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Meet the Start-up Doctor

What do hyper-creatives, emergency room nurses, and CEOs have in common? Dr. Aaron Blackledge has identified a particular neuro-chemical pattern. Do you have "entrepreneur brain?"
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Aaron Blackledge doesn't like to stand still. He possesses kind of mindset that is often too fidgety to stand tedious processes, such as attending lectures or writing papers to attain advanced degrees. So when he wanted to become a doctor, instead of settling into higher education, Blackledge doubled down and completed his pre-med in nine months. He decided to open Care Practice in the Mission District of San Francisco in 2008 with the goal of shaking up traditional doctor's offices: Instead of relying on insurance referrals, he swarmed social media with information about the clinic, treating its opening like a buzzy new restaurant launch. The formula was a hit with the area's start-up crowd. Thee and half years later, he's seen more than 8,500 patients. And treating these largely tech-savvy and entrepreneurial-minded clinets has revealed a common thread about how the entrepreneurial mind works—and how to treat it. He spoke with Tim Donnelly in advance of delivering a talk Saturday at Summit Series, entitled: "The Entrepreneur's Mind: Understanding Our Most Powerful Resource."

How did you go from medical student to entrepreneur?
I was a young doctor that had worked in the system. I had come from art school, I was a hypercreative, I had gone to medical school because I had thought "if I have an M.D. I can pretty much go around and do whatever the hell I want." I was so frustrated with health care, I couldn't find out why health care was so non-intuitive. It made absolutely no sense how it was structured. All these different places I've worked from ERs to urgent cares to to hotel doctor to house call, and I was like, "OK screw it, I'm going to build a  clinic that makes sense to me and I don't care what it takes." I really wanted to prove a point that a young doctor with no name-recognition, no funding, no backing, could do what people thought would be impossible.

What did you want to change about the system?
Go on Google, and search for a doctor's office. There's no doctor that's hired a graphic designer who is outside of their immediately family. Let's brand, and create something hip. Let's not take insurance but let's not charge a huge price point. Let's launch through social media platforms." We opened in 2008 right during economic Armageddon. Everyone was writing my obituary. We cash-flowed in about eight days and we had a full practice in three months. And people just couldn't believe it, how busy I was. But I had created this thing that become huge overnight.

Who was your typical client?
I had created the clinic for myself—for what made sense to me. At first I thought it was just really popular and it spoke to lots of consumers. But what it really did is it appealed to people like myself, hyper-creative people, people who can't stand to wait in lines, people who can't stand anything that's not intuitive, they use the internet for everything. They'll take their insurance card, they'll try to find a place, and they'll see me on Yelp and say, "Oh screw it I'm just going to go to this guy." We became really popular with entrepreneurs, programmers. We probably have 2,000 people that write code and probably at least 400 CEOs of tech companies.

What have you learned about the way an entrepreneur's brain works?
I'd always just gone and done something new and creative and innovate anytime it struck me. And building a brick-and-mortar business, suddenly I was dealing with stuff that wasn't innovative, and suddenly I was losing my physical activity level. I was fidgety. But I've never had this kind of success. Everything was perfect, I was living the ultimate dream doctor's job. And I knew inherently that if a giant boulder fell from the sky and destroyed my business and my entire life savings, I would be totally happy.

I was trying to figure out why this was. I had more and more tech people coming in, so I was dealing with more and more issues of hyper-creatives: Addiction, struggle, relationship problems, smoking, chronic fatigue, ADD. These are people who were burning themselves out. I had all these patients strating to come, people moving here from all over the world, diagnosed with ADD, trying to take Adderall. I don't understand this diagnosis. It makes no sense to me. The description is like written for a 12-year-old boy who can't get his homework done.

Wait, so everyone's on Adderall these days? 
People are taking Adderall to write code all night. No one's following any instructions or using this stuff properly, everyone's borrowing stuff from other people in this entrepreneurial community. And it's really just a mess. I watched this PBS documentary on ADD and I was in shock. I realized "Oh my God, that's my brain, that's how my brain works." I don't meet any of the criteria for ADD, I don't have the dysfunction, I just related to that neurochemical pattern and what they were describing.

