On this week's episode of the PNC podcast, we revisit my interview with Dr. Helen Rhodes from 2019. She describes how persistence and flexibility helped her find meaningful clinical and nonclinical jobs to create a delightful career.

Helen describes the difficulties of returning to obstetrics after several years away, the value of diversifying your employment opportunities, and the fascinating world of plasmapheresis.

Early Clinical Career Opportunities

Helen began her career in her home state of Texas, completing her residency there. Shortly thereafter, an academic medical center in Houston recruited her to do gynecology only.

Although she felt fortunate to be doing gynecology, Helen soon realized she was unprepared for academic medicine. Not yet 30 years old, traditional practice beckoned. So, Helen left academic medicine and returned to full-service OB-GYN work, serving a community in Houston for ten years. However, after ten years of service, she felt the OB-GYN lifestyle no longer fit her goals.

I really was having difficulty with the lifestyle, of obstetrics primarily. – Dr. Helen Rhodes

Feeling better prepared for it, she returned to the same academic institution she had left a decade before and worked there for ten more years as a gynecologist.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Private Practice

After her youngest son graduated high school, Helen decided to take a big leap and go into private practice doing only gynecology. She knew it was a risky move, given that she had no patients to follow her and would not be offering obstetrics.

On top of that, her reason for the change was to reconnect with her patients and spend more time on patient care. She quickly realized, however, that fewer patients would mean less revenue, particularly in private practice.

The post Be Creative And Flexible And Love Your Career – A PNC Classic from 2019 appeared first on NonClinical Physicians.

In this podcast episode, John interviews the author of The Purpose Code, Dr. Jordan Grumet. 

As the host of the Earn and Invest Podcast and a physician-turned-author, Dr. Grumet combines insights from his hospice patients with his own experiences to offer fresh perspectives on finding authentic purpose and creating lasting impact. His new book, “The Purpose Code: How to Unlock Meaning, Maximize Happiness, and Leave a Lasting Legacy,” challenges traditional views about purpose while providing practical guidance for those seeking greater fulfillment.

Our Episode Sponsor

We're proud to have a NEW EPISODE SPONSOR: Dr. Armin Feldman's Prelitigation Pre-trial Medical Legal Consulting Coaching Program.

The Medical Legal Consulting Coaching Program will teach you to build your own nonclinical consulting business. Open to physicians in ANY specialty, completing Dr. Armin Feldman’s Program will teach you how to become a valued consultant to attorneys without doing med mal cases or expert witness work.

His program will enable you to use your medical education and experience to generate a great income and a balanced lifestyle. Dr. Feldman will teach you everything, from the business concepts to the medicine involved, to launch your new consulting business during one year of unlimited coaching.

For more information, go to nonclinicalphysicians.com/mlconsulting or arminfeldman.com.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Redefining Purpose for Modern Life

Dr. Grumet introduces a fresh perspective on purpose by distinguishing between two distinct types: “Big P” and “Little P”. This approach challenges conventional wisdom about how we view and pursue purpose in our lives.

Through his research and personal experience, he explains why pursuing Big P purpose often leads to anxiety and frustration, while Little P purpose offers a more accessible and fulfilling alternative that anyone can implement.

The Path to Lasting Impact

Drawing from compelling real-life stories and evidence-based research, Dr. Grumet demonstrates how small, meaningful actions can create profound and lasting impacts. His insights reveal why some of our most significant contributions may come not from grand ambitions, but from authentic engagement in activities that naturally resonate with us. And that often leads to unexpected but meaningful legacies.

Summary

For those seeking guidance on finding meaning and happiness while building a lasting legacy, “The Purpose Code” is available at Dr. Grumet's Website and major booksellers.

Dr. Grumet's approach offers practical tools for creating a more fulfilling life by reimagining how we think about and pursue purpose. This is particularly relevant for professionals experiencing burnout.

Links for today's episode:

• Dr. Grumet's Website
• Official Trailer for The Purpose Code
• The Purpose Code: How to Unlock Meaning, Maximize Happiness, and Leave a Lasting Legacy (this is an Amazon Affiliate Link*)
• How to Be Purposeful with Your Life and Career – 317
• Why You Must Dare to Discover Your Purpose When You Retire – 258
• How to Develop a Passionate Side Hustle – 098
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 386

Now Find Happiness and Meaning and The Purpose Code

- Interview with Dr. Jordan Grumet

John: I'm pleased to welcome a fellow physician podcaster to the show today. He's an internist, hospice medical director, and an author. Actually, that's why he's here today for the most part, because he has a book coming out called "The Purpose Code: How to Unlock Meaning, Maximize Happiness, and Leave a Lasting Legacy." So that's coming out right as this is being released, actually. So with that, I'll say hello and welcome, Dr. Jordan Grumet.

Dr. Jordan Grumet: John, thank you so much for having me. I'm excited for this conversation.

John: Yeah. And my listeners may know you if they listen to earn and invest podcast or have seen that, you know, that term out there, then they're already familiar with you. But I think probably there's many people that haven't either met you, seen you, or even read your previous book. So we're going to get into it right now. But let's start by you telling me and the audience a little bit about your medical training and experience and kind of what you're doing right now, everything a little smattering of what you do.

Dr. Jordan Grumet: So basically, at the age of seven, my father was 40 and he was an oncologist, and he died suddenly from a brain aneurysm, was actually rounding at the hospital. And right then and there, I decided I want to be a doctor. I think part of it was that I think I could cosmically fix this wrong that happened, this trauma that I went through, by walking in his shoes and fulfilling his role. And that's exactly what I did. I went to college and medical school with the certainty that was my sense of purpose, that was my identity, that was what I was going to do. Did my training in internal medicine, and basically after a few years of practicing, really started to burn out. I realized that maybe this was my father's sense of purpose and not mine. There were things I loved about medicine, but the paperwork and the feeling like sometimes you weren't making a difference and the long hours started to grate on me. And I started looking for a way out. And strangely enough, at the time I was writing a medical blog, and this guy named Jim Dally wrote me, and he said, "I just came out with this book called 'The White Co-Investor.' Would you review it for your medical blog?" I reviewed it. I learned about financial independence. I realized that my parents had given me great modeling when it came to money and probably was already financially independent. I was very emphatically joyful for about a moment because I could leave medicine, the thing that was burning me out, until I realized that I had no idea who I was or what I wanted to do.

And that basically started a long road where I got rid of everything in medicine I didn't like except hospice care. I was doing it almost as a side hustle, and I loved it. So I kept that and started doing it 10 to 15 hours a week. But because I was only doing that 10 to 15 hours a week, I had all sorts of time and I started blogging about personal finance because that's what got me there. Eventually it turned into a podcast. And what was really interesting is I'd have on my podcast all these authors, entrepreneurs, people who are making lots of money. But when I asked them about what enough look like, or why they were doing what they were doing, a lot of them couldn't answer. And I was finding the answers from my dying hospice patients who could talk about regret and what was really important to them. So I wrote my first book called "Taking Stock," about what the dying could teach us about money and life. And one of the big questions, or one of the big premises of that book was that we should put purpose before we build the financial framework. I went out to market this book and I got all sorts of angry people saying, "You keep on saying find your purpose and I can't find it. I've been looking forever. It's pissing me off. Please stop saying this." So I did a deep dive into purpose and I eventually wrote the book, "The Purpose Code," to answer all those naysayers who are having what I call purpose anxiety, this idea that they can't figure out their purpose and they don't know what to do. I found a lot of us people are in that exact place and I wanted to answer that question: How do you "find your purpose?"

John: Well, yeah, I mean, that is a very common conundrum for some of us. I mean, you talk about mission or the meaning of life, purpose, sometimes what's... yeah, I don't know. There's all kinds of terms people use and they're like, "I just, it seems like it's something that should just flow from my heart, it should just be obvious. Why should I have to look for it? It doesn't come to me naturally." So I think this is going to be really good, a good book. So we're going to dig into that a bit, and the fact that you have this history in hospice is awesome too. I mean, like you said, where else to really learn about, but at the end of life, you know, the purpose and meaning of life, which you address everything in the book, 'cause I've had access to it for a little while. So I appreciate that. So was it just obvious after the first book? When did this decision to actually write a second book and to focus on this area, how did that come about?

Dr. Jordan Grumet: Well, after having people come up to me angry at the end of conferences and public speeches about this idea that they were angry that I was telling them to find their purpose, I did a deep dive and I found two things that seem to contradict each other. The first was there are tons of studies about purpose in life and it's been shown to increase health, longevity, and happiness, like really clear studies, tons of them. But then I found other studies that show that up to 91% of people at some point in their life have what's called purpose anxiety. This idea of purpose makes them frustrated, angry, depressed. And so the question is, how can purpose be the most important thing, but also cause us so much unhappiness? And the answer is that we get purpose wrong. We usually think of it as one thing. It's probably two things. And one of those things is probably much more associated with that anxiety, and the other is probably more associated with the health, happiness, and longevity. But the problem is most people go after that more toxic version of purpose because society has told us that that's what we should do. I call it big P purpose. It's big, audacious, goal-oriented purpose. And from the day we're born, we are sold this idea that that's what we're supposed to base our life on. And so it leaves a lot of people feeling frustrated when they can't find that one thing that's supposed to make everything better.

John: So distinguish the Big P and the little P, since you mentioned that. I mean, so how should we go about searching for our purpose and distinguish those two things?

Dr. Jordan Grumet: So big P purpose is that toxic purpose and it's big and audacious. And if we think about America, it's this idea of you can think it, you can build it. And so often this kind of purpose is really huge. Like "I'm gonna become a billionaire, I'm gonna cure cancer, or I'm gonna have an eight-figure business." The problem with that kind of purpose is you got to be the right person at the right time saying the right things with the right genetics and a whole lot of luck. So big audacious purpose or big P purpose is easy to fail. It's all or nothing. You either succeed or you fail. And it's usually winner takes all. Let's think about "I want to be president." Well, only one person can be president. So there's going to be a bunch of losers and one winner. Because of that, Big P-purpose is often easy to fail and it's very scarcity mindset oriented. Only a few people are going to get there. Let's contrast that to little P-purpose. Little P-purpose is not as much worried about goals as it is the process. So it's this idea of find things we love doing and spend our time doing those things. So instead of being scarce, those are really abundant. Think about all the millions of things you could enjoy doing. Instead of being all or nothing, it's all or all and it's almost impossible to fail. And so that's the difference. Big P purpose, I think really brings out a lot of anxiety. Little P purpose, the kind that actually most people don't strive for, is a lot more reassuring and nurturing and is much more tangible as opposed to big P purpose, which is very ephemeral and pie in the sky. And I wanna do these crazy things, but I'm not sure how to get there.

John: But you know, you give several examples in the book and I wonder if you could talk about the one that I really remember. It was going way back, baseball cards, maybe just a little review of that story because it was pretty touching in a way.

Dr. Jordan Grumet: So there was a gentleman who changed my world and he did it without even trying. And he did it with little P purpose. And this is the importance of this story is, A, it helps us define what little P purpose is, but it also shows the impact. And so I get this argument all the time. The reason I go after big audacious goals is I want more impact and legacy. And that's fine if you happen to succeed in your big audacious purpose, which most people don't. But I think little p-purpose actually can be more impactful. And the guy who taught me this was Roman. He owned an antique store. He was a baseball player, actually had dreams of becoming a baseball player. His version of big p-purpose was becoming a baseball player, but he blew out his knee. And so after high school, he called it quits. Instead of going to college, he decided to run his father's antique shop. And he liked refinishing furniture. And so he would get various pieces of furniture, he'd refinish them and sell them. And one day a gentleman brings in an armoire and he says, "Okay, I can fix this and sell it." So he buys it and he's in the middle of refinishing it, opens one of the drawers, and there's a stack of baseball cards there. So he says, "Okay," he calls the guy back. He says, "You know what? I have these baseball cards. You forgot them. Do you want them back?" The guy says, "No, keep them, do with them what you want." Roman had no idea what to do with these things. So he just put them on the counter and left them there. A few days later, a woman had come in with her teenage son and you know how snarky teenagers are. They pretend they don't care, but when he came up to the counter and saw these baseball cards, he all of a sudden got interested. He flipped through them and he looked up at Roman and said, "How much for these cards?" Roman had no idea. For him, it was just on the top. It didn't matter. So Roman says "10 bucks" and the kid says, "Fine," takes out 10 bucks, gives it to him. Then he spreads the cards out on the table and points out three or four of them. And he said, "These three are worth a hundred dollars on their own." Now, Roman was enthralled. He could have been pissed, but he wasn't. He was actually excited. There was something about this that lit him up and he knew all of a sudden that this was something he wanted to be engaged in.

Maybe it was the fact that he played baseball himself. Maybe it was memories of having the cards himself and putting them in the spokes of his bike, or maybe it was going to Wrigley Field with his dad and sitting in the bleachers. He can't remember exactly what it was, but this lit him up. But here's the thing: he could have just given up there, or he could have just waited for something to happen to him, but Roman realized that you don't find purpose - you kind of build and create it. So he had to take action. So he hired the snarky teenager right there to help him. He started researching baseball cards, and he started buying them, selling them in his antique store. And believe it or not, within a few years he was selling more baseball cards than he was antiques.

Here's the interesting thing: Roman did this because it just lit him up. It wasn't that he wanted a better business plan. He never thought it was going to make that much money. But what he also didn't foresee was there was a group of kids, a community, who found themselves surrounding his antique store and these baseball cards. I was one of these kids. And I had a learning disability, and my dad just died, and I had no friends. I was kind of one of those nerdy kids. And he built a community of these nerdy, geeky kids who had nowhere else to go but loved baseball cards. And this meant everything to me.

And I think back... As I got older, as many of the kids who went to that baseball card shop, as they got older, we carried with us a sense of community and belonging and even a new sense of self-confidence. Roman himself actually got cancer and died a few years later. His antique shop closed. But 30 years later, I'm still talking about him, which is interesting because he never set out to change my life. He never set out to fix all these kids. He just... performed his sense of little P purpose. He just got involved in something he loved.

Let's compare that to Mickey Mantle. Mickey Mantle was notably one of the best baseball players to ever play. He was one of the baseball cards that I sought after when I was a little kid. I always wanted his baseball card. If I instead had decided that I wanted, or if Roman instead had decided that either of us wanted to be Mickey Mantle as opposed to enjoy the little P purpose of baseball cards, there are many reasons it would have never happened. Me? I didn't have the genetics, the skill, the talent. I didn't have any mentors to teach it to me. Him? His knee had blown out. He physically just couldn't do it anymore. But if that had been our version of purpose, this big audacious purpose, we probably both would have failed and been unhappy and we wouldn't have accomplished anything. We would have had what I call a purpose anxiety. But instead, Roman's Little P purpose built a community, and we're all better for it. It still affects my life today, all these years after he's gone. And so Little P Purpose not only lights us up, but it changes the world. And I think if impact and legacy is what you're looking for, you're a lot more likely to get there with Little P Purpose than Big P Purpose.

John: Let me ask you more about the purpose, this whole thing. Should we try to imagine where if we are working, and you know, we have to put money on the table and we can make a lot in job A, maybe a little less than job B, but job B is maybe a little closer to my purpose. What are your thoughts about going for the... the P instead of the money?

Dr. Jordan Grumet: And I actually get this criticism all the time. People are like, "Well, you are a doctor. You made all sorts of money, realize you're financially independent. Of course you can talk about purpose." That's kind of, they use the other P word, privilege. And here's what I say to that. And it's a complicated answer, but I think it's a really important one. If we look at our lives, we all know this, we're doctors, right? You're born one day and you die hopefully many years later, and you get a set amount of time. You don't know how much time that's gonna be. And yeah, maybe you're exercising, you wear your seatbelt, you do some things to help it along and maybe get a little more time, but mostly it's set. And here's the problem: Time passes and we can't control it. We can't buy it, we can't sell it, we can't exchange it. The only thing you can really do is control what activities you're involved in as time passes. That's it.

Winning the game is if you look at life as a series of time slots. You want to fill as many of those time slots with things you love or little p-purpose and get rid of as many things that you loathe as possible. So that's what we want to do from the time we're a young adult till we die - we want to continuously look at our schedule and improve those numbers. So this is where the conversation about work comes in. We look at money as a very important tool in living a life of purpose. And we think, well, if we have lots of money, that's privilege, and then we can do whatever we want. But if we don't have a lot of money, we're kind of lost.

Well, I'd like to tell you, we have a lot more tools than just money. We have our youth, our energy, our communities, our relationships, our joys. So we have a bunch of tools, and then we also have some levers. We can use the joy of addition, which means we add in purposeful activities to our life. We can use the art of subtraction, which means we just get rid of things we loathe. And then we can use substitution, which means we can change one thing for the other.

So here's the thing: If you really want to win the game and make your calendar better every year for the rest of your life, where you're doing more things you love, unless you loathe, you got to use those tools and those levers to make a better life. And for each person, that's going to be a little bit different. And so if you're young at the beginning of your career and you have a job and you don't love it, but it makes lots of money, you've got a different tool, maybe not a huge amount of money yet, but you've got the tool of your energy and your free time. Maybe you're not married. Maybe you don't have a mortgage. So for you, you can work 60 hours a week and probably still spend three or four hours on a Sunday doing something purposeful.

So you've used the joy of addition to add in purpose to your life. So already you're winning the game because you're adding more purpose to your life. You might monetize that, turn it into a side hustle, and then not only are you doing three or four more hours of purposeful activity a day, but maybe you have a little more economic margin to cut back on that job you don't love. And so what we really want to do is use these tools and these levers, and that's going to look different at different times in our lives and different times of our careers. And depending on how much family we have and what our economic needs are.

So there's not a simple answer of, do I go with passion and purpose and not get the high paying job or vice versa? The answer is we want to continuously use our levers and tools to bring in more purpose and get rid of more things we loathe. But we have to do that in such a way that we can financially manage. And I don't think it's a difficult equation, but we've got to be really thoughtful about how we do it. And so maybe I have a job I don't love and I can't add in more purpose and I can't subtract out things I don't like, but maybe I can work for a different boss at the same company. Maybe it's the boss that's making me loathe this. Maybe I can do the same job but for a new company. This is all substitution. So I'm just trying to bring out ways we can use these tools and levers to make the calculus better. But there's not a simple answer. It really depends on you and what your situation is.

John: Well, you know, some of the guests I've had before, and when I hear from my listeners, you know, they're physicians, sometimes they're burned out and they feel like it's all or none. And what a lot of us talk about on this end is, well, you don't necessarily hate healthcare. You hate whatever you happen to be doing right now. So why not volunteer for something on a board or become a part-time physician advisor? Only takes a couple hours a day if that. You might like it, you know, and look at these other opportunities instead of saying, "Well, I'm just going to drop it all and just go become a, I don't know, a mutual fund investor or something."

Dr. Jordan Grumet: The mistake that most people make is they don't do enough thinking about little p-purpose. So they realize they're burning out and they realize that work's overwhelming and they realize it's the only way they think they can make money. But because they haven't invested at all in little p-purpose, they don't even know what to strive for. And so for instance, look at me: I was a practicing internal medicine physician and I was exhausted, but I didn't go into hospice immediately. When I eventually realized I liked hospice and I would do it even if someone wasn't paying me for it, I was lucky enough to have this tool of money such that I could get rid of everything else and keep it. But what if I understood purpose a little better at the beginning of my career? Even though I didn't have much money, I could have gone into hospice in the first place. And that could have been a version of Little P-Purpose for me. And yes, I would have made less money, but I don't think I would have burned out my career so fast. And so I would have had much longer career longevity and I probably would have spent more of my time doing things that I love.

So this calculus would have been much better for me if I just went into hospice in the first place. And so most of us haven't done enough deep thinking about what purpose looks like in their life. And so we can't improve. Who knows? I love writing. A lot of medical practices actually have a blog or create content and will pay doctors to do some of those things. I could have brought that into my work life even if I didn't love my job itself. There's a lot of tools and levers. We just got to be real thoughtful about them and we've got to have a better understanding of what purpose looks like in our life.

John: Well, I want to talk more directly about the book because we're touching on the big P, the little P and some other things. So maybe give us a little... a glimpse of what else is in the book. What kind of things do you talk about in the book? What kind of problems do you solve in the book? And then just tell us where we can get the book at that point.

Dr. Jordan Grumet: So really what the book is, is hopefully the book is a journey to happiness. And so we start with purpose because I think people get purpose wrong. And I think when we redefine it as little P purpose and big P purpose, it goes from something very ephemeral and difficult to reach to something very tangible and easy. And so that solves the purpose problem. But happiness is not only purpose, I actually say it's meaning and purpose. So in the book we talk about the difference between meaning and purpose and how to build both of them in your life so you ultimately get to happiness. And a lot of the book is spent talking about how little p-purpose, again, leads to legacy and impact. A lot of people like big audacious purpose because they think it's going to change the world and they're going to make their mark. And I spend a lot of time, especially at the end of the book, talking about how little p-purpose actually makes more of a mark. And so that's kind of what the book talks about. And if you're interested in getting it, you can of course get it anywhere books are sold, places like Amazon, or you can go to my website, JordanGrumet.com, J-O-R-D-A-N-G-R-U-M-M-E-T.com where you can get the book, my other book, Taking Stock, as well as see all the places I create content like the Earn and Invest podcast and the Purpose Code Substack.

John: All right. And the publisher is a traditional publisher, is that right?

Dr. Jordan Grumet: Correct. So, Hairman House actually is an imprint of Pan Macmillan. So, it is a traditionally published book, which a lot of people like to self-publish, but I really enjoy the process of working with the editors and the creators and the designers and coming out with a beautiful product and that is always my goal whenever I write something.

John: Excellent. Yeah, because we've had authors out here and we go from everything from self-publishing to hybrid to... traditional and it's just interesting to see what people choose just based on, you know, their preferences and their priorities. So that's awesome. You know, I usually ask like what advice you would have for someone who's in the hospital setting or just in the clinic, you know, a lot of family physicians no longer enter the hospital like myself. And I mean, maybe this is part of the solution to burnout is, is to focus on the P. So tell us more about how they could think about that.

Dr. Jordan Grumet: Yeah. I really believe burnout is pretty much people who are searching for big audacious purpose and either getting there and finding it doesn't fulfill them, or not getting there and feeling frustrated like they're failing. And the problem with big audacious purpose is it's so goal-oriented that a lot of times we spend time doing things we really don't like in service of this goal that we may or may not reach, but doesn't really gratify us for that long. And so I do very much believe little P purpose is part of the antidote to burnout. I think when we start doing things we love the process of doing, regardless of the outcome, it adds to our life. So if you're a busy physician, and again, you're doing it on nights or weekends, you're adding in some gratifying time to your life. But I think as you do that and you connect with other people and you build communities, you can also find ways to build that into your career. Sometimes that looks like changing your career as a physician where you go to a different specialty or focus on one thing that you were doing before, but it becomes your specialty. Other times it means leaving medicine and pursuing completely other types of work. There's no right or wrong. The question is, what could you love the process of doing and how to build more of that into your life? And if we start that process, everyone's going to end up somewhere different. Some people are going to continue that job they don't love, but build purpose in other ways. Some people are going to find that they can move out of that job they don't love, or some people will turn the job they don't love into a job they do love. All of that's possible, but none of it happens until you A, understand better what lights you up - what's your little P purpose. And then B, you got to take action.

John: Sounds like awesome advice to me. I'm going to just record that last two minutes and replay it every time and my podcast. But no, I appreciate you taking the time to tell us about this. Is there anything we missed that we need to know before I let you go? We've got the place to be at the book, website.

