MD/MBA Panel: Social Entrepreneurship

Highlights from the Association of MD/MBA Programs 8th Annual Conference.

This morning's panel discussion on social entrepreneurship included:

• Marcel Tam, MD, MBA candidate (Boston University School of Medicine)
• John Dorsey, MD, MBA (Co-Developer of Project Horseshoe Farm)
• Bill Walczak (CEO of Codman Square Health Center)
• Anne Light, MD (Founder and Director of OEL Foundation) could not attend

So, what's happening in the world of social entrepreneurship?  Are we seeing enough disruptive innovation in health care? If you really want to make a difference in the health care industry, then perhaps you can apply your business training to make a difference in public health.

Dr. Dorsey: Each person has to find his/her own hat. Question assumptions and follow your internal compass. Ambiguity tolerance. Prepare to work very hard. When you pursue something that doesn't have an established path, it's a lot of work. He moved from southern California to the south to provide health care at a different level. He saw a need for housing for people who have mental illness. He also saw opportunities to provide students in the area with hands-on training in community service.

Project Horseshoe Farm is a non-profit service, leadership development, and educational initiative located in Greensboro (Hale County), Alabama that was formed in October, 2007, and began full operation in the summer of 2009. The program has three main goals:

• Service – To initiate, develop, and carry out service leadership driven and social entrepreneurial community based programs that improve the quality of life of vulnerable residents of Hale County and surrounding communities.
• Leadership Development and Education – Through the Horseshoe Farm Fellowship Program, to expose promising prospective service leaders of healthcare or other community organizations to ideas, experiences, and skills that will help prepare them to become more discerning and effective leaders in the service to others.
• Community and Citizenship – Through our service programs, to provide additional support and opportunities to members of our community interested in helping and serving vulnerable people in our community.

Bill Walczak reminded the group today that social entrepreneurship is about social good. People who go into social entrepreneurship really want to make a difference. The Codman Square Health Center is a community-based, outpatient health care and multi-service center. There was a significant shortage of physicians and patients were relying on the ER for basic health care needs.

So, how do you make a difference when you're dealing with a low-income population where patients lack opportunities, where substance abuse is highly prevalent? How do you deal with crime, teen pregnancy, unemployment, etc? What do you do to create opportunities for people in these situations?

The root of poverty is education. So, the Codman Square Health Center started a charter school so that people can get educated and find employment. These students are attending school 6 days each week and these students are catching up. Plus, each student has a social worker and they are provided with mental health services because many of them suffer from PTSD. Students are also given opportunities to participate in internships.

Dr. Dorsey: If you're going to start something now, pay attention to the mission of the organization. There are so many ways that you can make an impact, so pay attention to the mission. Get involved with patients who are living in turmoil. These are the ones who are consuming a large proportion of health care resources.

Marcel Tam: What can MD/MBA students do to prepare for social entrepreneurship?

Mr. Walczak: It's not easy to change behavior. In fact, low-income people have a much more difficult time changing health behaviors. Consider starting a group visit for patients who need home care. Teach them how to exercise, how to cook, and see their health improve. Group visits for pregnant women evolved into social networking, social support, and higher levels of patient satisfaction. Look for better ways to improve public policy.

Dr. Dorsey: MD/MBA students are in an ideal position to redesign the health care system. You'll be in a position to lead teams and organizations.

Question from the audience: Funding? Financial landscape?

Dr. Dorsey: Funded the project significantly himself. The Board has helped to raise funds. You probably won't break even at the beginning. If the funds were already there, someone would probably be doing it. You have to find a creative way to get funds. Demonstrate value and then you'll have more success getting more funding. Control your living expenses so that you can use your own savings to seed these types of initiatives. You'll be able to start something small.

Mr. Walczak: We've been around for 30 years. We have about $10 million in the bank. They have about $5 million to work with and they have no debt. A health center is a source of revenue and you can apply for government grants related to health care. Charter schools are public schools, so 2/3 of the school funds come from the government. They raise $4k per student each year to enhance student experiences. They pay physicians enough so that they have never lost a physician. They also teach health care students and have opportunities for research.

Mr. Walczak: Harlem Children Zone is a great program, but it probably can't be reproduced. It needs $60 million each year. The health care system could replicate elements found in the Harlem Children Zone since we have money in health care. The golden opportunity is to look at some of the new policies found in the reform bill to create initiatives.

Comment from Dr. Stephen Ober: In the private world, you have investors and there is an established business model. In the social entrepreneurship world, there are philanthropic funds that are available and you need to learn how to approach these sources. There is a personal ROI for philanthropic givers.

Dr. Dorsey: Get started with something. Spend a few hours on an idea and you may build something.

Mr. Walczak: I was a probation officer. We started with National Service Corps workers. I took a leave of absence for 6 months to invest in the project. We took advantage of abandoned buildings and then raised $20 million to rebuild them. If you can find a way to tap into a combination of private funds and government funds, you'll be successful.