We are watching physicians lose power in the system at the exact moment we need physicians to gain it.

Corporations are consolidating at a pace that's swallowing private practices whole. Meanwhile, healthcare is more broken than ever. It’s inefficient, expensive, and desperately in need of the kind of front-line innovation only physicians can drive. The issue is most doctors were never taught how to do any of this.

In this article, I’ll discuss what medical training is missing, what the data says about physician entrepreneurship, and why one major organization is finally trying to do something about it.

I went to medical school intending to learn pathophysiology and clinical medicine. But I came in with an entrepreneurship background, and I was surprised by how little innovation and business training was offered. As of 2016 (almost 10 years ago, but it’s the most recent data I could find), only 13 of 158 (8.2%) U.S. allopathic medical schools had a formal innovation and entrepreneurship program. Given the pace of innovation in healthcare over the past two decades, from artificial intelligence to new reimbursement models—this is concerning. Are medical schools keeping up? A 2024 survey of over 500 medical students found 90% reported no, minimal, or basic knowledge of the business of medicine.

Parambath and colleagues (including fellow Huddler, Sherman Leung) put it plainly:

The irony shows up even in residency selection. 61% of program directors said startup experience was a positive in applications. But only 25% thought taking time away from training to actually do it was worthwhile. The message to trainees is entrepreneurship looks good on paper. Just don't let it get in the way of medicine (story of my life).

Clinical expertise alone isn't enough anymore. The problems worth solving in healthcare require physicians who can both diagnose the dysfunction and build something to fix it. That combination (clinical insight plus business fluency) is exactly what's been systematically left out of our training. And the data on what physicians are actually doing out there suggests the instinct is already there but the training just hasn't caught up.

Healthcare is becoming more corporatized. Nearly 80% of all physicians are now employed by a health system or corporation—up from 60% in 2019. Four out of five physicians in the U.S. right now work for Optum, CVS Health, or HCA Healthcare. As I wrote recently:

The economics show horizontal and vertical integration increase negotiating power and help the corporate entity own the entire care journey. Physicians, systematically undertrained in business, are losing ground to the people who understand that game.

The formal response has been underwhelming. MD/MBA programs have more than doubled since 2002, from 26.4% to 60.9% of medical schools. But the numbers reveal a subpar response, with only 0.8% of medical students actually graduating with an MBA—roughly 160 students per year out of ~22,000 annual graduates. And the degree itself has been diluted, since a vast majority of dual programs require fewer business credits than a standalone MBA. The system responded to the demand by offering a credential but it didn't change what physicians actually learn.

Here's what the data elucidates, though: physicians aren't averse to business. The instinct is already there. What's missing is the pipeline.

A study of Massachusetts-licensed physicians found that the proportion who had ever founded a company—clinical practice, biotech, or otherwise—was higher for physicians who graduated in 1970 than for those graduating in 2010.

This shows that older physicians, trained before the corporatization era, were more likely to build something. And when physicians do break into business today, it happens late—on average, about 20 years post-graduation, when they're in their mid-to-late 40s.

The question worth asking is could that timeline be shortened with earlier exposure to business training? Could some of that consolidation have played out differently if physicians had understood the game while they were still being trained?

The outcomes, when physicians do engage, are significant. Parambath and colleagues found that more than 25% of the 105 healthcare companies that reached unicorn status ($1B+ valuation) between 2015–2024 had at least one physician founder—collectively valued at $68.9 billion. Among nearly 3,000 U.S.-based venture-backed unicorn founders, ~4% had medical degrees. More than 25 health systems had launched their own venture divisions as of 2023.

Informally, the gap is being filled. Communities like Scrub Capital—a VC firm backed by hundreds of physician investors and entrepreneurs—and MDplus, a network for business-minded medical students and trainees, have emerged to provide the experiential learning that training programs never offered.

What's more significant is who's paying attention now: the largest physician organization in the country.

I’ll be the first to tell you how important any business knowledge is for physicians. My entrepreneurship exposure before medical school, and during training with Healthcare Huddle, has given me a different perspective on the healthcare system and why so much dysfunction exists.

The American Medical Association thinks so, too.

Dr. John Whyte—the AMA’s CEO and Executive Vice President—is about one year into the role, and is already pushing physician entrepreneurship and career growth beyond clinical medicine. His background is noteworthy, coming through clinical medicine, federal health policy, and corporate roles including CMO of WebMD. He's not an organizer but he is someone who's lived at the intersection.

Dr. Whyte and the AMA team are hosting their first AMA Physician Entrepreneur Forum in Chicago August 7th through August 8th. It’s meant to be intimate—a small, application-based cohort of 100 attendees—designed for physicians, fellows, residents, and med students who want to explore business leadership pathways, whether founding a company, joining a venture, or simply understanding the business dimensions of healthcare.

The agenda warrants a closer look because it's covering exactly what medical school never did:

I wish something like this had existed when I was figuring out what "medicine plus something else" could even look like. The forum won't close the systemic gap overnight but it's exactly the kind of signal that matters. The largest physician organization in the country is finally saying out loud what a lot of us have been saying in our group chats for years: clinical expertise alone doesn't cut it anymore, and the system has a responsibility to do something about that.

In summary, physicians are already shaping billion-dollar companies and founding businesses at remarkable rates—yet fewer than 1 in 12 medical schools had a formal program just a decade ago, and most students today still graduate without a single business course. The demand exists, the interest exists, the need exists. The system just hasn't caught up. That’s why the AMA Physician Entrepreneur Forum is a significant step in the right direction.

Space is capped at 100. If this is the gap you've been feeling, save your spot.