I am asked very often about whether a doctor needs to quit his job to lead a start-up. Well, there is no straightforward answer; I can’t give a yes or a no. It depends.

I understand this is highly controversial, many of you will think a doctor should quit his/her job to start something entrepreneurial, and others will think the opposite, arguing that the healthcare professional adds more value precisely by leading scientifically, hiring a good full-time general manager and staying at his work. As usually in life, this is not a black or white issue, it has many shades of grey.

A start-up needs leadership and management. A start-up needs tremendous commitment. In the start-up world we usually use the catchphrase “to have skin in the game”. Certainly leaving his/her job is one way to have skin in the game, but this is an oversimplification. When I see an MD willing to be an entrepreneur I usually ask myself the question: if the start-up died tomorrow, what would be the impact on this particular doctor? The point here is that just because someone quits their physicians job, just because they write a large check, just because they take the founder title – none of these necessarily means that they’re committed. It’s possible that in all of these cases, the actual impact on the physician is relatively minor.

Committed means to me something much more complex than staying or quitting a job. It means an emotional implication, a deep desire to make things happen. And every case is different.

The healthcare professional may well end up leading but not managing the start-up. That’s his choice and his prerogative if he originated the idea. He can lead, inspire, bring the science into the company, push forward the project, without managing the day by day, or he can choose to manage. This decision will be important to find an answer to the previous question.

By the way, for those of you willing to understand the difference between being committed and involved: When you prepare bacon and eggs for breakfast, the chicken is involved, but the pig is definitely committed.