career Archives - NonClinical Physicians

Exploit Your Medical Knowledge In New Ways

John Jurica — Tue, 18 Feb 2025 13:26:49 +0000

Interview with Dr. Robert Cooper – Part 2 – 392

On this week's episode, John posts Part 2 of his interview with Dr. Robert Cooper who explains how to exploit your medical knowledge in new and profitable ways.

Picking up from Episode 391, Dr. Cooper dives deeper into nonclinical consulting opportunities, including disability file reviews, expert witness work, and medical necessity reviews. He shares key insights on how physicians from all backgrounds, including primary care, can enter these fields, optimize earnings, and avoid common pitfalls.

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John hosts a short weekly Q&A session on topics related to physicians' 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 monthly.
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.

Navigating Disability File Reviews

Dr. Cooper provides an insider's view of disability file review work, emphasizing the importance of choosing ethical companies and maintaining professional standards. He discusses how to identify legitimate opportunities, appropriate compensation rates, and ways to avoid common pitfalls in this field.

Most importantly, he stresses that specialists and primary care physicians can succeed in this area, making it an accessible option for many doctors.

Exploit Your Medical Knowledge with Multiple Revenue Streams

From expert witness consulting to continuing medical education teaching, Dr. Cooper demonstrates how physicians can create diverse income streams while maintaining professional integrity.

He emphasizes the importance of delivering quality work, understanding market rates, and being selective about opportunities. His experience shows how combining various consulting roles can provide financial rewards and professional satisfaction.

Summary

Physicians interested in exploring consulting opportunities can learn more through Dr. Cooper's Website or by connecting with him on LinkedIn. His approach to combining clinical practice with strategic consulting work demonstrates how to maintain independence and avoid burnout while maximizing earning potential through ethical and professional side gigs.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 392

Exploit Your Medical Knowledge In New Ways

- Interview with Dr. Robert Cooper - Part 2

John: Well, let's go back to another one then. I think that's one that you've been doing for the most amount of time and have spent the most cumulative hours on, and that's the disability file reviews. So how did you find that? Did someone point you to it? Were you just searching around the internet? I mean, how did you find that? What should we do if we're interested in it? Because I have looked into this a little bit myself. And I'll just say, as a family physician, they're usually looking for a specialist. I mean, there's a lot for neuro and physiatrists and that, but I know they're out there for primary care at times when they just need the general. So any tips on that? What's it like? How long does it take? We'll kind of do that first, and then we'll move on to the next one.

Dr. Robert Cooper: Sure. The first gig, I think, was through the New England Journal of Medicine. Like I said, I answered that in the New England Journal of Medicine. Small company, I went out and learned how to do it, and they trained you to some degree—not terrific. And I started doing it. I like it because it's almost like taking raw materials, right? Looking through a file like a detective and trying to figure out what's going on. What you're trying to do is determine the level of impairment of a claimant—we call them claimants. There's terminology involved, but you have to know what you're doing when you're going through this. It's a method for actually sorting out the file, figuring out where it is, where the pieces are, how to put it together, and the different components.

I have not found really good training in this, honestly speaking. I took a course in it, but it didn't help me—I had done it before. So I think really providing nuts and bolts is important. I worked for three companies, but there is another way to find it. I'm not gonna mention the specific companies, but I will say that NAIRO—N-A-I-R-O, the National Association of Independent Review Organizations—has companies on there. Now, here's the important thing. Here's the important point for viewers: don't be undersold, okay? A lot of these companies are paying rates that are ridiculous.

What's happened in the disability world, unfortunately, is that they're moving a lot of stuff in-house to do full-time physicians come on board, and they're taking it away from some of that. I found that that's happened over the last five years. I told you before, I worked 10 hours a week for a major insurance company as an independent contractor. So I was doing that in addition to the other vendor companies. It was just a lot of work—10 hours a weekend. But I learned a lot from doing it. Then they stopped that and moved it in-house. So you have to be careful.

There are companies out there who ghostwrite reports. I'll just tell you that what they do basically is—they write the whole report up, and you just sign it. And they pay you very little money to do it. They're trying to save money. That is something you want to avoid. Okay, I won't mention any specific companies except to say that you don't want to do that. You want to really be legitimate about this. This is important. If you're doing this kind of work, it's important to be fair and impartial and to look at the work and come up with a conclusion that's reasonable. And that's what they want, actually—insurance companies want. Unfortunately, they're constrained like everybody else financially, so they're looking to cut corners. Unfortunately, that doesn't work too well when it happens.

So you have to be careful what you're getting yourself into. It's very important to pick and choose who you're working for carefully—not just in terms of what they're paying but also if they're ethical and so forth.

John: So does it seem like that's one of the things that's sort of changed since you've been doing this, right? I mean, heck, you started probably doing this before the pandemic, and then the pandemic hit, and everything's going online. Any other observations about what we should look for or not look for when looking for disability evaluation file reviews?

Dr. Robert Cooper: I mean, a reasonable rate is reasonable. I mean, I don't want to go into exactly what I mean. The ranges generally are, just to give you a range, I mean, $150 to $200 an hour is reasonable or over that. Some companies—I mean, I've not settled for $50 an hour or $25—I mean, it's ridiculous. Some companies that are actually coming into play, I would just walk away from them. Again, walk away. Instead of walking away, they get in trouble with that.

I will make a comment about something you said, John. There are a lot of family physicians doing this—general physicians. It's not actually—it’s just as much general physicians as there are actually specialists doing this because you need to have a holistic point of view of some of these patients. They look for this, and they want somebody to go through everything, all the problems, and come up with a conclusion. So, it's very much driven by primary care, family medicine, and internal medicine. In fact, the whole segment of that, in the company I worked in, was for that. So, you could do that.

You could also use this, by the way, any of these things, as a segue. I mean, mine is the expert network consultant, but a segue to get into full-time work. If it is what you choose to do and say, "Listen, I just don't wanna do clinical medicine anymore. I have to determine this is not for me." I mean, unfortunately, that's what happens sometimes. It's nothing—somebody's choice.

You could use this because many of these companies will ask you, "Have you had any work before? Have you done this before? Have you done disability file review? Have you done medical assessment review before?" Yes, I have. I've done, you know, X, Y, and Z, and this is what I've done. "Okay, great." And they'll interview you. This is why people have a problem getting in at the ground floor if they want to convert to full-time. If that's what they choose to do, it's because they don't have the experience. This is a way to get experience.

John: One of the things in my little research I've done on this topic is looking at Social Security disability file reviews. And that one seems to be a unique animal. Have you ever done those for Social Security? I think they have different companies specifically that only do SSDI-type reviews.

