At Lucens, we believe there's no one "right" way to build a fulfilling medical career, and every medical professional has a story worth sharing.
Our "Behind the Scrubs" series pulls back the curtain on the diverse journeys of remarkable individuals in healthcare. Join us and discover the human stories that make medicine such a rewarding field.
Meet Rich Popwell, MD
Meet Rich. He’s a neurologist, entrepreneur, physician executive, Air Force veteran, and assistant clinical professor at the University of Washington.
While he’s practiced neurology for 24 years, Rich’s other passion is entrepreneurship. His latest startup, DocSide, a reimagined curbside experience delivered through an innovative, mobile and web-based application that streamlines communication, documentation, and charge capture.
He’s been married to his amazing wife for 28 years, and has two adult sons and two lovable Labrador retrievers. Rich enjoys hunting, fly fishing, singing, and reading. He also holds the USPA Montana state powerlifting record for both squat and deadlift for his age & weight class! 🏋🏼
When did the concept of medicine first come into your life?
I distinctly remember when I was a kid, I got this God-awful ear infection. After visiting the doctor, I got a lollipop from the nurse, and within a couple of hours of leaving the doctor's office, I started feeling better. I thought that was the coolest thing ever.
And then, when I was a bit older, I interacted more seriously with medicine.
I remember attending a company function where my dad worked and we joined a softball game. My dad went all out with everything he did, which I inherited. At the event, he blew a disc while playing softball, but he didn't know it until the next morning when he woke up and couldn't move his legs.
It swelled overnight and compressed his cauda equina. Being my Dad, he refused to let me get an ambulance, so I threw him in the back of the truck and drove him to the ER.
We were living in Laplace, Louisiana, at the time, and they flew in a neurosurgeon via helicopter to do an emergency decompression of my dad's lower spine. The emergency surgery saved his ability to walk and allowed him to return to work. And that blew me away. And I was like, "That's what I want to do."
For a long time, I thought I would be a neurosurgeon because of that experience.
It wasn't until I got to medical school, got into the operating suites, and started opening my eyes to other directions that I discovered that I could be in neuroscience but not necessarily a surgical field and eventually change gears for various reasons and I landed in neurology.
Why did you change your focus from surgery?
I got my degree in biomedical engineering at Tulane University. I was a poor kid. My parents were in fast food and convenience stores, but I was blessed to have a good brain. As an undergrad at Tulane, I got a scholarship for my academics, and when medical school came around, I knew it would be pretty pricey.
So, I went into a military recruiter's office with three letters of acceptance for medical schools, literally in my back pocket, and asked them how it all worked. I walked out of the office with an application for a military scholarship, and the next thing I knew, I was in the United States Air Force.
Because of my military scholarship, I was able to stay home and do medical school at Tulane, but it was still challenging.
I got up on Saturday mornings at 4 a.m. to go around with the neurosurgery team and do fusion imaging work with the neurosurgical team as well. Based on my biomedical engineering background, I was trying to wrap my head around how to blend CTs and MRIs for stereotactic imaging. Eventually, I got into my third-year rotations in surgery.
At the time Tulane's surgical program was, let’s say, “traditional”, with an unforgiving hierarchical structure. The experience turned me away from surgery.
Thankfully, during rotations, I had some good mentorship. There was a wonderful neurologist at Tulane, Dr. Anne Foundas. She was a behavioral neurologist and really encouraged me to think about neurology.
Since I was in a military program, I had the opportunity to visit and eventually have an interview with another incredible neurologist, Gary Gronseth, he's now retired, but he was a world-class epidemiologist and neurologist. He was my chairman when I was in my training program and a great mentor.
What do you think makes great mentoring from what have you noticed over 20-plus years of practicing?
It's about wanting to serve others and being as humble as possible. Leadership is not about hierarchy. I've seen so many leaders who allow their egos to get in the way of what they're trying to do. I've had the misfortune to report directly and indirectly to some of those types of leaders, so I know what it feels like. And that is not the type of leader that anybody wants to follow.
When you look back and realize that people are volitionally following you and coming to you with questions and concerns, they know that you actually care about them as human beings, and that's what leadership should be about.
Physicians definitely need that type of leadership, especially in the current world, where 70-plus percent of physicians in the United States are employed by a large organization.
These organizations typically have "physician leadership" built into the structure. Depending on the organization, it might be genuine physician leadership, where the organization allows the physicians to have influence and listen to what they hope to achieve. But with some of the organizations, it's lip service, and that's unfortunate.. Regardless, servant leadership has to be a priority. If you're considering getting into leadership, that's where you should start.
Leadership should be about serving others and doing so with the understanding that they will teach you just as much as you will teach them.
Are there ways that a physician should think about leadership that are slightly different because of the nature of the work?
With the average time spent on training a physician, especially considering these crazy multi-year residencies and fellowships, most physicians don't start practicing until nine or more years after college. Millions of dollars go into training physicians coming out of some of those prestigious programs.
So how do you lead somebody like that?
You walk alongside them. You support them. You tell them, "Hey, you don't have to worry about all the nuances; we will have your back. We will give you all the support and resources you need to take care of your patients. If you have a problem, and it's a reasonable ask, we will address it."
