Back to Basics

In today's podcast, John dispels the myths about alternative jobs for clinicians.

When you're burned out and thinking about leaving clinical practice, you may feel overwhelmed. And you may buy into certain myths that can stop you before you even get started.

Your first step will be to learn that the following myths are easily dispelled:

  1. “There aren't that many jobs available.”
  2. “All I know how to do is practice medicine.”
  3. “I won't be able to make a reasonable income.”
  4. “I will be abandoning patients.”
  5. “My reputation and status will decline.”

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Common Myths About Alternative Jobs

Here are the reasons that these common myths about alternative jobs are NOT true.

1.  “There are limited jobs”

There are jobs in pharma and medical device companies, in hospitals and health systems, and in the insurance industry (health, life, and disability insurance). And there are at least five distinct types of medical writing jobs.

There are jobs in consulting and consumer health. The federal government and public health organizations employ thousands of physicians doing nonclinical work.

There are nonprofit companies and educational institutions that need experienced physicians for nonclinical positions.

2. “All I know is medicine.”

As a physician, you have a deep understanding of biochemistry, pharmacology, physiology, microbiology, anatomy, epidemiology, and statistics. There are dozens of domains in which you have extensive training and experience (from informatics to billing to quality improvement). And you are knowledgeable about the healthcare system itself.

3. “My income will drop.”

When you consider the long hours, the medical liability, the frustration, the stress, and the lack of balance in your life, a slight drop in income becomes meaningless. While income may suffer temporarily, it's usually associated with working fewer hours and taking time off for vacations. You're going to sleep better; you're not going to be on call; and you're not going to be sued.

4. “I'm abandoning my patients”

If you're working in pharma, you're creating medications that help patients. As Medical Director for Quality Improvement or CQO you're doing quality and safety in the hospital or outpatient setting and saving lives and improving the safety of those patients. If you're in an insurance company, you're keeping patients from getting the wrong tests and the wrong procedures. And if you're a writer or educator, you're teaching patients, colleagues, or medical students.

So, you will be improving healthcare and helping large numbers of patients rather than the few you would treat individually.

5. “My reputation and influence will decline.”

You're still a physician, leveraging your clinical knowledge. You'll often be managing a team. You're seen as a content expert. And you're often a leader in these positions.

As a primary care doctor in a hospital, you will be just one of many working at that institution. But if you're a medical director or CMO, you are the person that others seek out to improve a process or solve a problem. And your standing and visibility improve.

Getting Started

Once you've accepted that the myths about alternative jobs are NOT true, the next step is to become familiar with as many potential nontraditional jobs as you can. You can do that by downloading a list of 70 nonclinical jobs here and reading books dedicated to the subject, such as Dr. Sylvie Stacy's 50 Nonclinical Careers for Physicians.

Spend time thinking about your personality, interests, and skill sets. Then create a list of jobs that align with those 3 factors, as well as the demand for physicians for those jobs. 

Once you've narrowed the list to one or two options, get to work on learning, preparing a resume and cover letter, networking, finding a mentor or two, and building your LinkedIn profile.


The bottom line is that there are many alternative job openings for physicians, regardless of background and years in practice. The first step is to overcome limiting beliefs keeping you from looking. Then spend time learning about the nature of available alternative careers.

Furthermore, when you're preparing to pursue an alternative career, it doesn't hurt to stack other skills. And it could be anything: how to do photography; how to read financial statements; or becoming a better public speaker. Simply pick a few and work on them, and you'll find that by adding them to your existing skills, you'll become a unique applicant for one of these new positions.

NOTE: Look below for a transcript of today's episode.

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Transcription PNC Podcast Episode 252

How to Kill the Myths About Alternative Jobs for Clinicians

John: All right. My friends and colleagues, as I mentioned, I am going to go through the content of a presentation I did a few months ago. And we're going to talk about some of the myths associated with alternative careers, and how to overcome those. And so, let's just get right into it at this point.