Dr. Robert Cooper: I have a friend that does that for endocrinology. But the problem is they don’t pay well. Private insurances, the vendors, the ones that deal with private insurance, pay much more. So it's not uncommon to get about a third or a half. She actually looks at me and says, "Oh my God, you're getting that kind of thing for doing it for the vendors? That's ridiculous, I'm getting nothing." And so I don’t, and I get those rates back, and they come back to me. And then, you know, people come to me and they'll approach me all the time. Today I had three of them approach me. "Would you like to do some work for us?" And I just look at it and say, "It's not worth it for me to do what I make." It’s not gonna do it. And I think once you get to the point where you're comfortable doing this, you’re gonna realize that and say, "You know, I’ve just not." It’s better to walk away.

John: Well, that’s good to know. I’ll just stop even trying because it’s been difficult to get any information on the SSDI ones, but they don’t pay well. What’s the point? Are there other types of chart reviews? This one, I get this question all the time. I know, for example, that state medical societies, you know, they have quality reviews. Those are pretty few and far between. But any other types of, you know, more or less paperwork, file review, based on your clinical knowledge that you've done or that you know of?

Dr. Robert Cooper: The medical necessity ones are good ones actually too, because they could be quick sometimes. Unfortunately, they don’t pay as much as the disability ones. But some of the private vendors will pay fairly well for a medical necessity review. The big thing about— I didn’t talk about this—but the peer-to-peer phone calls, those can be challenging. So you have to have a thick neck about you, particularly when you're doing a peer-to-peer for a medical necessity review. But I worked full-time for the insurance company. Every day was filled with these peer-to-peers. And eventually, after about two or three months, I said, "Uh-uh, no more." I went back to clinical medicine because I just didn’t want to. I was just... But doing it on a part-time basis, you know, and calling up, you can conduct these, and it's an act of doing this. You have to have a knack for doing this and calling up, but it’s a challenge sometimes. Because physicians are generally, you know, not going to be amenable. You know, they’re frustrated and upset. You’re calling them up and telling them that you're going to deny something or you don’t have the adequate information, and they're gonna come back at you. But there’s a way to handle yourself in both these things. And that includes disability file reviews too, because there’s peer-to-peer for that as well when you're calling up the attorney position. So you get that a lot too. So you have to be willing to do that. Some people are, some people aren’t. And just handle that. I mean, everything has its pros and cons. Every one of these things, okay? So you have to kind of take the good with the bad when you're doing it.

John: Well, yeah, I guess, you know, each person has to sort of assess what they’re good at, what they’re interested in. You know, I’m a meticulous person. Maybe that helps in certain situations. Maybe it doesn’t help in others. I was going to also ask your opinion, switching gears here, on some follow-up on—you've been, in the past, an expert witness, which, you know, as you mentioned earlier, in the field of endocrinology. But what advice would you have for physicians who maybe are still working, you know, part-time, thinking about entering that field?

Dr. Robert Cooper: It’s a good field. It’s very lucrative. I mean, it’s not uncommon for somebody to charge upwards of up to a thousand dollars an hour in some cases for some specialties. I mean, it sounds great, but it has its problems too. I mean, you have to have a thick neck. I mean, just sitting in the seat I'm in right now—I told you last week, I had a deposition. I was deposed actually on a case. I have another case that’s going on that I’m getting subpoenaed in. I might have to travel to a different state—it’s a criminal case that spun out of a civil case. I mean, I’ve never had that happen before in the years I’ve been doing it, but I mean, these things happen, and they can be disruptive to practice. They can be disruptive to doing it. You have to have a contract in place. I mean, all these things are important. They're not something that you just kind of throw yourself into. And you have to be able to carry yourself well to be able to do that.

I mean, writing an expert report is very important. I mean, SEEK has some courses on this, how to do it. There's a great book on that too, but I think also being coached—like, how do I write a report? How do I put one together that's going to make sense, that's going to flow? Because the better your report is, the less chance you're going to be deposed or put to court because it's going to settle most of these cases. So you have to learn that. It's the kind of thing that you learn as you go along.

So again, you need to enact this—kind of figuring out what is the best way to put a good report together, different stages, learning a little bit about law and how it works, and the evolution of a case. How do you get deposed? When you get deposed, how do you handle yourself during a deposition? How do you handle yourself during a trial? These are all things to consider because if you screw up a couple of times, you're not going to get asked again to do any cases.

So it's all about putting your hands into one thing. You know, I always step back and say, "You know what, I want to do a good job. I really do, as an expert witness." But if, for some reason, something out of my control happens—and it does sometimes—that I get looked upon or frowned upon negatively for whatever reason, I have something else to fall back on. I can do other work. I don't have to throw myself into one particular thing. That's how I always look at it. I still want to do a good job.

John: Let me ask you this, because this comes up, I think, in others I’ve spoken with who are looking to get more and more into expert witness consulting. I guess, marketing themselves—how do they find clients or attorneys? Do they just come to you when you've done this just because of your local notoriety? Or do you have a process for trying to get visibility for some of these attorneys who are looking for help?

Dr. Robert Cooper: First off, you have to be careful with that. If you start listing yourself all over the place, that's going to come up during deposition. It came up last week. "How many directories are you in, Dr. Cooper? How many times do you do this? What are you doing?" Because they're looking for people that are hired guns and trying to nail them on that. So actually, I don’t list myself in anything except SEEK. SEEK is the only directory I list. I’ll make a little plug because they’re a good company.

I just had somebody call me right before I got on the phone with you, saying, "You know, the spam call—it wasn't a spam call—it was somebody trying to get me into a directory." I just quickly got them out of there. "How much money is it going to cost me? What is it going to do?" I really don't have a need to list myself in 16 different directories. I've never really found it to be helpful.

I think the best thing is word of mouth. When you do a good job, the next thing that happens is the next attorney tells somebody else about it. Then they call you and say, "You know, you worked with my friend on a case, and I want to work with you too as well. I've heard that you are pretty good. You're responsive, you get back to me, and you're available."

I think calling people—like if an expert, if an attorney calls you—you need to get on the phone with that attorney the same day, within an hour or two. Get on the phone and respond to that attorney, saying, "What's the deal?" And also, you're interviewing them too. You don’t want to get involved with any type of attorney who’s not doing anything ethical. Everything has got to be ethical. It’s got to be impartial. You don’t want to come across as somebody who’s biased during a case.

These are all things you learn as you do it. There’s a way to conduct yourself. It’s very, very important. You don’t just jump into these things—you have to know what to do to provide a good product.

