Interview with Dr. Laura Kaufman
Dr. Laura Kaufman shares her thoughts on advanced degrees and other decisions as she moved from traditional practice to consulting.
She recently quit her full-time clinical position and launched her consulting business. And she enrolled at the Johns Hopkins Bloomberg School of Public Health to pursue a master's degree in patient safety and healthcare quality.
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Pursuing Advanced Degrees and Other Decisions
Dr. Kaufman began her private practice because she values its efficiency. Since completing her residency, she has mostly worked in obstetric anesthesia and served on quality and patient safety committees.
She was concerned about treating patients properly and safely. And she became frustrated when her patients seemed to be rushed through preoperative evaluation in spite of her concerns about their medical readiness.
So when her employer was acquired by another company, she began her consulting company and reduced her clinical hours. She started her nonclinical activities by providing medical opinions in legal proceedings and worked as a consultant for a respiratory therapy device company and an infection control consulting firm. But her main area of interest is improving quality and safety for obstetrical anesthesia care.
Choosing her Master's Degree
As she made those changes, she evaluated master's degree curricula that would support her transition. The Johns Hopkins program provides the coursework and the flexibility she needs.
Dr. Laura Kaufman's Advice
Build your connections, link to other people on LinkedIn because that's how those people find you.
Summary
When Laura became increasingly frustrated with constraints on her ability to practice the way she preferred, she took steps to make a shift in her career. She focused on a consulting business that would meet her desire to improve patient care quality and safety. And she took steps, including evaluation of advanced degrees and other decisions, that would improve her knowledge and authority in her chosen field.
You can reach Dr. Laura Kaufman on LinkedIn.
NOTE: Look below for a transcript of today's episode.
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Links for Today's Episode:
- Dr. Laura Kaufman's LinkedIn Page
- Johns Hopkins Bloomberg School of Public Health
- Physician Leaders: Top 10 Reasons to Pursue a Business Degree
- Which Advanced Degree Will Be Right for a Nonclinical Career? – 191
- How to Use Consulting and Advising to Find Freedom – 249
- How to Build a Terrific Freelance Consulting Business – 145
- NewScr!pt
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Transcription PNC Podcast Episode 283
Advanced Degrees and Other Decisions on the Road to a Nonclinical Career
- Interview with Dr. Laura Kaufman
John: I connected with today's guest on LinkedIn a little while ago because I was drawn to her interest in patient safety and quality improvement. Something I was always interested in when I was a CMO. But anyway, she's a little bit earlier than a lot of my guests in her transition, but I thought her story is interesting and I thought we can learn from her. So, I would like to say hello and welcome to Dr. Laura Kaufman.
Dr. Laura Kaufman: Thank you. Thanks for having me on the show.
John: I'm glad you took the time to join us. We're going to learn a lot from you and. I think it's interesting to talk to someone who's kind of still feeling their way for part of it and making that transition. And so, I look forward to really hear what your thought process has been in this transition that you're in.
Dr. Laura Kaufman: Well, thank you. Yeah.
John: Okay. Why don't you tell us some bit about your background, your education and clinical experience before we get into some of the other things that you're doing.
Dr. Laura Kaufman: Yeah. I did my residency from 2007 to 2011. I'm a little over a decade out from residency. I'm an anesthesiologist by training. I did my undergrad and my med school at University of Missouri in Columbia. My husband and I are both physicians, kind of corny. We're the couple that met in training and we both went up to Rochester, New York then for residency. He was finishing up his neurosurgery residency, I did my anesthesia residency up there.
And then we went down to Atlanta and I started private practice work. I thought I was destined for private practice because I like efficiency, I like speed. I thought that's where I'm going to keep things rolling. I went into private practice then, and I've done private practice ever since. And my husband did his fellowship at the time, and then we came back to Kansas City where I'm from. I did mostly OB anesthesia, it was kind of my area of specialty, kind of 50% or more. That was basically what I did for a decade plus after residency up until May of 2022.
John: Very good. So, you've got a lot of clinical experience, you know what it's like to practice. But for some reason you decided, "Well, maybe I should try something different." I like to hear what was it that triggered you to start thinking of trying something outside of clinical medicine or something in healthcare that can be helpful obviously to patients and to physicians, but is not necessarily giving direct patient care all the time?
Dr. Laura Kaufman: Yeah, I've always been interested in patient safety and quality. I've served on patient safety committees, quality committees, really since finishing residency. But there have been times throughout my career in residency and especially post residency where I thought I really don't know if this is being done as safe as it could have been. I wish that this patient had been more optimized before surgery. I wish that this process was better standardized for the patient. And a couple of patient cases where I got really frustrated and thought, "Wow, I just really don't think we're doing this right for the patient."
That came to a head a couple times in 2021. So, the year before I stopped practicing full-time clinically. While we were on family vacation, I reached out to a few master's programs and I thought "I can get frustrated, I can get mad, I can just say that's it, I quit. I'm not going to do this anymore because it's not safe, it's not the way I want it to be. I don't like it. It's not what I want it to be. I'm not going to do it."
But I found the master's in patient safety and healthcare quality at Johns Hopkins, and I spoke to the advisor there, and it really just seemed to click, it seemed to be what I wanted healthcare to be or be able to take me in the direction of when I wanted healthcare to be. And so, I started working on that master's last year. Honestly not knowing quite where it would take me, but just kind of excited about what that course of study was. And then the unit where I was in charge of OP anesthesia had a corporate buyout in May of 2022, and that's when I transitioned to the master's full-time.