Dr. Jordan Grumet: My simple message is just to remind everyone that purpose is easy and it's straightforward. It's not nearly complicated as the world has made it out to be. It's abundant. You can, I don't want to say find, because you don't find your purpose. You build and create it. But you can start creating purpose in your life. It's just some basic simple actions.

John: All right. Well, with that, Jordan, I will say goodbye and hopefully we can catch up with you maybe when you write your next book.

Dr. Jordan Grumet: Thank you so much for having me.

John: My pleasure, bye-bye.

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The post Now Find Happiness and Meaning with The Purpose Code appeared first on NonClinical Physicians.

In this podcast episode, John interviews the founder of a fantastic B2B Business. Dr. Nicole Rochester returns to the podcast 5 years after her initial appearance in Episode 127 in 2020.

Starting as a pediatrician who launched Your GPS Doc, LLC in 2017 to help patients navigate the healthcare system, Dr. Rochester has expanded her business to include consulting for major healthcare organizations, speaking engagements, and coaching other physicians to start health advocacy practices.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
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• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Building a Career with a Fantastic B2B Business

Nicole's journey from clinical medicine to entrepreneurship demonstrates how physicians can leverage their expertise to create multiple revenue streams while making a significant impact. Dr. Rochester's business evolution exemplifies organic growth through network building and opportunity recognition.

Starting with board participation and speaking engagements about health disparities, she expanded into consulting for healthcare organizations and hospitals. By accepting new challenges and learning as she went – from creating scopes of work to determining consulting rates – she built a successful B2B practice.

Her approach emphasizes the importance of valuing one's expertise appropriately, with payment rates for consulting that significantly exceed clinical hourly rates.

Expanding Revenue Streams

Beyond consulting, Dr. Rochester has developed additional business streams, including coaching other physicians to start their own health advocacy businesses. Her eight-week program helps doctors leverage their medical expertise in the growing field of patient advocacy.

She emphasizes the importance of mindset work for physicians transitioning to entrepreneurship, noting that doctors often underestimate their ability to run successful businesses despite their significant accomplishments in medicine.

Her approach combines practical business guidance with strategies to overcome imposter syndrome and build confidence in their nonclinical roles.

Summary

Physicians interested in exploring health advocacy or healthcare consulting can connect with Nicole through her website or by scheduling a discovery call to learn about her coaching program.

Her journey demonstrates how physicians can successfully transition from clinical practice to entrepreneurship. Leverage your medical expertise, personal experiences, and professional networks and create innovative healthcare solutions and multiple revenue streams.

Links for today's episode:

• Your GPS Doc
• Your GPS Doc Consulting for Healthcare Organizations
• Free Discovery Call to learn about coaching to build a Health Advocacy Consulting Business
• How This Consulting Business Grew Directly From a Patient Need – 289
• How to Use Consulting and Advising to Find Freedom – 249
• How to Become a Consultant to Venture Capital Firms
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 385

How to Create A Fantastic B2B Business

- Interview with Dr. Nicole Rochester

John: Today, I'm very happy to welcome back my guest from five years ago. It's hard to believe. And at that time, she introduced us to her new innovative work as a physician health navigator. I think that's the right term; it can probably be called other things. But anyway, her business has grown and evolved since then, and so I thought I'd invite her back to talk to us, provide us some inspiration and share what she's learned and— maybe some things we can apply to our businesses. So with that, Dr. Nicole Rochester, welcome back to the podcast.

Dr. Nicole Rochester: Thank you, Dr. John Jurica. It's so great to be back. Thank you for having me.

John: My pleasure. I know people are just gonna get a lot out of this because what you do is somewhat unique, I think. I know you're teaching others to do it, so that's awesome. But it's somewhat unique and you're running businesses or your business since, I don't know, six, seven years ago. And I see you're doing a lot more speaking recently. So why don't you catch us up? What's been going on for the past five years? You can maybe mention a little bit about your medical background before that, but bring us back up to speed.

Dr. Nicole Rochester: Sure. Yeah, so I'll start a little bit at the beginning, like you said, just for those who may not have heard the prior episode. So I'm Nicole Rochester. I am a pediatrician by training, and I always like to say that I loved pediatrics because I know in this day and age, many doctors are finding their ways into non-clinical careers out of necessity, or they're kind of running away from something. And there's nothing wrong with that. There are lots of reasons to run away from medicine these days. But in my case, I really did enjoy my job and really thought that I would work there until I retired.

And for my situation, it was the life experience that led to my transition into entrepreneurship. It was a caregiving journey with my late father and seeing how difficult it was to get the care that he needed, to communicate effectively with the members of his medical team, to advocate for him. And so I found myself doing these things behind the scenes, realizing that as a physician and an insider, I was really uniquely positioned to advocate for my dad. And then after he passed away wondering, how is everybody else managing this? If it was this hard for me, who's a doctor, one of my sisters is a nurse, how much more difficult must it be?

And so I really felt this calling to advocate for other patients and family caregivers the way I had advocated for my dad. I thought I was making this up; it turns out I wasn't. There's an entire field of what's known as professional health advocates or independent health advocates. And so as I started thinking about this business model and doing research, I discovered that others were already doing it. And so in 2017, I left my academic pediatric career and launched Your GPS Doc, LLC, which started as a health advocacy company where I was working one-on-one with other patients and family caregivers, helping them understand and navigate the healthcare system, which involves a whole lot of things.

So yeah, so that was kind of how I got started. Since then, you know, since I was last on your podcast, my work has really evolved from working one-on-one with clients, which were patients and family caregivers, to working with healthcare organizations and hospitals and health systems. And that work involves some speaking, workshops, and training, as well as consulting. And then, as you alluded to, I also am coaching and teaching other physicians how to launch their own health advocacy businesses. So a lot has happened in the last five years, and honestly, things just continue to evolve. And I think I'm still learning, growing, and figuring things out as I go.

John: Good, we can learn from you and with you then as you know this continues. There are so many things that I could say about your opening comments. I'll start by saying that I bet 99% of the people that go see a physician when they're done with their visit and they go home—if they're really sick or not really sick—they can't spit back 5% of what they were told, except, "I saw the doctor and my blood pressure was okay." I have a 96-year-old aunt who doesn't live close to me, but I keep in touch with her. She goes and sees physicians, and then when she comes home, she asks me all these questions. And she's not even given a piece of paper with what her meds are or what she's supposed to do. It's just like, "Come back in two months." So that's shocking.

But the other thing I wanted to mention when you were talking about, you said there are these health advocates, but at the time you started doing this, what percentage of those health advocates were physicians?

Dr. Nicole Rochester: Yeah, that is a great question, John. I, to this day, have not been able to get reliable, validated data on that, but very, very little. And today, very, very few. You know, there are more, and I'm happy that I've contributed to that increase. But there were very few when I first started. And in fact, I was on a mission to find other physicians who were doing health advocacy, and I found a few, you know, maybe four or five. But it's something that I think most physicians continue to not be aware of. When people find out about me, specifically other doctors, they're like, "Oh my gosh, this is the part of my job that I love the most." And to your point about your aunt, these are the things that most of us went into medicine for. We liked talking to our patients when we were medical students and being able to sit and spend that time. And the reality is that we just can't do that for so many reasons. And so I always get excited when I talk to other physicians about the work because it's the communicating and the explaining and the connecting, the part of our jobs that most of us love but don't have enough time to do in the current environment.

John: Well, I wanna learn more about that aspect of what you're doing. So let's go a little deeper into your GPS Doc business and how it's changed in the last five years. How did you kind of migrate to working with organizations?

Dr. Nicole Rochester: Sure, sure. So in terms of the work now, you know, I think the biggest lesson that I've learned and that I hope that your listeners will take away is that the things I'm doing now were birthed out of opportunities to which I said yes. I didn't go back and get another degree. I didn't go back and get more certifications. And I'm not saying there's anything wrong with that but I allow myself to sit in the space that they're asking me to do these things. How can I figure out how to do them? What do I already know? What do I need to learn? And we know doctors are great at learning and finding information. And I say that because there are opportunities that I easily could have shied away from due to fear, due to imposter syndrome and all those other things that we amazing, brilliant doctors face.

And so I look at where I am now, and I think about like those first opportunities that led to this pivot. And it just reminds me that we don't give ourselves enough credit for all of the knowledge and experience that we have. So what happened with me is that I was on a board. In fact, I just finished my ninth year and just fell off of the board, but I was on the board of an organization in Maryland where I live that basically serves as the primary source of education and training, leadership education and training for healthcare professionals. And so they are deeply connected to the local hospitals and healthcare systems.

And so I was on the board, and in 2020, we had a meeting in June, just a few weeks after George Floyd had been murdered. We were in the midst of the pandemic, and so we were talking about what was going on in the world. And the meeting headed to an end, and I said, "Wait a minute, like, what are we going to do? Like, what, what can we do in this space?" And we were specifically talking about health disparities and racism in medicine. And so me asking that question kind of led to me being, I won't say voluntold, but I was asked, "Hey, what do you think we should do?"

And so I thought about how could we provide education in this space and start to educate healthcare leaders and healthcare professionals about structural racism and how that impacts the healthcare that individuals from marginalized communities receive. So then that led to, "Well, would you be willing to do it? You know, can you develop a talk?" And I have been giving, you know, all of us give talks, right? As medical students, we give talks as residents. I had definitely given a lot of talks as an attending, but I had never given a talk about this. And so this was the first time I said, "Okay, I'm going to say yes to this."

I had already always had an interest in health disparities, even as a medical student, so I kind of relied on that, did a bunch of research, found out, you know, what's going on, looked at statistics, all those things. And I developed a talk called, combating, I think it was called "Combating Structural Racism and Disparities in Healthcare" or something like that. I gave that talk for this organization, and it put me in front of a lot of hospital leaders, doctors, and other medical professionals in my state. And so then some of them reached out after the talk and said, "This was great. Can you come give that talk to my hospital? Can you come give that talk to my medical staff?" And so that led to more opportunities for speaking.

And then an organization that's affiliated with that original organization, the Maryland Hospital Association—actually, I'm sorry, it was the Maryland Patient Safety Center—they reached out, and I had been familiar with the CEO of that organization, who happens to be a pediatrician, a retired pediatrician. He and I had worked together in a hospital. So again, there's a thread here, that leverages network. So he saw the work that I was doing, he attended the talk and he said, "Hey, you know, we're in the middle of COVID. We're seeing that a lot of community members who are minoritized, marginalized are saying no to the vaccine, not only in the community, but we're even seeing healthcare workers who are Black and Brown and marginalized saying no."

And so they had a project where they wanted to address vaccine hesitancy in the context of health disparities. And so he said, you know, "We'd like for you to work for us as a consultant." At this point, John, I had never ever done a consulting job. They asked me to provide them with a scope of work. I literally didn't know what that was. Said yes, got off the phone, Googled how do you write a scope of work, and looked at a bunch of templates and examples, and basically created this scope of work around what I thought would be helpful. And that led to my first consulting gig, which then led to other consulting gigs and more speaking. And now, that has really kind of positioned me as a thought leader and an expert in health equity. And so then that led to some specific health equity projects around maternal health. And it just, you know, the snowball just keeps on going, and it all started with me asking a question in a board meeting and then developing a single talk, which has led to lots of iterations of that talk and many more.

John: All right. So I can ask you many questions about this, but I'm going to focus on two. One is, a lot of people that are trying to get something like that going find themselves having to do some kind of marketing, but it sounds to me like this thing kind of snowballed kind of on its own to some extent. So were you seeking speaking engagements, for example, or doing other things? Number one. Number two. Did you at any point charge for the speaking, or did you just use that as your marketing tool?

Dr. Nicole Rochester: OK. Yes. So I definitely—I had already been doing some speaking within the context of my business, Your GPS Doc. But because I started out primarily working with family caregivers and helping people navigate the healthcare system, the talks that I was giving were really focused on that. So I was giving talks at caregiver conferences, I was giving talks for local departments of aging around that, and some of those talks were paid. Initially, a lot of free talks, and then like many speakers, you start out free, and then finally either you get the courage to ask for money or somebody offers you money and then you go, "Oh my gosh, I can make money." And then you gradually raise your price.

So definitely the talks that I'm describing now were paid engagements. And once I did a few of them and really, really loved it, I did formally market in the sense that I put a page on my website, speaker page. I put a contact form so that people could contact me if they were interested in having me come speak. And I'm very active on LinkedIn, and so I started to post. If I would have a speaking engagement, I would post about it on LinkedIn. I would post a picture. I would usually ask somebody, "Can you please take a picture of me while I'm speaking?" And I would post that photo. I would tag the organization. Inevitably the organization would comment, "Oh, this was such an amazing presentation." You know, maybe they would share my post or maybe they would do their own post. And so that definitely led to some traction on LinkedIn. And so periodically, I continue to get requests about speaking engagements, either from people that saw something on LinkedIn or maybe they went to my website and saw it there.

So there definitely has been some intentional marketing. I will say that one of the things that I am admitting and acknowledging—and I always think about this to myself—is that I really don't market myself as much as I could or should. And I've just really been lucky, blessed all the things with the opportunities that have come my way. And I also recognize that moving forward, I am going to have to probably be more intentional about marketing and making sure that I'm top of mind and that people are continuing to find me.

John: Did you end up, at least on the marketing side and, you know, whether it's emails or posts on different social media, did you hire anyone and you have any assistance or are you handling all that yourself at that point?

Dr. Nicole Rochester: There have been a lot of iterations of having help and not having help. I definitely will say I probably waited too long to get some help in my business. And so I have had a virtual assistant at times, and I've had a social media manager. And I'll also say very transparently that at times those are my two young adult daughters. So, you know, if you have kids, teenagers, young adults, they can be amazing at helping you with those things. And then I've also had other individuals that I've worked with. But a lot of it I do and have done and continue to do on my own, just organically. And I have to, you know, social media is its own beast. Sometimes I'm really good at keeping up to date. And then other times I'll look and say, "Oh my gosh, I haven't posted in a month." And so I try to balance that.

John: Well, it's tough when you're helping patients directly, you're doing the things with an organization, and trying to manage and handle everything. And then, oh, I, got to remember to, you know, go on Facebook or Instagram or LinkedIn or whatever. It it gets overwhelming pretty quickly.

Dr. Nicole Rochester: Yes, absolutely.

John: If you're like me, then you go in cycles, though, when you really nail it for a while and then you drift away for a while. So you had to learn how to basically write a proposal, a scope of work. And actually, like you said, one of the big things was, well, how much do I charge? I don't want to necessarily ask what you charge then or what you're charging now, but maybe like, how did you figure out what? How did you come up with that number thinking, I don't want it to be so high it's crazy, but I don't want to leave a lot on the table? I mean, I'm spending a lot of time researching and doing all this work.

Dr. Nicole Rochester: Yes, that is a great question. That is something that I feel like it's hard to know, and I will say that generally—and this sounds crazy, John—but I just, I make it up. Not completely make it up, but I try to do some research. I try to ask around and see what other people are charging. As you know, a lot of times for many reasons, you don't get straight answers with that. And then I just would try something. I would say typically whether it's speaking, consulting, and even coaching, the initial price was much too low. Like I would significantly underprice my services. And then I would realize, you know, after getting feedback or seeing how it's going, it's like, "Wait, you know, I could be charging more." And then I would charge a little bit more the next time. And If I get a very quick yes, I'm like, "Uh-oh, you know, that probably was too low."

And so you kind of inch your way up as you get more comfortable, as you get more experience. For me though, like I did go in some of the Facebook groups for physicians, nonclinical careers, things like that. And you ask the question and a lot of times you would get kind of a range or people would say it depends. But I really felt strongly that as a physician, regardless of what I'm doing, whether it's consulting, definitely in the consulting space, what I was hearing from other doctors who were willing to share is that they were charging anywhere from $300 to $600, some even more, dollars per hour. And so I felt like, "Okay, let me maybe land in the middle of that and then kind of see if they say yes and then work my way up from there."

I think that we—one thing that I've noticed when coaching physicians is that they often start... When we're talking about the hourly rate, for example, with the health advocacy, they will go to their clinical hourly rate. And if they're a pediatrician like me, we're at the bottom of the pay scale and they'll say stuff like, "I don't think I should charge more than $150 an hour." And I'm like, "Absolutely not." Especially if you're working with organizations and things like that. So I think we all have a tendency to try to compare that work to what we did in a clinical setting, and the two are little like apples and oranges. And getting accustomed to the fact that your knowledge and expertise is extremely valuable and that you know the companies that are hiring you to consult or advise they're doing that because of your unique vantage point and your experience, and that deserves to be compensated. So it's not about taking advantage of anyone, but it's really kind of standing in your truth and trying to understand and figure out what you're worth.

John: That's good advice. You know, I was a chief medical officer for a hospital, so we had consultants always coming in. And, you know, a lot of times there were big consultations, so they wouldn't even give an hourly rate. It would be like just a project that would take a year, and, you know, it would be $100,000 or something like that. Now, you know, you have to do some work backwards, I guess, and see how much time you think it's going to take. But I would say, again, this is based on nothing except just talking to people like you. Like if you're a physician doing consulting and your clinical rate is like $200, $300 an hour, you know, doing whatever you're doing, you should at least double it.

Dr. Nicole Rochester: I agree.

John: What else have you learned in the last five years as you're making this, transition to doing really these bigger things and working with more of an institution? Anything you want to share with us about your mindset?

Dr. Nicole Rochester: Oh, wow. Oh, yeah, mindset. I think what I have learned—I know that what I have learned in the last seven years since becoming a business owner is that 95, if not more, percent of the work is in our own head. It's our mindset. Everything else can be figured out. The information is out there; you can find it. But having the information, like as doctors, we always feel like if I just have more information... But for us, it's here—for everybody, but particularly for us. And I've been really intrigued with my own journey and with now coaching physicians, this idea that we represent—I don't know the exact number, but we're in the top echelon, I believe, in terms of intelligence and things like that. And we do really, really hard things as physicians, like literal hard things, like intubation and putting in central lines and saving lives. And yet when it comes to starting a business—and I'm not saying it's easy, because it is not easy—but we have so many fears and trepidations.

And I've talked to so many doctors that are like, "I want to do this, but I'm afraid to start my own business. I don't think I can start my own business. I don't think I could do it." And it's like, "Are you serious? Like you save lives every day. You're an emergency room physician. You're a critical care doc." And you don't think that you can start a business? So our mindsets are so important. And you know, whatever it takes, whether it's mantras, affirmations—for me, sometimes, John, I will actually go look at my CV, and anytime I have an opportunity to update my CV, it becomes an amazing exercise in boosting my confidence because I start to look back at like all of the talks that I've given and you know, my regular job and all the work I did as a pediatrician. Then to look at the different talks that I've given, the articles that I've contributed to, and the clients that I've had a chance to work with. And that reminds me like, "Nicole, you're doing pretty well,"

And so I think that we discount ourselves so much as physicians, and we just don't appreciate that, yes, we have the medical knowledge, but there's so much more that you can do with that medical knowledge beyond the clinical arena, and really, you know, just embracing that. So mindset, I continue to work on my mindset regularly because every now and then, it's something that you don't conquer, at least for me. Like sometimes I'm thinking like, "I've got this," and then some new opportunity will come my way and I see myself, I see that old part of Nicole trying to sneak back in. So I think mindset is incredibly important.

The other thing I've noticed specifically around speaking as a doctor is that I have had to creatively and respectfully remind organizations I'm a small business owner. And I say that because I continue to speak for free periodically, but it has to be like a very small nonprofit or a very religious organization or just a cause that really aligns with my purpose in life. But there are large organizations, like large John, that will approach me about speaking and then tell me that they don't have a budget or the budget that they have is significantly below what I would charge. And I've gotten to the place now where I just politely decline. And if there is a back and forth, which sometimes there is, I will tell them, you know, they'll say, "Well, Dr. So-and-so spoke for us last year, and he or she did it for free." But they're always naming a physician who works for an employer. And so, you know, you may recall, when I worked in academia, speaking was considered, you know, you do it for "exposure."

I love when they say, "Oh, we thought you would just do it for exposure." And it's not... to sound arrogant by any means, but I don't need—well, I don't want to say I don't need exposure. I always need exposure, but I'm kind of beyond the stage of speaking for exposure. And when they bring up a physician who is employed, I remember when I was employed, absolutely, I gave talks all the time for free. But at that time, I had a goal of, you know, maybe advancing up the academic ranks; like there was something tied to that effort. And so now, you know, my CV doesn't earn me a title of associate professor or professor, and I literally work for myself; I provide for my family.

And so I think that's another thing that I want to share. You know, certainly in the beginning, again, there's nothing wrong with doing things for free. There's nothing wrong with doing things for lower cost as you are making a name for yourself. But after you've done that, you deserve to be paid. And so I just find a lot of times because we're so altruistic, there's just this attitude that we should come speak to large healthcare systems and pharmaceutical companies even just out of the goodness of our hearts.

John: Wise words there. So it's absolutely true. And when you're going your own and run a small business, you have to earn a living and you have to put money aside for when maybe it gets a little light for a while, you know.

Dr. Nicole Rochester: Yes.

John: It makes perfect sense. That's good encouragement. Okay, now there are some people that like what you're doing and, you know, different aspects, but I'm sure there are people that like the advocacy part because that's something, again, that maybe they hadn't realized they could actually get paid to do. So you're teaching other people how to do that as well, correct?

Dr. Nicole Rochester: Yes. Yes, that is correct.

John: So tell us all about that.

Dr. Nicole Rochester: Sure. Yeah. And that's another thing, you know, there's a theme I'm realizing now. There's a theme in our conversation in terms of saying yes and embracing opportunity. Because with the coaching, I started my company in 2017. I was doing health advocacy. Within a couple of years, I became known in some physician circles as the doctor who does this. And so one, when doctors would say, "Hey, I have a family member who this happened to or this happened to," they would remember, "Oh, Nicole dealt with that when she was caring for her dad," or "Nicole now works with people."

And so I would get tagged in these Facebook posts. And so initially I would get tagged for like helping someone's family member navigate the healthcare system. But then doctors would sometimes say, often in the nonclinical groups, "Hey, is there such thing where I could just like help people understand their medical conditions or maybe when they're hospitalized, I can help them understand what's going on and communicate with their doctors?" And then I started getting tagged. They were like, "Hey, Nicole does that."

And so I would get tagged and then I would reach out to someone, I would hop on Zoom calls and maybe talk for an hour or two hours and just kind of answer their questions about how I got started and all the things. How much do you charge? Do you need insurance? All these things. And so I started doing that and then as I got busier, I didn't have the time or the capacity to have these two-hour Zoom calls. And so then doctors would say, "Well, can you just coach me?" And the first four or five or six or eight maybe times, I said no. I was like, "No, I don't do that." And they were like, "Well, can you just coach me?" "Nope, I'm not a coach."

So finally, around 2020, I started saying yes. I never advertised it. I just, you know, I said, "Okay, somebody reached out and they were like, 'I really would love to learn from you.'" And so I said, yes. So similar to that consulting scope of work package where I had to figure out what it was, I started researching, you know, coaching and like, how much should I charge? And then I thought about my journey. What were the things that I needed to know in order to launch Your GPS Doc? But even more importantly, what are all the mistakes that I have made? What are the things that I wish I knew when I first started?

And so I started developing a curriculum and I took my first coaching client and I worked with her one-on-one, and that was great. Everything went great. And so then, you know, the next doctor that came, I said, yes, I do this. But I never advertised it. I was still afraid. So if somebody came to me, I would say yes. But I wasn't out there saying "Hey, you all, I'm a physician coach." So then that led to me formalizing a curriculum that went from like a three-week program to four weeks to six weeks. Now it's an eight-weeks program. And then I went from a one-on-one to a group model.

