Presentation by Dr. John Jurica- 463
In today's lecture, John presents his overview of alternative careers for physicians thinking of using their medical training and experience in new ways.
He covers the industries that hire physicians, the five myths that tend to hold them back, the transferable skills they already have, and the practical steps to begin a real transition.
Dispelling the Myths That Keep Physicians Stuck
Five myths consistently arise when physicians consider a career change, and John addresses each directly. The first is that there aren't enough jobs. Pharma and medical device companies, hospital and health systems, insurance companies, consulting firms, medical writing agencies, government agencies, nonprofits, and educational institutions all employ physicians in roles that require a medical degree.
The second myth is that “medicine” is all a physician knows, which overlooks the breadth of medical training: biology, chemistry, biochemistry, microbiology, pharmacology, statistics, public health, patient communication, and years of systems-level experience.
The income concern is addressed with context. Nonclinical salaries for physician advisors, medical directors, and CMOs are competitive, and the comparison becomes more favorable when accounting for hours worked, liability exposure, call coverage, and the long-term toll of high-volume clinical practice.
On the patient care concern, John's own experience as a Chief Medical Officer overseeing quality, safety, pharmacy, utilization management, and informatics illustrates a consistent point: nonclinical physicians typically affect more patients indirectly than they could ever reach in direct patient care.
Finally, on the issue of reputation and influence, the dynamic shifts in the same direction; specialty surgeons and cardiologists came to John for help with problems when he was CMO, not the other way around.
Skills, Options, and Where to Begin
Physicians already carry 70 to 80 percent of the skills required for most non-clinical roles. The gap is rarely the skills themselves. It is knowing how to connect them explicitly to a job description. A physician who tracked and reported medication side effects in practice, for example, can position that experience directly toward a pharmacovigilance or medical affairs role in pharma.
The skills worth developing include healthcare finance, contract negotiation, persuasive writing, and public speaking. Volunteering for committee or board positions, even unpaid, is one of the most practical ways to build those before making a formal move.
Starting the search means working through a defined sequence:
- resolve the mindset concerns first,
- then identify the industries and roles that fit your interests and personality,
- read job postings to understand the positions employers are filling,
- join relevant professional associations, and
- build or convert a LinkedIn profile that reflects the transition you are pursuing.
Advanced degrees are worth pursuing selectively; an MBA or MHA makes more sense after gaining some management experience, when an employer may help pay for it, than as a prerequisite at the start. And the CPE (Certified Physician Executive) credential from the American Association for Physician Leadership (AAPL), which requires coursework plus one year of management experience, is often more meaningful to hiring organizations than a business degree alone.
Summary
The nonclinical career landscape is broader than most physicians realize, and the barriers to entry are lower than they appear. The skills are already there. The industries are hiring. The salaries are competitive. What most physicians lack at the start is not qualifications, but a map of where to look and how to present what they already have. This lecture is that map.
NOTE: Look below for a transcript of today's episode.
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Links for Today's Episode:
- Let’s Dispel These 5 Persistent Myths About Nonclinical Careers – 309
- How Do I Choose the Best Coaches Mentors and Masterminds for Me? – 208
- 50 Nonclinical Careers by Sylvie Stacy
- Physician Nonclinical Career Hunters Facebook group
- American Association for Physician Leadership
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Overview of Alternative Careers for Physicians
Lecture by John Jurica
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You're listening to Physician Non-Clinical Careers with John Jurica, episode number 463. Welcome back, non-clinical nation. Today I'm presenting another one of my recent lectures on the topic of non-clinical careers for physicians. This is a foundational presentation with an overview of alternative careers for physicians who are just beginning their search When you first started to sense that classic traditional practice in a healthcare system or independent medical group didn't resonate with your personal goals, vision, and mission, you probably didn't recognize that there are multiple industries that hire physicians to do non-clinical work and that there are recognized approaches to preparing for and pursuing careers in those industries And that is what I'm going to share with you today, an overview of the most common jobs out there and some of the steps you can take to begin that journey So let's get right into today's [00:01:00] presentation
You should be able to see my slides, and as it says here, I am going to be speaking about alternative careers for physicians.
I have gone from clinical to non-clinical, back to clinical and non-clinical, to just non-clinical twice in my career, and let me give you the short version of how that happened.
I started as a family physician. I joined two other doctors in a private practice, and when I joined, I had to build my own practice because they were busy, but they didn't really have patients for me to see on day one. So while I was trying to build the practice and volunteering for a lot of call and things of that nature, I started looking for other things to do.
And I did moonlight a little bit as, I worked at a family planning clinic, and I worked in an occupational medicine clinic, and I joined, committees at the hospital where I had privileges. And I started to get involved with the CME committee and shortly thereafter became the chair While this was all going on, I later became the medical director for the OccMed Cliinic and the family planning clinics, and I also did some physician advisory work at, the hospital at the same time to make a little extra money.
So I was doing a lot of things that really didn't involve direct patient care at that point. And by virtue of being in the CME committee, which we call the Program and Education Committee, I was chosen for the chair, and we had to be surveyed. We were surveyed by Illinois State Medical Society so that we could grant CME credit.
And that led me to join the ISMS's committee on CME accreditation at the state level. All this to say that that led me to meeting some other very interesting physicians who were doing things that I'd never heard of before. And in particular, one of those physicians was a former chair of that committee for the state, which I later did chair myself, was an internist that worked at basically the largest freestanding nonprofit hospital in the state of Illinois at the time.
It, it had 700 beds, and it wasn't an academic medical center. And I found out that he didn't actually see patients. And when I asked him about what he was doing, he said that he was a chief medical officer for that hospital. And over a period of time, I was able to engage with him, and I asked him a few questions, think about that.
And as this was going on, I was experiencing some symptoms of burnout. I shouldn't admit it, but there were times I was starting to hate my patients. I was frustrated. I was involved in three lawsuits, all of which I was dropped from, but they typically would take five years of my time off and on to get the heck out of those.
And so I was experiencing a lot of the same things that you and other physicians are experiencing today, which is that I just didn't like doing medicine anymore or it was getting too stressful at times. And so by consulting him, he told me I should join the American College of Physician Executives, which today is called the American Association for Physician Leadership.
And I thought, "Okay, this looks pretty neat. What can I do?" I took some classes. I got a master's in public health, and I decided to pursue what he had done. And so I was able to leverage those experiences as medical director. I got to know all the directors at the hospital as well as the CEO and the CFO and those people.
And so ultimately, I was signed as the first VPMA (Vice President for Medical Affairs), and then the chief medical officer, which I did for 14 years. And it got me thinking at the end of that whole process about this situation of burnout and nonclinical careers and, what can we do to overcome burnout.
And while I'm, definitely one who wants physicians out there taking care of patients, myself included, I think there's just situations where the joy of practicing medicine, usually because of sort of the corporatization of medicine, the pressures, the EMR, the long hours, the understaffing, it just gets to a point where it's just not really worth it.
And at the same time, there are things out there which I wanna talk about today, which are very exciting, very positive things that you can do to contribute to the healthcare system. So that's want to lead into with as far as, some of the things that you might be thinking about. Now, we did a survey of you.
You may have answered some of the questions, but really it was two questions about your degree of burnout and had you thought about leaving clinical medicine. And in terms of the burnout question, between the frequently and occasionally, 80% of you said you had symptoms of burnout at one time or another and were experiencing that.
And the other question about thinking about leaving, I think, was over 50% had considered something outside of direct patient care. So this is a very timely topic, I gather from those results. So today what I want to do is, first of all, I want to define alternative careers for the purposes of this discussion today.
I mean, it could be defined in different ways really, but I'll tell you exactly what I'm talking about and we'll go from there. The second is to dispel the common myths. So if any of you in this audience have already explored options, you've looked, you've talked to friends, you've networked, you've gone on LinkedIn, you may have already done some things.
But what I've found in speaking with my podcast guests and my colleagues and my students and my, and my mentees, that there are common myths about alternative careers, and I think what they do is they lead to these self-limiting beliefs about whether it's even possible for us to make such a change as an option to address our burnout or just our dissatisfaction or just getting tired of doing what we're doing.
~Now once I finish talking about that and convincing you that those are myths and you need to get over them, then we're gonna talk about something practical. Like if you really are thinking about doing this, are there skills that you already have that you can develop further, or are there new skills you should try to acquire even before you think about making a change?
Because transitions are tough, but if you can plan for your transition, and there's ways to do that, there's a variety of ways to do that really. One of those is to either, identify new skills, obtain new skills or certifications, things like that, which the certification part normally you don't have to do.
So we'll talk about that a little bit. And then a real short, overview of how to begin the process once you've, you've really settled on that decision
All right, so let's define alternative careers. I use typically the term nonclinical, but the thing is when I'm talking to my guests and my audience on my podcast and elsewhere, I usually include nonclinical and unconventional clinical careers.
So I include things that have a lot more freedom and flexibility in this, area, like telemedicine, which can be done actually half a dozen or more different ways, and locum tenens, which is clinical also, but if you do it right, it brings a lot more freedom and actually pays more, and you can create times in your life where you're completely off of work and can go a month or two without working, and then you can do locums for three months or so, that kinda thing.
But basically, we'll use the terms non-clinical, unconventional, non-traditional, or alternative to what we're talking about, and we're also talking about things that build on your medical education, training, and experience, as well as your knowledge of the healthcare system because it's-- You learn most of that actually after you get out of medical school.
You're kind of exposed to it, but all those things that you have to work within that the, the teams and the, and the construct and the, and the billing systems and the way things are done, that's, that whole thing is also a great big knowledge base that you can apply to a non-clinical or alternative career.
And just to make it easy, when you're looking for a job and you're trying to decide, okay, is this a non-clinical career or not, or how much of a nonclinical? If it has the term physician or medical in it, it's going to be, most of the time, a job that is geared for physicians that is nonclinical based on the actual name of that job.
So typically, you're gonna see something that says physician advisor, medical director, executive medical director, medical writer. Although there are a lot of non-physicians that do medical writing, physicians definitely do a lot of medical writings themselves, of course. Chief medical officer, chief medical information officer.
There's also chief quality officer. There's also chief patient safety officer. And so all of those, uh, can indicate that it's probably a physician, particularly if it says medical or physician in the title. Now, a CMO for a hospital is not the same as a CMO for an insurance company or a CMO for pharma, but it does tell you it's something that they have to have a physician in that position by definition.
So if you have an MD, a DO, an MDDS, or equivalent degree, then that-- you're the only professional that can do those jobs. Now you might need other experience beyond the medical degree, but at least that's sort of the entry-level position and, and background you have to have. I'm not talking about people that are going into running ~some kind of ~small business or [00:10:00] managing real estate or becoming a welder or job that doesn't have some connection to medicine or to healthcare.
