Bridging Clinical and Entrepreneurial Intelligence: The Dual Acumen Model for Integrating Scientific Expertise and Innovation Strategy in Healthcare Leadership

Physicians are increasingly called to lead beyond clinical care, addressing system inefficiencies through innovation and entrepreneurial action. This qualitative multiple-case study examined how 21 physicians in the United States developed and applied "dual acumen," the integration of scientific expertise and entrepreneurial intelligence to advance healthcare innovation. Guided by effectuation theory, data were analyzed by NVivo 12 for thematic coding. Findings demonstrate how physician entrepreneurs navigated uncertainty through five effectual principles: bird-in-hand, affordable loss, crazy quilt, lemonade, and pilot-in-the-plane. These principles informed the development of the Dual Acumen Model, an empirically derived framework explaining how physicians translate clinical insights into entrepreneurial practice and system-level innovation. The study contributes empirical evidence that hybrid physician leaders advance healthcare improvement by integrating scientific and innovation competencies that build leadership capacity and organizational adaptability.