Now I usually tell a short story here. And the reason I do this is because for some of you who are just starting on this journey, it can seem very daunting, but I know of someone and she was not the world's best student, but she made it through high school, graduated a little bit early and then went to junior college and became certified as a respiratory therapist.

She loved her job, and she worked at several big hospitals and some smaller hospitals. And ultimately, she got to the point though, where she was experiencing a lot of frustration and burnout, just the way we as physicians typically do. She was staffed very thinly at the hospital she was working at. She and two or three of her other respiratory therapists had to cover the entire hospital, including the ORs, including the nursery, including the ER. They were running around all day. They were doing 12-hour shifts. They had to all rotate through every third weekend. And so, they were just getting very frustrated. Then the EMRs came into play and those became more and more frustrating and more time consuming.

And she reached a point where she was burnt out and wanted to look for something to do. In the meantime, her mother became quite ill and moved in with her and her husband and ended up dying in their home. The subject of this story, she found out was that there was very great difficulty in finding caregivers to help with her mother, which would free up herself to do other things that needed to be done around the house. Once her mother passed away, there was a very small inheritance and she decided to look into ways of how she could provide a service like the one that she could have really used. And so, she became a franchisee for a company that provided in-home care and she really, really loved it.

Now, mind you, she had no background in finances. She had no MBA or any kind of medical degree or accounting degree or anything of that nature. And she basically was a clinician providing respiratory services. But they trained her. They provided a lot of support. And over a period of a few years, she became very busy and the people loved the service. She actually ended up reaching significantly over a million dollars in annual revenue.

Now, this is a person who had no medical background. The growth in her revenues and earnings increased by double digits. And she really enjoyed what she was doing. And again, mind you, she had no background in management or in finances, no MBA or anything like that.

I tell you this story because this is a situation that you may find yourselves in. You feel as though all you know is medicine. That's a quote that I've heard from many of my listeners. And the reality is you're intelligent, you're resourceful, you're hardworking. And if you can get through med school and residency in particular, you can easily shift or pivot to a nonclinical or alternative career.

That story is about my wife, Kay. And to this day, she's running a very successful business and she's happy that she got into that whole thing and walked away from clinical activities.

All right. So, let's define what an alternative career is. I usually don't include any possible sort of pursuit here, but I try to limit it to things that are based on our medical education, our training and our experience and our knowledge of the healthcare system. And you can usually tell it because it typically will include the term physician or medical in the title of the job. Now, not always. Sometimes we use nonclinical as a synonym for alternative, unconventional, nontraditional. The reason we use those terms sometimes is because they are actually clinical in nature. They're just different and nontraditional, such as locums or DPC practice or things like telemedicine and variations of telemedicine.

So, some of those can be clinical, but they're so different that we lump them in there oftentimes just to be clear. It does not include things like opening a hot dog stand or something like that. Again, just to remember, I said the word physician or medical is in there. So typically, it is something like a physician advisor, medical director, medical writer, executive medical director, chief medical officer, chief medical information officer. And it includes jobs that depend on an MD/DO or MD/DS or equivalent degree.

I like to joke that it does not include running a car wash or managing real estate or becoming a welder, anything like that, although you're free to do that. It's just that it doesn't actually build on your medical knowledge and your experience in the healthcare system. And so, if you want to build on those things and make a higher salary, that's the way you should really go.

Now here's some of the common myths. There are some common myths in anybody looking at career transition, and these are just the kinds of myths or self-limiting beliefs that people have in general, that I'm not going to talk about. Things like "I'm not good enough. I might fail. There's something wrong with me. If I'm leaving this job, it's too much to learn. It's too hard to do." Those are basic common human feelings that occur in any major shift or pivot. But the things that are more common as myths within the nonclinical or alternative career realm are one, "There are limited jobs." Because nobody has heard about these kinds of jobs in the past.