We asked: do you feel more comfortable sitting in traffic or sitting in a burning building? To which, 15 CEOs all around the table all said in unison, "in a burning building."

I was on a Summit Series cruise after that. I worked out a series of really obscure [potential symptoms] to question people about. I went on the boat with all these famous people and I was shocked to realize: It wasn't 20 percent of the people, it wasn't 50 percent of the people, it was like 85 percent of the people [who shared these characteristics]. It was like a parlor trick. I could totally freak people out and I could tell them about their struggle and I could say, "Well I bet you tried this." And they'd say, "How the hell do you know that? My wife doesn't even know that." We did an event in Seattle for CEOs a couple months ago. We asked: do you feel more comfortable sitting in traffic or sitting in a burning building? To which, 15 CEOs all around the table all said in unison, "in a burning building." When you have a rush of fight or flight, you get norepinephrine and dopamine in your brain, which actually calms you down.

This isn't just CEOs, though?
I realized I've created a clinic that attracts people like this. They are emergency room nurses, Navy SEALs, firefighters. All these subsets of people that fall under a specific neurochemical pattern. They'll actually be calmer than they are in their normal lives. A lot of the SEALs are very similar. They constantly need to be on mission doing something stimulating at all times. If they don't they feel discombobulated, constantly feel agitated, get in trouble, get in fights. They only feel serene when they're in the field under fire or under the danger of fire. I was like, "Wow, these are entrepreneurs." I'll go to Start-up Weekends and talk about this with a bunch of young hackers and stuff. Almost every time there will be some kid who will pull me aside out of the crowd and whip out his bars or something and say "I'm a year out of Afghanistan."

What can this teach us about treating entrepreneurs?
They're people that balance their neurochemistry by constantly doing something stimulating or innovative at all times. If you sat in a room with hyper-creatives and tech entrepreneurs, and asked, "How many of you can go to the beach and sit under and umbrella for more than 15 minutes?" probably 90 percent of them would say "no." And the 5 percent that said "yes" would not realize that they're not allowed to have three electronic devices working under that umbrella.

I have all these patients that have $15 million in the bank and are 27 years old, and they're running around in flip flops and T-shirts advising six companies, building a school in Ethiopia, running around the world. They can't stop. Boredom is like a torture for entrepreneurs. So they constantly crave stimulation.

I have all these patients that have $15 million in the bank and are 27 years old, and they're running around in flip flops and T-shirts advising six companies, building a school in Ethiopia, running around the world. They can't stop.

The most important thing for them: They're meant to be physically active. I encourage every one of my tech entrepreneurs to find intense activity that's both creative and social. Unfortunately some of them get off track and get into some of these triathlon things and ultra marathons. They lose some of the creative component and they run themselves into the ground. They're running three hours a day and working 12 hours, and they're just killing themselves. But if they're physically active in a creative social process they actually can achieve balance. This is the way their brains are designed, this is the way they're meant to be in the world.

How else can they achieve balance? 
A lot of these people will do bike rides across states or go surfing in Nicaragua, all these crazy things, but if they're lost, everything is new. Everything is new process: Where's the bathroom? Where do I eat? It's incredibly stimulating for their brain. They can do relaxing things. They can sit and read a book. A lot of them really love to travel.

Hyper creatives, they leave work and they go home and think about work all night long. These people can't stop. None of these people can read instruction manuals. Their brain likes to anticipate and it makes them feel better to figure things out. So therefore I can't give tell them to do these 15 things and you'll feel fine, because they'll never follow instructions. 

IMAGE: bmyers2010/Flickr
Last updated: Jan 27, 2012

TIM DONNELLY | Columnist | Inc.com Contributor

Tim Donnelly is a freelance writer and managing editor of Brokelyn.com. His work has appeared in Billboard, The Atlantic, Thought Catalog, and The New York Post.

The opinions expressed here by Inc.com columnists are their own, not those of Inc.com.



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