I had lunch with a colleague who is finishing his MBA in May. We talked about what he planned to do going forward.  The conversation then turned to doctors and the way they see themselves and their options.  In medicine we’re used to having the way paved for us. We’re lockstep physicians. We do what’s been done before. We practice lockstep medicine.

When you’re training to be a doctor you’re always looking to the next thing. When you’re a student, your endpoint is getting into medical school. In medical school you see residency as the goal. During residency you count the days to completion or look to do a fellowship.  In academic medicine you march to accumulate scholarly accomplishments and publications in peer-reviewed journals. It’s all about following the path. You desperately keep in step with the doctor in front of you. Flowchart-like endpoints drive our existence. We live and die by checklists, administrative throughput, and process.

And our most visible mentors are those who have walked the same path.

But recently I’ve met a few doctors doing amazing things after creating their own way.  In nearly every case they took risk with no one to show them how. I suspect physician-driven health care innovation will come not from those who stick to the century old milestones, but from those looking to mark professional advancement in a new way.

This doesn’t require an MBA or the culture of a startup. Disruption can begin with one doctor, a good idea and an environment willing to shoulder some of the risk of looking at things just a little differently.

We should help students and residents understand that its okay to think outside of our current system of lockstep professional advancement.

West Point Cadets in lockstep via the Library of Congress.