And so since 2022, I've been hosting or leading the small group cohorts of physicians who want to start their own health advocacy business. And again, as the landscape changes, as new things pop up with the industry, I go back in, we update the modules. But right now, it's an eight-week program; there are lessons and modules and videos and downloadable templates and things that live on an online platform. And then weekly during the program, we have coaching calls, live coaching calls where I answer questions, where I deal with mindset challenges and coach the individuals. And yeah, we do that, and there's even an alumni program that I started just a few months ago because what I noticed is that a lot of the doctors that would finish, some of them would just take right off. Like they would finish the program, implement everything, start their business.

But a lot of them were still kind of nervous or scared, and they still needed a little more support. And so now we have an alumni program for those who want ongoing support after the eight-week program is finished. And it's just been an amazing thing to see these doctors in various seasons of their career. Some are retired, some have been out on disability for injury or illness, and some are still working full-time or part-time, and seeing them launch their health advocacy business and helping other patients and families has just been amazing.

John: Sounds like, though, from your standpoint, I mean, looking at what you're doing, you're definitely juggling a lot of things here.

Dr. Nicole Rochester: Yeah.

John: You know, you have, but it's interesting. I mean, real entrepreneurs, that's kind of what they do. Maybe you didn't really consider yourself an entrepreneur 10, 15 years ago, but you know, you're just meeting these needs as they arise. And some are, you know, huge, you know, organizations and some are just individuals. So it's really, I think it's very—I was going to say impressive, no, but it's very—it is impressive, but it's just, it's encouraging, I guess. It's like you said, there's so many things you can do if you just have that mindset. You could do a whole thing. It's all the mistakes to avoid because that's really like the, what did a consultant provides: "Don't do any of these things; do these things, and you're going to be where I was only it's going to take one-third of the time or whatever."

Dr. Nicole Rochester: That part. That is so important. Time is compressed when you work with somebody who's already done it. They've already made all the mistakes. Absolutely.

John: So where does somebody go to learn about that part of it, the coaching?

Dr. Nicole Rochester: Probably the best way you can schedule a call with me to learn more about health advocacy and about the program and we can decide if this is a good fit. And that's bit.ly/NHAcall. And N-H-A is in all caps. And they can also just go to my website, which is yourgpsdoc.com.

John: Well, you've covered a lot and you've really given us a lot of inspiration and actual good practical advice as well. So, anything else you—I guess we're going to get to the end here. So, I just would open it up for any advice you have for physicians. You know, my audience, a lot of them are either burned out or they're frustrated or they've been in medicine for 25 years and they're like, "You know, I just don't want to work like a crazy person anymore." What advice would you have for them?

Dr. Nicole Rochester: Yeah, one, I, you know, I—sending hugs because it's really, really difficult to practice medicine now for so many reasons. And honestly, I'm afraid as I get older, like who's going to be around to take care of me because I know that so many of our colleagues are leaving. But I guess the advice I would give is really, really embrace the knowledge and the expertise that you have—not just with your medical career, although that's incredibly important—but your lived experiences, your personal experiences, your interests, your hobbies—like all of those things make you who you are. And all of those things are potentially monetizable.

And I think that's something that I've learned and continue to learn is exactly what I'm always surprised at: What is monetizable? And for me, it's not just making money. Like that's not my, that's never been my motivation: is to make money. I'm excited that I get to make money while I'm still doing things that bring me joy. But realizing that there's so much information and knowledge that we have that can help others and that other people are willing to pay for that information. So it's a win-win. I mean, you have a way of monetizing your skills and your knowledge and you're doing it in a way that helps the broader society.

John: I agree 100% and you're a good example of it..

Dr. Nicole Rochester: Thank you.

John: All right, Nicole. I don't think I'm going to wait another five years, but if I still have a podcast going maybe in two years or so, then I think we're going to have to get together again and see what else you've been up to. But this has been very interesting, fascinating, helpful. And I thank you for being on the podcast today.

Dr. Nicole Rochester: Thank you, John. Thank you for having me. And thank you for this platform. I've talked to a lot of doctors who listen to your podcast, and that's been their motivation to step out into the deep. So thank you for what you do.

John: Well, I appreciate that. All right. Well, take care. Bye-bye.

Dr. Nicole Rochester: Take care.

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The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

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The post How to Create A Fantastic B2B Business appeared first on NonClinical Physicians.

In this podcast episode, John discusses how to save your career if you wish to continue working in clinical medicine.

John shares five proven strategies for physicians to revitalize their medical careers while maintaining patient care, drawing from his experience as a Chief Medical Officer to help doctors reimagine their practice rather than abandon clinical work.

Drawing on real-world success stories, he offers practical solutions for physicians who enjoy patient care but struggle with administrative burdens and work-life balance.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Taking Control of Your Practice to Save Your Career

Contract renegotiation offers a powerful tool for employed physicians to improve their work conditions. Key areas for negotiation include vacation coverage, and ensuring adequate support during colleagues' time off through locum tenens or community coverage. Working hours should account for documentation time, and supervisory responsibilities for NPs and PAs need clear boundaries.

When approaching renegotiation, physicians should review their contracts months in advance, engage legal counsel, and strategically time their negotiations, especially as healthcare systems face increasing challenges in physician retention.

Breaking Free from Traditional Constraints

You can explore various practice models to eliminate common stressors while maintaining clinical work. Options include direct primary care (DPC), cash-only practices, concierge medicine, or specialized focus areas. These models often eliminate insurance billing headaches and allow for better work-life balance.

Alternatively, you can consider micro-incorporation, forming an LLC to work as an independent contractor with hospitals, gaining tax advantages and greater flexibility while maintaining the appearance of traditional employment.

Summary

Each approach requires careful consideration and planning. However, there are solutions to the challenges in modern medical practice that preserve the physician-patient relationship.

Links for today's episode:

• Why an Infusion Lounge May Be the Best New Thing
• How to Save Healthcare, Satisfy Patients, and Fix Physician Burnout – 256
• Negotiate a Great Contract, Avoid Burnout, and Be Happy
• Now Every Doctor Can Win As a Micro-Corporation
• More On The Benefits of a Professional Corporation
• Avoid These Mistakes When Seeking a New Practice
• Make Your Clinical Practice Great or Move On
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

If you liked today’s episode, please tell your friends about it and SHARE it on Facebook, Twitter, and LinkedIn.

Right click here and “Save As” to download this podcast episode to your computer.

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 384

First Consider 5 Proven Strategies To Save Your Career

- Recent Trends Offer Options for Physicians - 384

John: Okay, today I want to describe several ways that you can fight to save your clinical career. Normally, I talk about nonclinical and unconventional careers to consider when you're fed up or burned out from your practice, but I've learned that sometimes it's not practice per se, but the long hours, dwindling salaries, and unsympathetic bosses that lead physicians to leave practice. You may still enjoy seeing patients and working in a clinical practice if you could get rid of all the other nonsense.

I'm coming to believe that reimagining your practice might be a valid, maybe even a better way to save your medical career and get back on track than just abandoning it and doing something nonclinical, albeit still in the field of medicine or in the field of healthcare.

I've had several guests over the last year or two who have confirmed that belief, and I want to spend a few minutes today to provide a little bit of food for thought on a short list of strategies to get you back on track in your career, bring some happiness and satisfaction without leaving medicine. So let's get to that discussion.

All right, we're talking about considering five proven strategies, and these strategies are designed to save your career. Let me work from this premise that you're in this position and you actually still like seeing patients for the most part. You enjoy practicing medicine, and that's not the problem, but it's all the other stuff that gets in the way.

Things are happening, most of the time it's because you're employed, you feel you don't have a lot of control, and you know what's going on is not really aligned with your lifestyle desires or your values, that kind of thing. And you'd really like to be able to spend time with your patients, make a decent living, and maybe even not be sued and other factors that I'm going to talk about here in the next few minutes.

But while you're thinking about these strategies, remember several things, that most of these will require hiring an attorney, most of them or some of them will require moving at least to a new practice. You might not have to move from your city if you're in a big city where you can actually still commute, but some of these things I'm going to mention do require you leaving your current practice. And sometimes it might not only involve moving to a new practice, but it might involve starting a new practice. So those are big things if you have to sell a house and so forth, they can be a barrier.

But these are all situations where you can continue to practice. And in many of these situations, your practice is extremely rewarding. So I have five strategies for you to consider today, and I'll go through all five right now, and then we'll go through them one by one.

The simple one is to aggressively renegotiate your contract. The second is to hire an agent. Now that might seem kind of unusual. We don't think of using agents for physicians to negotiate their contract. This one usually applies for your first job, but it can apply to your second or third as well. If you can somehow eliminate the billing from insurance companies, that can sometimes eliminate a big chunk of problems in a practice.

Let's say you're in a private practice now, either alone or with others. If you can figure out a way to avoid the need to do billing, hiring staff, tracking it down, working with the big insurers, which is extremely frustrating, that might solve the problem. Possibly you can just narrow your focus, narrow your practice.

I'll give you some of my ideas on that. And then the other is maybe switching from an employee to an independent contractor, even in a similar situation, or what some people call micro-incorporation, that might solve the problem and bring you closer to the practice of your dreams.

Well then, let's talk about aggressively renegotiating a contract. Now this is for those who are already employed. And I have a fair amount of experience with this because I was a CMO for my hospital and I either negotiated or renegotiated over a hundred contracts. I even oversaw the hiring and then also the recruiting of new physicians from their own practice. In other words, we would buy their practice and we would add them to our group.

But if you're already employed, you have a contract, there are usually certain factors that cause the burnout, that cause the dissatisfaction. One could be the vacation coverage. And it's not that you don't have enough vacation. You may have two, three, four, even up to six weeks or so. The problem is that sometimes you don't take your vacation because you're so busy and you feel like your patients will be let down.

Sometimes you don't take vacation because you don't have enough coverage. And related to that is you don't take vacation because you realize the more vacation that you take, the more that the other physicians who cover you are going to take. And when they're gone, your own time is extremely stressful because you're covering for all their patients while they're gone.

So if you're in a group with six, seven, eight specialists in a certain field, it's not always a big problem to have only one person gone at a time. But if you have three and one leaves for two weeks, then that means the other two are on call every other night or every other day for those two weeks. And so, it's kind of a misnomer, and I realized this even when I was negotiating these contracts, but sometimes we just had these difficulties with the small groups of specialists that it's really not every third or every fourth call rotation.

Because let's say that you have four people working in that. Well, all four of those physicians could conceivably take off three weeks each year, which means during let's say the nine weeks when other people are taking call, you're no longer on every fourth night. Now you're on every third. So your contract is essentially in violation. What they're doing is in violation of your agreement. Really what you should be doing is plan those out well in advance and get locum tenants to come in and fill.

And it's even worse if there's only three of you or two of you, because then when one person's gone, if there are two, then it's extremely stressful. And yet they say, well, we'll work around it, but no, that can be devastating. So vacation coverage is a big deal. And that's something that should be really clarified that if you're really on every fourth, then that means when people are taking off, you should get locums in there to cover or pay somebody in the community to cover.

The hours and salary of course are big deals too, but it's mainly the hours that you're expected to work. And I think we need to start pushing back on the employer and say, okay, I'm including the hours of my documentation. So you shouldn't be seeing patients for eight, nine hours a day. And that's quote your normal office hours when you're going to be spending an hour or two at night doing your charts, there needs to be time taken during the day while you're seeing patients to do your charts. And if that doesn't work out, then you need to come up with another plan.

And the other one that came up a lot when I was doing this was working with physicians and getting enough supervisory time for the NPs and PAs that we had, because we were hiring a lot of them. And it really got to the point where we were struggling to get them coverage and sponsoring or collaborating physicians. And so they could be the designated coverage or sponsor for, let's say some PAs, it could be 5, 10, 12, 14 PAs that could be calling at any time that they're seeing patients. And this is like a minor thing in a contract theoretically, but it's really a big deal.

And so, what you need to do is look at all those things in your workplace that are making you unhappy and take the opportunity to plan for it and aggressively renegotiate your contract so that it actually provides you what you need safely and at a low risk of being sued. Some of these things lead to fatigue and leads to mistakes and all that kind of thing. So that's one option.

Now, this has always been out there, obviously. I think as hospitals and systems are having more difficulty keeping physicians, you can get a little more leverage now that maybe you had five or 10 years ago. So that's the first thing. You can definitely start by renegotiating aggressively. Obviously, you're going to need to have a good attorney and you're going to want to strategize with the months and months before it's time to renegotiate. And you're going to look at your contract and make sure that you give them enough notice that they don't just say, oh, it just rolled over for another three years because you didn't dispute it. That's enough of that one.

The next one is hiring an agent. And this is mainly for your first job and then subsequent jobs. But I interviewed a guest by the name of Ethan Encana. He was trained as an attorney and that was in February of 24. And he has a full time company job and associates who are hired by physicians as an agent to do the negotiation upfront for their jobs. And they're really serving more like they would for an athlete, a professional athlete. They're going to look after you. They're going to approach the organizations that have these jobs posted. And they're going to negotiate even before they get to the negotiation of the actual contract, the arrangement. And the arrangement is that they are going to pay the fee for this agent. And this agent is going to keep all of your best interests in mind and negotiate very aggressively to get you a contract that has all the things in it that you want and need.

And it's again, usually those same issues that include vacation, the hours and salary, the pay for supervising other medical providers, the restrictive covenant. It's tough to get rid of that restrictive covenant, but there's more and more examples where they are getting rid of that. So if for some reason you would want to go private at some point, then you can do that.

But you can actually hire an agent. And again, I had never even heard of this until earlier this year in 2024. And so, I'll put links in the show notes to any of these things that I mentioned in terms of previous guests and resources to follow up on these options.

Hiring an agent is an option. Maybe they can get you a better deal that is to your satisfaction and has a great life work-life balance and so forth. And particularly if you're willing to look not maybe rurally for sure, because they're really having trouble, but even in the suburbs and stay away from the big cities, you're going to find a lot more opportunities because they are struggling to find physicians, but you're going to have to keep them honest in terms of what their contract requires them to do.

The next one, number three is eliminate billing. Particularly if you're already in your own practice. It seems like it's that whole issue of billing and hiring more staff to do the billing and then have to go after payments that are declined, costs a lot of money, you spend a lot of time, you might have to be doing a lot of paperwork and signing off on paperwork to challenge these billing decisions. Really, there are different ways of doing that. But we know, of course, that DPC, direct primary care is a great one.

I've had, I think, two or three guests on. And let's see there. Also, I talked to someone who is doing an infusion lounge, which is cash only. Direct primary care most of the time is cash only based on a membership fee. Concierge is very similar, kind of high end, more expensive.

A lot of the DPCs, the monthly cost is reasonable and patients really are not opposed to paying that because they have such high deductibles and copays that they do better doing DPC. A med spa is another example. Or you could really narrowly focus your practice and do cash only. You could do functional medicine, I think even lifestyle medicine are ways that you can eliminate third party billing. It's not that the patient can't access their billing, they can do that. You just have to give them records that they can then submit their own reimbursement. Of course, a lot of people have health savings account and similar accounts.

So, if you're in your own practice and that's one of the things that's really making your life miserable, then you want to move to a model that doesn't require you to do a lot of billing. Well, at least not billing of the insurance companies because that's where you really get killed. Normally, if you're doing DPC or even free for service, you're going to get paid by your patients because they'll be afraid that they can't keep you as a primary care doctor. Now, if you're doing urgent care, you could do cash only urgent care. Of course, you do need to be paid at time of service for that.

So, let's move along here. Another thing you can do is narrow your focus. We'll look at this and start in a pretty general practice and that's what we get overwhelmed with. Sometimes, if you can focus on just one sub area or two sub areas of a practice, then you have the ability to systematize things. You can master the billing. So, even if you're doing billing, usually if you're only using, let's say, a handful of codes, you know how to document and how to get paid for that.

I'll give you an example. I have a friend, he's sort of pre-retirement. He's a pediatrician. Obviously, he did a lot of different things, was working in the hospital for a long time, eventually stopped doing hospital work once we got some pediatric hospitalists in town. And then he decided that he wanted to simplify his life a bit and so he started doing only care for attention deficit disorders.

Now, he's still charging fee for service and he's not using a DPC model per se, but you could. You can do either one. But the patients that he has, they are so happy to have someone who's really focusing on this area that they'll pay the money rather than go to a general pediatrician who's doing so many other things and isn't necessarily able to sit down and spend the time and doesn't have the staff in the office like this friend of mine who since we're all on the same page, we're all working on the same problems with these patients. Everyone's very knowledgeable and they get a lot of personal care and they're happy to pay for it.

And so, you can do things like that. I can imagine a neurologist focusing on Parkinson's disease or something with some other neurodegenerative disease and have just a lot of patients with that particular condition or certain cancers or certain cardiac disease. And so, think about ways you could focus down, simplify your practice. Again, you'd have to be in practice to do this. In some cases, you might be able to do it in a large group, but you may end up on your own or with a small group to be able to do this. But at least you're still practicing and your patients will really appreciate you.

The last one, number five here is what I'm going to call microincorporation. I spoke with Todd Stillman back in October of this year, 24, and he was recommending, and there's a reason why this makes so much sense too, besides the fact that it's just another option to get more independence. But you're thinking what I just described in terms DPCs and concierge and med spas and narrowly focused practices, you have to build a practice. It's expensive. You have to market it. You have to have space. You have to pay rent. You have to hire staff. You have to have someone to help you with the billing if you're doing the billing. But you can avoid all of that. And to get a lot of the benefits of being in your own practice by forming an LLC, but then using that LLC to become a pseudo-employee of a hospital system or a large group.

And basically you're a 1099, you're an independent contractor, and you negotiate a contract with the hospital. And the hospital contract is not an employee contract. And so they are alleviated of some responsibilities. They don't have to treat you as an employee. They don't have to give you any benefits. So you have to make sure on the other side of the equation that you make up for that.

But the thing is when you incorporate as an LLC or whatever other PLLC, each state's a little different. You work as an independent contractor, but you look as though you're employed by the hospital and you're not opening. As a matter of fact, you're working in one of their clinics and one of their offices. When I was talking to Todd Stillman, he was funny because he actually had owned an office. Now he was leasing that office to the hospital, which was then allowing him to work in that space. And so he was actually making money by leasing the space to the hospital and other physicians have done this.

And then granted, you've got to cover some things like your own health insurance, but you can find good policies and you have more options as an LLC or PLC to actually diversify your income. You can, through that LLC, do other things. You can have much higher limits on a 401(k) and other tax advantaged investments and so forth. And there's a lot of other tax write-offs that can be used legitimately.

If the first three or four options that I talked about involve starting your own practice, it seems too onerous and you don't want to borrow $100,000 or $500,000 to do that, then this micro-incorporation is another way to really achieve the type of practice that you want to achieve, but mostly onus of the investment on the hospital and still kind of maintaining that arm's length relationship, which enables you to do these other things that make up for it, which includes investing in other ventures and maybe even have other side jobs.

And by the way, nobody else needs to know that this is how it is. You can be doing this and to everyone else in the hospital, in the community, it will look as though you're an employee of the hospital, but you've created your own mini-corporation to get the advantages of the flexibility and so forth that you desire. And yet everyone else and you're still participate with committees at the hospital and stuff to meet all the requirements as a physician, but it does add a lot of flexibility. And I think there's two episodes. I'll put links to everything here in the show notes.

There are five ideas for trying to improve your lifestyle, improve your satisfaction without leaving clinical medicine. Some of the prep will involve really start by reviewing your contract right now, even if it's not due for a year, look in there, see what you're restricted. What can you do? What can't you do? How much notice is required? Early on in the process, as you're reaching that deadline, you need to let them know early and say, look, I'm not leaving. I have no plans to leave this organization, but I want you to know that I have some things I'm not happy with and I'm going to be renegotiating this contract. So if that requires me to give you six months notice that I'm leaving, then I'm going to then you give that notice in writing.

But even in that letter, you can say, I'm planning to stay, but I'm giving you notice as required by my contract that I might not stay if some of the concerns I have about my contract are not addressed. And it doesn't have to be anything onerous, doesn't have to be very confrontational. You go in professionally, you talk with your attorney and you go in and say, here's what I want.

From a negotiation standpoint, I would always ask for the moon. And if you have three or four issues, you start with putting it out there and say, I don't want a restrictive covenant. And then you can come back and negotiate maybe something that's much less restrictive than it was in the past. I don't want to work in this office, or I don't want to supervise 10 NPs and PAs. It's too much work unless I get a lot more compensation and cut back my hours in other areas. These are things you can do. You definitely want to talk to either an agent, as I said, or an attorney, and then discuss your options and negotiation strategy before starting that process.

That's basically it for me today. You know, if you find yourself on the way to burnout, consider taking some of these steps now and go to the show notes for links to the interviews mentioned so that you can learn more about each strategy. And to find those, you can go to nonclinicalphysicians.com/save-your-career.

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Many of the links that I refer you to and in the show notes are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. I only promote products and services that I believe are of high quality and will be useful to you, and that I have personally used or am very familiar with.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

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The post First Consider 5 Proven Strategies To Save Your Career appeared first on NonClinical Physicians.

In this podcast episode, John interviews pediatrician Dr. Zhen Chan whose startup offers a new way to find a job by eliminating third-party recruiters and putting physicians at the center of recruitment.

Through his platform Grapevyne, doctors can earn substantial referral bonuses while helping colleagues find positions with unprecedented transparency and detail. With his unique combination of medical training and business school education, Dr. Chan is reshaping how physicians connect with career opportunities.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

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Reimagining Medical Recruitment Through Physician Networks

Dr. Zhen Chan noticed something broken in physician recruitment – endless vague job listings, intrusive third-party recruiters, and a lack of transparency. His solution? Grapevyne is a physician-only platform that puts doctors in control of the hiring process.

The platform incentivizes physicians to refer qualified colleagues while providing detailed job listings that answer doctors' questions about potential positions. In just a few months since launch, the platform has attracted over 315 physician members and eight healthcare organization partnerships, with 40+ new positions currently being onboarded.

Building a New Way to Find a Job While Staying Clinical

Despite the demands of launching a startup, Dr. Chan maintains his clinical practice as a per diem pediatrician while running Grapevyne full-time. He partnered with HealthWorx Studio for initial funding and assembled an expert team spanning technology, recruitment, and healthcare operations.

The platform aims to expand beyond job matching to become a comprehensive career resource for physicians, offering guidance on contract negotiation, healthcare payment systems, and professional development.

Summary

Grapevyne is the next revolution in physician recruitment through a peer-driven platform that eliminates traditional recruiters. The platform offers substantial referral bonuses and detailed job listings. It has already attracted over 315 physician members and eight healthcare clients. Physicians interested in joining can visit grapevyne.health or contact Dr. Chan directly at zhen@grapevyne.health.

Links for today's episode:

• Grapevyne.health
• Dr. Zhen Chan's LinkedIn Page
• Zhen Chan's Email Address: zhen@grapevyne.health
• Healthworx Studio – building the future of healthcare by working with founders driven by purpose, passion, and impact. 
• How to Practice Hospital Medicine and Found a Startup
• Introducing a Fearless Medical Entrepreneur
• How to Nurture a Career in Cutting-Edge Healthcare Technology – 156
• How to Fulfill an Academic Need and Spawn a Business with Dr. Jason Ryan – 081
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

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Transcription PNC Podcast Episode 383

This Physician Entrepreneur Offers a New Way to Find a Job

- Interview with Dr. Zhen Chan

John: Well, I like talking with physician entrepreneurs, as some of you listeners know, and today is going to be very interesting. He's a relatively young physician pediatrician who's also running a company full-time. So with that, let's just get into our conversation with Dr. Zhen Chan. Hi, Zhen.

