In working to provide a platform for some doctors to develop new mindsets and others share as key thought leaders, we believe it’s important to bring together not only doctors, and medical professionals, also artists, technologists, engineers, biotechnologies, bio-designers innovators, scientists, even philosophers and many many others (e.g. entrepreneurs, corporate executives, academics, and investors) in order to transform healthcare, innovate and develop new mindsets, and through this movement, new approaches would emerge that could ensure human doctors are not “left behind” and could actually be more important in the HUMAN-MACHINE Interactions, AI Healthcare and as the “linchpin” at the center of all emerging technologies.

As discussed in previous statements, WE believe in the power of Recombination, and Synthesis to enable the emergence of new Innovations, which are critical to doctors now in the midst of the “white water rapids”. Acceleration is accelerating, and doctors need to row their boats faster and faster to keep from being left behind!

1 out of 3 doctors are “Independent”

2 out of 3 doctors as “Employees”

For several years there were flurry of increasing acquisitions. Many doctors decided to forego entrepreneur-ism and take a full time position. That trend has now slowed and leveled off. And Doctors are now seeking ways to become “independent” again. With the exponential growth of technology many feel threatened. However it is also this same technology that is democratizing healthcare and making it easier than ever for doctors to either remain or go or return to being independent. As the old saying goes; they have every opportunity BUT they have every opportunity! Some doctors must embrace or “lean into” the exponential growth of technology, overcoming their resistance to change. The ones who are already there. The ones that are the Key Opinion Leaders, top influencers, that are rowing their boats way out front, need to learn how to transfer the knowledge to their peers that are not yet there. If the doctors out front have embraced all of these technologies, become “surgineers” (surgeon + engineer), are programming in Python (AI), marketing themselves like digital pros and doing everything right yet have not developed a mindset of

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“ABUNDANCE” then they must. They must not see only competition, guard the knowledge they have been so fortunate to obtain, they must share it. The famous APPLE evangelist and startup guru, Guy Kawasaki, said that over his career if he had not helped, shared and told everyone all of his ideas he would not have been the success he is today. Guy admonishes that he shared 1,000 ideas and perhaps someone took one as their own. Without sharing he would not have gotten where he is and if someone takes one, they still can not copy your style and implement they way you would have. So especially doctors that are already leaders, must “put themselves out there”, share what they know. join the community and movement, coach, mentor and be the guideposts to other doctors on their journey.

How can doctors that are independent remain independent?

How can doctors that are employees transition to being independent?

How can current residents/fellows start their careers as independent doctors?

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doctors can, in addition to developing the aforementioned “innovative mindsets” and embracing the “WE” movement, can take action. Once doctors have developed new mindsets they can start to create, innovate, design and biodesign. It is important to note that Innovation CAN apply to more than just designing medical instruments! Doctors can innovate processes, innovate workflows, business models, client services, technologies. They can innovate themselves, their careers, their lives, by developing this new mindset. Literally ANYTHING can be innovated once you have this new mindset. And it is not a “nice to have” now–it IS a “MUST HAVE”!

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The Fourth Culture doctor must now, get into this new Autonomous Driving Vehicle of ECG that is driven by 3 engines to become

1. Enabled

2. Connected

3. Grow

In addition to making these 3 engines part of their whole being they must also embrace the power of “WE”.

WE is a movement, of on and offline doctors contributing to something bigger than themselves, sharing, giving back, mentoring on a global scale, contributing to, and helping to build a new “community ecosystem for wellness”. This ecosystem allows doctors that are also thought leaders, key opinion leaders, digital healthcare influencers, and experts in their specialties to AMPLIFY themselves and attract new WE followers. It is no longer just an opportunity it is an OBLIGATION!

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Once they have developed the proper Fourth Culture Doctor mindset, and are living the power of WE, with thinking, doing, feeling believing and acting,

doctors can begin to pursue action and interaction, setting into motion positive change. Courage is taking that first step, not knowing where it may end up. Once a commitment is made in the mind and the first action is taken, the universe will move in behind the doctor, and propel them forward. The universe WANTS doctors to be a SUCCESS. The Universe CONSPIRES for doctors to be a success! Regardless of where you believe this is GODs “Grace” and/or another quantum law of the universe, it IS the TRUTH and it will happen. Once doctors know who “walks along beside them, they will have NO fear!”

So now that doctors are super pysched up, motivated as all get out, and inspired, what are some practical steps they can take to put their newfound innovative, purpose, plan, strategy into action. This community offers an ecosystem enabling doctors to do something that will enable doctors to move up Maslow’s Hieracrchy towards “self actualization” by doing something other than practicing medicine. In this community doctors will be enabled and empowered to create using the DPPC method WE have provided:


  1. Design
  2. Plan
  3. Pitch
  4. Connect

Design begins with working through the entire design thinking process (which is not a process after some time, rather a mindset, see previous article on design thinking), then the business model canvas, business plan, pitch deck, oral pitch, and finally connecting to investors and global distribution. Through this process or new innovative mindset doctors can generate new sources of revenue.