John: Oh, okay. There was an obvious sort of draw the line somewhere because you would've had to do something different or acclimate even to a new system. That's where a lot of people find it's really tough.
Dr. Laura Kaufman: Yeah, yeah. A forced transition of sorts.
John: Yeah. Now I wanted to clarify too, most of us have a combination of things that are pushing us away and things that are drawing us to it. And so, you described that to some extent. For a lot of us, it's burnout. would you say you were affected or by that much at all in terms of just the volumes and the pressure to see more patients, that kind of thing?
Dr. Laura Kaufman: Yeah, for sure. There were moments, especially because of the pandemic, we had not enough staff. We were working 72-hour calls. We were Q2. Every physician has their moments of stress when there's a lot going on. But we were trying to hire, and it's hard to hire when you're showing someone a Q2 schedule.
John: Yes.
Dr. Laura Kaufman: And so, I think that on top of changing to a system where we're transitioning out of the unit where I was in charge, you pile all that on top of a situation where you're already frustrated and it's only a matter of time.
John: Right, right. I was impressed we were talking offline before, and it wasn't just the fact that maybe there were times where it got busy or that kind of thing, but you were really concerned about doing the right thing and treating patients appropriately and in situations where it wouldn't necessarily have really caused a problem to delay. Tell us more.
Dr. Laura Kaufman: Yeah. There were a couple of cases that really prompted me to call or to look into the master's programs where they weren't even necessarily my patient cases, but I was as aware of them or became aware of them. And I wanted to have conversations with other people about them. I talked to my colleagues, talked to other people in the hospital, talked to administrators, and I said, "Look, I really feel that maybe this patient would be better served if they were optimized before coming in, or if they saw other specialists or if they were able to see their primary care doctor before coming in in this context. Or maybe if they weren't treated at this hospital, but they were treated at a different hospital that was more specialized for it."
It wasn't that people weren't willing to listen, but it was more "We hear you, but we still think that we can do it without taking those steps." And I didn't feel that was appropriate and I wasn't personally involved in the care after voicing my concerns, but I just thought this isn't the way it's supposed to be. I need to find a way to fix it. And I'm probably not going to fix it overnight but it needs to be fixed. This isn't serving the patients in the long run.
John: Right. And particularly when you're in a situation where you're asked to maybe give an opinion or you just happen to have to be part of the care for that patient at the time, you definitely want your concerns to be listened to. I think in general, and maybe this isn't true of your institution, but a lot of institutions we get a sense of they just don't appreciate us. They're not really grateful that we're here. They just have us here because we have to be there. We have to sign off on things.
Dr. Laura Kaufman: Right. Right. And you're not trying to be a barrier to getting things done, and you're trying to get that across. That it's not that I don't want to work, it's just that I want to make sure that everything is done safely and, in the patient's best interest.
John: All right. That was one of the things that helped you make that decision. And then you mentioned the other things that went into that. So, what do you think long term? I'm trying to get what your mind is thinking in terms of do you feel like you will maintain your license that you'll be still seeing some patients? Or is that kind of up in the air at this point?
Dr. Laura Kaufman: It's a little up in the air. I have two state licenses because I live really close to the state line of Missouri and Kansas. And I have renewed both of those state licenses into 2023 for both. And I've spoken to a couple of groups around town about doing just some kind of vacation PRN coverage because I don't know that I'm fully ready to step away from clinical work.
But when some other folks have offered me a part-time job, that's not what I'm looking for right now. I like the consulting work. I like working on the masters. And I would like to head more in the direction of the consulting and patient safety and quality work. So, I know some people when they head in the direction that I've headed in are ready to just fully abandon clinical work and send it out the doorway, see you later. But I like keeping that door open.
John: Well, I know a lot of physicians who basically balance the nonclinical and the clinical because they get bored with either one, honestly. They like doing both. And particularly if you're in quality and safety, well, it doesn't hurt to have continued exposure to patients and seeing what is happening in the real world because you're still doing some as opposed to being out completely. And even like the CEOs of Cleveland Clinic and Mayo still see patients or worse, seeing patients one day a week or something. So, it's not like you can't do any kind of even high-level job and not still do...
Dr. Laura Kaufman: Yeah. Yeah.
John: Now on the consulting side, consulting is like this giant possibility. Everybody means different things by consulting. Some do some coaching, they call consulting. Some actually are employed by healthcare consulting firms. Of course, we're talking about freelance consulting type of thing.
Tell us a little bit of what you've done and at this point where you hope your consulting goes, because I think it'll probably evolve, but it's good to hear where you are and what you're planning on doing going forward.
Dr. Laura Kaufman: Yeah, absolutely. The easiest thing, or the first step for me, was legal chart review. I come from a family of lawyers. Much more of my family are lawyers than doctors. And I have friends from growing up and from school that were lawyers. And so, over the years I had family and friends ask what do you think about this case? Or what's your take on this case? What would you have said about this case?
You have enough of those conversations and then maybe someone says, "Can you look at this chart? If I sent you this chart, could you look through this chart, give me an opinion as to whether we should consider settling this or whether we should move forward with it?" And you get a big chart on a CD. Or even before the CDs, it was the giant stack of paper.