Dr. Zhen Chan: Hi, John. How are you doing?

John: Really good. I came across, I don't know how we met, actually; I think we were introduced basically.

Dr. Zhen Chan: Yeah.

John: When I looked at your website and your LinkedIn profile, I mean, it's really interesting. You're involved with this company. But before we get into that, let's have you go ahead, like we do every podcast interview, and just tell us about your medical training, your background experience, and then kind of lead up to what you're doing now.

Dr. Zhen Chan: Sure, that sounds good. So I'm a pediatrician by training. Didn't do any fellowship, but I graduated residency summer of 2023, which I can't believe it's been that long already. Yeah, I did that up in New York Presbyterian with Weill Cornell in Brighton, Manhattan. And then the rest of my education was all back in Miami where I grew up— Miami, Florida. So, I was at the University of Miami for undergrad and medical school, and I took a year off between third and fourth year for business school as well. It was focused on health management and policy, and it really kind of expanded my knowledge of healthcare beyond just the clinical piece. So that was the seed of some of this extracurricular interest, so to speak. And then during residency, I did a lot of quality improvement work, was able to have the opportunity to lead a couple projects as well, which was super fun. And I think because of how fulfilled I was from doing that, and also some of the advocacy work too, I was like, "Oh, maybe I gotta do some more career exploration and like soul searching." I wanted to apply for Peds Hema Fellowship. Second year, I toyed with the idea of doing PICU. And then I was like, wait a minute, I really enjoy these like back end healthcare solutions. I really think that working on them allows you to really scale your impact. And so let me do some exploring. I networked people all over the field— public, private sector, you name it. And worked in venture capital actually for about a year as like a part-time associate. And that started as a fellowship position just to get to learn and get a lay of the land. And then I really, really enjoyed meeting founders. I really enjoyed people working in early stage startups because of how mission-driven they were and really trying to solve problems that are out there. And that's when I said, "Oh, I really want to build something on my own." And here I am.

John: All right. Well then, tell us what is it that you decided to build and what problem were you solving by building that.

Dr. Zhen Chan: Yeah. So the company's called Grapevyne— Grapevine spelled with a "Y". And the name comes from this, kind of comes from the song. I heard it through the Grapevine, or the saying, "I heard it through the grapevine." Because what we're doing is we're driving physician recruitment and the job matching process through physicians. So, no need for third-party recruiters. We're also, because we're physician-founded and we're building a team around understanding what doctors truly value, we're creating job posts that are fundamentally different from the other job boards that you see out there. So no more of these like vague, undescriptive listings that you're looking at this and you're honestly, you don't know salary, you don't know location, you have no idea what this job even entails. And more importantly, you don't know what it's going to be like day to day, which is very important to understand. And so, as someone who went through a job search myself, I know exactly what we need. I want to, if there's certain specialties, I'll go out and interview those specialists to say, "Hey, in your specialty, what are the things that you really want to see on a job post?" And we'll put that all there. So that's one fundamentally different piece. The other piece is that how we drive the process and that is through referrals. So, once an employer contracts with us and puts a post on our job board, we activate the network and we tell members— who are all physicians right now— to say, "Hey, look at these posts." If you're interested yourself, you can apply. But if you know someone who could be interested and you think they're a good match based on this very detailed listing, comprehensive listing, you can refer that over to them and you will actually get a significant cash payout for a successful referral, meaning like right now, the structure is if someone submits an application because of your referral and it's a qualified application, that you can get $25 on most of our posts right now. If they complete the interview process, you'll get another incremental payout. And then if they actually get hired and truly start the position because of your referral, you'll get the most significant payout. Right now on our job board, every post has a payout of $2,000. That could be different in the future, but that's what all the posts have now. So, we're driving the process through physicians. We're a company led by a doctor— not that I can speak for everybody, I do want to say that. Then we're bringing money back into the process too. So ownership, cash, everything— we're putting back into the physician community.

John: Okay. That's pretty unique and interesting. It seems like there's always processes that can be improved— made less costly, less onerous, less time consuming and so forth. So, let me just kind of think about the different stakeholders here.

Dr. Zhen Chan: Yeah.

John: So, I mean, it sounds like a physician can, if they know of a job opening, and let's say their organization, they can make a referral or put a post or something. Or do they come from directly from the hospitals and the medical groups that are looking for physicians?

Dr. Zhen Chan: Yeah, that's an important distinction. So it's not that everyone can just post whatever opening they have. We do contract with the employer. And then we look at the post that they want to give us. And we will work through because they probably already have some standard materials and bulletins that they're sharing with the traditional recruiters out there and the traditional job boards that are out there. But we will take that bulletin, inject kind of our own flavor into that. If it's an ENT job, we'll try to find an ENT member of our community and we'll try to find an ENT maybe in our personal networks and then say, "Hey, if you were to look at a job, what would actually entice you? What do you need to know? What are the questions that you probably would have had to go through a lot of intermediaries to find out before you actually get a comprehensive understanding of the job?" Let's get all those details and let's just smack them onto the job post. And then for the employers, the reason why it's a better format is- we're creating posts that are more engaging. So, doctors can see these and will say, "Wow, I actually really like what's on here. I know everything I need to know. I'm willing- I wanna apply." As opposed to somebody coming in and saying, "Hey, I have this fantastic job that's perfect for you. It's in a great location. Do you wanna hear about it?" And you're like, "I'm not gonna respond to this email. Like I get a million of those. Like what's gonna make this one any different?"

John: Yeah, I can think about some of the complaints I've heard about the usual process. Like... For some it is they find something online— a job— but they really don't know. Like they might even be blinded in the sense that they don't even really know exactly where it is because the host isn't actually revealing that until they get your name and phone number. And then they apply, they send in the resume and they don't hear anything forever. Sometimes, you know, just they don't qualify, but. So yeah, I mean, there's a lot to improve in that process. So, and the revenues for this that really is supported by the companies, the hospitals and the groups that are looking for physicians.

Dr. Zhen Chan: That's correct. That's correct. We are on that kind of contingency fee structure, but we're able to charge a much more affordable flat fee structure. And right now, since we're early, we're not charging any subscription fees, any listing fees— nothing like that. So there's no downside risk to working with us and we're not expecting any exclusivity. We really just want to solve a problem in this space and be able to reduce the administrative expense that goes out into things that frankly, we are seeing as unnecessary.

John: Interesting. I'm just kind of thinking through the process too. Like if I were, let's say working at that organization already, let's say there's 500 physicians there. I mean, would it make sense for the HR department, whoever's putting these out to actually promote let their people know, I suppose. Sometimes I like to do things, you know, like in a vacuum or quietly. But I mean, they could just let all their interns know that they've got an opening for another internist. They're probably doing it because these internists have asked for it. And so, hey, by the way, if you're gonna help us get the word out, feel free. That would, I would assume, would be something that could work.

Dr. Zhen Chan: Yeah, many groups have internal employee referral programs. What I like to say is this is an employee referral program scaled to the entire network of physicians that are out there and anyone can look at jobs and refer each other. It's not going to be siloed to your facility.

John: Okay. Awesome. Well, let me ask how are things going so far. What's the feedback? I think you are relatively new.

Dr. Zhen Chan: We are. We are. So we launched our first job post in end of September, got another— if I remember correctly— seven onboarded at the end of October, and then we had another 16 mid-November and we're currently onboarding another 40 from a larger health system. We're up to eight clients just in these short few months and in terms of member size, that's probably been the most exciting thing to see— how many physicians really enjoy the idea of this platform and want to support its growth. We've gained now over 315 members, just I would say over October, November, and these first couple of weeks of December, we've gained about three-quarters of that. So it's been tremendous growth.

John: Interesting. So those what do you find? Are they all actively looking, or are they thinking, "Wait a second, doesn't cost me to join? I might need something six months down the road. Why not just join now and find out?" And then when they see the right position, they say, "Maybe I should jump on that."

Dr. Zhen Chan: Yeah. combination. So we have a combination of members who came because they were looking for some things right now. And, you know, frankly, we're because of how new we are, we may not have the right opportunity for that specific person actively looking. But most physicians are passive job seekers, meaning and that I think there's a paper that was put out that it's around 80% of physicians are passive job seekers with a survey from it wasn't a paper sorry, a misnomer. It was a survey of about 1,500 hundred doctors and so what passive means is "I'm not actively looking but if something nice rolls my way, maybe I'll pay attention to it" and so, I'm not gonna be on job boards; I'm probably gonna ignore those text and calls from outside recruiters but if someone I know sends me something that's interesting I'll take a look and that's how our process works so we have a lot of those individuals to and my hope is that as we bring on more employers have more jobs going to be more opportunities for everybody to see. And if they want to apply for themselves, they can. If they feel like there's someone else that's in their network, that's a good fit, they can refer that out. And I see it as a potential to make significant cash too, when you're making a lot of referrals. And I don't think doctors are going to be out there spamming and trying to scam each other for a quick buck in this way. You can lose a lot of trust in that process. And that's exactly why there's so much lost trust in traditional recruitment.

John: Yeah, I guess it'll be interesting how things pan out, but I would assume that most physicians have a lot of integrity and they're not going to be even making a referral to something that they think is at an organization they're not really fond of or something like that. So, that's awesome. Well, let's pause on this for a minute. Tell us how to go to Grapevyne and do that, and then I want to come back to something else.

Dr. Zhen Chan: Sure. So you can find us at our website, grapevyne.health. That's Grapevyne spell with a "Y", dot health. Our websites allows you to take a look at what we're all about, and then you sign up for our platform. Really the onboarding process, I would say it takes about maybe three minutes-ish to just give some basic info. We use a cell phone number for the sign-on, so we can have that one-step verification with you. We're really keen on not having anybody that's not a physician, be excluded from the platform. So it's a physician-only platform. We have an NPI right now that you use, which the NPI is out there, but that's how we verify. Once you're on, you'll see a dashboard with featured jobs. There's another page with all of our jobs, and we're working on a couple extra features to make sure that what you see is most relevant to you, and that there's a way for you to search, and filter, and everything like that.

John: Awesome. That's good. No, it sounds— I went on there and I only went so far before I thought, "Well, I'm not really looking for a job," but yeah, it was well-designed. And that brings me back to this other question I wanted to ask you. It has to do with running this business, practicing at the same time, that piece of it. And we also like to hear about the business building itself. And, you know, who did you pick out - how did you get this thing built and all that? So we kind of want to know a little bit about the business and what it takes to run this thing while you're still practicing.

Dr. Zhen Chan: Yeah, yeah, yeah. So I'll talk about the practicing piece. I do still practice part-time. I am on a per diem contract, here in D.C., and this is a really good balance for me, based on my interest. Is it going to be the balance for the rest of my entire career? I don't know. But I do enjoy what I'm doing right now and the full time, running a startup aspect of things. It's- I would say hours-wise, it's as intense as I think I had residency. Like, yeah, it's as many hours as it was in residency. Now, do I get to do my work remotely? Do I have my puppy sleeping next to me and I can have my lunch and everything like that? Of course! I'm not going to compare it to the physical exhaustion I was experiencing in residency, but it's a full-time 24/7 type job. I'm working on the weekends, all that kind of thing. And The business side, building out a team is super important. So one of the first things I personally had to recognize was where are my gaps— where are things that I'm not an expert in? I won't be able to be the best person to do this part. And that was dealing with the lawyers, like the legal side, the day-to-day operations. I've never built a business from the bottom up before as a first-time founder, so I wanted to go out and find someone, and I found an amazing co-founder. His name is Drew Mayer, has been a repeat founder of early-stage companies, has been working in the healthcare startup space for a long time and worked with physicians. His father was a physician. So, when we were talking to him and I was developing that relationship, just felt like we were really aligned on the physicians take back medicine kind of push and that sentiment. And then as we move forward, we brought on an engineer. I can't do product development; I can't code. So went out and looked for someone there, brought on an individual who he worked on Indeed job board. And so, you know, had experience and expertise there. And then finally, you know, as much as we are trying to replace the third party recruiters, I have to be sensible and say, "Well, if there's established recruiters out there who are good and who really do care about physicians. Is there someone out there that can give me that expertise and has been in the industry for a long time?" And we did bring someone on just like that who's been working in health systems, in the exec positions and can really, and just bring her expertise and experience in ways that I personally like. So, finding what I don't have and being able to find the others to come in and help team up kind of building this "Avengers-like group" is the way I see it. And building this business— I have to give credit where credit's due, the concept of Grapevyne came from a venture studio. And so that venture studio is based here in D.C. It's called HealthWorx Studio, spelled with an "X". Yeah, we both have like words that are spelled differently. And so HealthWorx Studio, and they are always incubating and coming up with new ideas. And when they think they have enough research to say there's something here, they go out and look for founders to really come in and build out the concept. Like it's like you start with one puzzle piece and then you want someone to come in and build the whole puzzle. So they come out and look for founders that align with the vision or can give their own vision, build out the business strategy, build out the team, and then take it out of the studio. So that's the model that we're working under right now.

John: So are they the ones that provide the capital to support some of this? Or do you do a separate, you know, fundraising? How does that work?

Dr. Zhen Chan: Yeah, so from the conceptualization up to today, it's all been funded by the studio. And we are going out and looking for outside investors. We really want to find well aligned investors, specifically in the physician community— those that are going to be, I think ideally our end users too, right? Because then they can give us feedback, they can be the users of the product, whether if it's for their own practices to help them hire more. physicians or it's going to be physicians who are like, "wow, this is something I can really use." Those are the types of well-aligned investors that we are looking for, but we're starting those conversations now for angels, VCs, etc.

John: Okay. So with the studio, would it be people have used "incubator" as a term, you know, with other is that a similar type of idea that kind of get ideas, get people together?

Dr. Zhen Chan: Yeah. The way I like to explain it using what I understand is typically in venture capital, and you usually associate venture capital with earlier-stage companies or growth-stage companies, there's traditional venture capital firms, which is all about, you know, we're going to financially analyze you, we're going to do our diligence on your product, make sure that you have the right team, all that, and say, "All right, we're willing to give you capital for whatever returns expectations." That's traditional VC. And then you have the accelerators and incubators out there that outside founders will come up with an idea and then apply in, in exchange for equity. They apply in to obtain the expertise, to obtain the support resources, et cetera. Then you have now what's, there's more and more of them coming out, venture studios, which act like this reverse incubator or this reverse accelerator. They come up with the idea, start funding it. When they feel there's something there, they'll go out and bring in founders to take it out of the studio. That's my understanding. There may be listeners who will say, "I don't know if Zhen's right about that."

John: Well, it seems to be your experience, you know? So things do evolve over time, but it's a good explanation. It helps me understand really what's going on a little bit better.

Dr. Zhen Chan: Yeah.

John: Okay. Well, we're going to get to the end pretty soon here. So I want you to go back and kind of re, just restate, like, what do you think, like the big advantages to Grapevyne over, the current way of trying to find a job.

Dr. Zhen Chan: Yeah. So for us, recognizing that traditional recruitment, it's not efficient, it's not effective, and it's costly. And there's not really great guarantees for finding the right candidate. So our process, because it's referral-based through the physician community itself, and we're crafting job posts fundamentally different than the bulletins and posts that you see out there, we believe we're gonna be better, where our posts are gonna be better in engaging. And your jobs are going to be more visible by a larger swath of physicians that are out there. And on the physician side, the source of truth or the, not the source of truth, but the person who's going to be reaching out to you and giving you anything is always going to be someone you are already connected with— a trusted existing connection. So, driving trust, driving transparency, and ultimately for us as boots-on-the-ground clinicians, if I can improve job matching, if I can say doctors will be put into jobs that they are better fit for because the sourcing is inherently better, we can reduce burnout, we can reduce churn and turnover, doctors will stay in these jobs for longer and especially in fields like primary care or especially in practices that are in rural and underserved settings. Physicians are likely to take those jobs, stay in those jobs, and you have better access and better continuity. That's a hypothesis. I hope that plays out that way. But those are all the, I would say, the value props for what I, to me are the three different stakeholders, the employers, the physicians, and the patients, to be honest. And we're also, you know, for physicians, the job board for me, that's one piece of the puzzle. I want to also build out a career center, provide all of those resources that frankly in residency and medical school, we just didn't get that education. We didn't get that training on how to negotiate contracts. What are the different payment systems that are out there? Everybody talks about value-based care and a fee for service and all these kinds of things, the trends. How do I provide education on all of that we missed that I think is very important practicing medicine in the modern day. Because also, if I can provide more of that education in a way that it's digestible and people will actually view it and take it and absorb it, then I think we will also be able to practice medicine better, take back that ownership again— it's aligned with that sentiment— and not be burnt out as much as an entire industry of workers.

John: Now that sounds like a good plan. I think we were talking earlier before we started recording that looking to the future, I think a lot of physicians are looking to do maybe a nonclinical and a clinical.

Dr. Zhen Chan: Yeah.

John: And there would be no reason why that couldn't be something that just normally kind of evolves on this site.

Dr. Zhen Chan: Yeah, absolutely. We are open to posting nonclinical positions on our site. Physicians are looking for them, you know, extra avenues, not just in the form of side-gigs but thinking the similar vein to me— where there are things in healthcare that I also wanna work on. What are the jobs that are out there that can allow me to do that? I think more physicians need to be in those positions. And then you have physicians that are burnt out and are looking for an alternative while still making a difference. Those are out there. So we wanna be a supportive platform for every doctor, no matter what they are looking for in their professional careers.

John: That makes me think of another issue, which maybe you've already reached out to, but what about locums, which is a different kind of clinical job, but it is a clinical job and just need to find them.

Dr. Zhen Chan: Yeah, there are a lot of agencies that are out there in the locum space. And we just felt from a business strategy standpoint, let's not go into them. Would we ever go into them? I don't have an answer for that right now. But for me. There's also an element where Locums is an expensive band-aid to provide access to care. Now, don't get me wrong; it's a great gig for a lot of physicians that are looking for them. And I would never stop someone who is looking for them to, I would never stop them from doing so. But for us, we wanna drive more of those full-time positions right now. And I think that's the right strategy. But again, I think in business, it's not like medicine where we try to be as— well, we do try to be as surefire as possible— but a lot of these strategy decisions, I think, some may say that it's the right call; some may say it's not, and right now we're making the call to not do locums just yet.

John: Got it. Got it. Okay, what if someone wants to reach out to you personally for a question or something?

Dr. Zhen Chan: Yeah, so my email address is Zhen, Z-H-E-N@grapevyne.health. Again, reminder Grapevyne with a "Y". And so you can reach me by my email, and then I'm on like every social media platform. Too many, I think. It's been great. I love engaging with the community on social media. So, I'm on LinkedIn. I'm on TikTok, Instagram, and there's a Grapevyne account and my own personal account. And maybe we'll just link it in the show notes. It'd be it'd be a doozy to list.

John: OK, I'll put a few in and I'll definitely put grapevyne.health. I kind of used the dot com at first when I was looking for you. But no, Grapevyne with a y dot health. I'll put that in the show notes. And I think pretty much people can get information, everything they need to know. Physicians, if they're really thinking they're gonna access this kind of service, your service, then just go to grapevyne.health and do it. Check it out.

Dr. Zhen Chan: Yeah, yeah, yeah.

John: All right, well, this is pretty exciting. I'm glad you could be here and answer my questions. I think it's inspirational to people— physicians who are thinking, "Well, maybe I could do something entrepreneurial. I could do a startup," or maybe not something as this, is a pretty big deal. This is a big thing. You're devoting full-time to it. So it's not like starting a little side gig on the weekends or something. So, I'm really glad you could join us and I'll be watching the growth of this thing. And it should be pretty interesting. And it sounds like that a lot of planning and a lot of investment of time and effort in this. So, you're to be congratulated.

Dr. Zhen Chan: Yeah, well, I really appreciate the support. I really appreciate you inviting me on. And I have to plug this podcast because I forgot to mention that when I was in my exploration journey, I love learning by podcasts. And this was one of the first ones, if not the first one, I hopped on to listen to a whole slew of episodes to learn just what else is out there for physicians to do. And yeah. So, so anybody who anybody who's listening I hope you share this with more physicians out there.

John: Well, I appreciate those comments. All right, Zhen, we're gonna let you go then. And with that, I'll say goodbye. And hopefully I'll catch up with you again, maybe a year from now.

Sounds great. Have a good one.

John: All right. Bye bye.

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The post This Physician Entrepreneur Offers a New Way to Find a Job appeared first on NonClinical Physicians.

In this podcast episode, John interviews TJ Oshun, founder of CallonDoc, who shares his remarkable journey from practicing medicine to fearless medical entrepreneur. 

Starting with a simple solution to help patients access care outside regular clinic hours, TJ transformed a basic telephone consultation service into a comprehensive telehealth platform now serving all 50 states. 

TJ's transition from healthcare provider to tech company CEO offers valuable insights for medical professionals interested in entrepreneurship and digital healthcare innovation.

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The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

From Medical Practice to Tech Innovation: Building a Telehealth Empire

TJ's entrepreneurial journey began with a failing clinic in Texas, where he discovered patients struggled to access care during regular business hours. By starting with simple phone consultations and gradually developing a custom technology platform, he built CallonDoc into a comprehensive digital health solution.

The company now offers telehealth services, lab testing, white-label solutions for medical practices, and software licensing – demonstrating how healthcare entrepreneurs can scale beyond traditional medical services into technology-driven solutions.

Keys to Being a Fearless Medical Entrepreneur

Success in healthcare entrepreneurship requires both medical expertise and business acumen. TJ emphasizes the importance of gaining clinical confidence through experience before venturing into independent practice or entrepreneurship.

He advocates for continuous learning through audiobooks, coaching, and formal mentorship programs. He also recommends building strong partnerships and maintaining a focus on the patient experience and satisfaction.

Summary

TJ can be reached via LinkedIn for professional inquiries and networking opportunities, particularly from medical professionals interested in telehealth or healthcare entrepreneurship. You can explore opportunities through CallonDoc by visiting their partnerships page or contacting their business development team.

Links for today's episode:

• CallonDoc
• Light Your Entrepreneurial Fire and Create Your Ideal Life
• How to Practice Hospital Medicine and Found a Startup
• How to Start a Thriving Educational Company with Dr. Andrea Paul – 073
• How Do I Generate Awesome Income with Telemedicine Services? – 222
• What Is the Latest Telemedicine-Supported Specialty? – 173
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 382

Introducing a Fearless Medical Entrepreneur

- Interview with TJ Oshun

John: Sometimes I find myself really in awe of the healthcare professionals who, they recognize a problem in medicine or with patients or something, and then they just run full speed into trying to solve that problem. I'm talking about entrepreneurs, of course. So today's guest was one of those people that recognized a problem well before the pandemic that patients didn't have the kind of access that they needed to their medical providers. And so in spite of maybe not having a background in IT, I don't think he did, we'll talk about it, but he jumped in and started working on telehealth and telemedicine. So let's welcome TJ Oshun to the podcast. Hi, TJ.

TJ Oshun: Hello, John. How's it going today? Thanks for having me.

John: It's going well. It's a nice quiet day before Thanksgiving. For those that are listening, of course, that'll be two weeks ago, but we're still going to have fun on this otherwise relatively slow day.