Because I think, and the reason that I focus on that, and I think it's true, is because, doing another business, another, ~you know, jumping~ into another ~non-related~ business is sort of a, a horizontal move. When you move into one of these positions as a medical director or a CMO or something like that Almost 100% of the time you're actually moving up in your career.
So you have to think of this not as a failure, not as a stepping back, and I'll go into that in a little more detail, but you're actually stepping up to that next phase of your career and you should be proud of it. So here are the common myths that we see in people that are undergoing career transition.
Now, we're gonna get rid of the first five because those don't apply to physicians anymore because you've already overcome those to get into medical school, to get into residency, to get into fellowship, and to succeed and to pass, ~you know, your~ boards and do all those things that you've already done.
The most common myths or sort of beliefs that I see physicians have if they're thinking about pursuing this is number one, there aren't really that many jobs. I mean, I don't see that many people doing these things. Number two, all I know is medicine. I mean, I, I've spent my life niching down, okay? I started as a generalist in undergrad and learned all these things, all these different subjects and might have even ~done non-biologically related things ~like music or language studies and that kind of thing.~
But now-- And I niched down to medical school, and then once I finished that, I niched down to being a pediatrician, and now I've niched down even further by virtue of my fellowship. So I just narrowed my focus to the point where I really don't have skills for doing anything but what I'm doing now?
~That's kind of the way people talk to themselves about this issue. The third is that I'm definitely going to lose my income. If I shift out of this highly specialized field that I've spent all these years learning how to do, the next thing I do, if it's not building directly on that, is my income is going to drop?
The fourth one is that what about my patients? I feel bad about leaving my patients. I'm a professional, a physician. ~I've~ spent my whole life learning how to take care of my patients. Who's gonna take care of them? And, ~you know, this even bleeds ~into~ the other thought of, eh, what about my family?
I mean, my parents are going to be so disappointed. I mean, that's a big cultural thing in, in some areas, in some societies that, becoming that physician. And then finally whatever I ~do nonclinical, it's gonna~ be a letdown to my colleagues. My~ reputation and my influence are going to decline.
So I actually wanna spend about five or ten minutes going through each of these individually because I want you to get over these things and I don't think me just telling you to get over them is gonna necessarily help. So let me explain where I'm coming from when I'm, when I'm talking about these. So number one, limited jobs.
This is a list, a partial list of the industries that employ physicians, and they employ them as professionals, as physicians using their medical knowledge and, and understanding of patients. So pharma and medical device companies, massive, huge. I mean, pharma is like, I don't know, 8% of all healthcare spending in this country.
Oh, number two, hospital and health systems. That's 25% of all hospital, of all medical spending in the United States They, those first two employ enormous numbers of physicians, and I'm not talking about the clinical positions in the hospital and health systems. ~You know, every service line has a medical director.
~There's quality medical directors in the hospital setting. You know, this is~ the one I'm most familiar with 'cause I worked in the hospital setting. And there's medical directors for, informatics, medical directors for quality, for coding and documentation, for utilization management.
And the bigger the system, the more medical directors they have, and there's assistant medical directors, and then you've got the VPs and so forth. You've got health and disability and life insurance all employ physicians. Some of those jobs are awesome. Boy, the happiest doctor I ever met on my podcast, I think one of, was a cardiologist who really was doing okay, but she reached a point where she was thinking about getting another job.
Now, she took a shortcut. She happened to talk to a former either, co-resident or medical student, ~you know, ~alumnus that she knew, and that person happened to be working at an insurance company that was looking for a chief medical officer, I think. She might have gone in as a medical director. But when I talked to her, I think she was working as a chief medical officer, and she loved that job.
And, and it only took her a month or two to transition. It doesn't happen that often, so we can't all get our hopes up. But it's something that I-- And, and I've talked to other people in insurance and medicine, life insurance, and they love it, and, they would never leave that job. So it's hard to get a job as a CMO at a life insurance, ~um,~ i-industry because nobody leaves.
Those jobs are so wonderful. Because it matches up with, with her personality. She really loves doing the research on, and then looking deep into complicated sort of situations and help the underwriters decide whether a person ~with, you know, three~ different sort of overlapping disease entities ~or, you know, processes going on, you know, should be~ insured or not, and what would be the cost of that insurance.
And the [00:15:00] actuaries do ~the simple~ ones, and then they get ~the~ physicians involved for the more complicated ones who can really understand how those things interact. So that's awesome. Medical writing, there's at least five or six different discrete ways to do medical writing or ~field, you know, whether~ it's for journalistic or for patient ed or for, ~you know, f- um, ~medical education or technical.
And each of those can be done either ~as~ a freelancer or as an employee, ~uh,~ an employed physician at a, at a company that does that. And, ~uh,~ of course, the medical writers, a certain percentage of them go on to be medical directors who are usually the editors of the other writers ~or, you know, for the~ other writers.
So you've got consulting firms. There's international and national consulting ~firms. They~ almost all have health care, ~uh,~ divisions, and they all employ physicians. ~Um,~ and then you've also got your ~f- your~ freelance consultants that are physicians that go off and just focus on something they do very well, and they share it with other people, and they can definitely create a, a small business doing that.
Consumer health, ~you know, you~ get involved in helping patients, but they're really clients, [00:16:00] helping the public, fitness, health, wellness, um, nutrition. A lot of physicians, oddly enough, the job-- I'll get real specific for a moment, but a lot of the physicians I've interviewed, um, they love coaching because coaching is like treating patients, uh, as you would, ~you know, ~medically or even as a psychiatrist.
But there's no risk, there's no liability, there's, ~you know, ~no overhead, and you don't have insurance companies interfering in your coaching. And coaching is actually ~a~ very popular side job and full-time career for physicians, and it's very rewarding. You've got the whole government and public health sector.
You've got nonprofits. ~Uh,~ some of the nonprofits, if they're related to medical care, like the Accreditation Council for CME, I was a surveyor for them for a while. They don't pay, so that's not considered a ~non-c-clinical~ job. That was a volunteer position. But the CEO of that, of the ACCME, is a physician, and others.
And the J-Joint Commission and, ~uh,~ the other, ~uh,~ accrediting agencies all [00:17:00] use physicians as surveyors if they're involving, ~you know, s- if the sur- if~ the survey, like Joint Commission, involves looking at medical care. And then education at all levels. ~Physicians~ can go back and teach anatomy and physiology ~in, you know, ~community colleges and high schools and universities, and a lot of them will teach at PA schools and will ~teach, you know, physical~ exam and, ~uh,~ all sorts of different variations thereof, either if not full-time, at least part-time.
So ~there~ are lots and lots of jobs out there, and it's hard to quantify. There's only a million physicians in the country, and I swear that at least a third of them are doing non-clinical jobs at this point, but I can't, I can't really quantify that. All right. Now, the next one is number two: All I know is medicine.
Well, let me pause for a minute and say that we're gonna do a mental exercise on this one just to maybe think at, think about it in a different way. So imagine, if you will, that you're on a ship in the ocean and, ~uh,~ it's damaged, it's sinking, and all of you are gonna have to get in a lifeboat. So y'all are gonna get in a group of five [00:18:00] in these lifeboats and you can go off in all different directions.
So the mental exercise is this: if you were in that boat and you get to select the people that are going in the boat with you, and knowing that you might be shipwrecked on a deserted island somewhere and you might have to figure out how to survive, what would be the top two or three professions of the people you'd ask on that boat?
Think of all the professions and the things that people do, ~you know, ~from just, ~you know, ~repairing your telephone to serving you meals as a waiter or waitress, to being a cook, ~to accounting~ to, ~you know, the~ scores of different things. So I'm gonna jump to the end of the, this little quiz here and ~answer it~ my way, and this is what I have come to conclude thinking about that.
I would want to be... I would wanna have at least the following two people with me on that little boat and on the island: an engineer and a physician. 'Cause an engineer knows how things work and they can fix things and, uh, they understand what's safe or not safe to ~do, you know, if you're~ on a bridge or you're building a, ~some kind of ~structure.
And then the other one is the physician, because a physician is an [00:19:00] expert in biology. Many of us have expertise in chemistry, biochemistry, microbiology. We understand how to treat injuries and how to monitor illness, even if we don't have all the fancy tools that we use every day. We have a vast background.
We have a very broad background. I mean, basically we're liberal ~ar- arts specialists, you know, as~ our undergrad, and then you just keep adding to it. So I get questions all the time, ~you know, about the~ chemistry of this, ~uh,~ botany. It doesn't matter. We have such a broad exposure that ~y-~ a lot of those things apply to other jobs.
So rather than go down the list of things we know, although I will have a slide on that here. So this is just a starting list of the things we were trained in depth in, and it goes on and on and on, and I'm not even getting into the, the non sort of scientific ones. Uh, but this is just a sampling of the things that we're pretty, pretty good at.
Most of us could go work in a lab. Most of us could, ~you know, uh, ~evaluate studies. So, ~uh,~ there's a lot of skills in there that can be translated. So you do know a lot ~about a~ lot of different [00:20:00] things. All right. Now, what about the issue of income and finances? Are you gonna become financially ruined if you decide to leave medicine?
Well, I mean, if you're generating ten thousand RVUs a year, I don't know what the averages are these days, ~you know, it's~ gonna be hard to match that ~if, you know, if~ you're a, an, an invasive cardiologist, ~uh,~ I don't know where neonatologists fall ~on~ this whole, ~uh, you know, spectrum of~ salaries. But yeah, sure, there are certain specialties that are very high- highly paid specialists.
But ~I'm gonna tell~ you that The pay for non-clinical careers is, is, is up there and it's competitive for, for the most part. I made a lot more money as a CMO than I would ever make as a family physician without killing myself. I mean, I have some friends who are family physicians who work 80 hours a week and, ~you know, they kind of barely~ get by and their records never get done, and they make a lot of money, but it's no way to live.
So really think of it, I guess, teleologically. I don't know if that's the right term, but if you turn it around, you can't attract a physician to be [00:21:00] an employee to do some of these thousands of jobs that I've mentioned briefly, unless you're going to pay them a commensurate salary. They're just not gonna leave that old job, even if they are burnt out.
~Uh,~ so they have to pay a sufficient amount. The other thing is we should really compare apples to apples, okay? Let's keep in mind that if you're working ~f- you know, ~supposedly on a 50-hour job, a full-time in the US really is 50 hours, even in, in the, let's say, in the hospital leadership setting. ~Yeah,~ nobody really sticks to a 35 or 40-hour workweek.
~But you know, if you're~ a physician and ~y- you're~ down on staff and whatever, you're working 60 hours, you're working 65 hours, 70 hours, you're on call for, in many specialties, ~you know, every~ third, every fourth, and that doesn't mean just answering one phone call. I mean, it means getting up and getting out of bed and seeing a sick patient and doing all you have to do, and doing records at home and, ~you know, certain~ specialties.