John: I think that particular one—the expert witness—it’s a good combination because you're acting as a physician, as an expert, as a professional, but at the same time, it’s a business if you decide to continue doing it on a regular basis. So you have to know about those resources, like the SEEK list of available consultants.

And again, there are places where you can learn—SEEK included—that, you know, maybe give you a little advice on how to prepare for these things. And if you're doing your first deposition, that kind of thing. So that's always been interesting to me.

Dr. Robert Cooper: Yeah, oh, sure. It's a very interesting thing. I mean, I've done probably over 100 cases in expert witness work over the last 10 years. And I would say that I've had everything from somebody having a terrorist attack and blowing up the pituitary gland in our country and having me testify in that to, you know, hypoglycemic episodes in jail and things like that. I've had cases like that. I mean, it's so fascinating. It really is. You find yourself like a detective. Many times, I've come back to an attorney and said, "You know what, you don't have a case here." They don't want to hear that, but you don't have a case. You have to be honest, very honest with your attorneys that are coming to you. Very ethical and very honest. This is very important, any of the work you do.

John: Well, they might not like to hear that, but better that than they waste tens of thousands of dollars and find out at the end that they don't have a worthwhile case at that point.

Dr. Robert Cooper: That's right.

John: All right, well, have there been any of these other side gigs, consulting types of things, and reviews that we haven't learned yet from you, any others, examples, or have we kind of covered the majority today?

Dr. Robert Cooper: Well, there is another thing I do—I love actually too. I teach actually, I teach at a, there's a company called MCE—I'll just be specific I guess about that. Cause I teach that once a year or twice a year, they have me fly out somewhere and teach primary care and I love it actually. I really enjoy it. We have about 150 people there sometimes and it's on it, usually it's on endocrinology review for primary care. And I've enjoyed that. I've had two stints in Disney world already.

John: Oh yeah?

Dr. Robert Cooper: Where I've gone out there and done that. And I love having people respond back and ask questions.

John: So that's just like a continuing education for physicians?

Dr. Robert Cooper: Yeah, that's right. That's right.

John: Okay.

Dr. Robert Cooper: Another part of this that we didn't talk about actually, too. Maybe we should at some point. Maybe we've done now. Locums. Locums are a way to freedom, actually, too. And I think I've done that. I've done a lot of locums work in the past. I don't now. I'm permanent. But it's some of the best freedom you can get. And if you're like in this position right now where you're kind of considering, like, I think I would just say to your viewers, if you're in a position where you say, "Oh my God, I can't go back to work," and you have that feeling in your stomach on Sunday night, like I've had a couple of times, think back for a second and say to yourself, "Hey, why do I feel that way?" That's the first thing—introspection. Why do I feel that way? Is it something that I could change in the environment I'm in first that could actually make things better? Or, if it's not, is it a different environment clinically that I could be in? Or do I need to figure out a way to integrate this other stuff maybe into place that I could do it so I could cut back on that? Because I don't think it's all or nothing.

I see people at SEEK when I taught this year. They come up to me at lunch and say to me, they sit down—we have like a group of, like, I have 50 people sitting next to me—and they say, "How do you kind of get away from this?" One physician came to me and said to me, "When I was pregnant, I was sitting on my bed. They were giving me an epidural, and the administrators were coming over to me, saying, 'Look at the computer at the CMR, at the letter on medical records, and go back to the records.'" And I said, "I can't believe that." She said to me, "How do you function in that environment? This is what I'm going through," she said. "I have to find some relief," she said, "because I don't have a break ever." I find that so difficult to deal with. I mean, you have to be able to practice. Medicine is a great field to be in. It's a great thing to be a physician, regardless of what specialty you're in. But I think you have to do it on your own terms. You can't have that plugging and deal dread and stuff. So that's the important point, actually, too.

John: Yeah, absolutely. And... You shouldn't put up with being burnt out and frustrated and unfulfilled for too long. You can do it for a little while, but you don't need to put up with that. Because really, as you said earlier, physicians, they have a lot of information, a lot of knowledge, skills, and it's all very valuable if you can leverage it to your advantage.

Dr. Robert Cooper: I think the thing about locums, I was going to say before, just to get back to that for a second, we used to think of locums as being outsiders. But the truth of the matter is that locums are actually becoming sort of the norm, almost.

John: Right.

Dr. Robert Cooper: That's not a great... I mean, it's getting competitive, actually, to get a locum position or something like that. Because there's a shortage of positions, people are looking. But there are some great companies out there that do locums kinds of activity, a call, and they can really provide you with some great experiences to do it, too. I mean, it may not be for everybody, but it's a way to sort of break away.

John: Yeah, I think if you're feeling desperate, you might as well consider everything and narrow it down, maybe, to what fits best. But locums and part-time work and consulting and telemedicine, you know, is another option.

Dr. Robert Cooper: Yeah, right.

John: So, let's see. So, you told me that you like to help other physicians learn this stuff. You're teaching at SEEK and other places. So, let's see if someone would want to get a hold of you, learn more about what you've been doing, and get some help. I think you are on LinkedIn, is that correct?

Dr. Robert Cooper: That's right. I have a website. You have it there. RJCmedicalconsulting.com.

John: Okay. RJCmedicalconsulting.com. Okay, go ahead.

Dr. Robert Cooper: Correct, correct. I'm looking at some point maybe in... I actually developed a course already for leveraging medical. I haven't done it yet. I'm looking to see if there's any traction, if people want to take it. And when I get a critical volume of people together, I might do that, actually, too—online or in person at some point. And I, you know, all these topics, I think, as I mentioned before, preparation and learning how to do it is very important. So, you know, you could direct them there to that website, and certainly, they can.

John: Yep, I will put those links in the show notes, along with a transcript of our whole conversation. And yeah, maybe they should reach out and at least maybe follow you or connect with you on LinkedIn and then look at the website for more information.

Dr. Robert Cooper: The other thing I haven't done, but if anybody is interested, if they want me to come out and give a lecture at one of the meetings, either a keynote or something else on this particular topic, I'm happy to come out there too. So I'll just ask you that.

John: Yeah, absolutely. In fact, I'll mention this. I haven't talked about this in the podcast much, but when you talk about these opportunities and sort of the non-clinical side of things, most of the time, it still qualifies as CME. So, some of these organizations can actually give you CME credit for it because it's something that supplements your practice. And, as I think you have said in the past, you know, like when you're doing expert witness work, you actually become a better physician. To prepare for that, you have to. So, that's all good stuff for CME.

Dr. Robert Cooper: Absolutely right, absolutely right. And even expert network consulting stuff—you learn things. And things that you wouldn’t know are coming—ARE coming and are the wave of the future. And it really keeps you up to date on what’s happening. It makes it diversified. So it gives a different meaning to going in every day and seeing patients.