And so, I started doing it that way. I really haven't even moved past just doing chart reviews or opinions. I don't do them directly for family members. I think that would probably be a conflict of interest, but my family members and friends have referred me to other lawyers. I haven't done depositions or done court appearances. I'm not opposed to it, but it just hasn't gotten to that point.
But that was what I did mostly in the beginning. And that doesn't take long. It's usually a few hours, but it's nice. It's like a big puzzle. And then I'm usually telling them like, "Yes, I think you're good. I think this is a case that you can easily argue or oh gosh that didn't look good. You might want to think about whether you want to settle."
And that was what I did a lot in the beginning. In the last month I talked to a company that's trying to start out with some anesthesia CME. They're in business doing other types of CME, but they were trying to break into the anesthesia world. So, they wanted to talk about how to structure anesthesia CME, what anesthesia CME is already out there, what I like about anesthesia CME, what I don't like about anesthesia CME, what price points I thought would be appropriate for CME, which was a good question, how the CME could be delivered that people would and wouldn't like. And that was over the course of five hours.
I spoke with a company that wanted consulting for a respiratory therapy device, which I thought was interesting at first. Why are we talking to an anesthesiologist about this? But because we used other devices. That was about an eight-hour job of just talking through respiratory support devices in the recovery room and whatnot.
I've done a little bit of infection control consulting as well. So, it's kind of been just a little bit here and there. When people reach out to me and they have something that I really don't think is in my field, I am going to be honest with them and say, "I'm not sure I'm the person for you." And every once in a while, that's happened and they'll say, "Well, why don't we talk through it anyway?" Or they'll just say, "Well, thank you. I appreciate the honesty."
John: Yeah, yeah. Boy, there's so many things we could talk about. One thing that a lot of beginner consultants talk about is, "How do I price my services?" I think sometimes it's a negotiation. Sometimes it's like the person looking for your help just has that idea in their head "Look, this is what help I need, this is what I'm willing to pay. Is that okay?" So, what have you found so far in trying to come up and especially if you're doing different types of consulting?
Dr. Laura Kaufman: Yeah, that is an excellent question. I will say that I think you should ask for double what you would charge for locums. I think that's a good rule of thumb. And then come down from there.
There was a company that was looking for a physician. By this description, people might be able to find them on LinkedIn, but there is a company that's looking for a physician consultant for a health and fitness app. And I gave them a number and they wanted to pay like a fourth of that. And I said, "Well, good luck." Because they're looking for someone for five to 10 hours a week, and the rate they're looking for is so low. I was willing to negotiate with them for maybe two-thirds to even half of the rate that I would've charged that they were just trying to get a physician for a ridiculous amount of money. And I think they just wanted to be able to say they had a physician on staff.
John: Yeah. I think a lot of startups especially, they'll even try and get you to work for free and they'll maybe promise you some kind of payout when they go public or something crazy, which is years down the road. I know of people that have done that, but it's something you have to have other sources of income and a lot of patience.
Dr. Laura Kaufman: Yeah. And they'll negotiate with you and sometimes they'll even give you a number. The respiratory company, they said, "Can you send us your CV and then we will send you our quote?" And their quote was twice what I would charge for locums. So, I was like, "Wow. Sounds good. Thank you."
John: Now let's go back to the other thing, the educational, that you're in the middle of it now, the master's degree. Explain what the master's degree that you're doing is, the title of it, what is being taught? And also, how you ended up at this one? And I'm trying to think in my head. If I'm in the east coast and I happen to be around a lot of medical schools and it would be really easy to find a master's with pretty good quality, but there's so many things online now too. So, I'd like to hear a little bit about how you decided. I mean, Johns Hopkins is a big name. It's a good story. But tell me more.
Dr. Laura Kaufman: I honestly just started looking at master's programs. Who has masters that I can access? Because there are universities here in town, here in Kansas City. I could have looked for an in-person program. I didn't think I was looking for an MPH. I wanted something that was geared towards quality and safety. And so, it was kind of great that that was all in the title Masters of Patient Safety and Healthcare Quality. At least when I started looking, there were two to three programs around the country.
The nice thing about the Johns Hopkins one is it is fully online. Because some physician's masters do require you to travel a few times a year. Not that if the masters that you really want to do, that should necessarily prevent you from doing it. Because I've met some people that were working on MPHs or MBHs or MBAs that traveled and they thought it was definitely worth it for that degree. But I really loved that this was fully online, that most of it was asynchronous except for a few live talks. They were willing to work with you if that live talk time that was at 7:00 PM really didn't work for you, that you emailed the professor and explained it and it was okay.
And also, their goal is that you finish it within two years, but it's a soft two years. If you need to stretch it out, your advisor is pretty reasonable. It's not easy coursework. The statistics and the epidemiology, it's graduate level. They're not softball for you just because you've already done an MD, which is fine. Because the degree should mean something when you're using it later. But I also really liked that the advisor talked me through it. She said, "These are the other master's programs we have. What is your goal?" And then when we finished talking about it, she's like, "Yeah, I don't really think any of the other masters would be right for you."
John: Let's see. I have other questions about that. In an MBA it's typical, of course, that is a business degree, it's a little different, that usually you end up working in a team on some project or something like that. Is there anything similar to that in this kind of master's program?