Number two, "All I know is medicine", whatever that means. Medicine is such a vast area, but it's a common thing. It's like you spent your whole life narrowing and niching down. You went from being a generalist and undergrad, and then you went to medical school, okay, it's a little bit broad base, but then you narrowed down for residency and some of you have narrowed down further for fellowship, and you think, "Well, each time I do that, I'm limiting what I can do." But that's not really true because you have to go back and consider everything you've learned in those last 8, 11, 15, 20 years and how it can apply to this next phase of your career.

The myth that "My income will drop", the myth that "I'm abandoning my patients", and the myth that "My reputation and influence will decline." Like I'm no longer a physician, I no longer have that position in my community. Again, I can just tell you right now, the five myths I just said are just that. There are myths. They're not true. And I'm going to spend a few minutes explaining why they're not true.

All right. So, let's go through them individually, quickly here. Limited jobs. Well, there are jobs in pharma and medical device companies, in the hospital and health systems, and in the insurance industry. And that includes health insurance, life insurance, and disability insurance. There are medical writing jobs out there. It's an entire industry of its own. And there's at least five or six types of medical writing. There's consulting, there's consumer health. That means it could include being a coach or teaching people in general about their health and fitness and nutrition. Those kinds of things without having a direct physician-patient relationship.

Government and public health have vast numbers of jobs. There are nonprofits that hire physicians all the time. And then there are lots of educational situations like undergrad and graduate schools and medical schools, and in residencies there where you can be teaching things that don't involve providing direct patient care.

So, let's consider this mental exercise briefly. If you were in a large ship that was sinking, and there were a bunch of people with you on this ship, and you're going to have to split up into different lifeboats and you get to pick one or two of the people that are going with you in your lifeboat. Think about all the different jobs there are and all the different options for people that might be in that boat with you. It could be a teacher, fireman, policeman, or salesperson. It could be anything, somebody in manufacturing, a business owner.

And I'll cut to the chase right now and tell you that if I was going to be stranded alone, there would be two people that I'd want to be in that boat with. That would be an engineer and a physician. The physician has everything covered on the biological, chemical, scientific side of things and health and how to treat injuries and how to recognize rashes, and so on. And the engineer covers the safety and building things and fixing things. Those are the two.

There is a reason why those two would be the most popular, no matter whom you ask. And it's because of your broad exposure to lots of different things, your knowledge in a lot of different areas, that's what you have to pull together to practice medicine. But it's also what you can pull together to do other sorts of alternative careers.

Remember, you have a lot of depth in biochemistry, pharmacology, physiology, microbiology, anatomy, epidemiology, and statistics, which we don't think about a lot. And you can think of another 5 to 10 different domains where you have a lot of training and experience, and you can leverage those. Not to mention everything you know about the healthcare system itself.

What else? You understand laboratory interpretation, physical exam skills, radiography, interviewing, teaching, presenting healthcare, economics, population health, and the list goes on and on. So, you're already suited to a lot of positions. And if you think about it, the reason that these companies are looking at physicians is that they need the physician to either translate something to other physicians and other clinicians. They need to understand how that relationship with a patient works and what it's like to provide medical care and other things that are related that put you in a really good position.

Now, the other common myth is this issue of financial ruin. "How am I going to get paid? And I definitely am not going to get paid the same as I was before. I'm in a very highly skilled and highly paid situation." But you need to understand that there's only a limit to that kind of myth. In other words, how could they attract a physician employee if they weren't paying at least an hourly rate commensurate with what you can do in your practice? So, unless you're a super high paid subspecialist who's pulling down near a million dollars a year or something. If they're going to hire a primary care doctor, if they're going to hire a gastroenterologist or a surgeon or anybody like that, they have to pay at a level that makes it attractive enough to come over to the other side so to speak.

Now, remember that you must consider the hours, the liability, the satisfaction, the stress, the lack of balance or presence of balance in your life. While some physicians do take a little bit of a cut in pay, it's usually also associated with working fewer hours and really taking all of your vacation, your four to six weeks of vacation, if you're employed in one of these positions. You're going to sleep better and you're not going to be on call, you're not going to be sued. And so, you really have to do an apples-to-apples comparison.

