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The Fourth Culture Doctor

What is the Fourth Culture Doctor is and how did I come up with this idea?  In 1995, as a Medical Center Administrator (and in the Executive MHA program) at Indiana University Medical Center (IUMC), I had the chance to read the Book “The Third Culture” which had a profound impact on me for many […]

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What is the Fourth Culture Doctor is and how did I come up with this idea?

 In 1995, as a Medical Center Administrator (and in the Executive MHA program) at Indiana University Medical Center (IUMC), I had the chance to read the Book “The Third Culture” which had a profound impact on me for many years, prompting me to think how we could do even better. There was quite a bit of talk back then about the rapid advances in science and medicine. I even recall watching futuristic videos in my MHA courses conjecturing how doctors might practice in high tech operating rooms of the future. However there was no talk of the kinds of new skills doctors would need to learn , the types of new mindsets that they would need to posses and the types of new, Human-Machine interactions that they would need to understand. Yet I knew that there would need to be other significant human changes if this type of future were to ever come about.

After leaving IUMC I entered a master’s degree program at Harvard University to explore and discover new ways that I could improve the art of medicine. I worked with Harvard Affiliated Hospitals, studied day and night for 6 semesters in the basement of Widener Library, attended countless seminars, even re-read that same book. As luck would have it, I had the honor to meet several of the “The Third Culture” intellectual interviewees (the “Father of AI” Marvin Minsky was my neighbor in Brookline, Massachusetts). I knew that this must all lead to a better way to solve the problems we were facing in healthcare, but how?

 Since that time, healthcare like other industries, has continued to experience dizzying, exponential growth, sometimes referred to as the “doubling effect” or “Moore’s Law”. Today, the Third Culture combination of Scientist and Literateur is no longer enough to keep up. All along I have been preparing for this moment, running a successful Learning & Development company (L&D), Executive Coaching Company, Emerging Technology Systems Integration and Startup Investment company. I have literally spent 1000s of hours to master each of these areas and still I must do more! Why?

“Acceleration is accelerating!”

World renowned futurist and Google AI adviser Ray Kurzweil and others.

New York Times Best Selling Author Thomas Friedman, author of Thank You for Being Late: An Optimist’s Guide to Thriving in the Age of Accelerations, told me when I met him during break from a speech in Taipei Taiwan:

Imagine we are in whitewater rapids; we must row our boat faster and faster or our boat will tip over!

I believe that doctors must also break free form their resistance to change, and learn to “row their boats faster and faster”! (to keep from being left behind)

More specifically the Fourth Culture Doctor must learn to :

  • Innovate new processes, workflows, products, and services
  • Innovate new products and services, patent and sell them to the world
  • Provide higher level of customer services (customized/personalized)
  • Better communicate with their customers (esp. Cross Cultural Communications)
  • Network to get quick answers, “where they need them, when they need them”
  • Build awareness about and Interact with Emerging Technology (VR/AR, AI, IoMT, Blockchain, Materials Science, 3D Printing, Robotics and more).
  • Properly Implement and Execute new technology strategies
  • Perfect Speaking, Medical/Scientific Writing and Presentation Skills

Once they have built up their awareness and developed a new innovative mindset, they need to determine the “must haves”, deciding which of the technologies, products and services generate real results, new revenue streams and add to the “bottom line”.

If the Third Culture Doctor needed to be part scientist and part litterateur, then, what I call,

The Fourth Culture Doctor now needs to be what the Third Culture was, PLUS a whole lot more:

  • Medical expert
  • Engineer/”Surgineer”
  • Artist
  • Technologist
  • and more!

The skills doctors need, the ones that will help them better compete in this digital era, especially to “compete” with AI or more aptly become augmented by AI through Human-Machine Interaction. Because it is really about the human, the human doctor and the human clients. It is not about competition at all. It is about abundance. And with a new innovative, Fourth Culture Doctor, mindset this will become abundantly clear!

The Fourth Culture Doctor must learn to embrace the 5 Cs: Communications, Change (Management) Critical Reasoning, Collaboration and Creativity

build awareness about them, use them, apply them, practice them, interact with them, implement and execute them in their practices.   

Discovery and Experimentation are no longer enough to keep up, as they were in the first 3 revolutions, the first 3 cultures. Doctors need to develop new Innovations through “Recombination and Synthesis”. They must change, grow, thrive, and self-actualize by challenging themselves and developing a new mindsets!

The change for doctors that must occur:

Persona B → Persona A

3rd Culture – Persona B 

4th Culture – New Mindset Persona A

3rd Culture – Persona B              4th Culture – New Mindset Persona A




Like Minded                          Liked Valued




Boundaried                           Limitless/Trusting




Compartmentalized                    Holistic/Fluid




Strategy                             Flow




Competition                          Collaboration




Hierarchy                            Synerchy




Discovery/Experimentation            Recombination/Synthesis

Courage is being able to go down a road, not knowing exactly what the end result will be. Doctors are extremely busy, they are inundated with information, they feel they can not keep up, stress and burnout rates are at an all time high and many are now suggesting to family and friends that they not enter the profession. This can all change by having the courage to take the first steps down the road to The Fourth Culture Doctor mindset.

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