And, ~you know, if~ you think about the risk of, ~uh,~ liability, the level of satisfaction, the stress, ~the balance,~ the addiction, the lost and destroyed relationships. [00:22:00] Now, put all that on a more even keel and compare it. All, all these jobs will, will definitely compete with that. And, ~you know, if~ you're, if you could just have a lifestyle that maybe isn't quite what it was before.
But I will say, if you look at the median salaries for physician advisors, medical directors, and chief medical officers, you'll see that you'll quickly get into very competitive salaries. ~You know, these~ are, these are across all industries, so it's hard to, to know what, what it means. But I can tell you ~that, you know, as~ a CMO for a hospital, I mean, the starting is 300 and, and up.
I think it's typical to even start at 350 to 400. Now, it takes a little while to work your way up to a CMO. You might have to be a medical director and, ~you know, or~ an assistant, ~uh, or, you know, even~ some intermediary, ~you know, ~job in the meantime. But, ~you know, if~ you're in, ~uh,~ medical affairs in a pharma company, if you're working ~in a~ hospital ~system,~ there are lots of ~jobs that~ pay very well.
~And for, you know, if you~ look at primary care And used to be psychiatry, although psychiatrists are paid very well these days. ~Um,~ definitely better than, than most primary care fields for ~sure.~ And there's-- what I'm gonna mention again in a moment is that there's a lot of [00:23:00] advancement once you get into these different industries.
Some of these industries, you're the only physician or one of two, two or three physicians on a team, and the physicians are always looked at as leaders, and so there are opportunities to just grow. So you could maybe take a little dip for a while, and then once you really get your bearings and now you're an experienced person doing that non-clinical career, your, your salary is going to go up as you take on more responsibilities, but not necessarily more risk or ~l- you know, longer~ hours.
So that's what I have to say about the finances. Now, what about my patients? I'm not gonna read everything ~on this~ slide, but what I found when I became chief medical officer and I began to realize, and it was pretty quickly too, 'cause the areas that I was working on were the ~f-~ the pharmacy director reported to me, the quality director reported to me, ~uh,~ for a time the UM, the utilization management and case management, ~um,~ and I had informatics, if you can believe that, which is not that common.
In any event, I was there, and I was overseeing the installation of quality measuring tools, [00:24:00] and we were working on improving mortality rates, reducing length of stay, ~uh,~ improving safety. We were doing, ~uh, you know, um- ~evaluations of, of, ~uh,~ sentinel events, ~uh,~ doing an RCA, root cause analyses, and we were identifying problems and fixing them and ~to where~ we were showing measurable improvements in those metrics, easily measurable, and that was risk-adjusted based on the severity of illness of the patients we were admitting.
And the same is true of all these other areas. ~You know, I have~ a colleague who runs a Facebook group about non-clinical careers, and she brought two new drugs to market under her leadership at the pharma industry or the pharma company she was working at. She was in OB, and she brought the-- And she was very proud of the fact that now these medications were gonna be used ~to, you know, reduce~ the need for surgery and improve the healthcare of those patients and maybe have fewer side effects than previous treatments and, and, uh, really the quality of life improved for those patients because of what she had done and her team.
We always work in a team. Insurance companies, same thing. You [00:25:00] can, you can show ~why, you know, ~utilization management itself, even though it seems annoying to have to answer that phone call sometimes, but those, those reviewers oftentimes ~save~ patients from getting the wrong procedure, number one. At the same time, they spend their time teaching the physicians how to document better so that they don't have to get these phone calls, and they can get the, the care that the patients need.
Since they've chosen to have insurance, then they have to meet the insurance guidelines and so on and so forth. ~You know, medical~ writing, you're teaching, you're educating. ~Uh,~ same thing with consulting. You're bringing new service lines to hospitals and other, ~uh,~ healthcare, ~uh,~ companies, hospices and, and nursing homes and, ~uh,~ surgery centers and so forth.
So, ~um~ You're doing service to the patients indirectly, and you're probably having a much bigger impact than most of these non-clinical positions. So I'm not gonna go into this whole list, but just want you ~to, you know, ~think about those things from that perspective. How about my reputation and influence?
Well, when I was a family physician, ~you know, I was~ running around all these different [00:26:00] meetings trying to get to know ~people. I~ was taking care of my patients and, ~you know, we~ had 4 or 500 people on staff. It was a relatively small, sort ~of~ semi-rural, because we were an hour south of Chicago. And, ~uh, you know, I was~ just another ~physician on~ the staff, ~you know, no~ big deal.
Nobody really cared. ~Uh,~ in fact, and the physicians that were kind enough to volunteer to be chairs of departments and even the president and vice president of the medical staff, no one ~really~ cared about them either. They were non-paid positions. It ~was kind of, you just~ take your turn and do it, ~you know, in an~ academic setting or a bigger hospital.
Nowadays, you get a little bit of reputation from that and pay for that, so that's, that's helpful. Technically, that's a non-clinical activity. ~Um, ~but when I became the CMO, well, now I felt like I was, like, at the pinnacle because the neurosurgeons and the, ~uh,~ cardiac surgeons and the cardiologists and the orthopedists were coming to me when they had an issue or a problem.
So now ~I-it~ seemed to me that by all means, I was still a physician, and that's actually one of the reasons why they need us is to communicate with our colleagues, physician to physician. So that's a secret of all of this, is that's one of the reasons we need physicians in these positions. And so I felt, heck, my reputation and influence had expanded immensely.
So ~that's, you know. So~ when you do a non-clinical for the most part, you're still a physician. You're still Dr. XYZ. You're very likely to end up managing a team in whatever you do because just ~we're born-- we're not~ really born leaders, but we're natural leaders because of our training experience and so forth, and just the way that people look at us.
You're seen as a content expert in whatever it is you're doing. ~You know, in~ UM, ~I--~ this is like a digression, I guess, but, ~you know, one~ of the questions I'm assuming a neonatologist might have is, "Well, as a neonatologist, what are the best jobs for me to do?" And ~I, I~ think I'll stop here and answer that question in general because maybe not everybody on here is a neonatologist.
But Most of the jobs are not specific to a particular specialty. So I had a pediatric cardiologist or a cardiac surgeon, ~I don't know, I think it was a cardiac--~ [00:28:00] pediatric cardiologist, and the first non-clinical job he had was a utilization management reviewer, physician advisor for a third party, for an insurance company, just like everybody else, just like the family doctors, just like the, ~uh, the, uh, you know, the~ internists, ER doctors.
You think of them as generalists, and they can do something like a UM job. But it didn't matter because all UM is based on, on guidelines that you need to look at and learn anyway. They train you to do that, and as long as you've got a medical school background, you can do that. And the same is true of almost everything.
There's no reason why a neonatologist can't be the chief medical officer of anything any more than a, an ER doctor or anyone else, because we know those things that I talked about earlier. Sometimes if you look in the jobs descriptions, you get a little discouraged. It'll say things like, "Prefer," ~you know, ~"internal medicine," or, "Prefer this," or, "Prefer that."
It doesn't really make a difference. What they wanna know is that you have the skills. They think that, ~you know, certain~ specialties might have more skills and experience in certain tactics and techniques [00:29:00] and, and attitudes, but It really doesn't matter. If you can demonstrate that you have those, then the jobs are open to you as well.
So it's, it's really not, ~uh,~ usually an issue. I haven't really seen a lot of trends in terms of the type of jobs and the nature of the specialty that the physician had been practicing before they switched out. ~Um, y-~ many times you advance up and become a leader. A lot of these-- And a lot of these companies promote that because they want physician leaders in those positions.
And, ~uh,~ I already talked about, ~you know, my~ situation. All right. So I did wanna talk about the, ~uh,~ skills that you may have now and then maybe you ~want, want~ to develop further. ~You know, the~ thing about applying for an alternative job or career, and I'll use those terms interchangeably, is that you need to demonstrate to whoever's doing the hiring that you have the skills and knowledge that they're looking for.
And the biggest barrier isn't that you don't have those skills and knowledge, but what's not uncommon, it's actually pretty common, it's one [00:30:00] of the big reasons why physicians sometimes, ~uh,~ struggle to move into one of those new careers, is because they don't know how to demonstrate that they have the skills and that the skills that they have are transferable to the job that they're applying for.
That's really-- It's one of the steps I'm gonna talk about at the end in terms of, ~um,~ actually getting the job that you're looking for, is learning certain steps that have to occur. And one of them is to show that, well, my, ~you know, my~ knowledge of quality improvement and patient safety is applicable to work in pharma, ~uh,~ as a medical director in medical affairs.
Just saying that doesn't make it so, but you have to be concrete. You have to be-- You have to specifically show what you were doing in quality improvement and patient safety, ~you know. Uh, I was~ in practice-- This could be an example. I was in practice, and, ~uh,~ I was really attuned to the side effects and problems my patients had with their medications.
And so I would definitely ~c- uh,~ counsel them about the side effects and ask them to report those to me. And in fact, I went a step further in my career And as I was doing this, and I joined some of the, ~uh, the safety, um,~ panels or, ~uh, uh,~ reporting systems, and I would report when I identified what seemed to be a side effect from, ~uh, uh,~ one of the newly released drugs in this particular field that I'm in and this particular class of drugs.
Anyway, connecting those dots is what it takes to get them to hire you. So, but you already have, as I said, because you're a physician, you already have 70 to 80% of what they need. They sometimes just need to know that you can take on the other aspects, and I can tell you right now that you can. I've never met a physician that was-- that started a job, ~a-~ any of these jobs, that, that couldn't quickly master what they needed to within the first few months of working in that position.
~Uh,~ but one of the things I did mention in the, ~uh,~ objectives for today was, well, what new skills should I develop? So I do wanna spend a minute to talk to you about that because if you're thinking about this-- And this is also another place where since we're talking about and we're transitioning here into thinking about moving, I do wanna make it clear that When you are not happy in a job, and I know you probably have already thought of this if you're not happy, but sometimes it helps to hear it from somebody else.
Sometimes you just have to pause and step back and ~s-~ ask yourself, "Okay, I'm miserable here at this point. Why am I miserable?" Well, 'cause of the things we talked about before, about the long hours and, and the fact ~that, you know, we're~ understaffed and so forth. But the question becomes, before we jump into this part, ~um,~ moving forward with a non-clinical or alternative career is, what can I do other than leaving medicine?
Okay, so usually it boils down to one of three things. I mean, this is true of other jobs, ~you know, outside~ of medicine. You either need a new boss, a new department, or a new company. So there... A lot of people are unhappy in their jobs. The most common reason that people are unhappy with their job is 'cause they don't like their boss.
And I think that doesn't apply necessarily as [00:33:00] much to physicians 'cause we, we somewhat work independently in a lot of situations. But oftentimes it really is because our boss doesn't listen, because our, the leadership team, the, , the whole team that we're working for isn't implementing changes that are addressing things that we've noticed.