Dr. Laura Kaufman: There are a couple of classes that have group papers. There is some online collaboration in Google classrooms and then there's some chat boards in the classes that are interactive sharing of articles and topics and things like that.
John: Okay. Because one of the things I hear on the MBA side is that the networking sometimes is as valuable as the actual education. In other words, you might come out with a cohort of 15 or 20 contacts all of whom are going into something. And for the ones that I'm know of, that involves physicians.
Dr. Laura Kaufman: Oh, sure.
John: There might be like the UT PEMBA is a Physician Executive MBA. Not only do they learn all those things, but then they have these contacts that over time may help with their careers if they're working in their system or something. So, it seems like a lot of the masters do. I did a master's in public health many, many years ago and it was remote. But there was very little kind of collaboration among the students in the program I did. I missed out on to some extent. But it's just amazing what's available now for people to start looking.
The other advantage, of course, of being in a program, not so much for someone like you who is kind of starting their consulting business, but to get a job, it demonstrates your commitment and it shows that you're really interested in that particular thing. Even though you don't have the degree when you're looking for let's say a job with an institution or something, even just being in the program can be very helpful.
Dr. Laura Kaufman: Yeah. Yeah.
John: Well, let's see. That's all useful. Now what about LinkedIn? I'm just curious because that's how I found you or you found me. We found each other.
Dr. Laura Kaufman: Yeah.
John: And we've talked many times about how useful it can be. Anything going on there with you at this point yet? Have you found it? You have a good profile. I looked at it and it's there. And if people that are listening want to reach out to you, they can definitely just look for Laura Kaufman MD on LinkedIn and find out more about what you're doing. But anything about LinkedIn you'd like to share at this point?
Dr. Laura Kaufman: I definitely would say I learned a lot about LinkedIn from the Physician Nonclinical group on Facebook. I knew nothing about it or resumes before that group. I used Heather Fork's resume builder to build myself a resume because I had a CV. I had a CV, not a resume. Very different. I made that mistake for a month or so.
John: Do you hear that? Do you hear that bell? That's my acknowledgement to plug for Heather Fork. Sorry, go ahead.
Dr. Laura Kaufman: Yeah, absolutely. I was not using a resume before I used that. And my LinkedIn did not look good before that. But the legal review stuff, because I had the connections, I think I could have done without the LinkedIn, but the companies that have found me have found me through LinkedIn. I think that's huge. I think you have to figure out how to build your LinkedIn in order to find the consulting, especially if you're doing the freelance like I am right now. Otherwise, I don't know how you would find those people. So, definitely build your connections, link to other people on LinkedIn because that's how those people find you. And so, that's great.
John: Yeah. I think if you even just connect with people that seem to be doing similar things in your industry or in your line of work or that kind of thing, see if they're posting things, maybe start posting things. I've known people that have done that as a way to just generate some interest and collaboration when they see what you're actually doing. But I think what you've put in there already shows your interests and people can definitely find you on LinkedIn if they're interested in getting some consulting for quality improvement in patient safety.
Is your focus to get back to that, the consulting itself? Is it focused on any particular setting? Is it mostly because of anesthesia and OB anesthesia and so forth? Is it more in the hospital setting? Is it large groups? I don't know, there might be things in public health, I don't even know. But what have you found so far to be the opportunities other than being the medical expert?
Dr. Laura Kaufman: Oh, sure. Mostly inpatient, really, because that's what I know. Yeah. I've got to be honest, I'm not as familiar with outpatient ambulatory clinic. Inpatient is more where I'm comfortable. Inpatient ORs, I love OR consulting. That's where I'm most comfortable. Absolutely. Yeah.
John: Well, that's good to know because there are a lot of people that listen to the podcast, so someone that's in that setting might even pick up on that. I will say this too, as a CMO, in my prior life, we hired a lot of consultants.
Dr. Laura Kaufman: Oh, yeah. I bet.
John: Every time we had a new project, we wanted to start a new service line or we needed to adopt a latest trend or whatever it was in patient care or coding and documentation, you name it. And that's where the money is for sure, because groups really don't have money to spend on consultants for the most part. But there's other agencies that do. Okay, that's very useful.
So, where do you see things going? Do you have any big plans for the next six months? Are you going to keep plugging away on the masters and just keep lining up new clients? Anything new that you're going to be trying?
Dr. Laura Kaufman: Yeah, that's a great question. I think I'm just going to keep plugging away. I've got two classes signed up for the spring and I've told a couple groups that I can do some vacation coverage for them here and there. Trying not to get too over-committed clinically though. But it's actually really refreshing to not have a definitive "This is where I will be Monday, Tuesday, Wednesday, Thursday, Friday." Especially as type A physicians, it's kind of fun to have it be a surprise what the next project is. Yeah, let this ride for a little bit.
John: Yeah. For some people that might be too scary, but I think I would enjoy that too. There are different things, you're being sort of tested in a way differently in different environments. Let me ask you this one side question though.
Dr. Laura Kaufman: Sure.
John: Have you been able to charge more for your clinical work as a part-time fill-in as kind of like a mini locums?
Dr. Laura Kaufman: Yes, I have. Yes. And I don't know if that bubble will burst, but yes.
John: When they need someone, it's like supply and demand, right?
Dr. Laura Kaufman: Right, right.