John: Exactly.

Dr. Robert Cooper: When you're doing it.

John: Exactly. All right, well, I think we're pretty much at our time now. So I want to say thank you very much for joining me today, Robert. This has been great. And I think the listeners will really appreciate all the wisdom you've shared with us today.

Dr. Robert Cooper: Thank you for having me on. I hope that reaches people and hopefully, we can help them.

John: I'm sure it will. All right. Bye now.

Dr. Robert Cooper: Thanks, John.

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How To Be A Stunning Success Doing Part Time Consulting

John Jurica — Tue, 11 Feb 2025 11:51:46 +0000

Interview with Dr. Robert Cooper – Part 1 – 391

On this week's episode of the PNC podcast, John interviews Dr. Robert Cooper, an expert at part time consulting. Robert is an endocrinologist who has mastered the art of combining clinical practice with lucrative side gigs.

He shares how he doubled his clinical salary by dedicating just one day a week to nonclinical work while maintaining his medical practice. His experience demonstrates how physicians can maintain independence through strategic part-time consulting 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.

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.

Building a Diversified Medical Career with Part Time Consulting

Creating a balanced portfolio of clinical and nonclinical work requires strategic planning and a willingness to explore various opportunities. Robert advises against putting “all your eggs in one basket” and encourages physicians to maintain independence through multiple revenue streams.

This approach includes carefully selecting opportunities that value physician expertise appropriately and being willing to walk away from undervalued propositions. This strategy provides financial benefits that help prevent burnout and maintain professional satisfaction.

Maximizing Value in Consulting Opportunities

Expert network consulting offers physicians unique opportunities to leverage their clinical knowledge for substantial compensation, often matching expert witness fees. The key to success lies in providing quality insights while maintaining professional boundaries and understanding market value.

Robert emphasizes the importance of proper preparation, effective communication skills, and setting appropriate fee structures that reflect a physician's expertise. Working with multiple platforms and maintaining strong professional boundaries helps create a sustainable consulting practice.

Summary

For physicians interested in exploring consulting opportunities while maintaining clinical practice, Dr. Cooper's experience provides a practical roadmap through his work with expert networks, disability reviews, and medical necessity reviews. By delivering quality and demanding appropriate compensation, physicians can create rewarding side gigs that complement their clinical practice.

Dr. Cooper actively shares his expertise by teaching at SEAK and he welcomes connections through LinkedIn for those interested in learning more about these opportunities.

Links for today's episode:

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

Email Download New Tab

Transcription PNC Podcast Episode 391

How To Be A Stunning Success Doing Part-Time Consulting

- Interview with Dr. Robert Cooper - Part 1

John: Today's guest is a specialist as a practicing physician, but I bring that up because in the world of physician non-clinical careers, I consider him sort of a generalist because he's done different side gigs and actually some things that are clinical and unconventional clinical. And so he's worked so many numerous side jobs that they're very interesting. And I thought, well, this is going to be really good because doing this kind of helps you avoid burnout. It's interesting, keeps things interesting. You make a little extra income and there's lots of opportunities for physicians. With that, welcome to the podcast, Dr. Robert Cooper.

Dr. Robert Cooper: Thank you very much for having me. It's a pleasure being here, both an honor and a pleasure. I can tell you, I listen to your podcast all the time and it's my favorite thing to do on the treadmill when I'm listening. I've got some great segments there that I've listened to and learned from too as well. So I'm happy to be here contributing. Thank you so much for having me.

John: I love that. I love that. But I think you have a ton to share and maybe some of the things I don't know if you found all these things yourself, or maybe there was something mentioned by one of my guests. It doesn't really matter. This is all going to be helpful. And I'm really happy to have you here to tell us about some of these things. So let's start by just introduce yourself in terms of who you are, what you do, mainly your clinical background, maybe, and clinical work that you've done through your career.

Dr. Robert Cooper: I'm a regular doc. I'm an endocrinologist. I started my training in New York. I trained at Albert Einstein in the Bronx, went on to do a residency at Long Island Jewish, then went on to do a fellowship at Long Island. And I have an entrepreneur spirit about me. So when I finished my training, I was the first endocrinologist out in the Hamptons.

And I enjoyed that, but having your own practice is very difficult these days, even then. When I first started medical school, I had no idea of managed care. I came in because I wanted to be, I actually wanted to be a family doc and I wanted to have people come to my house and set up a shingle.

I went to a very expensive medical school as I said, and I am still paying back my loans, but anyway, but I enjoyed, I enjoyed medicine to this day. I know my son is a medical student. He's a fourth year medical student now, finishing up his rotations and actually going for the match. And he's asked me many times would you go into medicine again? I said, absolutely. I think this is a great time to be in medicine. I actually despite what people say and the naysayers, I love what I do. I love practicing. I love seeing patients, but I like doing it on my terms.

That's the key thing here, John. When I was out in practice, I then got recruited to Western Massachusetts to a place over in Western Massachusetts to run the fellowship there. And I did it the traditional way. And I was in academic medicine and so forth. And there was issues and things like that. And I've been in different places in Western Massachusetts. About 10 or 15 years ago, I looked at, well, I'm not going to go any further. I want you to ask some questions.

John: No, tell me what happened then. Something changed at that point. Practice was okay. It was good. It was fun, but what happened?

Dr. Robert Cooper: It's always been good. But I think I answered an ad actually to do disability file reviews in the New England Journal of Medicine for a company, a small company at that point, so small that my son actually went out to Maine actually. And we went to dinner with the CEO of the company actually. And he still remembers that this day he's 24 years old now. And I started doing disability file reviews at that point. I learned how to do it. You have to learn how to do this stuff. It's very important to learn and to produce a good product. You can't just get thrown in there.

I think there's something I had to learn on my own over years. And that was my first real stint towards nonclinical medicine. And then I learned other companies and I learned how to do it well. And at points in time, I've taken other nonclinical responsibilities as well. That was my first break in to nonclinical. But what I like about it is that I could do things, as you said, in combination. The key to this whole thing, I think, and this is a little words of wisdom if you're going for practicing 30 years, is not to put your hand into one thing. I always say, I taught at SEAK as you mentioned before at SEAK. And when I put my hand, you put your hand into one thing, I tell the audience, it gets chopped off your hand.

And that's true of clinical medicine. That's true of being all in full time sometimes. That's true of being an all in employed as an insurance person. That's true as being all in you do it in little bits of pieces of each thing, actually, too. It makes the best thing because nobody has complete control of you. You have control of yourself. It's on your own terms. We as physicians are very independent people. That's why we went into medicine to begin with. And then now what happens is that all of a sudden we're being controlled. And we don't like that. I don't blame anybody for doing that.