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“FOURTH CULTURE Doctor Technologist + WE”

Doctors will begin to design inside of VRAR together with a virtual global team from WEST + EAST, implement VRAR in their practices (often for a multi-cultural medical tourism client base), use for their own and patient/client learning. Even learn to develop their own unique content, and equipment, specifically for their specialty.

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Doctors must begin to biodesign and develop their own therapies together with the WE COMMUNITY. And if not they must become at least become familiar with cell therapies, stem cell therapies, immunotherapies, and many other alternative therapies.


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Our WE Community is now also calling them “COE Clinics of Excellence” (named after “Centers of Excellence”). They include Internet of Medical Things or IoMT, VRAR, 3D Printing, Materials Science R&D centers, Genetic Testing Labs, Blockchain and more.

Also see previous articles describing the Smart Clinics where clients can enter, have body scans, diagnostics tests, a one hour genetic test, and be walking through their own DNA in Virtual or Augmented Reality VRAR (with Head Mounted Display HMD or AR Glasses), together with their doctor or genetics counselor within an hour, to learn about the clients own, individual biomarkers and what it means to them. Based on the outcome there will be a number of global therapies available including “WE therapies” from the West and therapies from the East including Chinese Medicine, Ayurveda, EuroSpa, Quantum, and other cell, stem cell, and immuno-therapies, some a combination of 2 or more of these.

Human-Machine Interaction.

Doctors can not as we say “just add water” or in this case “just add technology”. It requires proper “change management” (see previous articles on Harvard Professor Kotter, the father of Change Management and 8 step process for leading change, as well as, XLR8 implementing change in the “dual processor” model, innovation teams pursuing change on the right, business as usual on the left).

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In this community doctors can develop “Talk like TED” and “Walk like Executive” (Executive Presence), and McKinsey type Consultant Level Research + Speaking Skills. Doctors may be speaking to different cultures all over the world and must custom tailor their talks based on the cultures they are speaking to (and their are strategies for multi-cultural WE audiences as well)

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The Culture Map

Cross cultural communications and WE leadership is more important for doctors than ever. Doctors from the East want to speak, publish, network, collaborate, co-design with Doctors from the West and vice versa. WE countries and doctors are attracting more and more clients from outside their country due to the increase of “medical tourism”. Several countries recently listed doctor-patient communication skills as one of the biggest problems their citizens faced when traveling abroad for medical procedures.

See a diagram and descriptions of several key areas from Erin Meyer’s The Culture Map that the WE Community and Fourth Culture Doctors keep on their nigh-stand.

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When we say that someone is a good communicator, what do we actually mean? The responses differ wildly from society to society. I compare cultures along the Communicating scale by measuring the degree to which they are high- or low-context, a metric developed by the American anthropologist Edward Hall. In low-context cultures, good communication is precise, simple, explicit, and clear. Messages are understood at face value. Repetition is appreciated for purposes of clarification, as is putting messages in writing. In high-context cultures, communication is sophisticated, nuanced, and layered. Messages are often implied but not plainly stated. Less is put in writing, more is left open to interpretation, and understanding may depend on reading between the lines.


All cultures believe criticism should be given constructively, but the definition of “constructive” varies greatly. This scale measures a preference for frank versus diplomatic negative feedback. Evaluating is often confused with Communicating, but many countries have different positions on the two scales. The French, for example, are high-context (implicit) communicators relative to the Americans, yet they are more direct in their criticism. It is this difference that lead to the confusion Sabine experienced in her performance review. In France, positive feedback is given more implicitly and negative feedback may be given more strongly. In the US, managers are taught to give 3 positives with every negative and to catch people doing things right. When negative messages are wrapped in positives, the American knows to pay attention to the message in the middle., but for a French manager that is not nearly so obvious. Sabine left her performance review feeling she had never heard so many positive things about her work, easily overlooking the seemingly small negative messages that followed.


The ways in which you persuade others and the kinds of arguments you find convincing are deeply rooted in your culture’s philosophical, religious, and educational assumptions and attitudes. The traditional way to compare countries along this scale is to assess how they balance holistic and specific thought patterns. Typically, a western executive will break an argument down into a sequence of distinct components (specific thinking), while Asian managers tend to show how each component fits with all the others (holistic thinking). Beyond that, people from southern European and Germanic cultures tend to find deductive arguments (what I refer to as principles-first arguments) most persuasive, whereas American managers are more likely influenced by inductive logic (what I call applications-first logic).


This dimension measures the degree of respect and deference shown to authority figures, placing countries on a spectrum from egalitarian to hierarchical. In Nigeria, a child learns to defer (and not contradict) the words of an elder brother, a teacher, or a parent and an employee applies the same lesson to a boss. In Denmark, a child learns that the teachers or elders are facilitators and the boss’s opinion is one opinion amongst equal opinions. Learning to lead across these cultural differences is one of the great challenges of working in a global economy.