John: Now you not only have an easier clinical time of it because you're not doing so much, but you can actually get paid at a higher rate.
Dr. Laura Kaufman: Yeah. Yeah. And it could be location too because the Midwest is probably a harder place to bring people into.
John: Yeah. Especially when you get out in the country.
Dr. Laura Kaufman: Yeah, that's for sure.
John: That's really hard. All right, Laura. Well, this has been interesting. We're going to have to have you come back in a year or so.
Dr. Laura Kaufman: Yeah. To give an update.
John: I think it's been very interesting and I think the listeners will get some good insights if they're a little leery about doing something like you've already started to do.
Dr. Laura Kaufman: Hopefully it'll encourage some people to take some chances or to think about taking chances if they don't feel as adventurous.
John: I think it will. And if they want to reach out to you, again, connect on LinkedIn, Laura Kaufman MKD. I guess that's it for today. I want to really thank you again for coming on and sharing this with us.
Dr. Laura Kaufman: Yeah, thanks for having me.
John: You're welcome. All right. Bye-bye.
Dr. Laura Kaufman: Bye.
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Transcription PNC Podcast Episode 283
Advanced Degrees and Other Decisions on the Road to a Nonclinical Career
- Interview with Dr. Laura Kaufman
John: I connected with today's guest on LinkedIn a little while ago because I was drawn to her interest in patient safety and quality improvement. Something I was always interested in when I was a CMO. But anyway, she's a little bit earlier than a lot of my guests in her transition, but I thought her story is interesting and I thought we can learn from her. So, I would like to say hello and welcome to Dr. Laura Kaufman.
Dr. Laura Kaufman: Thank you. Thanks for having me on the show.
John: I'm glad you took the time to join us. We're going to learn a lot from you and. I think it's interesting to talk to someone who's kind of still feeling their way for part of it and making that transition. And so, I look forward to really hear what your thought process has been in this transition that you're in.
Dr. Laura Kaufman: Well, thank you. Yeah.
John: Okay. Why don't you tell us some bit about your background, your education and clinical experience before we get into some of the other things that you're doing.
Dr. Laura Kaufman: Yeah. I did my residency from 2007 to 2011. I'm a little over a decade out from residency. I'm an anesthesiologist by training. I did my undergrad and my med school at University of Missouri in Columbia. My husband and I are both physicians, kind of corny. We're the couple that met in training and we both went up to Rochester, New York then for residency. He was finishing up his neurosurgery residency, I did my anesthesia residency up there.
And then we went down to Atlanta and I started private practice work. I thought I was destined for private practice because I like efficiency, I like speed. I thought that's where I'm going to keep things rolling. I went into private practice then, and I've done private practice ever since. And my husband did his fellowship at the time, and then we came back to Kansas City where I'm from. I did mostly OB anesthesia, it was kind of my area of specialty, kind of 50% or more. That was basically what I did for a decade plus after residency up until May of 2022.
John: Very good. So, you've got a lot of clinical experience, you know what it's like to practice. But for some reason you decided, "Well, maybe I should try something different." I like to hear what was it that triggered you to start thinking of trying something outside of clinical medicine or something in healthcare that can be helpful obviously to patients and to physicians, but is not necessarily giving direct patient care all the time?
Dr. Laura Kaufman: Yeah, I've always been interested in patient safety and quality. I've served on patient safety committees, quality committees, really since finishing residency. But there have been times throughout my career in residency and especially post residency where I thought I really don't know if this is being done as safe as it could have been. I wish that this patient had been more optimized before surgery. I wish that this process was better standardized for the patient. And a couple of patient cases where I got really frustrated and thought, "Wow, I just really don't think we're doing this right for the patient."
That came to a head a couple times in 2021. So, the year before I stopped practicing full-time clinically. While we were on family vacation, I reached out to a few master's programs and I thought "I can get frustrated, I can get mad, I can just say that's it, I quit. I'm not going to do this anymore because it's not safe, it's not the way I want it to be. I don't like it. It's not what I want it to be. I'm not going to do it."
But I found the master's in patient safety and healthcare quality at Johns Hopkins, and I spoke to the advisor there, and it really just seemed to click, it seemed to be what I wanted healthcare to be or be able to take me in the direction of when I wanted healthcare to be. And so, I started working on that master's last year. Honestly not knowing quite where it would take me, but just kind of excited about what that course of study was. And then the unit where I was in charge of OP anesthesia had a corporate buyout in May of 2022, and that's when I transitioned to the master's full-time.
John: Oh, okay. There was an obvious sort of draw the line somewhere because you would've had to do something different or acclimate even to a new system. That's where a lot of people find it's really tough.
Dr. Laura Kaufman: Yeah, yeah. A forced transition of sorts.
John: Yeah. Now I wanted to clarify too, most of us have a combination of things that are pushing us away and things that are drawing us to it. And so, you described that to some extent. For a lot of us, it's burnout. would you say you were affected or by that much at all in terms of just the volumes and the pressure to see more patients, that kind of thing?
Dr. Laura Kaufman: Yeah, for sure. There were moments, especially because of the pandemic, we had not enough staff. We were working 72-hour calls. We were Q2. Every physician has their moments of stress when there's a lot going on. But we were trying to hire, and it's hard to hire when you're showing someone a Q2 schedule.
John: Yes.