And the problem is as you pointed out, I said before about burnout. And I hate to see physicians burn out. We have a shortage of physicians right now, a shortage of primary care, a shortage of specialists. I would like to see people remain in medicine, quite frankly, but to a certain degree. it's not for everybody.

But I think at some point also in time, if somebody could combine the nonclinical and leverage that as well and stay in clinical medicine, we'd be all better off as well as the person, maybe if they wanted to be and the population at large.

John: Absolutely. That's actually one of the reasons why I wanted you to come on, because I've seen this before where still being in clinical, but maybe cutting back a little bit, doing other things to give you that feeling of autonomy, give you that sense that, okay, you're not if this company goes out of business, if this hospital closes, I'm not going to have a job. And it also helps prevent burnout because it's just the variety and the interest. And I think there's a lot of advantages to it. I'm interested in hearing more. Why don't you run down a list, maybe without going into any depth, just in some of the things you've done over the years, even some of those things, maybe that you're not doing any longer.

Dr. Robert Cooper: Yeah. I'll outline the four things I think I do the most of, and some of it fades in and out. It depends. The thing I do, I mentioned before, disability-followed consulting. I've done that both with the vendors, part-time basis. I've also worked as an independent contracting physician for a major insurance company, 10 hours a week. And that required a little stress. You have to understand something else. I just want to step back for a stressful situations because it can be just as stressful as clinical medicine.

You want to step back and look at this and how much you could take on and so forth. And so I did that, that medical necessity reviews is also part of file review. And that's also something that I've enjoyed doing through vendors. I also worked full-time for a short period of time for an insurance company doing that as well. I didn't care for it too much. I can tell you, it's my own personal thing, but I just say, it's not peaches and cream that people would say, come on sometimes.

That's another end of it, the whole thing. I've done all, the thing I really like doing, and I've done more recently is expert network consulting. That is a wonderful way to do it. People don't know about this. I've gotten into in terms of providing expertise to nonclinical people, Wall Street people, in a way that provides just public information to platforms, but not getting specific about the platforms, but I it is something that is very lucrative. It pays almost as much or as much as expert witness consulting, which I've done also, another one of my things.

I find it to be very fascinating and I love teaching. To me, teaching is teaching fellows and residents in the past. Here, I'm actually teaching people that are brokers or people that are actually doing, or they're sometimes scientific people trying to develop a drug and diabetes or something. I'm an endocrinologist, so I'm doing that. And you could teach people how to, but basically any specialty can do this really, as long as you're doing a little bit of practice most of the time, I think, and you could combine this.

And I can tell you, I will say to you this, that with the nonclinical stuff I did, I told you before, I have a son in medical school who has a huge tuition in Boston and a very good school. I doubled my salary clinically as an endocrinologist last year, last two years doing this, working four days a week, full time. And one day a week doing the nonclinical stuff. If that's your avenue is to get in and make more money and you don't necessarily want to cut back your clinical stuff, that's okay too so you can do that. And it's been really great that way too.

You have to know how to do these things. It doesn't come just with sitting down. We didn't go, we didn't just get put into an exam room and have to examine patients. We went through years of training and residency and so forth, the same thing here. You'd have to know how to do it. You have to know how to be coached, what to do, and kind of how to come up with a good product.

People want a good product like anything else. And when you have to produce that good product, they keep coming back over and over and over again, and they'll pay you what you want, quite frankly.

I think having that, I tell my son who's graduating. I said he's going to go on and do a residency. And I said even if you didn't have that residency, you should have, I'll finish it and do it. But just having that degree, the fact that we went through what we did is, you mentioned this many times on the podcast I've listened to before, being a physician and having that amount of knowledge and be able to pick up on things, we're in a perfect position to do all this type of consulting.

And so, the thing is that doctors don't realize is they're in demand, not just clinically, but nonclinically. They're in huge demand, but they undervalue themselves. This is an important point. And this is another Cooper point.

Number two, I'll just say, it's this, walk away from an opportunity that doesn't pay, that undervalues you. People gravitate to these opportunities that I find disgraceful, actually, in terms of what they do. And that can be any breadth of thing, of the things I'm talking about. Walk away. It's more important to walk away, actually, and not get the opportunity, but to take the opportunity and undersell yourself. Very important point that I've learned.

John: Yeah, I think there's nothing wrong with trying different things. But as you said, if it's not really going to be worth the time, because our time is probably our most valuable asset other than our medical knowledge, then you just should move on or take the time back and spend it with your family.

Dr. Robert Cooper: Exactly right.

John: So let's see, why don't you pick one of those? I'm interested in everything you've said so far, but the expert network consulting, how did you personally find this? Is there any ideas you can give us in terms of how to locate some of those? And then what is it you need to know to be able to do? What are they actually looking for based on what you've done so far with that?

Dr. Robert Cooper: They're looking for people who practice, who have some sort of basis, but actually could even do it without practicing. They had knowledge of the scientific basis behind it, some consults. You get these surveys sometimes that come to you through, I guess, a company called Sago or Schlesinger or other companies like that.

I don't want to go into specific companies, as I said before, but I could certainly talk about that individually with the guests that want to do that. But I think that you get these companies that will approach you sometimes and ask you for your expertise, spend an hour or so. In fact, before I got on the line with you today, I spent three hours downstairs working on three different consultations, three different ones today, because I'm "off" on Fridays.

I was working on that, but really, it's just phenomenal in terms of that. So how did I come into this? All of this is really, things just come to me, I think, somehow. When you put yourself out there, that's the key. I have a LinkedIn page and I'd like myself open to opportunities. People will come to you and they see your profile, but the most important thing is when they come to you is being receptive, A. B, providing a good product. When you're on the phone with an hour with somebody coming on that's asking you about a diabetic product or something, or asking you about the sensors or something for how you feel about this different sensors, you want to provide insight into what you do.

We all know this already. I don't have anything non-public. The key thing you have to worry about with this is that you don't want to provide anything that's non-public. That could be construed as you get arrested for doing something like that or have really a problem. So you want to provide all public information that you're not from clinical trials or anything, but I don't know anything non-public. Most of us don't. We're not involved in clinical trials. We just do what we do each day, but that's what they want to know about.

These platforms, expert network platforms are looking for people. They keep asking me, can you refer somebody an endocrinologist, another endocrinologist? I get things that sometimes are outside my field of expertise. I never take anything that's outside my field of expertise. I will not feel uncomfortable with that. I will not do it. I will pass up on it. That's important actually not to do that, but I will go on and I will refer people sometimes to it. I've never actually gotten a commission for doing it.