And particularly for physicians, it's quality and safety issues more so than the work environment, although that's become much more important recently. But always keep that in mind. Can I change managers? Can I change departments? Or can I go to another institution? There are some medical institutions that have a very positive culture that it's very, ~um,~ amenable to and attuned to reducing burnout and looking to try to get balance in, in the mployees.
I talked to a recent guest who, it was interesting because she, she was on to talk about mainly about the fact that she was, you know, working~ as a medical director and the career path that she had followed and why it was such a positive thing, yet she was still practicing clinically. But the other side of the coin for her was she went from being a typical traditional [00:34:00] family medicine, it might have been internal medicine.
yeah, she was an outpatient internist, outpatient only internist, and she was getting killed in the office, and trying to balance that with her medical director was difficult. And she worked for a big system. And I could not believe, and I guess I am not keeping up as well as I should, but they had concierge practices in that system, and she was able to move to a concierge practice where she only has responsibility for, like, 700 patients working part-time, basically job sharing with another part-time physician who's a concierge internist, outpatient only.
So that kinda blew my mind, and, you know, if you~ can find something like that in, in your institution. Now, you know, something similar to that, obviously you're probably not, ~working directly, , ~outpatient only internist since we're talking to neonatologists. But I mean, there's some- there's things that are similar to that, that I'm sure we could find that neonatologists and pediatricians have done in the past.
So never sort of, ~you know, um, cross~ that out as a possibility. Once you're beyond that though, ~and say, "You know, it's~ not really where I'm working, it's not really the people I work with or for, but really I, I'm just tired of doing this. I don't get joy out of it anymore. It doesn't matter if I worked in an ideal situation, I still wouldn't enjoy it."
Okay, then it's time. So what do we do? What do we try-- What new skills can we try and develop? The ones that are typically, mentioned and, ~you know... ~So as you're preparing, ~you're, you know, putting~ some money aside in case you're unemployed for a little while for some reason. Maybe you, quit and then you don't have the new job yet or whatever.
but the other thing is ~to, you know, ~develop some skills if you can That might look positive when being reviewed by some of these. And you have to kinda narrow down the niche first, but these are generic ones. Like, and if you look at this list of healthcare finances, ~human resour- sources,~ contracting, negotiating, marketing, sales, leadership, recruiting, public health.
After I made this slide, I realized there are ~all the kind of ~topics that the American Association for Physician Leadership teaches. Because, ~you know, ~leadership involves taking on some of these broader roles in almost any industry. ~Um, so, you know, the~ simple [00:36:00] answer ~is, you know, join~ the APL ~and, you know, maybe~ take some of their courses.
But even just reading about things, reading about healthcare finances, how to read a P&L.You could just take a small course or even read a book, and you'll learn about those things. Read ~about, contracting. Get involved with negotiating, and~ it could be applied to your practice, could be applied to other things.
how to write persuasively. Most physicians can write pretty darn well technically, for sure. but to write and to write persuasively is a different skill. there's public speaking. It's one ~thing to do~ public speaking in terms of with your colleagues and teaching students and residents and so forth, but public speaking to the lay public, that could be a good skill to learn, and just start getting out there and do these things.
And there's a whole list of other things, ~um,~ that you can do, then you get involved. Like when you're volunteering for things is another good example of how to get the skills. I'm a volunteer for the local hospice. I'm on the board, and I'm the chair of the quality committee. But I could be on the finance committee.
I could learn all about finances by being involved with the [00:37:00] hospice finance committee, and that's healthcare. So there's lots of things. Just get a little bit out of your comfort zone, get involved with some volunteer activities or maybe some even very part-time activities where you can get exposed to other things.
And then later, you're gonna have to figure out how to translate those on a, on a resume and on a LinkedIn profile to convince others that they are useful. All right. Let's move forward Okay, so then finally I wanna talk about where do I begin? How do I begin? So this is gonna be a very down and dirty approach, but so you've recognized that you want and need to change jobs or careers.
So really the big steps are you have to, number one, address the mindset issues, which we've already talked about. Number two, identify the options. So ~I kind of ~glossed over that, but I showed you the different industries. But you could spend time. There's probably up to 30 pretty common non-clinical jobs that physicians do, uh, that I can't list here today.
But as you get exposed to those, you're going to see [00:38:00] some are remote, some are in person, some are full-time, some are part-time. Some require travel, some require no travel, some require a lot of travel. And so the job itself has different aspects. The, content of the job, pharma versus in a hospital system versus insurance.
Have different things that may or may not interest you. And so you just need to kinda work on that and, and understand that, and then do some introspection about your personality interests, skill sets, job factors, and then line things up. So I think I've got this slide just to say ~that, you know, these~ are some of the jobs.
I talk about McKinsey's a consulting firm and, ~you know, there's~ all these options. Kinda just start with a broad brush and then narrow it down over time, and you learn more and more. And as you narrow it, you can get more in depth. And, ~uh,~ the thing is, there are professional associations for most of the jobs you might consider.
And this is the slide where you're, you're looking at this overlap of interests, skills, personality. And the demand means if you're going to start your own business, then there has to be demand for the [00:39:00] product or the service. But if you're gonna become employed by one of these industries, then there has to be demand for that position.
And so,, if there's a glut of medical science liaisons and the competition's really, really tough, then probably you should maybe decide to go with, ~uh,~ something a little different. But if you hear there's a shortage-- And again, becoming an MSL requires absolutely no new training or certification.
And there's a lot of jobs ~and, uh, you know, ~alternative jobs like that that you can find So as far as getting to work, the process involves things like getting a mentor, maybe a coach. Coach is optional. Mentors are free. Mentors are people you just pick their brain from time to time like I did with my mentor.
Join those professional associations for their particular field and industry, and some of them are specific to an actual job like physician advisor, or MSL or, again, different jobs within, medical directors for quality and so forth. ~Um,~ early in the process, if you've narrowed it down, you should search through the job listings, not because you're going to apply for the job, but because you wanna read the job listing and see what the trends are, what the common threads are with respect to what are they asking for, what are the must-haves, ~you know.~
~And~ when I give this talk to others, ~you know, there are~ physicians who don't have a license who completed medical school, and they don't have residency, and they're not board certified. Well, they're still physicians, and they can get a lot of these jobs. But if the must-haves, you have to have a license, or the must-haves, you have to be board certified, then they just kinda put those aside.
So look at the must-haves and look at the nice-to-haves and then the list of the common, , vernacular, jargon, language they speak. You'll get a lot of hints there as you begin to prepare. You could consider new certifications. Some certifications are just mean taking an exam or taking some courses and an exam or a ten-week course or something.
I talked to a physician who was foreign medical grad who couldn't find a residency here. He was working almost as a paramedical in the UM Department of Hospital. But to make a long story short, he got certified by the [00:41:00] ACDIS in, ~uh,~ ICD ten at the time, and that parlayed into a position as a, ~uh,~ physician advisor for clinical documentation improvement.
Now he's a clinical documentation integrity, is the new term, the, ~uh,~ CDI, ~um,~ consultant basically working for a large firm, and they do all their reviews from home, so it's a remote position. He really found a fantastic job that fully used his medical degree even though he had no residency. And then you have to figure out how to do your LinkedIn profile and convert your CV to a resume.
There's a certain art and science to that. And then prepare for interviews. And there's not really any easy way to do that except to go on interviews and realize that you should probably go on interviews in companies that you really don't care about really getting the job because you can learn a lot just by doing the interviews and understand that you probably won't get the first or second job you interview for.
But that's sort of this down and dirty, ~uh,~ approach to getting going on this career search.
What's the role of getting the degree to learn the skills, or do you need the ~cr-~ the letters after your name to help for some of these positions Yeah, that's a very common question, and it's a, it's a good question because it's a big decision. It's expensive, it's time-consuming, it takes time away from your family to do that MHA or the MBA or the MMM or the other several others.
~Um,~ I did an MPH. It was the same idea, but it's not a business degree, but it was the same thing. It was the cost, it was the time. What I usually recommend people do is that if they have a definite goal in mind and they know what they're trying to achieve, then the MBA or the MHA fits into that, then it's worth getting, but I would probably get it in a different way.
~Uh,~ and the reason I say that is because I know many people that have MBAs that don't, they don't quote, "use their MBA" per se at all. In other words, they're just not in a job that would use it. Not that they don't use the information and understand, ~you know, uh, an concepts in their day-to-day life.
They might, and it's fun. For some of us, we like to just go to school, so I mean, that's cool. But I would say, like, if you're in a hospital setting and you're a medical director, I would, I would, ~I'd try~ to get some of those jobs, get that experience, the medical director experience, and then I would try to parlay that into a job where they will pay for your MBA or your MHA at least partially.
Because if you're on that track, it's very easy to go to the CEO of a hospital and say, "Hey, I'm running this service line, and, ~um,~ I wanna cut back over time. I wanna get more into management, and so I really, I'm really strongly thinking about getting that master's degree." And they'll say, "Well, yeah, we have, ~you know, ~education assistance for the nursing staff and everybody else in our hospital, so we'll help pay for you to do that because we think it aligns with, what we need."
~And you know, there's~ similar ways you can do that in other industries. I've had people tell me, "Well, should I get an MBA?" Or ask me this question, ~uh,~ so that I can figure out what I wanna do. That doesn't make sense to me because the MBA is a tool to do something, and you've gotta really know what you want to do to see and if it aligns with that.
Now, having said that, do I know people who have gotten the MBA and then it opened up a lot of opportunities? Yes. I will say that if you're applying for a job as a chief [00:44:00] medical officer or sort of an executive anywhere in any industry, then you get to the point where you're competing, with others, and having the MBA can be helpful.
The other thing that's very helpful in that situation is having the CPE from the AAPL. That's a lot of acronyms. The CPE is a certification as a physician executive, and what that demonstrates is that you've had the book learning, which could be an MBA, an MHA, or it could be just having completed all the AAPL courses for the core.
Plus, you have to have one year of experience in management. So that CPE, in some cases, is, is a better, ~um,~ demonstration of your skill as an executive or a manager and a leader than just the MBA. 'Cause the MBA, it teaches you the concepts and you do some, , workshops, and you have projects, but it's not the same as actually running a department or managing people, which is the other half of that equation.
There are books. Okay, so I've done podcast episodes, I've written blog posts. There are actually [00:45:00] books out there. ~Um,~ 50 Non-Clinical Careers, ~uh,~ was published actually by the AAPL. That keeps coming up for some reason. ~Uh, anyway,~ Sylvie Stacey wrote the book, and she has 50 non-clinical careers broken down by industry and, and ~kind of, uh, ~domain for each.
And so that's, that's one way to do it. Heidi Mowad is another one that wrote a book on non-clinical careers. there a Facebook group called Physician Non-Clinical Career Hunters Facebook group.
a lot of people don't like to go onto Facebook, but that group has only physicians in it, and they're verified as physicians,. There's a Facebook group called Physician Side Gigs, I think. It has 70,000 members in it. It's international, but it kinda blows your mind when you hear those numbers.