Dr. Laura Kaufman: And so, I think that on top of changing to a system where we're transitioning out of the unit where I was in charge, you pile all that on top of a situation where you're already frustrated and it's only a matter of time.
John: Right, right. I was impressed we were talking offline before, and it wasn't just the fact that maybe there were times where it got busy or that kind of thing, but you were really concerned about doing the right thing and treating patients appropriately and in situations where it wouldn't necessarily have really caused a problem to delay. Tell us more.
Dr. Laura Kaufman: Yeah. There were a couple of cases that really prompted me to call or to look into the master's programs where they weren't even necessarily my patient cases, but I was as aware of them or became aware of them. And I wanted to have conversations with other people about them. I talked to my colleagues, talked to other people in the hospital, talked to administrators, and I said, "Look, I really feel that maybe this patient would be better served if they were optimized before coming in, or if they saw other specialists or if they were able to see their primary care doctor before coming in in this context. Or maybe if they weren't treated at this hospital, but they were treated at a different hospital that was more specialized for it."
It wasn't that people weren't willing to listen, but it was more "We hear you, but we still think that we can do it without taking those steps." And I didn't feel that was appropriate and I wasn't personally involved in the care after voicing my concerns, but I just thought this isn't the way it's supposed to be. I need to find a way to fix it. And I'm probably not going to fix it overnight but it needs to be fixed. This isn't serving the patients in the long run.
John: Right. And particularly when you're in a situation where you're asked to maybe give an opinion or you just happen to have to be part of the care for that patient at the time, you definitely want your concerns to be listened to. I think in general, and maybe this isn't true of your institution, but a lot of institutions we get a sense of they just don't appreciate us. They're not really grateful that we're here. They just have us here because we have to be there. We have to sign off on things.
Dr. Laura Kaufman: Right. Right. And you're not trying to be a barrier to getting things done, and you're trying to get that across. That it's not that I don't want to work, it's just that I want to make sure that everything is done safely and, in the patient's best interest.
John: All right. That was one of the things that helped you make that decision. And then you mentioned the other things that went into that. So, what do you think long term? I'm trying to get what your mind is thinking in terms of do you feel like you will maintain your license that you'll be still seeing some patients? Or is that kind of up in the air at this point?
Dr. Laura Kaufman: It's a little up in the air. I have two state licenses because I live really close to the state line of Missouri and Kansas. And I have renewed both of those state licenses into 2023 for both. And I've spoken to a couple of groups around town about doing just some kind of vacation PRN coverage because I don't know that I'm fully ready to step away from clinical work.
But when some other folks have offered me a part-time job, that's not what I'm looking for right now. I like the consulting work. I like working on the masters. And I would like to head more in the direction of the consulting and patient safety and quality work. So, I know some people when they head in the direction that I've headed in are ready to just fully abandon clinical work and send it out the doorway, see you later. But I like keeping that door open.
John: Well, I know a lot of physicians who basically balance the nonclinical and the clinical because they get bored with either one, honestly. They like doing both. And particularly if you're in quality and safety, well, it doesn't hurt to have continued exposure to patients and seeing what is happening in the real world because you're still doing some as opposed to being out completely. And even like the CEOs of Cleveland Clinic and Mayo still see patients or worse, seeing patients one day a week or something. So, it's not like you can't do any kind of even high-level job and not still do...
Dr. Laura Kaufman: Yeah. Yeah.
John: Now on the consulting side, consulting is like this giant possibility. Everybody means different things by consulting. Some do some coaching, they call consulting. Some actually are employed by healthcare consulting firms. Of course, we're talking about freelance consulting type of thing.
Tell us a little bit of what you've done and at this point where you hope your consulting goes, because I think it'll probably evolve, but it's good to hear where you are and what you're planning on doing going forward.
Dr. Laura Kaufman: Yeah, absolutely. The easiest thing, or the first step for me, was legal chart review. I come from a family of lawyers. Much more of my family are lawyers than doctors. And I have friends from growing up and from school that were lawyers. And so, over the years I had family and friends ask what do you think about this case? Or what's your take on this case? What would you have said about this case?
You have enough of those conversations and then maybe someone says, "Can you look at this chart? If I sent you this chart, could you look through this chart, give me an opinion as to whether we should consider settling this or whether we should move forward with it?" And you get a big chart on a CD. Or even before the CDs, it was the giant stack of paper.
And so, I started doing it that way. I really haven't even moved past just doing chart reviews or opinions. I don't do them directly for family members. I think that would probably be a conflict of interest, but my family members and friends have referred me to other lawyers. I haven't done depositions or done court appearances. I'm not opposed to it, but it just hasn't gotten to that point.
But that was what I did mostly in the beginning. And that doesn't take long. It's usually a few hours, but it's nice. It's like a big puzzle. And then I'm usually telling them like, "Yes, I think you're good. I think this is a case that you can easily argue or oh gosh that didn't look good. You might want to think about whether you want to settle."
And that was what I did a lot in the beginning. In the last month I talked to a company that's trying to start out with some anesthesia CME. They're in business doing other types of CME, but they were trying to break into the anesthesia world. So, they wanted to talk about how to structure anesthesia CME, what anesthesia CME is already out there, what I like about anesthesia CME, what I don't like about anesthesia CME, what price points I thought would be appropriate for CME, which was a good question, how the CME could be delivered that people would and wouldn't like. And that was over the course of five hours.