If you refer people and they actually do consults, you can actually get a commission for it, but I've never actually seen anything like that, but that's okay. But anyway, I think you could get, there's multiple different platforms that are out there that you could look up and research, expert network platforms and do it. It's not perfect.

There are downsides to it. I taught a course at SEAK last year on this, and I think they're making that, they're a good organization, SEAK, and they're making it available too. I think they recorded me part of it, but I think they're making it available as well. But I also have my own course that I've taught already at SEAK.

John: Well, let me ask you this thing just to dig into it a little bit. When I'm online, I've had a LinkedIn profile for a while. And then again, the email addresses get out there, but are you saying that of the expert network consulting platforms, most of those coming through LinkedIn? Do you ever get just blind emails coming in?

Dr. Robert Cooper: Yeah, I do get blind emails coming in from different companies I even heard about before asking me, I've heard that you do this kind of work. Are you interested in joining our platform? Are you interested in doing a one-off consult? The nice things about these one-off is that you don't have to really, but I do prepare for it. There is a way to prepare for it. I wouldn't say I didn't prepare for it. And I could certainly go into elaboration about that in terms of looking at investor conferences. I find myself sometimes looking at that more than I do scientific conferences on different drugs and things like that. So I do prepare for it.

I want to provide a good product when I get online for an hour. Because if you spend an hour and you don't provide anything, I don't think anybody's going to want to come back to you again. It's like anything else. Even the expert witness work, you want to provide a good product when you're going through that. Disability file reviews, anything.

I think that it's important to prepare and to be ready for it. You also have to have a certain mindset when you do these consults. You have to be relaxed. I think the best investment you can make is to buy a headphone, a head jack, just to put it on because it frees you up and you can look at the computer at the same time. You want to get information. That sounds like a simple thing. I think it was a few dollars to buy the headphone investment for me.

But that was a very important thing. I'm not fumbling with the phone when I'm doing it. These are little tricks that you learn as you go along that you wouldn't know about. How do you conduct yourself? How do you continue to keep the conversation flowing? That's an important asset to have that. If you just stay still and don't elaborate or know something and don't talk about it, you're not going to get that across and you're not going to get the best outcome. So I think that there's a way to train people how to do this, I think, to some extent, to make them more effective.

John: Let me ask one more question about this and then we'll move on. I've never participated in that kind of thing, but I always kind of get the sense that from the invitation, sometimes it sounds like it's a one-on-one conversation. Other times it sounds like it's kind of a panel. For the ones that you've experienced, what is it like? Is it just getting on a Zoom call with somebody? Is it more of a multi-person call?

Dr. Robert Cooper: It's all the above. The ones that are multiple ones. Sometimes I'm actually listed as, I do a lecture actually, where I'm lecturing to a group of investors actually. For that, I charge more money for that. I actually have rates that I charge. And that's another thing. I'm not going to go into that now, but I would tell you that I do that and I charge more and I charge a minimum of 60 minutes. That's another important point. I don't prorate it because I don't want to be on a line for 15 minutes and waste my time when it's an hour I could be getting from somebody.

There's a whole series of things I've learned, how to maximize your time and your profitability when you're doing this. But it can be, I actually had times when I've actually had to travel New York City or Boston, I live in Western Massachusetts, to do something.

I always tell the story at SEAK when I'm there, that they had me, it's a funny story actually. They had me actually go to Boston to do, I think it was Sago or one of those companies, to go to Boston to insert into a dummy, a device for diabetes. They had me come there and they were actually paying $1,500 to do this plus travel for an hour's worth of work. Think about that for a second. That's not uncommon, by the way, to have that happen. I got this thing and I went and traveled into Boston. I'm sitting there, there's a one-way mirror actually on this place that I'm working on. I'm trying to put this thing and I was a cardiology fellow before I became an endocrine fellow for a couple of months. A little bit manual, not that disastrous. I'm trying to put this device into the dummy and I can't do it. I'm putting it in the wrong place. They must've been laughing at me behind the mirror. I can guarantee you.

And then they came out and I said, oh my God, they're not going to pay me because I didn't do anything right. They came back and they handed me a check and they said to me, that's exactly what we wanted to know, Dr. Cooper. We wanted to know how to put it in. We wanted to figure out whether endocrinologists were capable of doing this. That was the whole point of this. Thank you so much for your help. And they handed me a check.

John: Interesting. They learned they have to change it if they're going to involve an endocrinologists I guess.

Dr. Robert Cooper: That's right. But they're looking to learn. Exactly.

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Have Faith in Your New Life Insurance Medicine Career

John Jurica — Tue, 28 Jan 2025 12:04:27 +0000

Interview with Dr. Megan Leivant – 389

On this week's episode of the PNC podcast, Dr. Megan Leivant explains why you may want to pursue a new life insurance medicine career.

Dr. Leivant shares insights from her six-year journey in the industry. Starting as a medical director at a direct life insurance company, she shifted to a reinsurance company, demonstrating the career growth opportunities in this field. Her experience highlights how physicians can leverage their medical expertise in an intellectually stimulating environment while achieving better work-life balance.

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Demystifying Life Insurance Medicine

Life insurance medicine offers physicians a unique way to apply their clinical knowledge in assessing mortality and morbidity risks. Dr. Leivant explains how medical directors collaborate with underwriters, combining medical expertise with industry-specific knowledge to evaluate insurance applications. The role involves case consultations, teaching, and research, providing intellectual stimulation while maintaining a connection to medicine without direct patient care.

Building a Career Path in Insurance Medicine

The transition into life insurance medicine involves specific strategies and resources for success. Dr. Leivant discusses professional organizations, networking opportunities, and industry certifications that can help physicians enter and advance in the field.

She emphasizes how full-time and part-time opportunities exist, making it an attractive option for physicians seeking career alternatives.

Beyond Patients, Still Doctoring

Dr. Megan Leivant shares how her medical skills and ability to build relationships remain central to her new role.

I miss seeing patients, but I'm still able to create relationships. It's just done in a different way now… It's critical thinking, it's teaching, it's teamwork and collaboration. So, I'm getting to still use a lot of those skills that I used when I was a practicing physician. – Dr. Megan Leivant

Summary

For physicians interested in exploring life insurance medicine, connections can be made through the American Academy of Insurance Medicine (AAIM) and LinkedIn. Dr. Leivant welcomes connection requests from interested physicians on LinkedIn to learn more about this rewarding career path.

