our networks, I hope that we make that reach, I hope that we make that ask. Because people want to help us, they want us to succeed, and our success serves communities, our success makes people healthier. So I really want us to stay in medicine, and whatever we need to do to do that, I hope we can do it.

Kevin Pho: Carrie, thank you so much for sharing your story, perspective, and insight, and thanks again for coming on the show.

Carrie Atcheson: Absolutely, thank you.