I spoke with a company that wanted consulting for a respiratory therapy device, which I thought was interesting at first. Why are we talking to an anesthesiologist about this? But because we used other devices. That was about an eight-hour job of just talking through respiratory support devices in the recovery room and whatnot.
I've done a little bit of infection control consulting as well. So, it's kind of been just a little bit here and there. When people reach out to me and they have something that I really don't think is in my field, I am going to be honest with them and say, "I'm not sure I'm the person for you." And every once in a while, that's happened and they'll say, "Well, why don't we talk through it anyway?" Or they'll just say, "Well, thank you. I appreciate the honesty."
John: Yeah, yeah. Boy, there's so many things we could talk about. One thing that a lot of beginner consultants talk about is, "How do I price my services?" I think sometimes it's a negotiation. Sometimes it's like the person looking for your help just has that idea in their head "Look, this is what help I need, this is what I'm willing to pay. Is that okay?" So, what have you found so far in trying to come up and especially if you're doing different types of consulting?
Dr. Laura Kaufman: Yeah, that is an excellent question. I will say that I think you should ask for double what you would charge for locums. I think that's a good rule of thumb. And then come down from there.
There was a company that was looking for a physician. By this description, people might be able to find them on LinkedIn, but there is a company that's looking for a physician consultant for a health and fitness app. And I gave them a number and they wanted to pay like a fourth of that. And I said, "Well, good luck." Because they're looking for someone for five to 10 hours a week, and the rate they're looking for is so low. I was willing to negotiate with them for maybe two-thirds to even half of the rate that I would've charged that they were just trying to get a physician for a ridiculous amount of money. And I think they just wanted to be able to say they had a physician on staff.
John: Yeah. I think a lot of startups especially, they'll even try and get you to work for free and they'll maybe promise you some kind of payout when they go public or something crazy, which is years down the road. I know of people that have done that, but it's something you have to have other sources of income and a lot of patience.
Dr. Laura Kaufman: Yeah. And they'll negotiate with you and sometimes they'll even give you a number. The respiratory company, they said, "Can you send us your CV and then we will send you our quote?" And their quote was twice what I would charge for locums. So, I was like, "Wow. Sounds good. Thank you."
John: Now let's go back to the other thing, the educational, that you're in the middle of it now, the master's degree. Explain what the master's degree that you're doing is, the title of it, what is being taught? And also, how you ended up at this one? And I'm trying to think in my head. If I'm in the east coast and I happen to be around a lot of medical schools and it would be really easy to find a master's with pretty good quality, but there's so many things online now too. So, I'd like to hear a little bit about how you decided. I mean, Johns Hopkins is a big name. It's a good story. But tell me more.
Dr. Laura Kaufman: I honestly just started looking at master's programs. Who has masters that I can access? Because there are universities here in town, here in Kansas City. I could have looked for an in-person program. I didn't think I was looking for an MPH. I wanted something that was geared towards quality and safety. And so, it was kind of great that that was all in the title Masters of Patient Safety and Healthcare Quality. At least when I started looking, there were two to three programs around the country.
The nice thing about the Johns Hopkins one is it is fully online. Because some physician's masters do require you to travel a few times a year. Not that if the masters that you really want to do, that should necessarily prevent you from doing it. Because I've met some people that were working on MPHs or MBHs or MBAs that traveled and they thought it was definitely worth it for that degree. But I really loved that this was fully online, that most of it was asynchronous except for a few live talks. They were willing to work with you if that live talk time that was at 7:00 PM really didn't work for you, that you emailed the professor and explained it and it was okay.
And also, their goal is that you finish it within two years, but it's a soft two years. If you need to stretch it out, your advisor is pretty reasonable. It's not easy coursework. The statistics and the epidemiology, it's graduate level. They're not softball for you just because you've already done an MD, which is fine. Because the degree should mean something when you're using it later. But I also really liked that the advisor talked me through it. She said, "These are the other master's programs we have. What is your goal?" And then when we finished talking about it, she's like, "Yeah, I don't really think any of the other masters would be right for you."
John: Let's see. I have other questions about that. In an MBA it's typical, of course, that is a business degree, it's a little different, that usually you end up working in a team on some project or something like that. Is there anything similar to that in this kind of master's program?
Dr. Laura Kaufman: There are a couple of classes that have group papers. There is some online collaboration in Google classrooms and then there's some chat boards in the classes that are interactive sharing of articles and topics and things like that.
John: Okay. Because one of the things I hear on the MBA side is that the networking sometimes is as valuable as the actual education. In other words, you might come out with a cohort of 15 or 20 contacts all of whom are going into something. And for the ones that I'm know of, that involves physicians.
Dr. Laura Kaufman: Oh, sure.
John: There might be like the UT PEMBA is a Physician Executive MBA. Not only do they learn all those things, but then they have these contacts that over time may help with their careers if they're working in their system or something. So, it seems like a lot of the masters do. I did a master's in public health many, many years ago and it was remote. But there was very little kind of collaboration among the students in the program I did. I missed out on to some extent. But it's just amazing what's available now for people to start looking.
The other advantage, of course, of being in a program, not so much for someone like you who is kind of starting their consulting business, but to get a job, it demonstrates your commitment and it shows that you're really interested in that particular thing. Even though you don't have the degree when you're looking for let's say a job with an institution or something, even just being in the program can be very helpful.