Now, just as an example, these are the median salaries that were reported by recently. It's probably not the end all, and it's very specific to what you're doing, but in general, a physician advisor will make $134,000 a year. Now that's on the low end, granted, and those are really entry level positions. So, if you're doing something like a medical science liaison or some other full-time position in pharma, you're going to be closer to $200,000 for sure. And anything with a medical directorship in a hospital or insurance company, anything like that, the number that's quoted is $296,000 per year.

And chief medical officer, generic using that term, meaning it could be in a hospital or health system, it could be an insurance company, it could be in pharma, but upwards that's over $400,000 a year. And there are many CMOs, chief medical officers who work in hospitals and make a half a million dollars a year.

So, it's really not true that you're going to take a big cut in your pay. You obviously need to plan it. You need to make sure that you have the money available to cover some short-term shortfalls. But once you've made the transition, you demonstrate your skills and your worth, you actually will go up from there. So, there might be that small short episode where the income slows down.

Now, what about your patients? You're abandoning your patients? Well, you're not going to be providing one-on-one direct patient care for the most part, unless you're doing that part-time on the side or something. But think about it. If you're in pharma, you're creating medications and devices that are helping patients. If you are in quality and safety in the hospital setting or elsewhere, you are saving lives, improving the safety of those patients. If you're in an insurance company, you're keeping patients from getting the wrong tests and the wrong procedures and doing the right tests at the right time. And if you're in writing, you're educating and teaching patients or your colleagues or medical students.

So, you're also helping patients that way. We can go down the road. If you're doing consulting, it's to bring a new service, which is also improving care. If you're in the consumer aspect, you're teaching about health, wellness, nutrition, fitness. If you're in the government, you're usually trying to maintain quality and improve quality through CMS and NIH, the CDC, the FDA. Maybe providing some kind of indirect care and supervision of the prison medicine. In a nonprofit area, you're doing accreditations to make sure that people are providing care appropriately and doing things properly and so on and so forth. So, when you get into one of these jobs, you are definitely still providing for improvement in healthcare and helping populations and large numbers of people, rather than just the small numbers you can do individually.

How about reputation and influence? Well, you're still a physician for sure. Everyone will still call your doctor. That's a given. You'll likely be managing a team. You're seen as a content expert. You're often a leader in these positions. And I'll even give you my example. I was one of, I don't know, primary care in the hospital, I was there a hundred or so in doing all kinds of different things, some in the hospital, some outside the hospital. And the medical staff was 300, 400 active medical staff involved and coming and going and all having different things that they needed to do.

But the thing was when I became the medical director and then the chief medical officer, I was the individual at that point. Now I was in a sense at the top of the pyramid at that point, rather than just one of a hundred primary care doctors or one of several hundred physicians on staff there. I was the chief medical officer, the person you had to go to, to solve a problem, or get something taken care of, or ask for a new medicine on the formulary, or get a new bylaw passed or something like that. Really in these roles, you have a different type of reputation and influence, but in general, it's very positive.

You have certain existing skills, attitudes and traits that you want to leverage in this new position. I'll just run down a list of some of these. You're calm, you're composed, you're decisive. You're accountable and reliable. You understand psychology, medications, pharmacology, statistics, epidemiology.

You're usually a pretty good adept and good at communicating. You understand medical records, how to create them, how to store them. You understand documentation and coding. You understand the concepts of indications, contraindications, and other pharma concepts.

You also know quality improvement, patient safety. You may even have a background in that area that includes some epidemiology and statistics. You've probably become more familiar with informatics than you want to be. You're used to leading teams, and you've probably done some public speaking and presentations, and this can all be leveraged into that next job.