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Transcription PNC Podcast Episode 389

Have Faith in Your New Life Insurance Medicine Career

- Interview with Dr. Megan Leivant

John: Over the years, I've had the occasion to meet physicians who work in the life insurance industry, not health insurance not doing UM, but actual life insurance. And I've been sort of very interested in that topic. Those that I have spoken with informally, not necessarily on the podcast have said they really like those jobs. I've been interested in finding someone who's doing life insurance medicine. And so that is today's guest. I'm very happy to have the opportunity to talk to her. Hello, and welcome to the podcast, Dr. Megan Leivant.

Dr. Megan Leivant: Thank you so much for having me.

John: I think this is going to be fun. I wanted to learn more about this for years. And it's not as common a full time or even part time position as let's say, someone working in health insurance. I don't know about disability. Anyway, tell us a little bit about yourself, your mainly your education and clinical background that will get into what you do professionally now.

Dr. Megan Leivant: Sure. Well, thank you so much for having me on the podcast today. I'm really excited to be able to talk about life insurance medicine. It all started for me. I went to DePaul University for my undergrad, and I majored in biology and did a minor in French and then went to IU School of Medicine, Indiana University School of Medicine, and followed that up with my residency in internal medicine at Northwestern in Chicago. And then actually practiced outpatient internal medicine for 10 years.

And I did that in a variety of settings. I started out in a traditional private practice, and then I moved to the VA, and I worked at the VA for about five years. And then I was in more of a hospital based community practice before I made my transition. And then I did have a lot of teaching appointments throughout that period of time as well. And that was something that was really important to me.

John: Very nice. Well, then the obvious question that comes up is when a physician transitions from clinical to nonclinical, what led to that decision?

Dr. Megan Leivant: I would say several years before I transitioned out of clinical practice I realized that I was having an increasingly difficult time coping with the demands of outpatient clinical practice, which I know that many people are feeling that way. And present day. And so I actually started working with a physician career coach, Dr. Heather Fork, through Doctors Crossing, just to see what I could do to help my situation. Because at that point, I wasn't sure if I wanted to leave clinical medicine. I just wanted to try to figure out could I could I do better? Were there changes that I could make to try to make the day to day a little bit more manageable?

And we worked together for a good while. And I ultimately realized that transitioning to a nonclinical career was the path that I needed and wanted to follow. So through coaching, I learned a lot about my interests and my dislikes. We did the Enneagram and talked about marketable skills and personality traits. And it was really just a great growth experience to learn all that stuff and then help leverage those findings to apply them to different nonclinical career options. So part of that process, I attended the SEEK nonclinical careers conference to help jumpstart my research and look into other career options and reached out to former colleagues to kind of explore what they've done in the nonclinical realm.

I made new contacts on LinkedIn. it was a very kind of vulnerable, exposed experience putting myself out there to try to just figure out what was next. And I even tried some telemedicine during that transition. I did a little utilization management just to see what else is out there. But I kept hearing about this life insurance medicine career. And the more I heard about it, the more I thought it would be a really good fit. And so that's ultimately how I got from point A to point B.

John: Well, what you described is really, it could be considered like a model in some ways. These are things we always talk about in the podcast. Okay, getting a coach, using a coach. Heather Fork's been a guest here at least three or four times, and I've been on her podcast several times as well. And so she's kind of an icon from the standpoint of coaching physicians. There's many out there now. But while you've hit on a lot of the points we've talked about Seek here before. Many of the people I've interviewed have actually been alumni from Seek as speakers. So you can add your name to that list now. I guess you've been a mentor there, I believe?

Dr. Megan Leivant: Heather. Yes, I was actually a mentor just this past October, and that was a great experience.

John: I guess I'll go off a little longer on Seek. It's only like 45 minutes from where I live. It's held near Chicago, and I live south of Chicago. I've driven up there and attended a couple of times to meet some of the mentors and the speakers. So that is good. I mean, I think that'll inspire some people to get off the dime because I get asked a lot about what about coaching. And in the old days, Heather and a couple others were like the only ones. I don't know when you started.

Dr. Megan Leivant: Yes, yes, there are a lot of physician coaches out there.

John: It's always something to say, oh to try if that's if you're kind of stuck. All right. You kind of looked at your skills and your interests and what's out there. And then the lifestyle, I think, is always part of that decision. So why don't you start by next telling us what are the duties of a medical director? That's the really the entry point for most if they're going to do life insurance medicine. What does that look like?

Dr. Megan Leivant: Exactly. Yeah. And it is a bit of a of a frame shift, but at the core, I like to think of the primary duties of a life insurance medical director as three pillars. Case consultations are definitely the biggest pillar. And I'll talk about that a little bit more. Teaching is certainly part of that.

And then research. At a very basic level, you're assessing the morbidity and mortality risk of insurance applicants. And so they can be applying for many different types of life insurance products, but really at the core it's mortality and morbidity. And as a physician, really, that responsibility lies in understanding disease processes, their associated risk factors, and how that's going to impact morbidity and mortality. So that's where that frame shift comes in a little bit. as physicians, we are thinking certainly more in the moment, treating what is in front of us.

I think that's probably one of the biggest pivots that has to happen. But there's a number of areas of risk selection. So there's that life mortality risk, there's disability, there's critical illness, and then there's long term care, which is more that morbidity component.

Really a day in the life, the bulk of it is those case consultations. So an underwriter will send over a consultation. And I almost liken that to presentations on rounds. They ideally are sending over, this is a 58 year old male with X, Y, and Z medical conditions. Here's my question. And so, as a medical director, you were there as a consultant to give your opinion. And you provide your opinion back to the underwriter. You're also fielding messages from them and calls and that kind of stuff. But that's, that's, I'd say the bulk of the day to day.

But then you're teaching the underwriters are there to learn from you as well. So that's what I really enjoy about this career is I still get to teach. And it's formal, it's informal you could be giving an external presentation to a room of underwriters, or you're just teaching over over the phone or through one of your consults.

I like that piece of it as well. And then research we're always needing to research these medical conditions that we're encountering. I feel like I've learned so much more in this career, I could probably go back and be a much better clinician. I think from my experiences, but you're doing projects, you're helping update the manual, the manual is what you use to help rate the impairments that the applicants have. That's at the core, I think what the primary duties look like for a medical director.

John: The scary part of that might be if I'm imagining that I'm thinking about taking a job like this, it's well, how I have an understanding of how different illnesses impact one another and why having hypertension might be a risk factor for something involving cardiac problems and so on and so forth. But I'm thinking that people might be like, but I don't know how to quantify that. Where does the quantification come in? Does that come from the underwriter or is that working together or is there a book that has numbers in it? There's some training involved on the job, right?

