Here's Why Doctors are the Original Social Activists

Dr. David Mou left the solitary field of neurobiology research for medical school because he wanted to interact directly with patients. But when it came to changing their lives, he saw how much more quickly a startup could impact care.

The need he saw was in making sure mentally ill patients don’t fall through the cracks when they leave the hospital.

“Mental healthcare lags behind in adopting digital technologies,” said Mou, 30, a psychiatry resident who serves as medical director at technology company Valera Health. “There’s a big, dark space here.”

Practicing medicine is a noble calling on its own, but a small subset of physicians like Mou are using the skills they learned in medical school to tackle big problems in healthcare, both in the United States and abroad.

Mou is one of three such physicians on the LinkedIn Next Wave list who are combining medical practice with entrepreneurship or public service. As medicine continues to go through an economic upheaval—putting physicians under tremendous productivity pressure—doctors are looking for new ways to leave a bigger mark. Some realize that the technology all around us offers a unique chance to bring scale to what has long been a one-to-one relationship. Others are driven to give back, even if that means giving up precious reimbursable hours.

One of the biggest problems for digital health entrepreneurs is getting from the pilot stage to actually being integrated into a hospital’s workflow. That’s where having a physician at the head of a digital health startup can give that company a distinct advantage. Physicians who wear the dual hats of clinician and entrepreneur have the ability to tackle the underlying problems that might be invisible to a layperson—and they can speak the same language as other doctors and hospital professionals.

“Actually being able to see patients on the ground really helps me refine what the product should be,” said Mou, whose Boston-based company, Valera Health, keeps digital tabs on patients by monitoring their medical and social data. “You talk to patients and you ask them what could be helpful, and they are very responsive to this sort of thing. They’ll tell you, ‘Oh no, you can monitor this but you can’t monitor this.’”

Traditional medical training, however, can be at odds with sparking someone’s creative spirit. It’s years of rote memorization of anatomy, physiology and genetics. It’s 24-hour shifts and 80-hour work-weeks during residency. It’s graduating with six figures in debt and the constant pressure to squeeze in as many patients as possible.

“The people who do this are pretty inwardly motivated,” said Dr. Arlen Meyers, president and co-founder of the Society of Physician Entrepreneurs.

Only about 1 percent of physicians have that entrepreneurial mindset, he insisted. And, of those, only a small percentage will act.

The idea of a physician entrepreneur isn’t only someone who starts a company. It’s anyone delivering value through innovation, Meyers said. “The point is you’re trying to improve the human condition—the profit motive is secondary.”

Not Just Another Photo-sharing App

As Mou discovered, most innovators aren’t thinking about behavioral health because of the long-time stigma against mental illness. It’s also harder to show measurable impact on mental disease because of fewer concrete metrics like blood sugar levels or blood pressure readings.

But Mou and his two physician co-founders at Valera Health recognized the need—and found a way.

Valera’s technology platform searches for patterns in patients’ data—from electronic health records and insurance claims to how many text messages they send and how many steps they take—and flags patients who are deviating from their norms. That early alert allows case managers to check in and make sure everything is OK.

Mou’s own research at Harvard, where he pursued a joint MD/MBA degree, focused on identifying the risk factors associated with whether mentally ill patients will suffer an episode that requires hospital admission.

“There’s an unhealthy divide between academics and business,” said Mou, who is in his third year of residency at McLean Hospital, the psychiatric hospital affiliated with Harvard Medical School. “I want to be very much in that pipeline.”

Physicians as Social Activists

Doctors have long been on the front lines of major social upheavals, from protesting against torture to bringing attention to the AIDS crisis.

“There have been thousands of years of tradition of physicians being agents of social change,” said Dr. Ellen Bassuk, who collected autobiographical stories for a book on the topic, The Doctor-Activist: Physicians Fighting for Social Change. “Physicians are in a position of power in our society. There are a group of us who have set up our lives and embarked on nontraditional career paths.”

The social activism of the 1960s put in motion the organization that is now known as Doctors Without Borders, which was founded in 1971 by a group of doctors and journalists. Their idea was to provide medical care to people in need, regardless of their race, gender, religion, political affiliation—or geography. That spirit is now helping to shape a newer field of study known as international emergency medicine.

Next Waver Dr. Usha Periyanayagam has traveled to more than 10 countries practicing global emergency medicine and serves as director of research for the Global Emergency Care Collaborative. The Uganda-based program trains nurses to perform emergency care in places where there are severe physician shortages.

She’s also an affiliate faculty member at the Harvard Humanitarian Initiative, a research and academic center at the university that’s focused on understanding humanitarian crises. Periyanagam’s other research projects have focused on the effects of gang violence at a hospital in Honduras and how to manage mass casualty situations in Karachi, Pakistan, where bombings have killed hundreds.

The Prescription for Better Doctors

An increasing number of medical schools are also embracing the idea that more well-rounded students make better doctors. They’re also integrating more humanities and ethics content into the curriculum. That’s a shift from 40 or 50 years ago when the curriculum was much more exclusively science-focused, said Kayhan Parsi, a professor of bioethics and health policy at Loyola University Chicago.

“I think we’re seeing more students with more diverse backgrounds and more humanities backgrounds,” he said. “Medical students themselves want and expect this content as part of their education.”

Dr. Loren Robinson—who also made the LinkedIn Next Wave list—recalls being told that she would never be accepted to medical school with her major in French. People also discouraged her from taking a year off, which she spent in South Africa doing AIDS research.

“I think it’s important to be culturally aware and culturally sensitive,” said Robinson, who joined Pennsylvania’s Department of Health last year as deputy secretary for health promotion and disease prevention. There, she’s working to apply the latest research on the social determinants of health, or how someone’s environment impacts their health—factors like whether their local grocery store sells fresh fruits and vegetables and whether they have parks in their neighborhood for exercising.

Her medical background, she says, allows her to understand which ideas could be most successful in practice. Conversely, she encourages her own patients to contact their legislators when they see problems in their communities.

The 35-year-old physician, who completed residency in internal medicine and pediatrics, also sees patients two weekends a month, working as a nocturnist on Friday and Saturday nights from 7 p.m. to 7 a.m.

“As I went through residency, and I was seeing my patients in clinic, I realized that there were so many other things that touched their lives other than me for that 15-minute visit,” Robinson said. “And that’s what really continued to spur my interest in public health.”

The daughter of a pediatrician and nurse practitioner, Robinson always felt a calling to go into public service. She describes her mother, a significant influence in her life, as a child of the ‘60s, passionate about social justice and the concept of healthcare as a human right.

She originally wanted to be an ambassador, but abandoned that idea when she heard how hard the test is to become a diplomat. (The irony of pursuing a medical career, with its constant testing requirements, is not lost on her today.)

Sometimes worlds collide for Robinson. Pennsylvania’s prescription drug monitoring database finally went live this year, and was a key initiative for the health department. The program allows doctors to search a statewide database to check a patient’s prescription history before offering potentially-addictive drugs like Vicodin and Percocet.

It’s one of the initiatives Robinson is particularly excited about. And during her shifts as a nocturnist, she’s starting to see her colleagues using it in real-time. “They’re saying, ‘This is a godsend,’” she said.

Medical schools are making this shift at a time when healthcare itself is going through a tremendous overhaul.

“Because of healthcare reform and because of the way healthcare is changing, it’s not just about the physician-patient relationship but about community health and population health,” Parsi said. “The thinking is that it will improve health outcomes not just by treating people as a conglomeration of diseases but by treating patients as people.”

See more of LinkedIn's Next Wave list here.