Now, you might want to learn a sampling of some of the following list of items, not all, but if you were to learn something about the following things, it might help you depending on which direction you want to go. Healthcare, finances, human resources, contracting, negotiating, writing more from the standpoint of persuasion, rather than let's say writing a technical article. Understanding how to manage others and to work with direct reports. A little deeper into epidemiology and statistics. Understanding marketing, sales and promotion and public speaking. Learn maybe a little bit about leadership. Maybe get some industry specific expertise. And there's a lot of information out there that you can do, and you can get certifications, which are relatively straightforward, required to take an exam, but not a whole lot of time invested in that.

You might learn about recruiting and about public health. That's just a sampling. Remember, when you're preparing to change careers to do an alternative career, it doesn't hurt to stack other skills. And it could be anything. It could be how to do photography. It could be how to get deeply into healthcare finances, more about public speaking. Any of these things I've already listed, pick a few and you'll find that by adding those to your existing list of skills, you become a unique applicant for one of these new positions.

All right. I briefly wanted to mention what's the process, where do I begin? You have to start by recognizing the need to change careers and try to pause, try to take a break and really think about what's going on. Am I unhappy? Am I burnt out? Am I anxious, depressed? Am I just dissatisfied? Am I tired? Maybe I'm just getting old. I have plenty of years left in me, but not necessarily at the high intensity level of a neonatologist or an intensivist.

And then think about these myths that we talked about and the self-limiting beliefs. Try to make sure you're prepared to overcome those. Then start to identify your options. And the options you need to identify are just what's out there, and I've given you this list. But there's also a handout at that you can get, that has a list of more than 70 individual jobs that are suited to most physicians. But explore and learn about what's out there. Don't be in a big hurry, start to take your time. And intentionally begin to consider what those jobs entail.

Then spend a little time thinking about your personality, interests, skill sets, and job factors. Maybe write these things down. And then maybe write down all the jobs you've learned about. And then line up those two. Line up your options and your personality, interest, skill sets, and job factors that align together with your interests and skill sets. And then if you can find one or two, then start to get to work on learning more about preparing a resume and other steps.

As far as the options go, I'm not going to spend a lot of time on that today. But like I say, there's things in pharma, in the hospital setting, medical writing, utilization management and benefits management and the health insurance companies, consulting. And maybe doing some kind of a med spa or DPC or some other version of clinical might still be an option, including telemedicine and locums, which sometimes has a lot more freedom. And then explore and look for that sweet spot where the skills, interests, personality, and the demand for that job all overlap.

So, if you're one that likes to work remotely and you have a lot of self-discipline, and let's say your personality is such that you like interacting with people, and you find out that you can do a remote writing job, but maybe instead of writing go into communications, which involves some direct face to face time with people.

Anyway, you're trying to combine these things and see what matches together with your interest skills and personality, as well as the demand. It's kind of like if you're an entrepreneur. You need to find something that you're passionate about, that you can make money with, and in which there's a demand for. Similarly, when you're looking for a job like this, you need to figure that out.

And in the meantime, to learn more, go to LinkedIn, go to Facebook, go to mentors, talk to colleagues from the past so you can get some firsthand information about each of the jobs. And ideally if you could shadow in some of these jobs, but most of these situations, they really won't allow you to do that like in a pharma company or an insurance company. Maybe in the hospital setting or in an academic setting, you could.

Join a professional association. If you can find one that's applicable to the areas that you're considering. Start to search job listings just as research. Not because you're getting ready to apply, but because you want to see the keywords and what's listed in there.

Create a LinkedIn profile and get help with that if you need to, but it should be a complete LinkedIn profile. Then write a resume, start writing your cover letters. Every one of those should be customized to the person that you're applying for a job with, or the company. Prepare for your interviews and expect that the first several interviews aren't going to be the greatest, just because it's a skill, that unless you've done some interviews recently, it'll take a while to get prepared for that again.

That's what I wanted to tell you about alternative careers and dispelling the myths and a quick overview of what you can look forward to if you're thinking of changing to an alternate or nonclinical or nontraditional career.


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