There's a lot of activity out there in this area, but it is hard to get over that hump and to really start to discover these things you can look at LinkedIn. They have a very [00:46:00] extensive list of jobs, but you have to know the job. You can put something generic in there, like just, I said, physician advisor or medical director. ~Um-~ Or get the books or do one of these other things
There's no reason why you, as bright and hardworking and, ~you know, like~ anybody, shouldn't be happy and satisfied in your job. So if the job itself is the thing that's really the root cause of your problems, then definitely you can make a change, and there's lots of opportunities. It does take work, and it's challenging and frustrating at first, but it definitely works out, ~uh,~ for the positive in most of the time.
So I encourage you to do that if that's your situation take care, everybody. Thank you
Well, that's it for today's lecture. There are hundreds of potential jobs that build on your medical background and experience. Some are available to those with a medical degree only, some require completion of residency and a little practice experience, and others require a seasoned physician who can move into management or executive role.
[Salaries and benefits are excellent, and you will generally not face the hardships that clinical positions present if you have any questions or comments, feel free to email me at john@nonclinicalphysicians.com. And if you're not already receiving my newsletters, be sure to sign up so you don't miss updates and special offers at nonclinicalphysicians.com/newsletter. And join me next week for another episode of Physician Non-Clinical Careers.
Finally, don't forget that the opinions expressed here are mine, and while the information provided in the podcast is true and accurate to the best of my knowledge, there's no guarantee that using the methods discussed will lead to success in your career, life, or business. So always consult an attorney, accountant, or career strategist before making any major decision about your career.
Bye for now
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Overview of Alternative Careers for Physicians
Lecture by John Jurica
===
You're listening to Physician Non-Clinical Careers with John Jurica, episode number 463. Welcome back, non-clinical nation. Today I'm presenting another one of my recent lectures on the topic of non-clinical careers for physicians. This is a foundational presentation with an overview of alternative careers for physicians who are just beginning their search When you first started to sense that classic traditional practice in a healthcare system or independent medical group didn't resonate with your personal goals, vision, and mission, you probably didn't recognize that there are multiple industries that hire physicians to do non-clinical work and that there are recognized approaches to preparing for and pursuing careers in those industries And that is what I'm going to share with you today, an overview of the most common jobs out there and some of the steps you can take to begin that journey So let's get right into today's [00:01:00] presentation
You should be able to see my slides, and as it says here, I am going to be speaking about alternative careers for physicians.
I have gone from clinical to non-clinical, back to clinical and non-clinical, to just non-clinical twice in my career, and let me give you the short version of how that happened.
I started as a family physician. I joined two other doctors in a private practice, and when I joined, I had to build my own practice because they were busy, but they didn't really have patients for me to see on day one. So while I was trying to build the practice and volunteering for a lot of call and things of that nature, I started looking for other things to do.
And I did moonlight a little bit as, I worked at a family planning clinic, and I worked in an occupational medicine clinic, and I joined, committees at the hospital where I had privileges. And I started to get involved with the CME committee and shortly thereafter became the chair While this was all going on, I later became the medical director for the OccMed Cliinic and the family planning clinics, and I also did some physician advisory work at, the hospital at the same time to make a little extra money.
So I was doing a lot of things that really didn't involve direct patient care at that point. And by virtue of being in the CME committee, which we call the Program and Education Committee, I was chosen for the chair, and we had to be surveyed. We were surveyed by Illinois State Medical Society so that we could grant CME credit.
And that led me to join the ISMS's committee on CME accreditation at the state level. All this to say that that led me to meeting some other very interesting physicians who were doing things that I'd never heard of before. And in particular, one of those physicians was a former chair of that committee for the state, which I later did chair myself, was an internist that worked at basically the largest freestanding nonprofit hospital in the state of Illinois at the time.
It, it had 700 beds, and it wasn't an academic medical center. And I found out that he didn't actually see patients. And when I asked him about what he was doing, he said that he was a chief medical officer for that hospital. And over a period of time, I was able to engage with him, and I asked him a few questions, think about that.
And as this was going on, I was experiencing some symptoms of burnout. I shouldn't admit it, but there were times I was starting to hate my patients. I was frustrated. I was involved in three lawsuits, all of which I was dropped from, but they typically would take five years of my time off and on to get the heck out of those.
And so I was experiencing a lot of the same things that you and other physicians are experiencing today, which is that I just didn't like doing medicine anymore or it was getting too stressful at times. And so by consulting him, he told me I should join the American College of Physician Executives, which today is called the American Association for Physician Leadership.
And I thought, "Okay, this looks pretty neat. What can I do?" I took some classes. I got a master's in public health, and I decided to pursue what he had done. And so I was able to leverage those experiences as medical director. I got to know all the directors at the hospital as well as the CEO and the CFO and those people.
And so ultimately, I was signed as the first VPMA (Vice President for Medical Affairs), and then the chief medical officer, which I did for 14 years. And it got me thinking at the end of that whole process about this situation of burnout and nonclinical careers and, what can we do to overcome burnout.
And while I'm, definitely one who wants physicians out there taking care of patients, myself included, I think there's just situations where the joy of practicing medicine, usually because of sort of the corporatization of medicine, the pressures, the EMR, the long hours, the understaffing, it just gets to a point where it's just not really worth it.
And at the same time, there are things out there which I wanna talk about today, which are very exciting, very positive things that you can do to contribute to the healthcare system. So that's want to lead into with as far as, some of the things that you might be thinking about. Now, we did a survey of you.
You may have answered some of the questions, but really it was two questions about your degree of burnout and had you thought about leaving clinical medicine. And in terms of the burnout question, between the frequently and occasionally, 80% of you said you had symptoms of burnout at one time or another and were experiencing that.
And the other question about thinking about leaving, I think, was over 50% had considered something outside of direct patient care. So this is a very timely topic, I gather from those results. So today what I want to do is, first of all, I want to define alternative careers for the purposes of this discussion today.
I mean, it could be defined in different ways really, but I'll tell you exactly what I'm talking about and we'll go from there. The second is to dispel the common myths. So if any of you in this audience have already explored options, you've looked, you've talked to friends, you've networked, you've gone on LinkedIn, you may have already done some things.
But what I've found in speaking with my podcast guests and my colleagues and my students and my, and my mentees, that there are common myths about alternative careers, and I think what they do is they lead to these self-limiting beliefs about whether it's even possible for us to make such a change as an option to address our burnout or just our dissatisfaction or just getting tired of doing what we're doing.
~Now once I finish talking about that and convincing you that those are myths and you need to get over them, then we're gonna talk about something practical. Like if you really are thinking about doing this, are there skills that you already have that you can develop further, or are there new skills you should try to acquire even before you think about making a change?
Because transitions are tough, but if you can plan for your transition, and there's ways to do that, there's a variety of ways to do that really. One of those is to either, identify new skills, obtain new skills or certifications, things like that, which the certification part normally you don't have to do.
So we'll talk about that a little bit. And then a real short, overview of how to begin the process once you've, you've really settled on that decision
All right, so let's define alternative careers. I use typically the term nonclinical, but the thing is when I'm talking to my guests and my audience on my podcast and elsewhere, I usually include nonclinical and unconventional clinical careers.
So I include things that have a lot more freedom and flexibility in this, area, like telemedicine, which can be done actually half a dozen or more different ways, and locum tenens, which is clinical also, but if you do it right, it brings a lot more freedom and actually pays more, and you can create times in your life where you're completely off of work and can go a month or two without working, and then you can do locums for three months or so, that kinda thing.
But basically, we'll use the terms non-clinical, unconventional, non-traditional, or alternative to what we're talking about, and we're also talking about things that build on your medical education, training, and experience, as well as your knowledge of the healthcare system because it's-- You learn most of that actually after you get out of medical school.
You're kind of exposed to it, but all those things that you have to work within that the, the teams and the, and the construct and the, and the billing systems and the way things are done, that's, that whole thing is also a great big knowledge base that you can apply to a non-clinical or alternative career.
And just to make it easy, when you're looking for a job and you're trying to decide, okay, is this a non-clinical career or not, or how much of a nonclinical? If it has the term physician or medical in it, it's going to be, most of the time, a job that is geared for physicians that is nonclinical based on the actual name of that job.
So typically, you're gonna see something that says physician advisor, medical director, executive medical director, medical writer. Although there are a lot of non-physicians that do medical writing, physicians definitely do a lot of medical writings themselves, of course. Chief medical officer, chief medical information officer.
There's also chief quality officer. There's also chief patient safety officer. And so all of those, uh, can indicate that it's probably a physician, particularly if it says medical or physician in the title. Now, a CMO for a hospital is not the same as a CMO for an insurance company or a CMO for pharma, but it does tell you it's something that they have to have a physician in that position by definition.
So if you have an MD, a DO, an MDDS, or equivalent degree, then that-- you're the only professional that can do those jobs. Now you might need other experience beyond the medical degree, but at least that's sort of the entry-level position and, and background you have to have. I'm not talking about people that are going into running ~some kind of ~small business or [00:10:00] managing real estate or becoming a welder or job that doesn't have some connection to medicine or to healthcare.
Because I think, and the reason that I focus on that, and I think it's true, is because, doing another business, another, ~you know, jumping~ into another ~non-related~ business is sort of a, a horizontal move. When you move into one of these positions as a medical director or a CMO or something like that Almost 100% of the time you're actually moving up in your career.
So you have to think of this not as a failure, not as a stepping back, and I'll go into that in a little more detail, but you're actually stepping up to that next phase of your career and you should be proud of it. So here are the common myths that we see in people that are undergoing career transition.
Now, we're gonna get rid of the first five because those don't apply to physicians anymore because you've already overcome those to get into medical school, to get into residency, to get into fellowship, and to succeed and to pass, ~you know, your~ boards and do all those things that you've already done.
The most common myths or sort of beliefs that I see physicians have if they're thinking about pursuing this is number one, there aren't really that many jobs. I mean, I don't see that many people doing these things. Number two, all I know is medicine. I mean, I, I've spent my life niching down, okay? I started as a generalist in undergrad and learned all these things, all these different subjects and might have even ~done non-biologically related things ~like music or language studies and that kind of thing.~
But now-- And I niched down to medical school, and then once I finished that, I niched down to being a pediatrician, and now I've niched down even further by virtue of my fellowship. So I just narrowed my focus to the point where I really don't have skills for doing anything but what I'm doing now?
~That's kind of the way people talk to themselves about this issue. The third is that I'm definitely going to lose my income. If I shift out of this highly specialized field that I've spent all these years learning how to do, the next thing I do, if it's not building directly on that, is my income is going to drop?
The fourth one is that what about my patients? I feel bad about leaving my patients. I'm a professional, a physician. ~I've~ spent my whole life learning how to take care of my patients. Who's gonna take care of them? And, ~you know, this even bleeds ~into~ the other thought of, eh, what about my family?