This dimension measures the degree to which a culture is consensus-minded. We often assume that the most egalitarian cultures will also be the most democratic, while the most hierarchical ones will allow the boss to make unilateral decisions. This isn’t always the case. Germans are more hierarchical than Americans, but more likely than their US colleagues to build group agreement before making decisions. The Japanese are both strongly hierarchical and strongly consensual.


Cognitive trust (from the head) can be contrasted with affective trust (from the heart). In task-based cultures, trust is built cognitively through work. If we collaborate well, prove ourselves reliable, and respect each other’s contributions, we come to trust each other. In a relationship-based society, trust is a result of weaving a strong affective connection. If we spend time laughing and relaxing together, get to know each other at a personal level, and feel a mutual liking, then we will trust each other.


Everyone believes a little open disagreement is healthy, right? The recent American business literature certainly confirms this viewpoint. But different cultures have very different ideas about how productive confrontation is for a team or organisation. This scale measures tolerance for open disagreement, and views on whether it is likely to improve or destroy collegial relationships.


All businesses follow agendas and timetables, but in some cultures people strictly adhere to the schedule, while in other cultures people treat it as a suggestion. This scale assesses how much value is placed on operating in a structured, linear fashion versus being flexible and reactive.

Cross Cultural Communications applies to almost every area of The Fourth Culture WE Doctor’s life. From Medical/Scientific Writing Skills for a GLOBAL WE Audience to general articles, PR/marketing blogs etc. where it is critically important to understand the culture you are writing for.

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We know it is a lot to ask. Doctors are busy and it takes all of their time just to keep up with the latest medical information and procedures. If if they were to read all the existing medical information available today it might take them over 100 years.

For Doctors of Aesthetic Medicine, TAMP Inc. has, for the first time ever, developed, a FOURTH CULTURE WE, Doctor Community, Global, “platform ecosystem for wellness” with one of many powerful tools, called the “AMRdr” at the center. Later this community model can be expanded to include all medical specialties.

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WE WELCOME YOUR VALUABLE INPUT – Please answer the questions below. Thank you!

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1.     If you could improve your skills in any area what would it be? _________________________________________________________

2.     Please tell me about your biggest PAIN in the Aesthetic Medical Profession? What keeps you awake at night? _____________________

3.     If you could wave a magic wand and have everything perfect what would it look like? Please describe it to me. _____________________

4.     What would you try if you failed at fixing a problem? ________________________________________________________________

5.     How is your thinking different from other doctors and why? _______________________________________________________________

6.     If nothing was in your way what would you do next? ________________________________________________________________

7.     Imagine it is 5 years into the future. Please describe what you think Aesthetic Medicine will look like? ______________________________

 Any other better questions you would like to add? Any other thoughts, comments or suggestions?

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For Your Reference – Additional notes on what we have read or heard from other doctors:

From Millennial Doctors

·        We feel that we are Constantly Connected, “Blue Jeans Moments”

·        I get inundated with the Information “Fire Hose” – Constant Bombardment

·        We have 4-5 Generations Working Together – Cross Generational Communications Skills are challenging

·        There has been a Shift from Paternalism to Partnership Models

·        We have Increased Diversity – Some have Weak Cross-Cultural Communications Skills that need to improve

·        I need to improve our Empathy Skills for our Patients and for our Employers

·        Physician Scrutiny – We know there are Online Reviews, and this puts pressure on us

·        I know we are Missing Data, there is a lot of Unstructured Data, and we are Unable to Visualize Data but don’t know where to begin

·        We would like to Link to Authoritative Healthcare Influencers

·        Us Younger doctors prefer Constant Feedback, Reinforcement, Support. We want to know what we are doing right, wrong, how we can improve and how it fits into the big picture

·        Patient Centric Demands – We know we should be Empowering Patients but it is a challenge

What more experienced Senior Docs are telling us:

·        We are working hard Keeping Pace with Exponential, Digital Growth, Innovation

·        We often feel that we have a Lack of Change Management, Human-Machine Interaction, Leadership Skills (passing on our expertise to younger doctors in the right way)

·        I would like To Get Help from Expert Peers, Where and When you Need it

·        It is often difficult with myriad of new tech Determining “Must Haves” vs. “Nice to Haves” that Generate New Revenue

·        I want to improve our knowledge of HOW to Innovate, Integrate & Execute

·        There is something in the field called “Publish or Perish”, a Pressure to Develop Medical & Scientific Writing Skills

·        We need “You, Inc.” Self-Promotion PR & Marketing due constant Demands

·        I want to “Talk Like TED” and have interesting Public Speaking & Executive Level Presentation Skills

The PAIN ALL doctors are experiencing (regardless of level)

·        We are experiencing Doctor Shortages & Fierce Global Competition and need to do more and more

·        The Complexity we are seeing with AI and other Emerging Tech is exceeding our human capacity

·        We know that we have Broken workflows, discarded information, errors occur and must make a change

·        We are constantly worried about Privacy, Safety, Security Threats

·        Ever-Changing Clients Demanding Personalization, Precision, Ultra High Levels of Service and Experience

·        Digital Era Pace – Learn Quickly