TJ Oshun: Well, I wish I could say the same. It's actually quite busy on my end of town as we wind down and ready for the holiday. Usually we telemedicine around the holiday season when the clinics are closed, that's when we get our spikes. It's been a hectic week to say the least.

John: Yeah, that makes sense. While we're all trying to cool things down and go home, the people covering those off hours and those emergencies are getting busier. So it's good to have you backing us up, you know?

TJ Oshun: Yeah, absolutely.

John: All right. So you're an entrepreneur. I'm going to have you tell us a little bit about your story, but the reason I wanted you to come on today, for several reasons, you run a company that could be of value to physicians, you sometimes hire physicians, but you also support them. And as an entrepreneur, we can learn from you about that aspect because a lot of my guests, I mean, a lot of my followers really and listeners are interested in doing other things besides direct patient care. So why don't you start by just telling us what you're famous for?

TJ Oshun: Yes, absolutely. So what I'm generally, I guess, popular for, the company is popular for is the company cell, which is CallonDoc, a telehealth platform. I think we've actually grown beyond a telehealth company to more of a digital holistic medical platform, right? In the sense that we not only offer the direct patient care, we offer lab services, we offer software as a service where we're licensing our products to other doctors, we're providing provider services to all the telehealth companies. So we do a wide range of things to facilitate healthcare delivery virtually, right?

And at this point, I actually consider myself as a tech company versus a medical company. I spent 70% of my time in marketing and technology versus the medical side of things. So we position more on the technology and patient optimization component of it. But that's essentially what we do, a digital company that is out there to optimize access to healthcare in every way we can, from partnerships to optimizing technology and offering quick access to medical care.

John: Very good. Why don't you tell us a little bit about your story because I know that you started out, well, you immigrated, you started out in healthcare, going to being a PA and then going to med school. And at some point, this urge and this interest in doing what you just described started. So what prompted that? How did you start looking at even starting such a company?

TJ Oshun: Yeah, absolutely. As Will mentioned, it started when I was a hospital in a Texas hospital, UT Southwest. And so I worked there for two years. That was one of the best experience I've had, gave me all the confidence in the world to feel like I could practice independently. So I was there for a couple of years. Then I saw this failing clinic. I have a thing for buying into failing practices. It started even when I was in college where I bought a failing barbershop where I used to get my hair cut. It was closing out and I bought it and I revamped it and turned into a profitable company before I exited.

But the same concept happened. I wanted to start a practice, but then I found this local clinic in Irving, Texas that was failing. Partnered with a couple of my colleagues back then, invested and we turned it around and became profitable within a year. Because I knew what wanted it to happen was just optimizing again, the patient experience, looking for the pinpoints that patient needed and grow from there. But anyway, there were a couple of roadblocks as you can imagine, but we were able to stabilize and became profitable by year two. So as the clinic grew, and I wanted to expand, I couldn't expand past the four walls of the clinic as you can imagine.

So that's one of the things I've learned also as I grew a company, that when you start now, with a brick and mortar, you're limited to the ZIP Code, right? No one is going to travel 20, 30 miles to your clinic, even if you are the best doctor in the world, right? So to scale that, I thought, okay, it had to be something virtual. It had to have some element of technology because if you want to scale, you need to have technology involved and virtual. So it started with a phone call. I surveyed my patient at that time.

And as you can imagine, clinics open 9:00 to 5:00 and I knew there were a lot of no-shows and I started surveying my patients and figuring out why they were absent for their diabetes follow-up visit. And the primary, number one reason they gave me was that you guys open 9:00 to 5:00 when I get out of work. So I had to think outside the box.

How can I see my patient outside of the hours? I started extending hours, but obviously there were limitations to that. You can't open 24/7 at a primary care clinic. So the only way I could do that was actually reaching out to them and seeing them at home. The first thing that came to mind was a phone call because obviously technology wasn't available for telemedicine back then. So I called the medical board, Texas Medical Board of, I'm like, "Is it okay to see a patient virtually over the phone?"

They were like, "There's nothing like that. I can't really tell you what to do as long as you're establishing medical necessity and documenting that you're actually helping and documenting it." So we started that way and we just offered it to the self-pay patient only because there weren't any reimbursement for insurance at that time. So we didn't go that route. So it was only for patients that actually needed the medical service that could not make it and we can establish medical necessity for a phone visit.

And it were always the follow-ups, the patient that compliant with their medication that just needed refills, right? But couldn't make it because of office hours. So we started that way. And I remember telling the medical board on that time to email me so I can have it as an insurance in case something happened.

So I still have that email now in my inbox saying it was okay to treat patient virtually. So it started as a phone call, but I needed to do more. So I created, I went on GoDaddy, developed a website where, because -- and the reason why, yeah, let me just go back a little bit and I hate to dwell on this, but I think it's important, is even the phone call, I had to stay on the call for a long time getting the medical history.

So now the medical intake itself is about 15 minutes. So I'm like, why don't you just create a website where I can actually get all the information at hand. So the actual visit will be discussing the intake, right? And it will be sort of addressing the pain point. So create the website, collecting the data so I didn't have to need, I didn't have to involve a medical assistant. So I collected information on the website.

Then the phone visit would just be addressing those problems or areas and providing solution and refills in labs if I needed to. So that's how it started. Then we started scaling to other parts of urban Texas and Houston and other parts of Texas. And we're able to scale to neighboring states as well, providing telehealth. And this is now more from just a phone visit to more of a digital and video conferencing in some part. And COVID hit, but because we were prepared for that, we were able to scale rapidly to all 50 states within a couple of months of COVID.

And we were able to offer, I think, about 350,000 visits for a couple of months during the height of COVID in all 50 states. So that was how we were able to establish the credibility. And because I also made sure patient experience and satisfaction was the forefront of what I did, we were able to scale even faster. We retained our patient and grew from there.

John: Oh, boy. There's a lot I can ask you about in that whole journey there. So many businesses went out of business during the pandemic. You're one of the few, and I guess the other telehealth and telemedicine companies that actually exploded during the pandemic. But I would say there are a lot of physicians that have an idea and think, oh, I could do that. I'm going to solve this problem, whatever it might be. It could be recruiting, it could be patient care, whatever.

But there's always, if there's a tech component, they usually, they get stuck. Either they've got to invest a lot of money. How did you overcome that? How did you go from being a telephone and a website, which is pretty basic? I mean, now I know you've got these visits there. You can choose from the visits. You can populate the information. You can then talk to whoever you need to talk to. How did you get through that hoop?

TJ Oshun: I think the biggest thing for me, which was painful in the beginning, was actually investing in a homegrown technology. I think most people tend to license a software that may not be customizable or scalable and limiting, right? So we were able to invest in a homegrown technology that scaled with us.

So I was able to figure out what my patient wanted, the pain points, reiterate, customize it, take that out, optimize it. And I listened to the patients, right? I know exactly what they wanted, how they want it. And I gave them options, right? On how to see their doctors, right? So listening to a patient, optimizing the technology. Again, a homegrown technology will allow you to do that versus a legacy or a company that you only had what it offered you.

So that helped us a lot. And I quickly brought in, because I understand I quickly brought in, again, I see myself as a technology company more than a medical, right? So I could handle the medical side. So I was able to quickly bring in software engineers from the beginning, hire a team to power it from the beginning. So my medical, my technology team actually grew faster than my medical team.

So we were able to power that through and customize and optimize based off of that. And obviously we can analyze patient journey, optimize accordingly and go from there.

John: Now, before we got on the call, we were talking about how your company is continuing to expand and diversify and becoming more of a tech company and even supplying the infrastructure, I think, for some practices. But I guess if someone who has like an issue, whether it's an app or thinking about technology, is there any advice on where to find software engineers or where to find the tech people you might need to create something like that?

TJ Oshun: It's always a challenge. I have to go through a series of engineers, companies. There were a lot of politics that went behind that also. I had terrible experience. It wasn't always fun, by the way. One of the first technology company I actually partnered with actually sold my technology to a different telehealth company. Right, right.

So it's challenging, don't get me wrong. The good thing is I was cautious about what sort of information I revealed to them. So what they sold was actually the entry level, the MVP of my ideas. So that saved me there. So which I think the other company got stuck with that product because I was already ready to move to the next level. But it's difficult, right? It's difficult. It's about finding the right company that best fits you and has your best interests at heart. And as you can know, it's partnership.

You have to let them understand that this is a partnership. I'm with you if you guys have my back and compensate them accordingly so they can grow with you, right? If they know as you go, because the company I've been with, I've been with them for six years now and they power all my software engineers.

So I don't have to deal with the hiring process of scouting and recruiting the technology. So they do all of that for me. But as I grow, they grow also. They won multiple awards based on the growth that we've had. So they're growing with me and we continue to grow, right?

John: That's awesome.

TJ Oshun: So yeah, it's about finding the right partnership and someone that can actually grow with you, yeah.

John: I want to get your opinion on another thing because along the way you have hired physicians who actually work and do the telemedicine or answer, and maybe it's PAs and NPs as well. What's your advice for someone who's maybe just coming out of PA school or medical school residency, and they're thinking, I don't know if I want to be employed by a big hospital. Maybe I want to just do telehealth, telemedicine. It seems more flexible. What advice do you have about that for them?

TJ Oshun: Yeah, absolutely. It's always a good thing to try to be independent, but it has to be something that you want to do because starting a business is still at the end of the day a business, right? So you may be a provider, but if you don't have the knack for the entrepreneurial spirit or the ups and downs that comes, resiliency that comes with that, it may be challenging.

There are times where I've hit roadblocks and it would seem like we need to pack the things and go home, but you just have to persevere, right? So that's really, really important. That perseverance is very, very key. And if you don't have the bandwidth to be able to power through that, it may be challenging. So that's number one. It's still at the end of the day, it needs to be perceived as a business that needs to grow and be profitable.

So that's number one. Number two, I think having the medical confidence to be able to run an independent clinic is also important. So like I said, I said, I worked at UT Southwest and that gave me the confidence to be able to practice independently. So getting out of school and starting a company is definitely not advisable. Make sure you have that medical chops where you can confidently treat patients. And it could be just whatever you're comfortable with.

It could just be diabetes, but you have to be comfortable managing those patients independently. So the combination of your medical background, be confident in that, and also the medical chops of being able to run a company because you will do everything. You do everything from marketing, accounting, software development. You are going to be the first couple of years, the guy or person that will drive the force before you start bringing a team that will support you. So you have to have a thing for being an entrepreneur as well.

John: Yeah, and I think you made a good point that if you're going to be on your own and really being primarily responsible for, even if it's "during the off hours" or whatever by telemedicine, maybe it's best to do two or three years, make sure you're really comfortable practicing and then jump full-time into the remote type of telehealth.

TJ Oshun: Absolutely, because it's an isolated world there. You're by yourself, right? There's no one to call sometimes. So you have to be able to navigate independently, right?

John: I want to remind people again, the website where they could at least take a look at what it looks like when someone signs in is callondoc.com, right? C-A-L-L-O-N-D-O-C.com?

TJ Oshun: Correct, callondoc.com. Yes.

John: It's pretty interesting. And so it just gives them an idea of what you've built. But I didn't want to wait to just to the end to do that because sometimes people don't listen to the very end. All right. I want to ask you about some other things. So we've touched on this business and the entrepreneurial part of it. I know somehow, because I think you were in a podcast where you were actually being interviewed by, I think you would call this person a mentor, a coach.

She was through a very well-known company I recognize. So I just wanted your opinion as you've been going through this process. I don't know how long you've been involved with that particular, you might even call it a mastermind or coaching. What's your opinion of that? Why do you do that? And what advice do you have for other potential entrepreneurs or physicians that want to grow in there, even in their practice about that particular aspect?

TJ Oshun: Right. So being a CEO and founder of a company is isolating, you're up there by yourself. You sometimes feel like you're not getting genuine feedback or you may be doing something incorrectly and you just need that sort of reinforcement and reassurance. So even though as a company we were growing, it just felt like I was by myself.

I felt isolated. I felt that I needed to do more and reach out to like-minded thinkers like me. So I found V-Stage online for some reason and I was assigned to this amazing coach. Her name is Margaret. We meet once a month, one-on-one. And I had meet with my group once a month as well where we just talk about each other's problems and give honest feedback and how to address it.

And she takes time to dive deep into my business and try to figure out how we can resolve things, right? One of the things she asks me is, what can I do for you? What do you want to talk about today? So she's like my therapist really, where I can actually, more on the business side, but I can actually let her talk about things, right? Whether I'm struggling with an employee or try to hire someone. So it's just someone to sort of bounce ideas.

And when you talk through things, it actually gives a different perspective. And one of the things actually she gave me, advice she gave me, which actually has worked is I have a lot of ideas in my head, but I never write it down. She's like, "TJ, you have to write it down."

John: Or they just disappear. They float away for a while.

TJ Oshun: Absolutely, right. It just disappears, or you're not as organized as you think you will be. But when you start writing things down, putting things in perspective and assigning timeline and resources to things, it gives you a lot more structure. I say that to say this, that you need the support system, which you may not get from employees, right? I don't have a strong executive team like [inaudible 00:21:07]. When I say strong, it's more of, I'm the CEO and sometimes act as a COO sometimes.

So I don't have, so like a maid that can bounce ideas or an independent thinker. I think that's the best way to think. Someone independent with no vested interest in the company. So she gave me that honest opinion without bias.

John: Well, I'll tell you why I was so interested. First I was a CMO for a hospital and our CEO took advantage of the same company and we had a coach. And so he would meet with that coach and then he would meet with a group every month. And then at some point he found it so helpful that he actually brought that same coach into the organization for the senior executive team. So we were meeting as an entire group, the senior hospital team with this coach or whatever mentor. And then individually, we had the opportunity to do the same thing.

And I've always, I have addressed this on the podcast several times and the advantage or the benefits of having a coach, having a mentor, and even participating in basically what's like a mastermind where you get in a group with your peers from other organizations. So I think that's fantastic.

TJ Oshun: Absolutely, absolutely. And it highlights your strength and weaknesses. It's someone looking in and just giving you their honest opinion. So always, always helpful.

John: Yeah, I think it was that question that you mentioned and sometimes the way my mentor would put it is, what's the thing today that you really don't want to talk about that you should be talking about? And there are a lot of those. All right. So let's shift gears again, because I think what my listeners want sometimes is motivation and encouragement, which they've gotten just kind of hearing your story.

They want to learn some practical things, but some of them might need your services, not as a patient. So we were talking earlier and you have expanded your services. So explain what that's about in terms of how you can partner with individual doctors, individual practices to help cover some of their downtime.

TJ Oshun: Yeah, absolutely. And I'm happy to answer that question. I wanted to throw this in before I forget. So one of the things I do a lot of is read books. I didn't go to business school, right? I learned as I go, but to fast track that I've read a lot of books from people have gone through this already, and I just sort of like, it's like a cheat sheet in a way, right?

But I read a lot of books and I'm not the type that reads hardcore. I just listen to the audio books as I drive or walk down the street of New York. That's one of the things I do when I first wake up in the morning, take like an hour walk in New York, listening to e-book and you get a lot from there. By the time you get back, you have all these things and action plans so that you can go implement that practicable, right?

So I encourage people to actually, your audience listening to read a lot more of this sort of self-development book. And depending on your weaknesses, where I have, if I want to learn more about marketing, I pick up a book about marketing. If I need to scale or hire someone, I pick HR or HR related books. So I think that's very, very helpful. And in terms of how my software can actually help doctors.

So we have a lot of doctors willing to join our team. So I think hiring more doctors is not the way to go now. But what we do is again, we're a tech company. We're licensing our services to clinics. So we've been powering clinics throughout the U.S. Like I mentioned, you're about to retire or a clinic that is closing at six, eight o'clock. We can actually power them after hours if you need to go on vacation and you just need to keep your practice open.

We can come in, white label our platforms so your patients still have the experience as if the way we are cleaning. But it will be powered by our medical providers. You can still do the billing. We negotiate the rate, but we will power those clinics and medical practices. And we've had practices on telehealth companies, actually, that are local, but want to expand to all 50 states, but don't want to have to deal with the headache of hiring doctors in all 50 states. So we power them.

They do all the marketing. We see the patients and deliver the care for those patients, but they still own the business and practice, but it's all powered by CallonDoc. And by the way, most of the partnerships that we've actually been having are all the telehealth companies, which inherently are competition, but we negotiate rates that are not competitive, but we do all the software and medical services in the back end.

John: Nice, nice. So that's another entrepreneurial thing to do, expand really what you're offering outside of the initial services. So that's good. So how would someone that's in that situation that is looking to get someone to cover, and yet, like you said, white label or coordinate with their practice, how would they get ahold of you?

TJ Oshun: So absolutely. So just go on the website, callondoc.com. There's a tab in the menu at the top called our partnerships, our business, fill out a questionnaire, and someone from my business development will reach out to schedule an intake. The questionnaire is just learning about your practice and what sort of partnerships you want, and the right person in our BD will contact you to set you up. Very quick entry. We've done this multiple times. We can launch a platform within a day or a couple of weeks, depending on how demanding the interface is, but it's something we can quickly do just by filling out an intake form.

John: Okay, excellent. That's going to be helpful. All right. Well, I think we're getting close to running out of time here. So, well, we've covered a lot today. So before I let you go, is there any other places that you typically would, if someone had a follow-up question could they maybe send that to LinkedIn, something like that?

TJ Oshun: Yes, they can send that to LinkedIn. I'm active on LinkedIn, but that's the only social media platform I'm really active on.

John: That's cool. As long as they have a question, at least with LinkedIn you can do a little screening, make sure it's appropriate, instead of like, oh, just give us your home phone number. How about that? All right. No, we're going to let you go in a minute. So I guess the question I usually end with is if the physicians in my audience they have different things going on, some want to get out of medicine, some want to do -- they want to change, they want to do cash only, there's lots of options.

What advice do you have maybe for these physicians who are maybe a little frustrated with corporate style medicine, or they don't have the control, whether it be your advice for telemedicine, telehealth, or just doing something entrepreneurial, just any advice you might have for those people who are frustrated and don't know where to go?

TJ Oshun: Sure, absolutely. I think with healthcare, there's tremendous ways you can actually optimize or improve patient care, or even the healthcare as a whole, not necessarily just patient, just healthcare as a whole. I think it's just identifying a problem, and not necessarily try to follow what everyone is doing.

Identifying a problem, that's what I did, identify what the problem was, and solving it. Just in your own space find what the pinpoint is, whether it's a problem with a hospital system, or the clinic system, or a patient, right? Identify a problem and try to solve for that problem. If you can solve, you would definitely create a business out of that. And it will be organic. It will be an organic process because you're actually addressing a problem that no one wants to address and not necessarily be trying to be competitive with a hospital system, or I want to change the whole hospital system. No.

Well, how can you optimize whatever deficiencies they have and they will pay for that? Figure out a problem. Your patient will pay, the hospital system will pay, the clinic will pay. How can I help with a deficiency. Like I said, an example is, we know clinics open 9:00 to 5:00. How can I help the clinic after hours rather than competing with them? So that's what I try to do. Find a problem, help them, and be successful at it organically.

John: Nice. Well, that's good advice. And there's so many, I mean, people are getting frustrated because of the insurance payments and so forth, which you have to deal with that I guess in most situations, however, so a lot of cash pay, a lot of people have savings, health savings accounts and other ways that they can pay for the things. And so there's a lot of new ways to solve the problems, as you said.

TJ Oshun: Absolutely. And actually we don't accept insurance for that reason. One of the things that we try to do is offer a quick, easy access to healthcare. Once you introduce insurance, then you have to go through verification, eligibility check. That takes hours sometimes. But we want our patients to be seen quickly within minutes and done. So our constitution fee is average of $40, which is about your copay anyway. So we've never been incentivized to accept insurance. Our patients can still pay for their medication at their pharmacy with insurance, though. They can pay for labs with insurance. But the medical service itself is self-pay.

John: Yeah, good point. You're right. A lot of the urgent care visits, the people pay out of pocket even if they have insurance. Because you're right, they don't meet their deductible and they're going to have to go through so many hoops and we're going to have to go through so many hoops. We both say, you know what, let's just do that $99 visit and move on.

TJ Oshun: Move on. Absolutely. Absolutely. And it works out. Yeah.

John: Yep. And people get taken care of much more timely. All right, TJ, this has been great. I appreciate you coming onto the podcast. We'll have to catch up with you again down the road and see if you've dominated the entire landscape by two or three years from now.

TJ Oshun: That's the goal. That's the goal. That's the mission one patient at a time. Thank you so much, John, for having me. This was fun. I enjoyed the interaction.

John: Me too. You've been a good, great guest. So with that, I'll say goodbye.

TJ Oshun: Bye-bye, John.

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His experience highlights how physicians can leverage their natural leadership qualities developed through medical training while acquiring essential new skills in management and organizational leadership.

The transition from clinical practice to executive roles requires strategic learning through professional organizations, advanced certifications, and continuous education in management principles. Most importantly, John emphasizes that successful physician executives must master three core attributes.

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The Art of Total Immersion in Healthcare Leadership

John's approach to leadership development centered on complete dedication to learning and growth. Like his earlier experiences in medical training, he found that total immersion was key to mastering healthcare administration. This meant joining professional organizations like the American Association for Physician Leadership, pursuing additional certifications, and continuously expanding his knowledge through various educational opportunities.

This commitment to learning helped him transition from a practicing physician to an effective healthcare executive while maintaining a better work-life balance than clinical practice often allows.

Building the Bridge from Clinical Excellence to Organizational Impact

The transition from clinical practice to leadership requires a fundamental shift in perspective and approach. John emphasizes how physicians must evolve from individual contributors to organizational leaders. This means developing new skills in strategic planning, team management, and organizational development.

The reward comes in the form of broader impact – while clinical practice allows physicians to help individual patients, leadership roles enable us to improve healthcare delivery systems that serve entire communities.

Core Attributes to Be a Better Physician Leader

Three essential qualities are key to succeed as a physician executive:

1. Accountability,
2. Optimism, and
3. Humility

John emphasizes that accountability means following through on commitments and addressing challenges directly. Optimism drives organizational change and inspires teams, while humility ensures leaders remain open to learning and value input from all levels of the organization. These attributes combined with physicians' natural leadership qualities create a foundation for effective healthcare leadership.

As healthcare continues to evolve, the need for physician leaders becomes increasingly important. John's journey demonstrates that while the transition from clinical practice to leadership presents challenges, it also offers remarkable opportunities for professional growth and a broader impact on healthcare delivery.

Summary

Physicians who are interested in transitioning to healthcare leadership roles can access the resources through the American Association for Physician Leadership (AAPL) and the American College of Healthcare Executives. These organizations provide essential certifications, educational opportunities, and networking opportunities for developing executive capabilities.

Success in this transition requires the same dedication that drives clinical excellence and a commitment to continuous learning and professional development.

Links for today's episode:

• American Association for Physician Leadership (AAPL)
• Medical College of Wisconsin's healthcare executive education programs
• American College of Healthcare Executives
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 381

To Be a Better Physician Leader

John: Now I spent many years in management and leadership roles in the hospital setting, which culminated by working as a chief medical officer or CMO. And while moving from part-time physician advisor and medical director to chief medical officer, I took advantage of educational opportunities at the Medical College of Wisconsin, the American College of Healthcare Executives, the American Association for Physician Leadership.

And I'm a certified physician executive and a fellow of the AAPL, and I hold a master's in public health. So today I want to revisit the issue of physician leadership, encourage you to consider moving in that direction, and offer some advice about how to get started. So let's get to it. I think that I'm going to be talking about being a physician leader today, and I'm going to start by sharing my story about total immersion.