I mean, my parents are going to be so disappointed. I mean, that's a big cultural thing in, in some areas, in some societies that, becoming that physician. And then finally whatever I ~do nonclinical, it's gonna~ be a letdown to my colleagues. My~ reputation and my influence are going to decline.
So I actually wanna spend about five or ten minutes going through each of these individually because I want you to get over these things and I don't think me just telling you to get over them is gonna necessarily help. So let me explain where I'm coming from when I'm, when I'm talking about these. So number one, limited jobs.
This is a list, a partial list of the industries that employ physicians, and they employ them as professionals, as physicians using their medical knowledge and, and understanding of patients. So pharma and medical device companies, massive, huge. I mean, pharma is like, I don't know, 8% of all healthcare spending in this country.
Oh, number two, hospital and health systems. That's 25% of all hospital, of all medical spending in the United States They, those first two employ enormous numbers of physicians, and I'm not talking about the clinical positions in the hospital and health systems. ~You know, every service line has a medical director.
~There's quality medical directors in the hospital setting. You know, this is~ the one I'm most familiar with 'cause I worked in the hospital setting. And there's medical directors for, informatics, medical directors for quality, for coding and documentation, for utilization management.
And the bigger the system, the more medical directors they have, and there's assistant medical directors, and then you've got the VPs and so forth. You've got health and disability and life insurance all employ physicians. Some of those jobs are awesome. Boy, the happiest doctor I ever met on my podcast, I think one of, was a cardiologist who really was doing okay, but she reached a point where she was thinking about getting another job.
Now, she took a shortcut. She happened to talk to a former either, co-resident or medical student, ~you know, ~alumnus that she knew, and that person happened to be working at an insurance company that was looking for a chief medical officer, I think. She might have gone in as a medical director. But when I talked to her, I think she was working as a chief medical officer, and she loved that job.
And, and it only took her a month or two to transition. It doesn't happen that often, so we can't all get our hopes up. But it's something that I-- And, and I've talked to other people in insurance and medicine, life insurance, and they love it, and, they would never leave that job. So it's hard to get a job as a CMO at a life insurance, ~um,~ i-industry because nobody leaves.
Those jobs are so wonderful. Because it matches up with, with her personality. She really loves doing the research on, and then looking deep into complicated sort of situations and help the underwriters decide whether a person ~with, you know, three~ different sort of overlapping disease entities ~or, you know, processes going on, you know, should be~ insured or not, and what would be the cost of that insurance.
And the [00:15:00] actuaries do ~the simple~ ones, and then they get ~the~ physicians involved for the more complicated ones who can really understand how those things interact. So that's awesome. Medical writing, there's at least five or six different discrete ways to do medical writing or ~field, you know, whether~ it's for journalistic or for patient ed or for, ~you know, f- um, ~medical education or technical.
And each of those can be done either ~as~ a freelancer or as an employee, ~uh,~ an employed physician at a, at a company that does that. And, ~uh,~ of course, the medical writers, a certain percentage of them go on to be medical directors who are usually the editors of the other writers ~or, you know, for the~ other writers.
So you've got consulting firms. There's international and national consulting ~firms. They~ almost all have health care, ~uh,~ divisions, and they all employ physicians. ~Um,~ and then you've also got your ~f- your~ freelance consultants that are physicians that go off and just focus on something they do very well, and they share it with other people, and they can definitely create a, a small business doing that.
Consumer health, ~you know, you~ get involved in helping patients, but they're really clients, [00:16:00] helping the public, fitness, health, wellness, um, nutrition. A lot of physicians, oddly enough, the job-- I'll get real specific for a moment, but a lot of the physicians I've interviewed, um, they love coaching because coaching is like treating patients, uh, as you would, ~you know, ~medically or even as a psychiatrist.
But there's no risk, there's no liability, there's, ~you know, ~no overhead, and you don't have insurance companies interfering in your coaching. And coaching is actually ~a~ very popular side job and full-time career for physicians, and it's very rewarding. You've got the whole government and public health sector.
You've got nonprofits. ~Uh,~ some of the nonprofits, if they're related to medical care, like the Accreditation Council for CME, I was a surveyor for them for a while. They don't pay, so that's not considered a ~non-c-clinical~ job. That was a volunteer position. But the CEO of that, of the ACCME, is a physician, and others.
And the J-Joint Commission and, ~uh,~ the other, ~uh,~ accrediting agencies all [00:17:00] use physicians as surveyors if they're involving, ~you know, s- if the sur- if~ the survey, like Joint Commission, involves looking at medical care. And then education at all levels. ~Physicians~ can go back and teach anatomy and physiology ~in, you know, ~community colleges and high schools and universities, and a lot of them will teach at PA schools and will ~teach, you know, physical~ exam and, ~uh,~ all sorts of different variations thereof, either if not full-time, at least part-time.
So ~there~ are lots and lots of jobs out there, and it's hard to quantify. There's only a million physicians in the country, and I swear that at least a third of them are doing non-clinical jobs at this point, but I can't, I can't really quantify that. All right. Now, the next one is number two: All I know is medicine.
Well, let me pause for a minute and say that we're gonna do a mental exercise on this one just to maybe think at, think about it in a different way. So imagine, if you will, that you're on a ship in the ocean and, ~uh,~ it's damaged, it's sinking, and all of you are gonna have to get in a lifeboat. So y'all are gonna get in a group of five [00:18:00] in these lifeboats and you can go off in all different directions.
So the mental exercise is this: if you were in that boat and you get to select the people that are going in the boat with you, and knowing that you might be shipwrecked on a deserted island somewhere and you might have to figure out how to survive, what would be the top two or three professions of the people you'd ask on that boat?
Think of all the professions and the things that people do, ~you know, ~from just, ~you know, ~repairing your telephone to serving you meals as a waiter or waitress, to being a cook, ~to accounting~ to, ~you know, the~ scores of different things. So I'm gonna jump to the end of the, this little quiz here and ~answer it~ my way, and this is what I have come to conclude thinking about that.
I would want to be... I would wanna have at least the following two people with me on that little boat and on the island: an engineer and a physician. 'Cause an engineer knows how things work and they can fix things and, uh, they understand what's safe or not safe to ~do, you know, if you're~ on a bridge or you're building a, ~some kind of ~structure.
And then the other one is the physician, because a physician is an [00:19:00] expert in biology. Many of us have expertise in chemistry, biochemistry, microbiology. We understand how to treat injuries and how to monitor illness, even if we don't have all the fancy tools that we use every day. We have a vast background.
We have a very broad background. I mean, basically we're liberal ~ar- arts specialists, you know, as~ our undergrad, and then you just keep adding to it. So I get questions all the time, ~you know, about the~ chemistry of this, ~uh,~ botany. It doesn't matter. We have such a broad exposure that ~y-~ a lot of those things apply to other jobs.
So rather than go down the list of things we know, although I will have a slide on that here. So this is just a starting list of the things we were trained in depth in, and it goes on and on and on, and I'm not even getting into the, the non sort of scientific ones. Uh, but this is just a sampling of the things that we're pretty, pretty good at.
Most of us could go work in a lab. Most of us could, ~you know, uh, ~evaluate studies. So, ~uh,~ there's a lot of skills in there that can be translated. So you do know a lot ~about a~ lot of different [00:20:00] things. All right. Now, what about the issue of income and finances? Are you gonna become financially ruined if you decide to leave medicine?
Well, I mean, if you're generating ten thousand RVUs a year, I don't know what the averages are these days, ~you know, it's~ gonna be hard to match that ~if, you know, if~ you're a, an, an invasive cardiologist, ~uh,~ I don't know where neonatologists fall ~on~ this whole, ~uh, you know, spectrum of~ salaries. But yeah, sure, there are certain specialties that are very high- highly paid specialists.
But ~I'm gonna tell~ you that The pay for non-clinical careers is, is, is up there and it's competitive for, for the most part. I made a lot more money as a CMO than I would ever make as a family physician without killing myself. I mean, I have some friends who are family physicians who work 80 hours a week and, ~you know, they kind of barely~ get by and their records never get done, and they make a lot of money, but it's no way to live.
So really think of it, I guess, teleologically. I don't know if that's the right term, but if you turn it around, you can't attract a physician to be [00:21:00] an employee to do some of these thousands of jobs that I've mentioned briefly, unless you're going to pay them a commensurate salary. They're just not gonna leave that old job, even if they are burnt out.
~Uh,~ so they have to pay a sufficient amount. The other thing is we should really compare apples to apples, okay? Let's keep in mind that if you're working ~f- you know, ~supposedly on a 50-hour job, a full-time in the US really is 50 hours, even in, in the, let's say, in the hospital leadership setting. ~Yeah,~ nobody really sticks to a 35 or 40-hour workweek.
~But you know, if you're~ a physician and ~y- you're~ down on staff and whatever, you're working 60 hours, you're working 65 hours, 70 hours, you're on call for, in many specialties, ~you know, every~ third, every fourth, and that doesn't mean just answering one phone call. I mean, it means getting up and getting out of bed and seeing a sick patient and doing all you have to do, and doing records at home and, ~you know, certain~ specialties.
And, ~you know, if~ you think about the risk of, ~uh,~ liability, the level of satisfaction, the stress, ~the balance,~ the addiction, the lost and destroyed relationships. [00:22:00] Now, put all that on a more even keel and compare it. All, all these jobs will, will definitely compete with that. And, ~you know, if~ you're, if you could just have a lifestyle that maybe isn't quite what it was before.
But I will say, if you look at the median salaries for physician advisors, medical directors, and chief medical officers, you'll see that you'll quickly get into very competitive salaries. ~You know, these~ are, these are across all industries, so it's hard to, to know what, what it means. But I can tell you ~that, you know, as~ a CMO for a hospital, I mean, the starting is 300 and, and up.
I think it's typical to even start at 350 to 400. Now, it takes a little while to work your way up to a CMO. You might have to be a medical director and, ~you know, or~ an assistant, ~uh, or, you know, even~ some intermediary, ~you know, ~job in the meantime. But, ~you know, if~ you're in, ~uh,~ medical affairs in a pharma company, if you're working ~in a~ hospital ~system,~ there are lots of ~jobs that~ pay very well.
~And for, you know, if you~ look at primary care And used to be psychiatry, although psychiatrists are paid very well these days. ~Um,~ definitely better than, than most primary care fields for ~sure.~ And there's-- what I'm gonna mention again in a moment is that there's a lot of [00:23:00] advancement once you get into these different industries.
Some of these industries, you're the only physician or one of two, two or three physicians on a team, and the physicians are always looked at as leaders, and so there are opportunities to just grow. So you could maybe take a little dip for a while, and then once you really get your bearings and now you're an experienced person doing that non-clinical career, your, your salary is going to go up as you take on more responsibilities, but not necessarily more risk or ~l- you know, longer~ hours.
