Doctorpreneurship in the Digital Age: Perspectives From Ghana's Health Sector

Introduction

Ghana’s health system is ranked 135 out of 191 for the overall health system performance by the World Health Organisation, WHO (Aetna, 2020). This ranking, to a large extent, corroborates recent reports (e.g. Preko, Boateng & Effah, 2019; Adogla-Bessa, 2017) about the doctor deficits and low doctor-to-patient ratios in Ghana’s health sector. Adogla-Bessa (2017), for instance, attributed these deficits to the menace of brain drain, which causes medical practitioners to migrate from less developed economies to developed economies, and its implications for the healthcare industry and the Ghanaian economy as a whole. This unfavourable situation in Ghana’s healthcare industry has consequently caused a paradigm shift in its medical practice, making the concept of entrepreneurship to thrive in this domain. Additionally, the introduction of digitalisation into healthcare, i.e. the technology-enabled social change (Mihailescu & Mihailescu, 2018) that has introduced new approaches to delivering healthcare services through digital technologies, has further spurred the growth of entrepreneurship in the healthcare industry. Entrepreneurship, as has been widely described, is a process involving the nexus of two phenomena; (1) the presence of lucrative opportunities and (2) the presence of enterprising individuals (Mehrabi, Farsi & Talebi, 2019; Skica, Mroczek & Leśniowska-Gontarz, 2019). The foregoing definition, which is also adopted for this study, has given rise to a new phenomenon of doctor entrepreneurship, a form of individual or personal entrepreneurship in the field of medicine. In this paper, we describe the phenomenon as ‘Doctorpreneurship’, or ‘Locum’. Though not a new concept in medical practice, doctorpreneurship presents lucrative opportunities for enterprising medical practitioners to be engaged in entrepreneurial activities in healthcare facilities other than facilities where they are originally designated to serve.

The consolidation of doctorpreneurship in Ghana’s health sector, besides the notion of brain drain, has been primarily due to the increasing population growth and the recent rise in healthcare facilities across the country. Currently, there are about 1,300 private facilities and 1,800 public facilities in Ghana’s health sector alone (Aetna, 2020). The rising number of facilities and increasing patient demands are continuously being pegged against the relatively smaller number of medical practitioners who join the health sector every year. In a report, Adogla-Bessa (2017), for instance, noted that Ghana is currently said to have 22 nurses to every 10,000 patients; and one doctor to about 10,450 patients. These ratios were reported to be far below the standards of the Commonwealth and the World Health Organisation, which recommends 40 nurses to every 10,000 patients and one doctor to every 5000 patients, respectively (Adogla-Bessa, 2017). Other studies, (e.g. Preko et al., 2019) have similarly highlighted the alarming doctor-to-patient ratios in some developing economies, particularly within the African sub-region. In this study, we posit that the low doctor-to-patient ratios, coupled with the decreasing doctor-to-facility ratios, are partly accountable for the perpetuation of doctorpreneurship in Ghana’s health sector. Again, as a developing economy, we do not discount the financial considerations of medical practitioners before engaging in doctorpreneurial activities. However, from a theoretical perspective, while some studies (e.g. Mehrabi et al., 2019) have explored entrepreneurial business opportunities in the health sector of developing economies, the factors driving the phenomenon of doctorpreneurship have not been empirically discussed and documented in extant literature, particularly in the field of Information Systems (IS), and in a digital era where digitisation is driving several economic activities.