What do I mean by that? You know, this is something we do when we're trying to learn something new. So all of us have gone through medical school and residency for the most part. And of course that was pretty traditional type of education. And I found that once I got into practice, everything was going well. I was building my practice. I was working at the hospital to see my patients, nursing homes and in the office. And eventually I started to free up a little bit of my free time and became interested in learning other things that are important, like things like protecting your income, how to invest, maybe trying to find some ways to stay healthy, physically fit. What I've tended to do when I began to get interested in something like that was to just to totally go in a hundred percent and bury myself in information to help me learn about that. So that's what I did after about five years in practice. I realized that I did not have in my little three-man practice, we didn't have an IRA, we didn't have a 401k or anything like that. So my partners and I got together and we started talking about how we could set that up. And then I thought, well, I need to learn about how I'm going to invest because all these concepts were kind of new to me, you know, investing in the stock market, mutual funds, individual stocks, dividends, non-dividends, paying stocks, money market accounts, things like that.

And so I just went all in. I mean, I read everything I could possibly read. I listened to podcasts about the topic. I bought books. I subscribed to certain magazines. And so it was kind of a total immersion into the concept of investing and planning for the future financially. And I even ended up starting investment club with some friends I got so interested in. And in fact, still over 30 years later, I'm still involved in that investment club. Well, as I started dabbling in being a physician advisor and then a medical director, similarly, I didn't really know what I was doing. I mean, basically I had learned a little bit earlier in my life by being the chief in my residency and participating in a bunch of committees at the hospital and becoming the chair of a committee. And then I learned about how meetings worked and how minutes worked and all that kind of thing. But it was a pretty superficial exposure. So I thought, well, I've got to get involved in learning more about physician leadership and management. So that's when I started joining these organizations.

And reading about it, starting to subscribe to different podcasts, newsletters, magazines that told me a little bit about it. That's what I want to talk to you about today. Before getting into that, I would say that I really do promote the idea of getting into hospital management. If you're already in the hospital as a hospitalist or an ER doc or anesthesiologist or a surgeon or any of the other specialties that spend at least 20, 30% of their time or more in the hospital, I think it's a great place to work because you're providing very intense medical care. And in my opinion, we need more physician leaders in these settings. Most hospitals are run by people with an MBA or an MHA. They may have never done anything clinical.

There's some exceptions to that, like nurses who end up being in leadership positions. And they follow a path very similar to many physicians. In other words, they start out clinical and then they become a manager or they become a director. And actually there's a significant number of hospitals that are run by nurses, probably many more run by executive nurses than are run by executive physicians. And so again, I would encourage you to look at this path. The thing I like about it besides that it's intellectually stimulating and really it's something that any physician can do if they're interested is that it's a way to really help more patients. When I was seeing patients, I was dealing mostly with the healthy, worried well people came in with minor problems, really, that probably didn't really need a visit. Yes, you've got a lot of the screenings we're doing and health maintenance, but most things that come in are acute and they're relatively trivial, and then once in a while you see a really sick patient, get them admitted, and nowadays, if you're a family doctor, of course, you probably won't even be going to the hospital. The thing is, when I started getting into management, I found I was helping patients in new ways.

And at the same time, my lifestyle was better. The more I did in the hospital as a medical director and then ultimately as CMO, the less time I spent in the office, the less time I spent on call, and the more work-life balance I had. And it was something also where when you're in residency and early practice, you're challenged quite a bit because you're still learning and taking on new responsibilities, but then it becomes a little bit routine. And so when I started doing more and more in leadership, I really enjoyed learning more about how to manage, you know, learning about HR, learning about leadership and strategic planning and communication styles beyond those as a physician. And so there's a lot to it. And it is quite interesting. Let me talk a little bit about that. Is this right for you? Yeah, I don't think becoming a manager, director, or CMO in a hospital is necessary right for everybody. Because you have to be willing to take on some new skills, learn some new ways of doing things. I think there's some areas in particular that you really should try to strengthen and learn as you decide to do this. But let's think about how we should look at this and let's reflect in review some of the things that we should consider before making this move. So first of all, let's reflect about our motives.

You know, I have to admit that when I started getting into the physician advisory role, that was mainly to just make a little extra money. It was almost like moonlighting, but it was really non-clinical. But even as I became medical director, part of it was that I was really getting a little bit burnt out and I was trying to exchange hours of care as a medical director for hours of work as a primary care physician. So ultimately what that meant was I was getting paid on almost an equal basis for the medical director duties, but it didn't involve any call. And so over time I was cutting my call responsibilities back. And at some point later on, I actually hired my own hospitalist to start taking my in-house call. So if the motive is just because you're burnt out and fed up with medicine, that's probably not a good motive and it won't, you know, you'll end up a year or two later in the same situation, five years later, still burnt out and not happy. But if at least you have an interest in management and interest in learning new things, you have an interest in a specific area of management that might be fun, like when it's quality improvement or, um, CDI, clinical documentation integrity or informatics or, you know, one of the things we really normally get involved with as a medical director, then by all means, think about proceeding.

Reach out to your colleagues. If you've been out for a few years, you're bound to have some colleagues that are doing at least part-time work, and you may have even gone through residency and fellowship with someone who immediately went into a non-clinical role, although possibly related to their specialty.

Reach out and just talk to people, get their feedback and find out what it's like to make this transition, and also what it's like to be in a full-time management or leadership job. Read everything you can about it. Of course, when I say read, that includes online, that includes books. A lot of books written about this, a lot of articles written. When I say read, I also mean maybe listen to some podcasts like this one or others.

Go to websites and try and get a take on that. Then there are some formal places where you can go and you can register, meaning you should register or enroll with some of these professional societies. Of course, the one that I think is the best and probably most appropriate for those thinking about doing leadership roles and advanced management positions is the American Association for Physician Leadership. Now I've been a member of the APL for over 30 years, taking many of their courses. I've really been involved heavily in fact, that was the chair of the CCMM, which is a community that oversees the CPE designation and the requirements and the work that's done to apply for that recognition. So I've been heavily involved with it. I am not promoting it. I'm not paid, you know, but I got myself involved because I believe in what I did. It is always looking for new ways to expand and grow and provide more services to its physician members to become great leaders.

Now, I do believe that physicians are natural leaders and I don't say that they're born leaders because I think a lot of the leadership skills that they develop come as a result of their medical training. There's a lot of characteristics that we have that we're either born with, nurtured while we're young, and then are nurtured further as we go through our training. I'm going to talk a little bit about that in a minute.

These are the kind of, I guess, attributes that I see that physicians have. Obviously, the intellect is there, very focused. Most physicians I know are quite accountable. They've got the ability to handle complexity, so they can think through problems well. Their communication skills are usually pretty darn good and are usually improved while they're going through training. Now, a lot of that is with communicating with small teams and with patients and with patients' families and so forth. So sometimes you've got to learn a different type of communication as you get into leadership, but very good perseverance and patience and keeping on problems, not easily distracted. Decisive is another good attribute that physicians generally have that's encouraged and grown during their training. They don't tend to be wishy-washy or indecisive. So that's good. And a lot of people are prone to that indecisive nature because they're not confident. Commitment, altruism, and a people orientation, now, doesn't mean that we're not sometimes introverts. In fact, I think probably the majority of physicians or at least a little more than 50% are somewhat introverted. So it's not like they feel comfortable in a large group giving a presentation necessarily, although most of us practice that during our training. But we went into medicine because it's a combination of science and also the health professions helping others, that kind of thing.

So it makes for fairly natural leader. A thing is though, physicians do have to evolve. They have to add new skills and new attitudes to really be an effective leader at the level of, an executive in a hospital, which is what I'm really promoting here today. So we need to, if we tend to be a little reactive, because we're in the mix of things, if something happens, we respond immediately, that's fine. But when you're in a business setting, when you're in an organizational setting, a big organization, whether it's a hospital, large pharmaceutical company, health insurance company, anything like that, you really need to be more proactive. So you need to kind of migrate from reactive to proactive when looking at things. When you're managing large groups of people and people in big organizations, you need to be proactive. So that's something you have to develop. You need to stop.

Or I would say add to being a performer or a doer to being a planner. You know, we don't necessarily go into our office seeing patients planning what we're going to do for each patient before they show up. A lot of times we wait till they show up and then they, we assess them and then we make a plan, but to run an organization and have two, three, four, five, 10 people reporting to you, running a budget of 1 million, 5 million, 20 million, 50 million then you need to plan and you need to be proactive. You need to kind of move from tactical to strategic thinking. So this is, again, you know, we're talking about annual goals, maybe a two or three year strategic plan. These are fairly common to do when you get to the VP level or higher in a big organization.

And we need to go from being deciders to delegators. We have to feel comfortable. If you're like, I'll tell you, when I was, I don't know, I'd say, I wouldn't say at my peak, but there were times when I had six or seven directors reporting to me. And my main goal was to help them develop their goals every year and maintain some kind of tool that we could track their performance.

And then encourage them and push them to meet their goals and exceed their goals. But I really wasn't there to tell them how to do their job. I was really there more to keep them honest and to make sure they were pitching in and to also coordinate with other senior leaders to make sure that all of our directors and managers were working together collaboratively.

And working for the benefit of the whole organization, not for just their department. So when you delegate, that means you can't really look over the shoulder and everything they are doing. But you have to feel comfortable with tracking their performance and their progress and meeting their ongoing goals and performing according to your expectations. We have to migrate from being independent, working independently to being more participative. So working on a team, not a team that we're necessarily always leading, we might actually be just the co-members of a team. For example, for the first few years that I was working as chief medical officer, I always thought my team was the directors and myself, the directors that reported to me and myself, area they had the utilization management, the quality, the medical staff office. And then at times I also had always had the pharmacy and then sometimes radiology and lab. And it was more about, like I said, quality and performance. And we were still responsible for budgets, of course. I came to find out later, or I came to realize later, that my real team wasn't all those people reporting to me.

Like I was the coach and they were my team. My actual team were my co-VPs, the people on the senior management team. There were 10 of us, if you include the CEO, usually the CFO, the COO, the CMO, CMIO we had for a while. We had the VPs for HR, VP for lab, VP for maintenance and facility and so on and so forth.

And that was really our team, but we spent a lot of time bringing that team together as a cohesive unit. And where at that point, the way we looked at it was, we are there to make sure that our departments, that level of team are actually working together to achieve the organizational goals, not to just make sure that their particular department looked good or had good numbers. So that was an interesting evolution that I observed. And we're usually practice focused. And in a hospital, if you have several hundred or a thousand physicians, depending on the size of the organization, of course, we're all focused on our own practices, our own groups. And once you move into the executive level of hospital management, then you really have to have this organizational focus. And basically you're trying to get everybody on the bus, you might say, or everybody rowing in the same direction on the boat. And it's a little different than just running a small business like a practice or even a large business is a multi-specialty practice or single specialty practice. Or even if you run your own surgery center, that's even there, you start to get a little different feel than running just to practice. And then you need to really go from, you know, patient accountability, which is important in terms of you're accountable for the healthcare of the patient, which even in a hospital executive position you still are, but it's organizational accountability and it's different. You're no longer a lone wolf. You're working as a unit with others at your level.

And you have to learn to be accountable to one another and to the CEO. So let's focus on three of these aspects in a little more detail. So that accountability part is pretty darn important. And basically one way to define that is that you, you do what you said you would do when you said you would do it. And sometimes we'll add and the way you said you would do it. Now, in some things that you're saying you're going to do, you're gonna get done, you don't really care how it gets done. You know, if you're supervising some director, you say, look, you told me you're gonna do X, you're gonna meet this budget, and by six months from now, you're going to have this project halfway completed, fine. Just make sure you do what you said you would do when you said you would do it.

On occasion, you want to add the way you said you would do it. So sometimes the way you achieve something is important. Obviously, it has to be quite legitimate and honest and straightforward and not underhanded in any way. But as a leader, sometimes you don't want to worry so much about the way things are done. If they have a goal and the outcome is important, and as long as we're being authentic and we're being honest, then, you know, there are multiple ways to achieve the same goal. But again, if you want to quote this, do what you said you would do, when you said you would do it, the way you said you would do it, if you want to be accountable. And this could be to your team or to your boss. And when you don't achieve that, then you need to make amends.

So, the other thing that's really important is if you committed to something, if you promised to do something or just even agreed to some goal, you need to learn to apologize appropriately when it's not achieved. And that's what accountability is. And that means that, and this came up a lot in our senior management teams, we would meet and say, "Hey, you know, two weeks ago, this was what you said you were going to do. And you said it was going to be done by this meeting. So what have you got to show us?" And if one of us didn't have it, it meant that we had to say, "well, you know what I did, I committed to doing that two weeks ago. And I admit that I have not completed that. I don't have a reason or a good excuse was bad planning, timing and so forth on my part." So that's the first step is just admitting your mistake or your failure to comply with your own commitment, explain how you will rectify it. "I will get that done. In fact, I'll have that report that you needed by the end of the day tomorrow", commit to a deadline, which I did there.

That's basically it. Now, when you're being accountable and when you're stating that you did not meet the goal that you said you would meet, didn't complete what you said you would do, we never phrase it like this. Like, "I'm sorry" if, like, let's say that you were going to communicate with somebody and you ended up doing, you know, saying something that was not accurate.

You don't say, "well, I'm sorry if what I said bothered you. I didn't mean to bother you or to insult you." That's not really an apology because you're putting the if sentence in there, we're just putting it on them. Like if they took it the wrong way, you just say," I'm sorry, I offended you and I won't do that again," or in this case, to be accountable.

"Yes, I made a commitment. I did not meet that commitment. I'm sorry about that. And I make a recommit myself to completing this project by the end of the week. I will not fall behind in this project again." So you have to really commit to and not repeating your mistake. So accountability is a big thing. And a lot of physicians, I mean, we're accountable to our patients doing the right things and not doing something we're gonna get sued about or get reported about. That's one level of accountability. But when you're in a team for a large organization, you all have to make your commitments, stick to them and be ready to admit your mistake if you don't and move on. The other thing is it has to do with optimism. I think it's easy to become pessimistic and angry in healthcare.

You can, you know, you get, you feel like you're overwhelmed sometimes you're burnt out. And when you get that way, then you start to lash out, start to act negatively. You start to become resigned and that's not good for a leader. A leader cannot be depressed and resigned and feel like they have no control and they have to maintain a certain level of optimism that they and their team and the organization itself can solve important problems, can move forward successfully, and should not get that resigned feeling like nothing can change and we're not making any progress. Leaders with that attitude really don't last very long at all. So you have to avoid the negativity, defeatism, apathy, resignation, all those things I've mentioned.

You should embrace positivity, be kind of faithful, have faith, be inspired, be easy to encourage and encourage others. You know, always have hope and expectations that things will continue to get better because we're all working together to make things better and more successful and more responsive to our patients and to the community. So optimism is really important. If you can't...

If you can't be accountable and you cannot be optimistic, you really can't be a good leader. Then the other thing is humility in spite of all this. You're learning a lot, you're taking ever increasingly important levels of responsibility, working your way up to the C-suite, maybe even eventually become the COO or the CEO. But you have to have humility because again, you don't do anything by yourself. You should avoid being self-righteous if you'd fallen in that trap in the hospital and the operating room and the delivery room. If you become condescending, a part that goes back to being burned out or overwhelmed, but you have to stop that. You have to maintain some humility.

Continue to always be curious, meaning welcoming other people's opinion. When you're in a leadership role, it's not that you're making all the decisions without input from your peers and from the people that are reporting to you. You should focus on listening more than talking. You know, just because you're the chief medical officer doesn't mean when you're with your directors or with your teams, it's so-called that report up to you, they have the frontline observations. They have the frontline knowledge of what's actually going on day to day. You have to remain curious, you have to listen first. And then if there's a sort of a solution that's self-evident and a decision has to be made about, are we gonna invest money here? Are we gonna share personnel?

Are we going to try and find other ways to meet a goal? Then you might have to make that decision, but you need all the information first and that means being humble. I guess what I want you to just realize is that leading is a skill that builds on what you learned during your medical training, but it involves listening and inviting others to embrace your vision. And you know, you think about when you're a leader, you're always on stage and your patience, dedication, and integrity become a role model that are key to recruiting others to join your organizational journey as a leader. You're trying, like I said earlier, to get everybody on the bus that's going to debut. I mean, it's a metaphor, but it's one that one of my CEOs used all the time. It's like, we're all going to get on this bus and we're going together.

We're all going to hop in the boat and row in the same way, in the same direction. There's no sense us all being in the boat. We're all rowing in a different direction because then we're not going to move. And so really one of the core responsibilities for a leader is to inspire your team and to get them to want to join, not be forced to join.

Bottom line is if you are successful and you get 90, 95% of people to row in the same direction and hop on the bus that you're taking to debut, then if there's five or 10% that can't do it, won't do it for whatever reason, then they should be left behind. That means they should go find a job where they're going to be happier and more productive. So if those are the kinds of things when you're listening what I just talked about sound like fun. Well, then by all means, that's an indication that you should consider strongly to start your leadership journey. You've probably already been on it. If you're a physician and you're probably asked to do things and take on responsibilities where you're not just pitching in as a member of the team, but you're leading part of the team or leading the entire team.

Maybe you're working on temporary committees to solve a problem. Maybe you're chairing a committee that's really important. Or maybe you're on the board of a hospital or a public health organization, hospice, something like that. If you like that and what I've talked about today sounds like a fun, like I said, then go ahead and take off and continue your leadership journey.

I'll be coming back to talk about more issues related to management leadership in coming podcasts in addition to interviews with more that are also doing non-clinical jobs outside of leadership.

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Many of the links that I refer you to, and that you’ll find in the show notes, are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you, that I have personally used or am very familiar with.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

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The post To Be a Better Physician Leader appeared first on NonClinical Physicians.

In this week's Classic Podcast Episode from 2020, Dr. Jennifer Spector describes how to become a medical editor. Unlike other medical editors who spent years as a paid medical writer, Jennifer parlayed her involvement in a professional society and unpaid writing to land her new editor position.

Jennifer is a Board-Certified Podiatric Physician and Surgeon with 14 years of clinical experience. She spent over 5 years in national leadership positions at the American Association for Women Podiatrists (AAWP). She’s had a long-term interest in education, writing, and consulting. She is passionate about educating others. In June 2019, she became the Associate Editor for Podiatry Today.

She received her DPM degree from the Temple University School of Podiatric Medicine. Then she completed a three-year residency in podiatric medicine at Christian Care Health System.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

How to Become a Medical Editor

Medical writing and editing are great careers. They come in various arrangements: freelancing or employment; working remotely or in an office; technical, journalistic, or educational. And there are positions open to physicians of all backgrounds.

After completing her residency, Jennifer spent several years building her practice. She later volunteered at the American Association for Women Podiatrists. She chaired several committees. Then she held several leadership positions, becoming President of the organization in 2018.

There are so many things that we might have dipped our toes into in clinical practice without realizing how they can apply outside of actual practice. – Dr. Jennifer Spector

While at the AAWP she was responsible for writing and editing the newsletter and other documents. That experience enabled her to land her position as Associate Editor for Podiatry Today.

After working in that position for about 20 months, Jennifer was promoted to Senior Editor followed by Managing Editor at Podiatry Today. In July of 2022, she became one of the Assistant Editorial Directors at HMP Global, the parent company of Podiatry Today and a market leader in international healthcare education and clinician engagement.

Finding Editing Jobs

Today’s conversation with Jennifer clarified her process to become a medical editor for a news journal like Podiatry Today. Jennifer reminds us to develop a portfolio of writing and editing samples to share with prospective employers. She was able to do this while volunteering with the AAWP.

If you’re looking for freelance writing opportunities, you should look at the portfolio of journals published by the parent company of Podiatry Today, HMP Global. There are 12 journals and over 100 Online Digital and Learning Networks under its umbrella.

Summary

In today's interview, we learned what it takes to become a medical editor. This is often a natural step for established writers to pursue.

Links for Today's Episode:

• Dr. Jennifer Spector's LinkedIn Page
• Podiatry Today
• HMP GLOBAL
• AAWP
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

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Right Click Here and “Save As” to download this podcast episode to your computer.

The post How to Become a Medical Editor – A PNC Classic from 2020 appeared first on NonClinical Physicians.

In this podcast episode, John sits down with Dr. Neetu Sharma, who recently transitioned from a demanding nephrology practice to a health insurance medical director while maintaining a virtual clinical presence. 

In sharing her story, Dr. Sharma describes the challenges of managing patients at six hospitals, taking weekend “call” duty covering up to 120 inpatients, and the added stress of COVID-19 that led her to explore alternative career paths, ultimately finding fulfillment in utilization review.

John and Neetu discuss the realities of working as a medical director, debunking common misconceptions about insurance companies. And they explore how physicians can achieve improved work-life balance.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Inside the Role: What a Health Insurance Medical Director Does

The transition to medical director involved a structured 9-to-5 remote schedule, reviewing cases for compliance with CMS guidelines, and ensuring appropriate resource utilization. Dr. Sharma debunks the myth that insurance companies focus solely on denials, explaining how the role involves complex case reviews, peer-to-peer discussions, and collaboration with clinical teams.

Before starting her primary duties, the insurer provided comprehensive training. Neetu quickly developed the skills to handle cases from regular inpatient admissions to complex long-term acute care situations.

Creating Your Unique Path: Blending Tradition and Innovation

One of the most interesting aspects of Dr. Sharma's transition is how she's created a hybrid career model. While working as a medical director, she maintains clinical skills through virtual practice and weekend calls, launched an online wellness program, and is expanding into nationwide virtual care.

This approach enables Neetu to leverage her expertise while maintaining a better work-life balance.

Summary

Dr. Sharma's journey, which included certification by the American Board of Quality Assurance and Utilization Review Physicians and training with the Institute of Functional Medicine, offers a blueprint for physicians seeking similar career changes.

For those interested in learning more about utilization review or career transitions, Dr. Sharma welcomes connections through LinkedIn, email (staff@zealvitality.com), or her website, where you can schedule a call to discuss your career path.

Links for today's episode:

• Dr. Neetu Sharma's LinkedIn
• Zeal Vitality's Website
• American Board of Quality Assurance and Utilization Review Physicians
• Institute of Functional Medicine
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

If you liked today’s episode, please tell your friends about it and SHARE it on Facebook, Twitter, and LinkedIn.

Right click here and “Save As” to download this podcast episode to your computer.

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 379

Health Insurance Medical Director Is Still A Popular Job

- Interview with Dr. Neetu Sharma

John: It's been a long time since I interviewed a physician who recently left traditional clinical medicine to start a career as a medical director for a health insurance company. But I recently connected with someone on LinkedIn who's doing just that. And she's also maintaining a clinical practice and mentoring physicians and doing some other things. Dr. Neetu Sharma, welcome to the podcast.

Dr. Neetu Sharma: Thank you, John, it's my pleasure to be here.

John: I'm really happy to hear your story. This is going to be interesting. I think it's good to have someone who's recently made a transition and because there's a lot of physicians listening who are thinking or have been thinking about it for a long time and haven't done it. They can get some good inspiration from you. So, yeah, just tell us a little bit about your background and your medical education and clinical practice and things that were going on before you made a shift.

Dr. Neetu Sharma: Yeah, thank you for having me here, John. I have been listening to your podcast and got a tremendous help with my career. So thank you for doing that. And I wanted to give back to your community. So that's why I'm here today. I did my residency in Detroit with internal medicine, then went to University of Cincinnati for my fellowship in nephrology.