So that's what I have to say about the finances. Now, what about my patients? I'm not gonna read everything ~on this~ slide, but what I found when I became chief medical officer and I began to realize, and it was pretty quickly too, 'cause the areas that I was working on were the ~f-~ the pharmacy director reported to me, the quality director reported to me, ~uh,~ for a time the UM, the utilization management and case management, ~um,~ and I had informatics, if you can believe that, which is not that common.
In any event, I was there, and I was overseeing the installation of quality measuring tools, [00:24:00] and we were working on improving mortality rates, reducing length of stay, ~uh,~ improving safety. We were doing, ~uh, you know, um- ~evaluations of, of, ~uh,~ sentinel events, ~uh,~ doing an RCA, root cause analyses, and we were identifying problems and fixing them and ~to where~ we were showing measurable improvements in those metrics, easily measurable, and that was risk-adjusted based on the severity of illness of the patients we were admitting.
And the same is true of all these other areas. ~You know, I have~ a colleague who runs a Facebook group about non-clinical careers, and she brought two new drugs to market under her leadership at the pharma industry or the pharma company she was working at. She was in OB, and she brought the-- And she was very proud of the fact that now these medications were gonna be used ~to, you know, reduce~ the need for surgery and improve the healthcare of those patients and maybe have fewer side effects than previous treatments and, and, uh, really the quality of life improved for those patients because of what she had done and her team.
We always work in a team. Insurance companies, same thing. You [00:25:00] can, you can show ~why, you know, ~utilization management itself, even though it seems annoying to have to answer that phone call sometimes, but those, those reviewers oftentimes ~save~ patients from getting the wrong procedure, number one. At the same time, they spend their time teaching the physicians how to document better so that they don't have to get these phone calls, and they can get the, the care that the patients need.
Since they've chosen to have insurance, then they have to meet the insurance guidelines and so on and so forth. ~You know, medical~ writing, you're teaching, you're educating. ~Uh,~ same thing with consulting. You're bringing new service lines to hospitals and other, ~uh,~ healthcare, ~uh,~ companies, hospices and, and nursing homes and, ~uh,~ surgery centers and so forth.
So, ~um~ You're doing service to the patients indirectly, and you're probably having a much bigger impact than most of these non-clinical positions. So I'm not gonna go into this whole list, but just want you ~to, you know, ~think about those things from that perspective. How about my reputation and influence?
Well, when I was a family physician, ~you know, I was~ running around all these different [00:26:00] meetings trying to get to know ~people. I~ was taking care of my patients and, ~you know, we~ had 4 or 500 people on staff. It was a relatively small, sort ~of~ semi-rural, because we were an hour south of Chicago. And, ~uh, you know, I was~ just another ~physician on~ the staff, ~you know, no~ big deal.
Nobody really cared. ~Uh,~ in fact, and the physicians that were kind enough to volunteer to be chairs of departments and even the president and vice president of the medical staff, no one ~really~ cared about them either. They were non-paid positions. It ~was kind of, you just~ take your turn and do it, ~you know, in an~ academic setting or a bigger hospital.
Nowadays, you get a little bit of reputation from that and pay for that, so that's, that's helpful. Technically, that's a non-clinical activity. ~Um, ~but when I became the CMO, well, now I felt like I was, like, at the pinnacle because the neurosurgeons and the, ~uh,~ cardiac surgeons and the cardiologists and the orthopedists were coming to me when they had an issue or a problem.
So now ~I-it~ seemed to me that by all means, I was still a physician, and that's actually one of the reasons why they need us is to communicate with our colleagues, physician to physician. So that's a secret of all of this, is that's one of the reasons we need physicians in these positions. And so I felt, heck, my reputation and influence had expanded immensely.
So ~that's, you know. So~ when you do a non-clinical for the most part, you're still a physician. You're still Dr. XYZ. You're very likely to end up managing a team in whatever you do because just ~we're born-- we're not~ really born leaders, but we're natural leaders because of our training experience and so forth, and just the way that people look at us.
You're seen as a content expert in whatever it is you're doing. ~You know, in~ UM, ~I--~ this is like a digression, I guess, but, ~you know, one~ of the questions I'm assuming a neonatologist might have is, "Well, as a neonatologist, what are the best jobs for me to do?" And ~I, I~ think I'll stop here and answer that question in general because maybe not everybody on here is a neonatologist.
But Most of the jobs are not specific to a particular specialty. So I had a pediatric cardiologist or a cardiac surgeon, ~I don't know, I think it was a cardiac--~ [00:28:00] pediatric cardiologist, and the first non-clinical job he had was a utilization management reviewer, physician advisor for a third party, for an insurance company, just like everybody else, just like the family doctors, just like the, ~uh, the, uh, you know, the~ internists, ER doctors.
You think of them as generalists, and they can do something like a UM job. But it didn't matter because all UM is based on, on guidelines that you need to look at and learn anyway. They train you to do that, and as long as you've got a medical school background, you can do that. And the same is true of almost everything.
There's no reason why a neonatologist can't be the chief medical officer of anything any more than a, an ER doctor or anyone else, because we know those things that I talked about earlier. Sometimes if you look in the jobs descriptions, you get a little discouraged. It'll say things like, "Prefer," ~you know, ~"internal medicine," or, "Prefer this," or, "Prefer that."
It doesn't really make a difference. What they wanna know is that you have the skills. They think that, ~you know, certain~ specialties might have more skills and experience in certain tactics and techniques [00:29:00] and, and attitudes, but It really doesn't matter. If you can demonstrate that you have those, then the jobs are open to you as well.
So it's, it's really not, ~uh,~ usually an issue. I haven't really seen a lot of trends in terms of the type of jobs and the nature of the specialty that the physician had been practicing before they switched out. ~Um, y-~ many times you advance up and become a leader. A lot of these-- And a lot of these companies promote that because they want physician leaders in those positions.
And, ~uh,~ I already talked about, ~you know, my~ situation. All right. So I did wanna talk about the, ~uh,~ skills that you may have now and then maybe you ~want, want~ to develop further. ~You know, the~ thing about applying for an alternative job or career, and I'll use those terms interchangeably, is that you need to demonstrate to whoever's doing the hiring that you have the skills and knowledge that they're looking for.
And the biggest barrier isn't that you don't have those skills and knowledge, but what's not uncommon, it's actually pretty common, it's one [00:30:00] of the big reasons why physicians sometimes, ~uh,~ struggle to move into one of those new careers, is because they don't know how to demonstrate that they have the skills and that the skills that they have are transferable to the job that they're applying for.
That's really-- It's one of the steps I'm gonna talk about at the end in terms of, ~um,~ actually getting the job that you're looking for, is learning certain steps that have to occur. And one of them is to show that, well, my, ~you know, my~ knowledge of quality improvement and patient safety is applicable to work in pharma, ~uh,~ as a medical director in medical affairs.
Just saying that doesn't make it so, but you have to be concrete. You have to be-- You have to specifically show what you were doing in quality improvement and patient safety, ~you know. Uh, I was~ in practice-- This could be an example. I was in practice, and, ~uh,~ I was really attuned to the side effects and problems my patients had with their medications.
And so I would definitely ~c- uh,~ counsel them about the side effects and ask them to report those to me. And in fact, I went a step further in my career And as I was doing this, and I joined some of the, ~uh, the safety, um,~ panels or, ~uh, uh,~ reporting systems, and I would report when I identified what seemed to be a side effect from, ~uh, uh,~ one of the newly released drugs in this particular field that I'm in and this particular class of drugs.
Anyway, connecting those dots is what it takes to get them to hire you. So, but you already have, as I said, because you're a physician, you already have 70 to 80% of what they need. They sometimes just need to know that you can take on the other aspects, and I can tell you right now that you can. I've never met a physician that was-- that started a job, ~a-~ any of these jobs, that, that couldn't quickly master what they needed to within the first few months of working in that position.
~Uh,~ but one of the things I did mention in the, ~uh,~ objectives for today was, well, what new skills should I develop? So I do wanna spend a minute to talk to you about that because if you're thinking about this-- And this is also another place where since we're talking about and we're transitioning here into thinking about moving, I do wanna make it clear that When you are not happy in a job, and I know you probably have already thought of this if you're not happy, but sometimes it helps to hear it from somebody else.
Sometimes you just have to pause and step back and ~s-~ ask yourself, "Okay, I'm miserable here at this point. Why am I miserable?" Well, 'cause of the things we talked about before, about the long hours and, and the fact ~that, you know, we're~ understaffed and so forth. But the question becomes, before we jump into this part, ~um,~ moving forward with a non-clinical or alternative career is, what can I do other than leaving medicine?
Okay, so usually it boils down to one of three things. I mean, this is true of other jobs, ~you know, outside~ of medicine. You either need a new boss, a new department, or a new company. So there... A lot of people are unhappy in their jobs. The most common reason that people are unhappy with their job is 'cause they don't like their boss.
And I think that doesn't apply necessarily as [00:33:00] much to physicians 'cause we, we somewhat work independently in a lot of situations. But oftentimes it really is because our boss doesn't listen, because our, the leadership team, the, , the whole team that we're working for isn't implementing changes that are addressing things that we've noticed.
And particularly for physicians, it's quality and safety issues more so than the work environment, although that's become much more important recently. But always keep that in mind. Can I change managers? Can I change departments? Or can I go to another institution? There are some medical institutions that have a very positive culture that it's very, ~um,~ amenable to and attuned to reducing burnout and looking to try to get balance in, in the mployees.
I talked to a recent guest who, it was interesting because she, she was on to talk about mainly about the fact that she was, you know, working~ as a medical director and the career path that she had followed and why it was such a positive thing, yet she was still practicing clinically. But the other side of the coin for her was she went from being a typical traditional [00:34:00] family medicine, it might have been internal medicine.
yeah, she was an outpatient internist, outpatient only internist, and she was getting killed in the office, and trying to balance that with her medical director was difficult. And she worked for a big system. And I could not believe, and I guess I am not keeping up as well as I should, but they had concierge practices in that system, and she was able to move to a concierge practice where she only has responsibility for, like, 700 patients working part-time, basically job sharing with another part-time physician who's a concierge internist, outpatient only.
So that kinda blew my mind, and, you know, if you~ can find something like that in, in your institution. Now, you know, something similar to that, obviously you're probably not, ~working directly, , ~outpatient only internist since we're talking to neonatologists. But I mean, there's some- there's things that are similar to that, that I'm sure we could find that neonatologists and pediatricians have done in the past.
So never sort of, ~you know, um, cross~ that out as a possibility. Once you're beyond that though, ~and say, "You know, it's~ not really where I'm working, it's not really the people I work with or for, but really I, I'm just tired of doing this. I don't get joy out of it anymore. It doesn't matter if I worked in an ideal situation, I still wouldn't enjoy it."
