In this episode, we explore the proper way to pivot to a nonclinical career. Granted, there may be various ways to make such a change. But there is good evidence that following this process will minimize your risk while optimizing your odds of success.

There are four major phases, some of which can easily overlap. I plan to use this model of the four phases to help organize future episodes of this podcast. These phases definitely follow the steps I took as I transitioned from full-time family physician to hospital chief medical officer. While there is no ONE, this is a model that has been shown to work.


You may notice that they follow the steps outlined in a book written by Jenny Blake called Pivot: The Only Move That Matters Is Your Next OneIt’s a book I highly recommend, in part because Blake helps assure the reader that taking small, yet effective, steps can get you to that new career or business without risking everything.

Here are the four phases being discussed:

  1. Address the mindset
  2. Educate yourself
  3. Try small pilots
  4. Execute the transformation

Phase 1

The First Phase is emotional and intellectual. Most of us leave clinical medicine because of a combination of two factors:

  • Something about medicine is pushing us away, like burnout, boredom, tedium, or frustration, and
  • Something is also pulling us to it, like a mission, passion, sense of adventure, compelling interest, greater meaning or  more freedom.

The first question to answer is: Do I really need to leave clinical medicine to make a change? Or, are there alternatives?

  • Change my practice location, or move to another local organization?
  • Change or narrow my specialty?
  • Simplify my work (i.e., eliminate hospital work or office work)?
  • Go part-time?
  • Do locums?
  • Take a sabbatical?

Only when you are clear about the WHY, will your efforts be productive and sustainable. The WHY will help to sustain your journey.

You will also need to prepare for the self-doubt that will appear.

I remember at different times on my journey, internal self-talk that sounded like this:

  • I just don’t have the skills to do that job.
  • They’ll see right through me.
  • I’m not ready for this.
  • I don’t want to fail and I don’t want to look stupid.

This doubt is very common – it's human nature.

But here’s what I have to say about that…

As a successful physician, you have already demonstrated intelligence, focus, endurance, resolve, and what some call grit. I’m also convinced that you have the qualities to be a leader in whatever career you pursue. So, don't let those self-doubts and false self-limiting beliefs stop your progress.

In summary, this phase is complete when you’ve:

  • Determined the Why behind this transition,
  • Begun to formulate your vision for 1 to 5 years out, and,
  • Prepared to face the self-doubt that might show up.

Phase 2

The Second Phase is about EXPLORATION. You can start this Phase even while still considering the questions in Phase 1. Phase 2 involves refocusing your commitment to Lifelong Learning. Because now, some of the learning is directed to one or more Non-Clinical domains. Even if you are VERY early in the process, this Phase can both prepare you for a future pivot AND help you decide what that eventual career might be.

Shift some of the time that you now devote to your clinical realm to the NON-clinical. Some of the exploration can be quite nonspecific. There are many skills that will serve you well in almost ANY non-clinical career. Skills such as:

  • Non-medical writing
  • Negotiation
  • Accounting
  • Leadership and management
  • Public speaking
  • Creating PowerPoint presentations
  • Marketing
  • Information technology
  • Project management
  • Epidemiology and statistics

Learning these “generic” skills will expose you to related topics and potential career choices. As you narrow your options you can begin more intentional research and investigation into what’s available. Unless you’ve already discovered a likely new career, you may need to do some intense study on what’s out there.

Many options exist – here is a short list:

  • Consultant
  • Medical director
  • Medical advisor
  • Writer
  • Expert witness
  • Professional or life coach
  • Researcher
  • Entrepreneur
  • Medical group manager or executive
  • Paid speaker
  • Hospital executive
  • Nonprofit sector medical director or CEO
  • Government sector employee
  • Inventor

This phase involves research into what’s out there.

Phase 3

Phase Three involves trying small PILOTS. These can be a side hustle/part-time work, writing, speaking, volunteering in professional societies, utilization review, quality or safety work, or coding and documentation.

Phase 4

Finally, it will be time to jump in and execute your pivot to the new career. This is Phase Four. You’ve considered your options, committed to making the change, acquired the necessary skills to get started. And remember, you won’t really master this new career until you’ve been in it for a while.

It’s time to interview and take that new job, start the new business, or commit to full-time coaching, speaking or writing.

Not everyone follows this exact path, but it serves as a good model to follow.

Let me summarize the steps again:

  1. Address your mindset; consider alternatives to a nonclinical career; start to develop your mission and vision of what life will look like. And prepare yourself to ignore the negative self-talk and self-doubt that will show up.
  2. Learn general nonclinical skills such as writing and accounting, then investigate specific nonclinical career options. Expose yourself to them through internet research, blogs, websites, books and conversations.
  3. Try small pilots in the areas that seem attractive to you. Join appropriate professional groups and attend pertinent conferences. Find a mentor or two and do some part-time work, paid or volunteer, that will advance your progress.
  4. You can circle back and repeat parts of the process. But when it seems right – give it your best shot and execute your pivot to the new career.

Here is a list of resources mentioned in this episode:

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If you're ready to move on, here is Episode 003: Seeking an MBA.

If you'd like to listen to the premier episode and its show notes, you can find it here: Getting Acquainted with Physician NonClinical Careers Podcast – 001