And I have been Michigander, I've been in Michigan for a while. I returned here for my clinical practice after my training. And I was with a private practice for the past eight years, but I have been in clinical practice for about 15 years going. And I was, to be honest, getting to the point where I was getting burned out. As a nephrologist, you have to go from clinics to the hospitals, to dialysis clinics. So it's a lot. And I was on call every other weekend and when you're on call, you're seeing, pretty much I was covering six hospitals and seeing about 120 on average patients on that weekend call. And I wasn't getting any day off after that. And you come back on Monday tired.

And so, it took a while for me to look into different options. And last year I actually ran into somebody who was doing utilization review for insurance plan. And he kind of gave me an overview how happy he was, how he had a control on his life. Then I thought it's interesting to know, and I started digging more into it. And I happened to listen to a few of your other interviews about utilization review, got a tremendous help from that. And I became a member with the American Board of Quality Assurance and Utilization Review of Physicians, got certified with them last year. And then started my journey with interviews with the health insurance plans and ended up with a major health plan starting this year as a medical director.

John: Very good. Okay, I'm going to go back to the whole beginning of this. To some extent, how long was it that you were feeling kind of overwhelmed and kind of, I don't know, overworked before you decided, like in your mind, you said, "You know what? I'm definitely going to make a change." Obviously if you signed up to do the education, that was really concrete, but what was that timeframe like for you?

Dr. Neetu Sharma: John, COVID changed a lot of things and it was around 20 when the COVID hit. I got pay cut. I was working overtime. I was taking care of patients in the hospital. I was completely burnt out to the point that I started thinking there shouldn't be a better way of practicing medicine. Especially in nephrology, I can tell you that other nephrologists might relate to it that we deal with very complex patients who are having life-threatening disease.

And we lost a lot of patients during COVID and that was quite depressing. I felt like I wasn't making a difference in the lives of these patients and there was no job satisfaction. At that point, I started looking into other answers, functional medicine, and I became a fellow with the Institute of Functional Medicine, got some training in that. I decided that I want to transition and do a holistic approach to help my patients. And then at the same time, I started looking for utilization review jobs too.

John: The story that you're telling is not uncommon and there's a lot of physicians still where you were a year or two ago. Did you get a sense that the organization you were working for, like, had any sort of recognition that the physicians were getting burned out like yourself or were they putting in place any plans to try and address that? Or were they just saying you got to do what you got to do and that's just the way it is?

Dr. Neetu Sharma: The way things are, unfortunately it's all run around and seeing more patients and working hard, but not getting the reward for it or getting satisfaction of taking care of those patients. Because if you have five minutes to spend or 10 minutes to spend in the office with it, how much difference you can make in the lives of your patients? You are just giving out pills. And that did not set with my principles, with my goals of becoming a physician. And I wanted to do something more for my patients. And that's what led me here where I am today.

John: Just for background, about how big was the group that you were actually working in?

Dr. Neetu Sharma: We started with five physicians. When I joined, I was the third one. We grew the group to five. Then slowly, everybody left the group.

John: It sounds like that's kind of how it goes often, especially if you don't have a large group that can kind of absorb the ins and outs of employing physicians in a group or being partners. But okay, let's see. Let's get back to your new career now. Did you say someone had recommended this? You had talked to someone about it? Sounds like you zeroed in on that particular career pretty quickly. Was there other things you had considered?

Dr. Neetu Sharma: Yeah, I was looking into different things at that time. I was looking into pharmaceuticals. I was also looking with the FDA. I actually got offered from the FDA as well for the medical device position because they deal with a lot of the international investors who bring the medical devices to US and they have to make sure it's not a public hazard. So for public safety, they have engineers, they have physicians who are looking into those devices and other technology to make sure they are compliant. And that was the position I was offered. But then I ended up with this major health plan, which was local. So I thought it would be nice to see the team once in a while to have more collaboration and face-to-face interaction. And that would lead to the position.

John: Okay, you did, obviously you're in a big metropolitan area, fairly big. And so, the company that you chose had at least one office in that area. So that was one of the big draws for you?

Dr. Neetu Sharma: Yes.

John: Okay, but that leads me into this question about what's the job like? Because I have a feeling you probably don't spend nine to five at that office every day, do you? What's that like, the actual job? And is it remote and how remote and all that?

Dr. Neetu Sharma: Yeah, right now it is a remote job from nine to five, eight to five, I would say. My day starts at eight o'clock and I am in utilization review as a medical director. So my main job is reviewing all the cases and making sure they are in compliance with CMS published guidelines and with the medical policies in place and making sure the resources the institute utilize is appropriate for that particular member.

I deal with different appeals and also collaborate with the clinical team, pharmacy and other clinical providers. I do have peer to peer calls on a regular basis. And my day ends by five, if not like 5.30, depending on how busy we are. But it's interesting because you're always in, you're talking to your team over the team meet or you are in a queue where you are interacting with the other team members. And you are also encouraged to go to the office once a week. So if I choose to go there, I can. But mostly the team that I could work as remote, so you don't get to see many people. But we do have team meetings every month where we collaborate, we see each other and celebrate the organization. So that's really nice.

John: Now, what's the job like? Because this is what people always are interested in terms of not only exactly what are the duties, but in terms of, is it really rushed? Are you expected to go through so many cases on a given day? Does it feel like a little bit overwhelming or is it a pretty relaxed feeling where you get a chance to really get into the cases, determine what you need to make a decision and then have a conversation and peer to peer if necessary?

Dr. Neetu Sharma: Yeah, as a major corporation, they have set certain goals for the team members, including the medical directors. So we have certain goals to achieve, which also includes the number of cases you're doing every day. But in reality, many of these cases are complex cases.

They are high risk patients and it needs reaching out to the team, to the acute care hospitals, to other providers to get the feel of what the members have been going through. Always taught in a public view that insurance companies are there for denials, but that's not true because we really look into the utilization of resources and whether they are done appropriately. So we try to actually approve the cases if possible for the member and keeping members in mind, it is important to know what they're going through. Some of the complex cases take longer and it's not realistic to put those goals into that basket. Sometimes you meet those goals, sometimes not. But I think the leadership, they understand the complexity of this job.

And to be honest, I haven't, so far, like three months I have been with this health insurance plan. I haven't had any interaction where they're telling me that you haven't reached your goal today because they know that I am working hard to understand the utilization better, to help the members better. So our goal as an organization is mainly the member satisfaction.

John: Now, the medical side of what you're looking at and the records you're looking at and so forth, obviously is pretty straightforward for an experienced physician like you. But doing all the things you are doing with that information and then you've got reports to fill out and you're doing the communication, might be with nurses or other physicians or peers. How much training is involved and have you felt like that's gone pretty well in the first few months that you've been there?

Dr. Neetu Sharma: Yeah, so it's a dynamic role because I will be doing different kind of cases. Sometimes we have complex case reviews, sometimes we are dealing with LTACH patients. Sometimes we have regular inpatient admission reviews where we are seeing the utilization of resources or the length of stay.

Those cases, they may vary and we get trained for at least a couple of weeks to get used to review those kinds of cases effectively. So I would say two weeks to one month is needed for each kind of category of the review you're doing. And it's an ongoing process.

It's training on jobs. So once I was trained on one particular area, I've been doing that for a while to get more proficient in that area and then I will be moved to some other area where I'll be reviewing more complex cases.

John: Yeah, in most of the physicians I've talked to over the years, it hasn't been a lot, but it goes back about seven years now. They tell me that basically there's a set of criteria they probably changed over the years, but just getting used to how you have to demonstrate compliance with whatever, the Medicare if it's a Medicare and you have certain different formats for doing that. But in any way, they say you just have to learn the system basically.

And when you're a generalist and someone who's an internist and a nephrologist, you know so much medicine. I had a pediatric cardiologist that went in doing the exactly the same thing you're doing. And it took him a little longer to kind of get the feel for things because he hadn't taken care of adults for 10 years. So I think you're in a good position.

Dr. Neetu Sharma: Yeah, thank you. Yeah, my team is actually very diverse. We have pulmonologist, we have ER physician, we have pediatrician. So it's a very diverse team and we all are doing the same thing. And the learning process for everybody is different.

John: And it's new, something new. You're getting into it, but now that you're at this point is it kind of what you thought it would be? And are you so far, are you satisfied with the way the work is going and the support at the company and that kind of thing?

Dr. Neetu Sharma: Yes, absolutely. I have a great team. They're very supportive and they listen to you, they listen to the feedback and they always put an effort to improve things.

John: Now, what I've heard sometimes is you can definitely do this full time and not do anything else, I think, but some of the companies do like to have their clinicians continue to have some activity so that they can, makes it a little easier to be current and in the treatment of certain conditions. So, you are still doing some clinical. So, if you don't mind telling us about that so we can see how that kind of fits in.

Dr. Neetu Sharma: Yeah, these health insurance plans, they actually encourage you to do clinicals and get up to date with that because when you review the cases, you can relate to it better. So, I'm also doing some virtual practice and I also reached out to my previous practice to do some clinicals with them over the weekend, some weekend call, which I'm getting credentialed for. So, I don't want to lose touch with clinicals for sure, but I launched an online wellness program and some virtual care for nephrology patients as well.

John: Okay, now on the virtual side, were you doing any remote kind of virtual work before?

Dr. Neetu Sharma: No, this is all new for me. It's a learning curve.

John: Are you limiting the virtual care to the state you're licensed in now or are you licensed already in multiple states? How's that working? Because that can be a barrier sometimes.

Dr. Neetu Sharma: Yeah, that is in process. I'm getting licensed throughout the US so that I can see some virtual patients. But right now I'm just offering a group program which is more like a health coach program.

John: Ah, okay. That one doesn't really have all the risk and the other aspects of sort of a true virtual remote telehealth or telemedicine type practice and the need to get to have your DEA and your licenses and all those things wherever you might be interacting.

Dr. Neetu Sharma: Yeah, no, if you're seeing the patients and you're posing as a physician, then the risk is there, John. So, I would advise to take the full precaution. I have my malpractice insurance and I am doing my due diligence to be compliant with all the procedures involved with the virtual care. So, that is something we have to keep in mind.

John: Yeah, absolutely. You've got to know where you need those protections for sure or you'll end up in trouble. All right, well, thinking back your process seemed to go pretty well in terms of from the time you were burnt out and said something has to change to actually making the change. Do you have advice for others that might be in the situation you were in back a year or two ago?

Dr. Neetu Sharma: I would say that look for what you really want to do and get the feel of it. If you like utilization review, I would advise to start from your organization, from the hospital you are in or in a practice you are in to do some kind of utilization review, whether to join independent review organization and start reviewing those cases or participate in the hospital quality assurance, different committees to get the feel of the job. And if you really like to do that and then get serious about it and start applying.

John: Yeah, that makes sense. I have a friend who's... Well, now he's a CMO for a hospital, but that's what he started doing as a physician advisor for utilization management. He was reviewing charts, interacting with physicians. And then he took on more and more roles and he ended up staying in the hospital setting. But I think a lot of the people I've talked to started out just doing those kinds of things in the hospital setting. And then it makes it, I think, a little easier to transition to the payer side of things because you're not going into a blind.

Dr. Neetu Sharma: Yeah, I'm sure those roles are overlapping.

John: I think some of our listeners will have questions for you, I'm sure. So let's see, one way they could reach you, I think, from talking before is basically LinkedIn. That's probably a safe way to get in touch with people. And if you just look up Neetu Sharma, you'll find her pretty easily. That's how I found her on LinkedIn pretty simply. But what other ways can they get ahold of you if they want to follow up or have questions for you?

Dr. Neetu Sharma: Yeah, they can either email me directly at staffs@zealvitality.com or reach me on my website, zealvitality.com. But LinkedIn is a safe website and they can reach me. Neetu Sharma MD is my profile on LinkedIn.

John: The zealvitality.com is actually the website where you're doing some of this outreach and ongoing clinical or right now, I guess it's a group coaching type of thing.

Dr. Neetu Sharma: Yeah, it has a schedule call through that website and they can put in the notes that they just want my advice or whatever they want to know about utilization review, I'll be happy to touch base with them.

John: Okay, the way things are going so far, you feel like this is something you can do for a while and really expand your challenges and your practice and your knowledge of medicine and patient care. It sounds like that's the direction you're going.

Dr. Neetu Sharma: That is true. So, it's a learning curve. A lot of things to learn about in medical school, you don't get taught about these entrepreneurship and you learn on your own and in this world where we are living virtually on social media, it is even more important to learn all that.

John: Yes, yes, it is. I think it can be daunting. It can be a little bit scary, but if you can get to residency and fellowship and practice, and like you said, working a hundred hours a week and challenging all these life and death decisions, you can start a side job or pursue a career with some kind of industry, whether it's like you did or pharma or hospital or whatever. But yeah I think it's easy to get kind of bogged down and forget that it really is something that thousands of physicians have done. So I think you're a good example of that.

Dr. Neetu Sharma: Yeah, I think the challenges are definitely there, but I am a big believer in delegation. So if you don't like to do something, then you delegate your work. And I think that will make your life much more easier and you pursue what you like to do.

John: Neetu, thank you so much for being with us today. I think that's about it for today. We're kind of out of time. So let me say goodbye and hopefully we can maybe get together again down the road.

Dr. Neetu Sharma: Thank you, John. It was a pleasure.

John: Okay, bye-bye.

Dr. Neetu Sharma: Bye-bye.

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The post Health Insurance Medical Director Is Still A Popular Job appeared first on NonClinical Physicians.

In this podcast episode, we revisit our enlightening conversation with CDI Expert Dr. Christian Zouain. He shares his journey from foreign medical graduate to a Clinical Documentation Improvement (CDI) specialist.

Dr. Zouain reveals how his transition from pursuing a traditional residency path led him to discover CDI. There he found his calling in ensuring accurate medical documentation. This critical aspect of the medical record impacts patient care quality and hospital revenues, which creates excellent opportunities for CDI consultants and medical directors.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

The Daily Life of a CDI Specialist

Working as a CDI specialist involves reviewing patient records, collaborating with physicians, and ensuring accurate documentation for both quality care and appropriate reimbursement.

Dr. Zouain describes the evolution from traditional paper-based systems to modern electronic health records, emphasizing how technology has transformed the way CDI specialists interact with healthcare providers. The role offers regular working hours (typically 8-4 or 9-5) and provides opportunities for both on-site and remote work.

Growing Opportunities in the CDI Field

The CDI field continues to expand, offering various career paths from hospital-based positions to remote consulting roles. Dr. Zouain emphasizes the importance of starting with hands-on hospital experience before transitioning to remote work.

He recommends three helpful steps to consider when pursuing this career:

• joining professional organizations like ACDIS and AHIMA,
• pursuing certifications such as the CCDS (Certified Clinical Documentation Specialist) and CDIP (Certified Documentation Integrity Professional), and,
• networking within the CDI community.

Summary

Whether you're a foreign medical graduate, practicing physician, or healthcare professional looking for a change, CDI provides a promising career alternative that leverages clinical knowledge in a new way.

Want to learn more about CDI? Connect with Dr. Zouain on LinkedIn or check out ACDIS's apprenticeship program. Your journey into healthcare documentation excellence awaits.

Links for today's episode:

• Dr. Christian Zouain's LinkedIn
• ACDIS
• ACDIS Apprenticeship Program
• AHIMA
• Follow This Plan to Establish a Solid Hospital CDI Career
• Why CDI Medical Director Is a Great Nonclinical Job – 224
• PNC Podcast Blast from the Past – No Residency Is No Problem – 211
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

If you liked today’s episode, please tell your friends about it and SHARE it on Facebook, Twitter, and LinkedIn.

Right click here and “Save As” to download this podcast episode to your computer.

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 378

Become a CDI Expert

- A PNC Classic from 2019 with Dr. Christian Zouain

John: Hello, Dr. Christian Zouain, welcome to the PNC podcast. I'm happy that you're here with us today.

Dr. Christian Zouain: Oh, Dr. Jurica, thanks for having me. I'm a frequent listener, I really appreciate you having me today as a guest.

John: Awesome, one of my three listeners. I'm glad to hear. Hi, mom. No. Kidding. So, no, I really wanted to get you on here. I did listen to a recent podcast where you were a guest and it was really interesting. I personally have this interest in CDI, which we'll explain what that is in a minute, but I thought you'd be a good one because you've had some recent experience in different venues, and I thought, okay, let's get Christian on the podcast.

Dr. Christian Zouain: Great, thanks. Yeah, sure.

John: good, it'll be fun. All right. I'll have recorded a short intro. It gives a little background about you, but why don't you tell us just a little bit, if you want to give us the brief history and a little bit about what you're doing right now?

Dr. Christian Zouain: Yeah, sure. I am a foreign medical graduate, originally from the Dominican Republic. I moved to the United States in 2011 to pursue residency initially, and while I studied for the boards, I worked as a medical assistant, later as a medical scribe, later landed a job in case management, utilization review at a hospital, as a means to get closer to the hospital setting and make connections, meet the doctors and obtain a residency position.

This is when I started doing research and looking into other non-clinical options, which I've never, had never done before. To me, the only path was obviously coming from the Dominican Republic was going into clinical or that's it. I knew a few people that were doing research, but I started exploring the other options. I remember I attended the SEAK non-clinical careers conference in Chicago in 2015, which is the one you've mentioned in your podcast a couple of times already.

John: Let me break in here and clarify that the SEAK non-clinical careers conference is spelled S-E-A-K, and it's not an acronym for anything. There's a reason why it's spelled that way, but it really doesn't relate to the content of the conference. It is still running annually in the Chicago area as far as I know. They just had their most recent annual big non-clinical physicians conference this past October, a few weeks ago, and I believe they will continue to do this annually. It's held not too far from O'Hare airport. They say it's in Chicago.

It's really technically in a hotel at Rosemont, Illinois. Next year will be the 20th event. Most physicians find it really useful because it presents about 20 live lectures over two days, plus access to 40 mentors, more or less during those two days. And they also have, I think, one or two pre-conferences. there's a lot going on. And I thought I would just mention that, and let's get back to our conversation.

Dr. Christian Zouain: And it really helped me realize that I was not alone in my decision to pursue a non-clinical path. then I enrolled in a clinical documentation improvement and ICD-10 coding course at New York University through the advice of a friend. This was actually new because ICD-10 was coming up. It was 2015. It was a big change, October 1st. they were saying that CDI was a growing career that actually needed a lot of healthcare professionals to jump in.

And while taking this course, I learned a lot about the impact that a complete and accurate documentation had in all areas of healthcare. I became really interested in that, and I eventually just decided to jump all in into CDI as a career path. At that point, I also became more involved with the use of social media, LinkedIn. And through there, I was able to land my first position in CDI. right now, yeah.

John: That's great. Let me stop there because I want to check a couple of things with you because some of what you said resonates with me. My recollection when I was working in the hospital setting was, I was involved with UM and CDI both. And at least my recollection was anything having to do with utilization management and the cost of care and even quality, much of it depends on the documentation. it's a natural partner in that whole process of trying to at least improve how things look on paper in terms of the quality. Would you agree with that? Was that part of this thing that led you to the CDI?

Dr. Christian Zouain: Yeah, definitely. Everything, all aspects of that, I would say would fall into place after you would get that true clinical picture of that particular case with the documentation. It's not just about... Initially, I remember I was thinking, okay, it's about reimbursement. And that caught my attention. But then later I started to find that a lot of things besides the reimbursement had a huge say with documentation.

John: I remember when we had projects and we were working on some quality project or some UM project or whatever, we always had the director for, well, it was health information services or whatever it was, but basically it was the coding experts who were at every darn meeting.

Dr. Christian Zouain: Yeah, and that's a huge part of it. In my previous job as a CDI, I was the only CDI, and I was involved particularly with all the administration. I had to report directly to the CFO. And it was a new venture for me because I came from my first experience, which was a department of 12 CDI specialists. We were just there reviewing charts and closing our records, dealing with the coders. But now I would have to go to all these meetings with the administration. I had to interact with the doctors, with case management, with quality management. I would see how it all blended together. I had to be there. I had to be in those meetings. And it's actually also a good opportunity to let them know up front what things need to be done. When they discuss cases, I can just jump in and let them know, this is how we can better document this particular situation for next time, just we don't have to go through the query process. And that way you also work to educate the physicians.

John: Absolutely. The other factor that's heavily dependent on documentation and coding, and we're not talking a lot about it here today, maybe a little bit we're touching on it, but it's the perceived quality of your hospital. The risk-adjusted mortality, complications, and length of stay depend on the accuracy of coding and understanding of inclusion and exclusion criteria and risk adjustment related to preexisting conditions versus those that develop during a hospital stay.

So for all those top 100 hospitals and all those five-star hospitals and forth, they heavily depend on very complete and accurate documentation and coding to demonstrate the quality of care because of those factors I just mentioned. All right. Let's get back to our interview. we're going to go back and go through the detail of how you actually made that transition.

You started to tell us about that, but I want to put a plug in for myself right now, only because I did a podcast early on in one of my, I guess I'd call him a friend, although we don't keep in touch, but we were working together at the hospital I worked at, and that was Cesar Limjoco, who's sort of this icon in a sense of CDI. I think you've probably heard of him, and he's got this massive following on LinkedIn and everything.

Dr. Christian Zouain: Yeah, I do. I do follow him. I haven't been able to, probably this year at this conference, I think he usually presents every year. Probably I'll go ahead and meet up with him. I mean, I know him. I've seen his articles. I follow him on LinkedIn, and he has really good information.

John: Yeah. And the thing that it was, in doing that interview, I mean, I really liked it because he gave like his whole perspective, but the thing is he is unique in the sense that he's been doing this consulting for long, and now there's other companies that are doing it, and really the starting point for someone like you or I back years ago was not what he's doing because he's been doing this for long. So I've been wanting to get a hold of somebody like yourself who has been a more recent entry into this, and again, that's just another reason why I'm happy to have you here on the podcast today, but I will say that was episode number five for anyone that wants to listen to it.

Dr. Christian Zouain: Yeah, I do remember. That was actually, I think, that was the first episode I heard from your podcast when I heard his interview. Yeah, because I was, I really wanted to know more about his journey as well.

John: Well, now we're going to supplement with your journey because you're following in the footsteps.

Dr. Christian Zouain: Thank you.

John: you had been exposed to UM, you became interested in CDI, you actually took the ICD-10 course, but then what are the steps did you take to try and make that leap into basically was essentially a brand new career for you?

Dr. Christian Zouain: Well, I was doing case management and utilization review, and what really caught my attention again was the contribution that Accurate Documentation brought to the process of healthcare. And I mean, I just decided that at that point, clinical medicine wasn't for me. I think that I just saw value and importance of helping the hospitals, helping the physicians in this current profession. that's why I decided eventually to take it on as a career path. I don't know if I'm correctly answering your question. Just let me know.

John: Let me ask you this, and I'll ask you some leading questions. were the hospital, where you're doing the UM, did they have a formal CDI program and did you end up working for them or did you end up going somewhere else?

Dr. Christian Zouain: Oh, no, I ended up going somewhere else. I believe they did later. I would find out later. They have some sort of CDI program that was starting. But I, again, I started doing research. I started being more involved with LinkedIn. So I started following all these hospitals. I was back in New York. And I would follow their HR department and this particular opportunity came up where they said that they were looking for professionals in the healthcare arena to go into CDI.

It was actually a dinner conference. if you had some sort of exposure or knew a little bit about CDI in some formal way, you could attend that meeting. I, at the time I was doing, I was doing the course at NYU. that was my ticket to go, to get into that dinner conference. And that's where I met my future boss. And eventually I was hired as a CDS.