Physicians want you to work with them to accomplish things. They want their opinions to be considered.
For example, I once encountered a situation where a decision was made to change the availability of a certain type of product in the operating room from a cost-cutting standpoint.
The impacted surgeon wasn’t aware of the decision until one day he needs this product for a scheduled case, and the next thing you know, his preferred product is no longer available. Immediately, that surgeon is no longer considering staying with the organization.
That's avoidable when you make sure that you effectively communicate with your clinicians about what you're trying to achieve. Ask, "Hey guys, how about this as an alternative?"
Have a meeting, bring together all the stakeholders, and say, "We're trying to save X amount of dollars at this particular care site."
What we're really trying to achieve is to address some of the challenges in healthcare right now because everybody's facing substantial headwinds. While cost-cutting is part of the strategy, there may be an opportunity to be more efficient in delivering care.
The only other profession in which our society invests more money into training is fighter pilots.
What tips or recommendations would you have for a physician in that position who may be frustrated?
The problem is everybody's got a unique situation, but the self-awareness piece is critical. And the first response is going to be frustration. It's going to be anger. And a lot of that's valid.
But how do you get through that from the standpoint of self-awareness, from putting those frustrations aside and not running into the board room or the conference room on fire?
It's tough for an average physician with no self-awareness or centeredness training to engage with a decision-maker like a director, CEO, or COO.
The most important thing is to keep a level head and be very objective about the impact. Unfortunately, many decisions that influence clinicians are financial. That's why you need to ask the right questions.
It's a systems thinking approach. A practicing physician, doesn't matter if they're a surgeon or not, doesn't necessarily have any leadership responsibility.
Their main focus is to come to work every day and ensure their patients are cared for, but they also get the benefits of working as an employee for either a five-person practice or an organization with 5,000 clinicians. The reality is that they are definitely part of the improvement process.
This is what every health system would dream of having: a complete team of fully engaged physicians who would love to think they are working toward something bigger than themselves.
Physicians are some of the most heavily invested individuals in the world, some of the greatest minds in the world; why not ask them what they think about a possible solution?
Engaging and asking them allows them to feel like they're part of something bigger.
If you could make one change to the system, what would the change be?
Despite its complexity, healthcare is inevitably about good human beings taking care of suffering human beings. If you have never been a healthcare provider, whether a nurse, a counselor, a physical therapist, or a physician, it’s difficult to fully understand the sanctity of the work.. This is why clinical leadership should have awareness and input into every decision of an organization that impacts patient care.
Don’t get me wrong here. Administrative jobs require unique skills that most healthcare professionals simply lack. However, the ideal scenario is to have clinical leadership at every level of an organization, especially if you want to ensure high-quality, safe, and accessible care.
You call yourself a physician entrepreneur. How do you define that?
There's a big difference between a side gig and truly being an entrepreneur. When I think about side gigs, I think about getting on one of those sites to answer a couple of surveys, or I'm going to do some medical expert testimony work, which can be lucrative and very rewarding.
Fortunately, in my situation, I'm married to the president of our startup. But either way, you better make sure you're in and committed.
Entrepreneurship means that you're jumping in, and it's a commitment to sacrificing your hard-earned money and time to make to solve a problem.
How can physicians get started in entrepreneurship?
The system has demoralizing clinicians. We've turned them into employees and diminished their self-importance.
As a physician, especially when you're anchored in a community and respected by your peers, your voice carries weight, and people are hungry to hear from you..
Many physicians feel overwhelmed and say they don't have time, but there are so many problems in medicine that need a physician's mind to solve.
For example, the medical field is far behind the technological curve. We're still using fax machines for the vast majority of communication.
From my perspective, it's incredibly frustrating as a physician to watch our patients, especially our younger patients, look at us and ask, "What are you guys doing?"
No wonder patients are moving toward concierge practices. No wonder they're going to virtual care because they're looking at us like we're a bunch of dinosaurs.
The other part of that, from an innovation standpoint, is that people are thinking too big. If you think too big, you can get distracted. You get distracted when you try to solve all the world's problems.
Although not necessarily cheap, based on my personal experience, physicians should think small about solutions.
Our company, DocSide, is a perfect example of this. We're thinking about a niche solution. We're providing a tool that we hope every physician in the country will have in their hand to send a quick question to their buddy down the street and say, "Hey, I got this case. What do you think?"
The tools capture that information, and their buddy gets paid for it. It's not rocket science. Now, granted, putting something like DocSide together from a regulatory standpoint and design and structure gets to be a lot more complicated and expensive than you can imagine. But it's doable.
We believe we're going to be able to launch something into the market that'll impact access to specialty care. Reducing the overall cost of care will address healthcare disparities and inequities and improve access to specialty expertise in rural America.
These are meaningful things that we clinicians would love to see happen. As a physician, you already have credibility, so find something you're passionate about within health care and think about a problem that needs solving.
I don't think anybody is better positioned to be an entrepreneur in health care than those of us who are actually taking care of patients and have been embedded in these systems.
There has never been a better time to be an entrepreneur in health care.