Okay, then it's time. So what do we do? What do we try-- What new skills can we try and develop? The ones that are typically, mentioned and, ~you know... ~So as you're preparing, ~you're, you know, putting~ some money aside in case you're unemployed for a little while for some reason. Maybe you, quit and then you don't have the new job yet or whatever.
but the other thing is ~to, you know, ~develop some skills if you can That might look positive when being reviewed by some of these. And you have to kinda narrow down the niche first, but these are generic ones. Like, and if you look at this list of healthcare finances, ~human resour- sources,~ contracting, negotiating, marketing, sales, leadership, recruiting, public health.
After I made this slide, I realized there are ~all the kind of ~topics that the American Association for Physician Leadership teaches. Because, ~you know, ~leadership involves taking on some of these broader roles in almost any industry. ~Um, so, you know, the~ simple [00:36:00] answer ~is, you know, join~ the APL ~and, you know, maybe~ take some of their courses.
But even just reading about things, reading about healthcare finances, how to read a P&L.You could just take a small course or even read a book, and you'll learn about those things. Read ~about, contracting. Get involved with negotiating, and~ it could be applied to your practice, could be applied to other things.
how to write persuasively. Most physicians can write pretty darn well technically, for sure. but to write and to write persuasively is a different skill. there's public speaking. It's one ~thing to do~ public speaking in terms of with your colleagues and teaching students and residents and so forth, but public speaking to the lay public, that could be a good skill to learn, and just start getting out there and do these things.
And there's a whole list of other things, ~um,~ that you can do, then you get involved. Like when you're volunteering for things is another good example of how to get the skills. I'm a volunteer for the local hospice. I'm on the board, and I'm the chair of the quality committee. But I could be on the finance committee.
I could learn all about finances by being involved with the [00:37:00] hospice finance committee, and that's healthcare. So there's lots of things. Just get a little bit out of your comfort zone, get involved with some volunteer activities or maybe some even very part-time activities where you can get exposed to other things.
And then later, you're gonna have to figure out how to translate those on a, on a resume and on a LinkedIn profile to convince others that they are useful. All right. Let's move forward Okay, so then finally I wanna talk about where do I begin? How do I begin? So this is gonna be a very down and dirty approach, but so you've recognized that you want and need to change jobs or careers.
So really the big steps are you have to, number one, address the mindset issues, which we've already talked about. Number two, identify the options. So ~I kind of ~glossed over that, but I showed you the different industries. But you could spend time. There's probably up to 30 pretty common non-clinical jobs that physicians do, uh, that I can't list here today.
But as you get exposed to those, you're going to see [00:38:00] some are remote, some are in person, some are full-time, some are part-time. Some require travel, some require no travel, some require a lot of travel. And so the job itself has different aspects. The, content of the job, pharma versus in a hospital system versus insurance.
Have different things that may or may not interest you. And so you just need to kinda work on that and, and understand that, and then do some introspection about your personality interests, skill sets, job factors, and then line things up. So I think I've got this slide just to say ~that, you know, these~ are some of the jobs.
I talk about McKinsey's a consulting firm and, ~you know, there's~ all these options. Kinda just start with a broad brush and then narrow it down over time, and you learn more and more. And as you narrow it, you can get more in depth. And, ~uh,~ the thing is, there are professional associations for most of the jobs you might consider.
And this is the slide where you're, you're looking at this overlap of interests, skills, personality. And the demand means if you're going to start your own business, then there has to be demand for the [00:39:00] product or the service. But if you're gonna become employed by one of these industries, then there has to be demand for that position.
And so,, if there's a glut of medical science liaisons and the competition's really, really tough, then probably you should maybe decide to go with, ~uh,~ something a little different. But if you hear there's a shortage-- And again, becoming an MSL requires absolutely no new training or certification.
And there's a lot of jobs ~and, uh, you know, ~alternative jobs like that that you can find So as far as getting to work, the process involves things like getting a mentor, maybe a coach. Coach is optional. Mentors are free. Mentors are people you just pick their brain from time to time like I did with my mentor.
Join those professional associations for their particular field and industry, and some of them are specific to an actual job like physician advisor, or MSL or, again, different jobs within, medical directors for quality and so forth. ~Um,~ early in the process, if you've narrowed it down, you should search through the job listings, not because you're going to apply for the job, but because you wanna read the job listing and see what the trends are, what the common threads are with respect to what are they asking for, what are the must-haves, ~you know.~
~And~ when I give this talk to others, ~you know, there are~ physicians who don't have a license who completed medical school, and they don't have residency, and they're not board certified. Well, they're still physicians, and they can get a lot of these jobs. But if the must-haves, you have to have a license, or the must-haves, you have to be board certified, then they just kinda put those aside.
So look at the must-haves and look at the nice-to-haves and then the list of the common, , vernacular, jargon, language they speak. You'll get a lot of hints there as you begin to prepare. You could consider new certifications. Some certifications are just mean taking an exam or taking some courses and an exam or a ten-week course or something.
I talked to a physician who was foreign medical grad who couldn't find a residency here. He was working almost as a paramedical in the UM Department of Hospital. But to make a long story short, he got certified by the [00:41:00] ACDIS in, ~uh,~ ICD ten at the time, and that parlayed into a position as a, ~uh,~ physician advisor for clinical documentation improvement.
Now he's a clinical documentation integrity, is the new term, the, ~uh,~ CDI, ~um,~ consultant basically working for a large firm, and they do all their reviews from home, so it's a remote position. He really found a fantastic job that fully used his medical degree even though he had no residency. And then you have to figure out how to do your LinkedIn profile and convert your CV to a resume.
There's a certain art and science to that. And then prepare for interviews. And there's not really any easy way to do that except to go on interviews and realize that you should probably go on interviews in companies that you really don't care about really getting the job because you can learn a lot just by doing the interviews and understand that you probably won't get the first or second job you interview for.
But that's sort of this down and dirty, ~uh,~ approach to getting going on this career search.
What's the role of getting the degree to learn the skills, or do you need the ~cr-~ the letters after your name to help for some of these positions Yeah, that's a very common question, and it's a, it's a good question because it's a big decision. It's expensive, it's time-consuming, it takes time away from your family to do that MHA or the MBA or the MMM or the other several others.
~Um,~ I did an MPH. It was the same idea, but it's not a business degree, but it was the same thing. It was the cost, it was the time. What I usually recommend people do is that if they have a definite goal in mind and they know what they're trying to achieve, then the MBA or the MHA fits into that, then it's worth getting, but I would probably get it in a different way.
~Uh,~ and the reason I say that is because I know many people that have MBAs that don't, they don't quote, "use their MBA" per se at all. In other words, they're just not in a job that would use it. Not that they don't use the information and understand, ~you know, uh, an concepts in their day-to-day life.
They might, and it's fun. For some of us, we like to just go to school, so I mean, that's cool. But I would say, like, if you're in a hospital setting and you're a medical director, I would, I would, ~I'd try~ to get some of those jobs, get that experience, the medical director experience, and then I would try to parlay that into a job where they will pay for your MBA or your MHA at least partially.
Because if you're on that track, it's very easy to go to the CEO of a hospital and say, "Hey, I'm running this service line, and, ~um,~ I wanna cut back over time. I wanna get more into management, and so I really, I'm really strongly thinking about getting that master's degree." And they'll say, "Well, yeah, we have, ~you know, ~education assistance for the nursing staff and everybody else in our hospital, so we'll help pay for you to do that because we think it aligns with, what we need."
~And you know, there's~ similar ways you can do that in other industries. I've had people tell me, "Well, should I get an MBA?" Or ask me this question, ~uh,~ so that I can figure out what I wanna do. That doesn't make sense to me because the MBA is a tool to do something, and you've gotta really know what you want to do to see and if it aligns with that.
Now, having said that, do I know people who have gotten the MBA and then it opened up a lot of opportunities? Yes. I will say that if you're applying for a job as a chief [00:44:00] medical officer or sort of an executive anywhere in any industry, then you get to the point where you're competing, with others, and having the MBA can be helpful.
The other thing that's very helpful in that situation is having the CPE from the AAPL. That's a lot of acronyms. The CPE is a certification as a physician executive, and what that demonstrates is that you've had the book learning, which could be an MBA, an MHA, or it could be just having completed all the AAPL courses for the core.
Plus, you have to have one year of experience in management. So that CPE, in some cases, is, is a better, ~um,~ demonstration of your skill as an executive or a manager and a leader than just the MBA. 'Cause the MBA, it teaches you the concepts and you do some, , workshops, and you have projects, but it's not the same as actually running a department or managing people, which is the other half of that equation.
There are books. Okay, so I've done podcast episodes, I've written blog posts. There are actually [00:45:00] books out there. ~Um,~ 50 Non-Clinical Careers, ~uh,~ was published actually by the AAPL. That keeps coming up for some reason. ~Uh, anyway,~ Sylvie Stacey wrote the book, and she has 50 non-clinical careers broken down by industry and, and ~kind of, uh, ~domain for each.
And so that's, that's one way to do it. Heidi Mowad is another one that wrote a book on non-clinical careers. there a Facebook group called Physician Non-Clinical Career Hunters Facebook group.
a lot of people don't like to go onto Facebook, but that group has only physicians in it, and they're verified as physicians,. There's a Facebook group called Physician Side Gigs, I think. It has 70,000 members in it. It's international, but it kinda blows your mind when you hear those numbers.
There's a lot of activity out there in this area, but it is hard to get over that hump and to really start to discover these things you can look at LinkedIn. They have a very [00:46:00] extensive list of jobs, but you have to know the job. You can put something generic in there, like just, I said, physician advisor or medical director. ~Um-~ Or get the books or do one of these other things
There's no reason why you, as bright and hardworking and, ~you know, like~ anybody, shouldn't be happy and satisfied in your job. So if the job itself is the thing that's really the root cause of your problems, then definitely you can make a change, and there's lots of opportunities. It does take work, and it's challenging and frustrating at first, but it definitely works out, ~uh,~ for the positive in most of the time.
So I encourage you to do that if that's your situation take care, everybody. Thank you
Well, that's it for today's lecture. There are hundreds of potential jobs that build on your medical background and experience. Some are available to those with a medical degree only, some require completion of residency and a little practice experience, and others require a seasoned physician who can move into management or executive role.
[Salaries and benefits are excellent, and you will generally not face the hardships that clinical positions present if you have any questions or comments, feel free to email me at john@nonclinicalphysicians.com. And if you're not already receiving my newsletters, be sure to sign up so you don't miss updates and special offers at nonclinicalphysicians.com/newsletter. And join me next week for another episode of Physician Non-Clinical Careers.
Finally, don't forget that the opinions expressed here are mine, and while the information provided in the podcast is true and accurate to the best of my knowledge, there's no guarantee that using the methods discussed will lead to success in your career, life, or business. So always consult an attorney, accountant, or career strategist before making any major decision about your career.
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