John: now this was part of their recruiting process for people.

Dr. Christian Zouain: Yes.

John: Okay. Where were they promoting that? Where did you see that?

Dr. Christian Zouain: On LinkedIn.

John: On LinkedIn, was it a company that you were following or did they reach out to you?

Dr. Christian Zouain: It was a company that I was following, a health system. And yeah, they posted the human resources recruiter, posted the ad on LinkedIn. And I contacted them, send them all the information. At first they were hesitant because the course at NYU was new. they didn't know, but they wanted to. But I sent them the curriculum and everything and they said, "Okay, you know a bit about CDI. You've been studying for a while on that. you're good to come in." And I remember I was expecting for it to be a big conference or at least a lot of people to join in because I got new at the moment. That's all I would hear about how the CDI profession was growing. I was thinking I don't have the experience.

I was told by a friend initially that you might have to take a pay cut from your case management position because you don't have experiences in CDI. But I was willing to do that because I knew there was a better path for me in CDI. I actually went and it turned out to be the opposite. I didn't end up taking the pay cut. It was actually more. Well, I didn't have the experience, but at that point, there weren't a lot of professionals that had experience.

So I remember I showed up to the dinner meeting conference and we were like five applicants only. we had, there was the health system, each director for CDI of each hospital, which were around five. There were only five people that showed up that were interested. Two of them I remember were also foreign medical graduates, but didn't live close by. And one of them was a nurse who worked on the floor still. I was the only one who, okay, I was already taking the class of CDI and I had good interactions with the other directors.

The little I knew at that time, I was able to discuss during the dinner because they had a presentation, but then we had a moment where we would sit down at the table and meet the other directors. each one of them, I was able to interact with at some point. And one of them actually caught interest in me and decided to interview me and I was in.

John: No, that sounds excellent. That is such a good example of networking, getting in front of somebody who is in a position to make a decision about recruiting and forth. Let me jump in again on this point. LinkedIn is extremely useful. And I would say a necessity if you're looking for a non-clinical job. There is a lot of recruiting and hiring done directly through LinkedIn for many of these non-clinical jobs and some clinical. Many recruiters use it as their number one way to find and contact eligible candidates.

So it behooves you to optimize your LinkedIn profile and understand how to use it. If you're not comfortable setting up your LinkedIn profile and how to use LinkedIn effectively, I recommend you purchase the course called LinkedIn for Physicians by Dr. Heather Fork. Now, this has been out for, I think, at least three years. And she does updates on it every often. It's quite comprehensive.

And you can go find her website at doctorscrossing.com or you can go to my link and check it out at nonclinicalphysicians.com/linkedincourse. That's all one word. nonclinicalphysicians.com/inkedincourse. And I do receive a small payment. If you purchase using my link, the cost is the same either way. But this is an affiliate link. Okay. Now, let's return to the conversation. Now, at that point, were you already a member of any kind of professional society or organization? I mean, is it the ACDIS or there's other organizations? How does that fit into this whole scenario?

Dr. Christian Zouain: No, not yet. At that point, I remember I was still deciding. I was still studying for my boards and et cetera. I wasn't fully in. I haven't decided yet. I was still thinking about CDI as an approach to continue to work with the doctors and acquire experience and make connections.

But then it was that my director at that point, when she was a nurse, but she'd been doing CDI for 15 years. And I remember her telling me, "If you know CDI, if you learn to do CDI well, if you know the basics and acquire experience over time, this experience will take you a long way. You can do a lot of things. You can jump into different areas of healthcare, not necessarily clinical." I think that was the last step for me when I decided, you know what? I think I'm sticking with CDI instead of going into clinical.

So when I made that decision, I started reading more. I started getting more involved with the associations with ACDIS. After two years, I was able to, I got my ACDIS certification and also obtained the one from AHIMA, the CDIP. The one for ACDIS is the CCDS, which you're allowed to obtain two years after, with two years of experience working in the field. at that point, yeah. they have a lot of resources. So I really jumped in. I purchased. They have books, they have guides. that was a good turning point right there because even if when I took the class, I wasn't really sure until you get your hands on in the actual work, you start realizing what it's really about. when you combine that with the resources that are available out there, it makes it much easier. it makes much more sense.

John: let me just clarify for the listeners. the ACDIS is one big organization of people that are involved in CDI are with. Now AHIMA is A-H-I-M-A, right? Is the acronym?

Dr. Christian Zouain: That's correct.

John: Yes. That's more about health information.

Dr. Christian Zouain: Yes, that covers a lot more. That covers HIM, medical records, coding. ACDIS is focused on, exclusively on clinical documentation.

John: Allow me to clarify here a little bit. There are two major organizations that Christian discusses here. The first one is the ACDIS, Association of Clinical Documentation Specialists. You'll hear later in the interview about their apprentice program. But what they're really known for is the CCDS certification, that Certified Clinical Documentation Specialist. And you can find that at acdis.org. So that's the first one. And then the other organization is AHIMA. That's A-H-I-M-A, AHIMA, American Health Information Management Association. And it has at least eight different certification programs. Usually, I think the CDIP is the one most applicable to physicians, which stands for Clinical Documentation Integrity Professional. And that's a CDIP certification, can be found there at ahima.org, A-H-I-M-A.org.

Okay. Now, let's get back to the interview. And I think this is my last interruption. Now here's a question I have because you brought up ICD-10. Which is kind of, that's on the, pretty much the diagnosis codes basically, right?

Dr. Christian Zouain: Correct.

John: How important is that? I mean, that's important in inpatient and outpatient. We're talking mostly inpatient right now in terms of where you were, is that right?

Dr. Christian Zouain: Yes, yes. ICD-10 works, you have on the inpatient side, you have ICD-10, and for clinical codes and for procedures, you have ICD-10 PCS. In the outpatient, for clinical codes, you have ICD-10 and for procedural codes, you have CPT. that's something different right there. there's a lot of, yeah.

John: Now, in my recollection, sort of the coding, the documentation, the risk adjustment was more or less based on the MS-DRGs, but the ICD-10 feeds into the MS-DRGs. Is that how it works?

Dr. Christian Zouain: Yes. It's a bit of a complicated subject, but you have the right path right there. You have ICD-10, which then bundles up the list of diagnosis and then you obtain an MS-DRG, which is then what you use to then bill and what reflects the severity of the patient's condition while he was treated. Or outpatient.

John: there's many different directions we could go, but let's focus on your career at this point. what were you doing in that first job? If I remember, that was a hospital-based job and you're basically helping them better demonstrate the documentation and you can maybe tell us how that day looked like for you and what were the benefits for the hospital as well when you're discussing that? Maybe you can address that.

Dr. Christian Zouain: Sure. my first experience is CDI. we would basically come in CDI, you work Monday through Friday, it's office hours, but it also depends on the hospital and the hospital needs. You might be working with a specific department. It could be surgery. You might want to come in a little bit earlier because surgery is rounding at 7:00 a.m., 6:00 a.m., but our hours were around 8:00 to 4:00, 9:00 to 5:00.

So we would come in, we would have a list of records that we would need to review, particularly at, let's say, at the two-day, three-day mark after the patients were admitted. Not just right away because we wanted to give time to the physicians they could document, we could have enough documentation. It wasn't just like, okay, we just have an HMP, let's go with that. No, we wanted to give the admitting physician and the consultants to take a look at what was going on with the patient and then review.

So we would have a set number of cases that we would do in the morning, my colleagues and I. And in this particular hospital, it was still hybrid. it wasn't completely in... the medical records weren't completely in the electronic medical system. the progress notes were still in paper. we would have to go to the floors and it was a good opportunity as well because there we would see the doctors from time to time they were around or their residents or the physician assistants if we needed to ask them right away.

But we would, this is how the process goes, we review the cases. We would leave a query if we needed clarification on a case. We will leave a paper query inside written document, inside the record. they would see and remember it was a green fluorescent color. they wouldn't miss it. And once they opened that, they would look at the query and they would respond on the next progress note accordingly. And that we will leave there. We would come back the next day and follow up if the cases were not to see if the cases were answered or not. If they didn't, then we would escalate if it had been a couple of days. But particularly most of the time they would ask or we would see them around in the hospital. we would ask them just like I told you earlier, right there and there. And they were either document, agree or disagree. Then we would bring it back, close the cases. And once the case was already sent to billing in this particular hospital, we were involved with coding and we knew at the end what the final DRG was. we were able to make sure to see if we had impact or not on that particular case. we would start with what's called a working DRG, which is the initial DRG that reflected that patient when we first reviewed that case.

Once we obtained the further clarification, the diagnosis with more specificity, then we would change to DRG. we would have a system that would compare both and would tell us the difference that we had achieved on that particular case. I know that that's one of the metrics that we were able to capture with our program and see how good we were doing. We would also get feedback from the coding department. They would receive their denials.

So we would know if a particular case that we had impact had been taken back and it was denied because it didn't meet criteria. we knew what action to take further next time if we needed to change the criteria we were asking the doctors and what to do forth.

John: Yeah, and I want to jump in here and try and for you listeners that are maybe not used to hearing about CDI, I mean, if you work in a hospital, you're pretty much aware of it because you're going to be having these conversations. But the thing is, I mean, it can make such a big difference in both the payment that might because it's DRG based and if you're in a low DRG versus a high DRG, but the quality, that was my big thing when I was chief medical officer is that your risk adjustment's going to look lousy if your documentation's not good and someone who really has renal failure as opposed to, let's say, mild renal injury or something or you name it.

I mean, it becomes important to capture this information and to have basically these consultants like yourself, Christian, walking around helping the physicians. Now, they don't necessarily always want the help. Some do. I guess that's my question for you. Were they already used to having CDI people around and did your relationship with the physicians, was it pretty good there?

Dr. Christian Zouain: Yeah, this particular hospital, it was a big hospital. It was a 900-bed hospital and I know the program had been there for a couple of years already, but being that they were still in some part in paper, it would make it a bit, let's say, annoying for them because now a lot of programs, they use either email or you can send the queries through the actual medical record. in this case, you would have to leave everything, leave something in the medical record.

You don't know if they probably missed it or they didn't really want to answer the query. And in this particular hospital, it was interesting. Some of them were okay because coming also from a clinician's background, being a doctor myself, I know what they go through, what they're going through. So they have tons of other people calling them all the time. They have nurses, they have discharges that they have to do, they have case management, they have people from that administration calling them. with us, if we needed to contact them, we had to page them.

John: Right.

Dr. Christian Zouain: I knew that they were for me when I first started I said, oh my God, but a page that's for emergencies. And sometimes when I would call when I would page them with my number. I would pick up the phone I said I would say, "Good afternoon, CDI clinical documentation. This is Christian." Let's say, is this an emergency? This is not an emergency. I mean, you're paging me. So from that point, it was a bit difficult. Some of the doctors they would just run away. Sometimes we had to be a bit inappropriate because we would see them maybe in the cafeteria or just walking into the hospital. We tried to be as polite as we could they just let them know, "Doc, you have a query in one of your records would you mind taking a look when you have the chance or where can I find you later?"

That's what we don't have to do it right here and there in the cafeteria. Maybe they're taking a break. But yeah, those particular hospitals if it's a big facility and I would say with the inconvenience that this system is not fully automated it could be a bit of a hassle. Later when I was in my second job as CDI where I was the only one, everything was electronic and it was a smaller hospital, but I didn't have a problem there with going meeting with the physicians because it was mostly internal medicine doctors and they were all pretty good. So it depends a lot on the exposure that they have and if you're working with different specialties that could also be something to take in consideration because going from a multi-specialty hospital to internal medicine, basic medicine institution it's a big difference. You're able to handle it better.

John: Let me ask you, Christian. based on those first two experiences. I mean, how were you feeling? Were you pretty happy with the way things were going? Were you pleased that you had made that transition? I just want to understand how you were feeling and whether you feel like it also was a fit like with your personality and what advice you would give to others in that regard?

Dr. Christian Zouain: Yeah. It was tough. At that first one, it was tough because I wanted to let the doctors know that I wasn't there to really bother them again. The majority if we could handle it with the residents or with the PAs up front we would do it. But if it was, say, a surgery attending someone that's really, really busy, sometimes I would think twice on it. Maybe should I go? Should I do it?

I had my ups and downs on that particular job. But I knew that it was different because I've in other places because I would talk to other colleagues. I knew that it could change, that it was just the part that it was starting ICD-10 and in the whole process of documentation on the day until doctors would actually get readjusted. And until they would find update upgrade the system. it would make it easier for them. Because the way it was, it wasn't particularly really convenient for them right now, until later once I started my second job it was particularly way much easier. Now I had control electronically, the doctors could just come in and see my notification there and answer right away. They wouldn't have to be bothered with a call or a page unless they didn't really answer I did have to call them. Yeah, just to answer your question it was, initially I had my ups and downs. But I knew it was going to get better because it was just a particular case of where I was at the time.

John: Okay. Let me ask you this, because this can be a big impact on the way someone in your position is working and feeling. Did you feel like both institutions they had the support of leadership? I mean, here's what I experience is that sometimes the CEO or the COO doesn't want to have that conversation with the medical staff to say hey guys and gals, this is important, and we want to do a good job for you, we want to pair a nurse as well. We want to get paid and the only way we can do it is if you document and we support what we're doing here. We ask you to support it. I mean, did you feel like you had that kind of support at the institutions generally?

Dr. Christian Zouain: Yes, yes, but especially at my second job, because now I was, like I said, I was more involved with the hospital's administration. I was there at every meeting. The doctors already knew me. I remember when I first came in, they actually, they introduced me to the whole staff at one of their monthly meetings, to all of the attending docs. And I felt like I was really important. They really paid attention. And that's a good point you're making when you have the support of your CFO, your CEO when they back you up and they see that importance, they see that it's really necessary.

And especially when you're working in conjunction with the other disciplines again when I worked with case management and quality altogether. Sometimes the case management department would call me, the nurses would call me and will tell me, "I just saw that this particular GRG for this patient it's only giving us three days. Can you take a look at the case?" And sometimes I would say, "Oh." Especially turns out that this case, I had a query for one of the doctors until he answers if he answers, I mean, in the way that I'm expecting, it might change.

So I would tell them, "It might change, it might not. I just have to clarify. Well, I'm thinking of something but I just have to clarify the information with the attending." they would help me, once they had that conversation with the doctor in the floor, they would tell them, "Listen, Christian told me that you had some pending documentation that you need to further clarify. can you please go ahead go down to the floor where he's at and work on that to see if we can move this patient around, if we can keep him or what's going on." at that point, I had good interaction with everyone. we were all working together with a common goal.

John: Excellent. that's good. Yeah, I think that when you're working on a team and you have the support of administration, it's great. maybe that's even something to look at when someone's looking for that second or third job, maybe the first one. Now, I don't want to get bogged down here. you've been involved in a big institution with lots of staff. You've been involved where you're like the solo person, the solo at least the physician CDI person. then you made another change, right? you're doing something different now within CDI. why don't you explain that to us?

Dr. Christian Zouain: yeah, right now I'm working for a company. The company works for, I work remotely. Exclusively remote. I work from home. I know it's a big change. And I decided to make that change because I wanted to experience something different than just being in the hospital. I know there's a lot of these companies out there that they help in some sort of way. They either take over a whole CDI department for a hospital just like they did in the first hospital I used to work, or they help at the back end with physician education, denials management, and CDI. I was looking for that because I saw a trend and that's why I wanted to experience that. And also, I wanted to get to work in an environment with a lot of professionals from different backgrounds. CDI is a field that you're constantly learning new things and you don't know everything. That's why you have to stay updated, continue to read, go to conferences.

I like to be in an environment when I have all these professionals interacting with one another where you can get help in a particular thing to see what can you do in this particular situation? Do you have experience on this? that's also what caught my attention. that's what I'm doing right now.

John: now with that, how does that compare in your mind? Do you feel like this remote CDI activities, do you think that's going to be something that grows? Is it difficult to do when you don't actually have let's say a face-to-face relationship with somebody? What's your opinion on that?

Dr. Christian Zouain: Well, in this particular situation, I feel like the doctors have already, physicians in the hospitals that we work for, they've had some previous experience with CDI in the past couple of years. Every time if I'd contact them through email most of the time. But if they do have any questions or anything, they can just contact me. They can call me. But I haven't seen the need in this particular case to have that face-to-face because I think as time has gone by, they're used to the whole process. they know what CDI is looking for. I rarely get here and there a doctor that's asking me, "Do I have to do this same thing for every case that I have?" And I say, "No." Obviously. But that's one in 100. I mean, I think they're getting used to it and the whole process. I mean, it's still the process that we follow still has their CDI on site, which they can go to. But I mean, they can basically reach out to us via phone or email.

John: Okay. Now, would you say that if you were giving advice to someone who's thinking of moving out of clinical into CDI would it be, is there a better way to go would they try to find one of these companies that are completely remote? Or would it be better to start on the ground with colleagues that you can consult with? What do you think about that?

Dr. Christian Zouain: Yeah. I think it would be better to start in the actual hospital and get familiarized with the whole CDI process as much as you can. See, if you're a practicing physician at the hospital you can visit their CDI department, get to meet everyone and express your interest in CDI. If you can shadow them or they can sit down with you while they review your cases it's even better because these discussions between the CDS and the physician, the treating physician are a great learning experience for both of them and it will save a lot of time in the front and in the future just they don't have to query that much that the doctor knows up front what they need on a particular case.

John: Okay. That makes sense. That's what I assume but no, much is being done remote nowadays. Most people, let's say physicians even practicing telehealth or telemedicine, of course, started with you know live face-to-face patients, but I wonder if there'll come a time when they'll skip that step. But I did want to circle back to something and you went through your process and the fact that when you finished med school and then moved here to the States, but I do want to get your opinion on this because you were able to make this transition.

You did not end up doing a residency and becoming board certified and all that, which is fantastic because I have a lot of listeners who are for whatever reason finished med school whether it's in the US or elsewhere. Didn't do a residency and they're really saying okay, what are my options and there's several things out there. This is the first time that I've talked to anybody that's done that in the CDI realm.

So I just want you to comment on that and maybe what would be the difference if any between someone who maybe did have some clinical experience residency training and they were working for a while versus someone in a similar situation to you. How would the approach be different if it would be in your opinion?

Dr. Christian Zouain: I think that just like I mentioned, if you're already working at a hospital if you have the clinical experience could be easier because you've been already been exposed to CDI. You've had to work with them. The difference would be I would say if you're non-clinical if you're working somewhere else, and if you're interested in CDI you could enroll in a basic coding course of ICD-10. Again, get familiarized with the concepts and the guidelines, get involved with ACDIS. They actually right now they have an apprenticeship program that teaches the principles of CDI.

Which is also a good start if you don't have the experience and it will be valuable to employers later on. ACDIS has local chapters in every state you can look them up on their website. They have meetings every month, some of them maybe more frequent. And just like we said earlier networking is very important they can, both parties, I would say, the ones that have clinical experience and the ones that don't, they can become part of the meetings and go and attend, join ACDIS and the coding classes.

John: Now, you mentioned an apprenticeship. How does one find those or who are those through?

Dr. Christian Zouain: That's in the ACDIS website. I think you can just Google ACDIS apprenticeship program.

John: Okay. I'll definitely put links in the show notes. I'll track down all the URLs for these and listeners can do that, but yeah, another tool, another tactic I guess to really get experience.

Dr. Christian Zouain: Right. Definitely. Yeah, that will help a lot.

John: Any other bits of advice for someone thinking to go into this career that we haven't touched on already?

Dr. Christian Zouain: I would say, don't be discouraged if, this happened to me, if at the beginning you just don't understand right away how all of this works, how the coding side of healthcare works just like we were talking earlier about DRGs and ICD-10 and ESMs and all that. I know for a lot of us, we were not trained in this particular field in school and yet when we start working on it, we feel like we should be able to figure it out right away. But it really takes time to adjust your thought process into the CDI and the coding mindset.

I remember when I started I used to work with a group of nurses that were also CDS's and one of them told me once you have to lower your clinical brain a little bit. You turn down your clinical brain a little bit because as physicians we're taught to look at a case and diagnose, make a diagnosis, make a decision for management. Here we are looking for the wording and how it relates to codes it's different. We might see exactly what the treating physician is trying to portray but we have to be mindful of the coding guidelines and how it's supposed to be written. So that's different and it can take a while to make that transition. for those interested, if you start, and you start feeling like you quite don't get it, believe me, with enough practice and time and studying you'll get there.

John: Well, you're serving almost like a translator in two different languages in a way because the coding language is not meant to be or didn't, I mean it just it's like a legalese in a sense as opposed to what we learn as clinicians, this is what we mean when we say heart failure. But it may not be exactly the same when you're talking in coding language. yeah, you're translating being [inaudible 00:47:40].

Dr. Christian Zouain: Definitely.

John: Well, I think we're getting near the end here. what would be a way to maybe we could reach out to you if somebody just wanted to touch base and maybe follow what you're doing should they go to your LinkedIn page or what do you think?

Dr. Christian Zouain: Sure. Sure. Yeah. LinkedIn, you can send me a message. I have my email there and also my phone number which surprisingly I don't think people realize that because they usually send me messages. But yeah, I mean, if anyone has any further questions...

John: Yeah, I think that's great.

Dr. Christian Zouain: I'm glad to help.

John: And just to have that LinkedIn, it gives them, it's like a little bit of a barrier there. You got to make a little effort you don't get swamped with questions, but I'm not going to put your phone number out on the show notes but it's pretty easy to get through on LinkedIn. And sometimes if there's an issue, sometimes if you're like a third degree connection, you can't always, it won't let you necessarily ask to connect people can go to my LinkedIn page because some of my listeners probably already linked to me and then I could password along or whatever.

Dr. Christian Zouain: Yeah, sure. Definitely.

John: That would work. All right. Well, Christian, anything else you can think of we need to talk about before I let you go?

Dr. Christian Zouain: No, that's it. I think we have covered a lot today. Thanks for having me. Yeah.

John: No, I really appreciate it. And I think those that have even the slightest thought of going into CDI, here's a comment I was going to make earlier, but I guess I'll throw it into my little cynicism is that we have these cottage industries, which are now big industries that have all grown up because CMS has put processes and barriers in the way in a sense whether it's our views for capturing what we do in the clinic or UM there's just tons of rules and now CDI and for what it's worth I think we need physicians like you, Christian, in there serving as experts to translate all those crazy rules for us physicians. So, thanks.

Dr. Christian Zouain: Yeah. Yeah, definitely. There's a huge opportunity for right now just like you're saying, with all these companies developing and they're in great need of good clinicians to work for them and eventually take those things forward.

John: It didn't sound like there's a lot of call involved. that's a good thing.

Dr. Christian Zouain: I'm sorry?

John: It didn't sound like there's a lot of on-call duties involved as many of our non-clinical careers.

Dr. Christian Zouain: Yeah.

John: If you take a slight hit on the income, boy, you're going to make it up in terms of time with your family and free time and giving up the pagers. that's another positive to keep in mind.

Dr. Christian Zouain: Yeah, definitely. Definitely. Absolutely.

John: All right. Well, thanks again for joining us today, and hopefully, I'll get a chance to catch up with you again in the future, Christian.

Dr. Christian Zouain: Okay. Thank you, Dr. Jurica. It's my pleasure.

John: Okay. You're welcome. Bye-bye.

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The post Become a CDI Expert – A PNC Classic from 2019 appeared first on NonClinical Physicians.