Dr. Laura Kaufman: Yeah. Yeah.
John: Well, let's see. That's all useful. Now what about LinkedIn? I'm just curious because that's how I found you or you found me. We found each other.
Dr. Laura Kaufman: Yeah.
John: And we've talked many times about how useful it can be. Anything going on there with you at this point yet? Have you found it? You have a good profile. I looked at it and it's there. And if people that are listening want to reach out to you, they can definitely just look for Laura Kaufman MD on LinkedIn and find out more about what you're doing. But anything about LinkedIn you'd like to share at this point?
Dr. Laura Kaufman: I definitely would say I learned a lot about LinkedIn from the Physician Nonclinical group on Facebook. I knew nothing about it or resumes before that group. I used Heather Fork's resume builder to build myself a resume because I had a CV. I had a CV, not a resume. Very different. I made that mistake for a month or so.
John: Do you hear that? Do you hear that bell? That's my acknowledgement to plug for Heather Fork. Sorry, go ahead.
Dr. Laura Kaufman: Yeah, absolutely. I was not using a resume before I used that. And my LinkedIn did not look good before that. But the legal review stuff, because I had the connections, I think I could have done without the LinkedIn, but the companies that have found me have found me through LinkedIn. I think that's huge. I think you have to figure out how to build your LinkedIn in order to find the consulting, especially if you're doing the freelance like I am right now. Otherwise, I don't know how you would find those people. So, definitely build your connections, link to other people on LinkedIn because that's how those people find you. And so, that's great.
John: Yeah. I think if you even just connect with people that seem to be doing similar things in your industry or in your line of work or that kind of thing, see if they're posting things, maybe start posting things. I've known people that have done that as a way to just generate some interest and collaboration when they see what you're actually doing. But I think what you've put in there already shows your interests and people can definitely find you on LinkedIn if they're interested in getting some consulting for quality improvement in patient safety.
Is your focus to get back to that, the consulting itself? Is it focused on any particular setting? Is it mostly because of anesthesia and OB anesthesia and so forth? Is it more in the hospital setting? Is it large groups? I don't know, there might be things in public health, I don't even know. But what have you found so far to be the opportunities other than being the medical expert?
Dr. Laura Kaufman: Oh, sure. Mostly inpatient, really, because that's what I know. Yeah. I've got to be honest, I'm not as familiar with outpatient ambulatory clinic. Inpatient is more where I'm comfortable. Inpatient ORs, I love OR consulting. That's where I'm most comfortable. Absolutely. Yeah.
John: Well, that's good to know because there are a lot of people that listen to the podcast, so someone that's in that setting might even pick up on that. I will say this too, as a CMO, in my prior life, we hired a lot of consultants.
Dr. Laura Kaufman: Oh, yeah. I bet.
John: Every time we had a new project, we wanted to start a new service line or we needed to adopt a latest trend or whatever it was in patient care or coding and documentation, you name it. And that's where the money is for sure, because groups really don't have money to spend on consultants for the most part. But there's other agencies that do. Okay, that's very useful.
So, where do you see things going? Do you have any big plans for the next six months? Are you going to keep plugging away on the masters and just keep lining up new clients? Anything new that you're going to be trying?
Dr. Laura Kaufman: Yeah, that's a great question. I think I'm just going to keep plugging away. I've got two classes signed up for the spring and I've told a couple groups that I can do some vacation coverage for them here and there. Trying not to get too over-committed clinically though. But it's actually really refreshing to not have a definitive "This is where I will be Monday, Tuesday, Wednesday, Thursday, Friday." Especially as type A physicians, it's kind of fun to have it be a surprise what the next project is. Yeah, let this ride for a little bit.
John: Yeah. For some people that might be too scary, but I think I would enjoy that too. There are different things, you're being sort of tested in a way differently in different environments. Let me ask you this one side question though.
Dr. Laura Kaufman: Sure.
John: Have you been able to charge more for your clinical work as a part-time fill-in as kind of like a mini locums?
Dr. Laura Kaufman: Yes, I have. Yes. And I don't know if that bubble will burst, but yes.
John: When they need someone, it's like supply and demand, right?
Dr. Laura Kaufman: Right, right.
John: Now you not only have an easier clinical time of it because you're not doing so much, but you can actually get paid at a higher rate.
Dr. Laura Kaufman: Yeah. Yeah. And it could be location too because the Midwest is probably a harder place to bring people into.
John: Yeah. Especially when you get out in the country.
Dr. Laura Kaufman: Yeah, that's for sure.
John: That's really hard. All right, Laura. Well, this has been interesting. We're going to have to have you come back in a year or so.
Dr. Laura Kaufman: Yeah. To give an update.
John: I think it's been very interesting and I think the listeners will get some good insights if they're a little leery about doing something like you've already started to do.
Dr. Laura Kaufman: Hopefully it'll encourage some people to take some chances or to think about taking chances if they don't feel as adventurous.
John: I think it will. And if they want to reach out to you, again, connect on LinkedIn, Laura Kaufman MKD. I guess that's it for today. I want to really thank you again for coming on and sharing this with us.
Dr. Laura Kaufman: Yeah, thanks for having me.
John: You're welcome. All right. Bye-bye.
Dr. Laura Kaufman: Bye.
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