Dr. Megan Leivant: Oh, yes, absolutely. And I would say it probably takes a good six to 12 months just to really feel comfortable with that. So yes, to your point, when an applicant comes in and presents with, let's say diabetes or heart disease we all have 100% mortality that's a given, right? We all know that. But in the life insurance industry, we use what are called table ratings. And so they go up by 25 increments. 125%, 150%. And that corresponds to a person's mortality. So the higher that number gets the more medical impairments they have.

And every company uses a manual. And that manual includes those conditions like diabetes, heart disease, cancer and there's ratings that are associated with those disease processes. And that can vary. And it does vary per company. But that is where that risk is then assigned to the condition. And then as a medical director, where we come in is, well, what if you've got someone who's had diabetes and heart disease and prostate cancer? Is that a risk that we can consider that the company wants to consider? And from a medical standpoint, can we put all that together to determine if that applicant is suitable for a policy? Jennifer That's a great question.

John: Dr. Justin Marchegiani. But just like anything that you're doing, when you're going from clinical to non-clinical, there's obviously something you're doing in that new job that, well, it uses those skills and that background. It's different because it's a different industry. And I think that's what stops some people. And the thing is, all of these things have been figured out. whether you're going to health insurance or life insurance or pharma, these are not mysteries to the people that are on the other side. And usually they are well-prepared to train you. Now, there isn't really any certification that a physician would typically pursue or do other education before maybe applying for their first job as a medical director in the insurance industry.

Dr. Megan Leivant: That's correct. there are definitely a number of things a person can do to build their knowledge base. But there are a number of directors, myself included, where I walked into this industry very green. I'd had no experience in life insurance medicine, and I was trained on the job. And I've done a lot of those additional classes and certifications now as a director within the industry.

John: I want to hear more about what your career has done since you've been there. But why don't we go first into the obvious question? Maybe they've talked to people that have started doing this, they really love their job, their lifestyle is good. How would I start to look for those jobs and or prepare for the job?

Dr. Megan Leivant: Yeah, that's a great question. So I think there's a number of ways to start looking into this career. And I think there's not just one pathway, probably one of the most useful tools would be to consider joining AIM.

And through that organization, this is kind of like our governing body, if you will, of within insurance medicine. So it's a group of insurance medicine directors, but there are also underwriters and that are members as well. And when you become a member of AIM, you actually can get paired up with a mentor. And the mentor is usually a director who is already in the industry. And I have really found that that's been a great way for individuals who are interested in getting into the industry. they now have a point of contact.

And that really can be a great nurturing relationship to help jumpstart that interest within insurance medicine. But then I think it's a lot of the other things that individuals do to look for new jobs, right? Look for job postings on LinkedIn, get your LinkedIn profile spruced up, try to reach out to if you happen to know anybody that's in the life insurance industry, certainly that's always really, really helpful.

Let others know that you are looking for a new career or that you're interested in this. Connect with an industry recruiter. they are definitely out there. Depending on where you live most of our positions are remote. There are some that are hybrid, but research life insurance companies that are in your hometown that could always potentially provide an opportunity, whether it's a bigger name or a smaller name. And attending a meeting.

That's an absolutely wonderful way to get to network and meet other industry directors, industry professionals. And there's a number of those. So, AIM has its own meeting every fall. And then there are several others that also could provide really good opportunities to try to help kind of jumpstart that career.

John: That sounds logical. Yeah. And I, one thing that I ask about, because we, for some of the big industries, there are these things like LinkedIn groups and Facebook groups. Do are there any such entities that you're aware of for life insurance medicine?

Dr. Megan Leivant: AIM does have a presence on LinkedIn, and I would say that would be a great place to start. I am not aware of any specific life insurance medicine, Facebook groups or anything, but, but AIM again has so many great resources. And so, that's where we end up directing a lot of our individuals that are interested.

John: Okay. So, I'll be sure to put a link to AIM in the show notes.

Dr. Megan Leivant: Yes.

John: So, now let's talk more about you. A couple of things. Maybe you can tell us a little bit about what you like about it and, and, and then what you've done because you're, I think you're no longer an entry-level medical director. We'll just kind of talk about both of those issues.

Dr. Megan Leivant: Sure. I'd say what, what keeps me coming back every day is that this is a really mentally stimulating job. I've really enjoyed, and I continue to enjoy the, the challenge that comes from reviewing these cases that come through every day. This is why I went into internal medicine. I love to solve problems. So, it really gives me the chance to still continue to do that on a day-to-day basis.

There's a ton of variety. I'm seeing diseases that to this day, I still had never seen before. So, I'm still getting to use my medical, medical degree. I'm growing my knowledge base, and, and that was really important to me as I was considering the, the pivot. But it's also a small industry, so there's a lot of great networking opportunities. I've really been able to kind of expand a different part of my marketable skills, if you will.

I miss seeing patients, but I'm still able to create relationships. It's just done in a different way now. And so I'd say that those are probably the big things that kind of keep me coming back every day. It's critical thinking, it's teaching, it's teamwork and collaboration. So, I'm getting to still use a lot of those skills that I used when I was a practicing physician. Yeah, as far as my kind of course throughout my career so far, I've been in the industry over six years, and I started out at what's called a direct life insurance company.

So, a direct life insurance company would be the company where you apply for your life insurance policy. So, they directly, they do that underwriting, and I worked there as a medical director for just under two years, and I got that experience. And then I've, since then, have been working for reinsurance companies.

There are a lot more direct life insurance companies than there are reinsurance companies. So, reinsurance companies help to insure the direct insurance companies. That's probably a very high-level way to kind of describe it, but, but so our clients are the direct insurance companies.

We still, as a medical director, are doing very much the same thing on a day-to-day basis, whether you're at a reinsurance company or a direct insurance company. But in a reinsurance company, we're probably seeing cases that might be a little bit more medically complex. There are certainly some differences there. But at the core, like I said, this is ultimately, it's still the case consults, but there's more teaching, there's more research, and that's kind of helps keep it really interesting and a lot of variety.

John: I wonder I was a CMO for a hospital for a while, and our hospital insured itself from liability. We're talking a little different than life insurance. But they had a consortium, they were so, quote, self-insured. But they did have a reinsurance company, I think, on top of that. Like, there's things that happen that they can't really predict or plan for. So, it's kind of the same idea.

Dr. Megan Leivant: Exactly. if I had a whiteboard, I could draw a diagram the direct companies would be in the middle, and then the reinsurance would kind of be a bubble around it. So, here's an extra layer of protection. We might take on the full risk that a direct company doesn't want to take, or maybe we share that risk because it's a really high net worth case. There's just so many different permutations. But that is a great way to describe it.

John: All right. Now, let me ask you this. Do most of medical directors for a reinsurance company come from a direct insurance company, or are they just out there trying to grab anybody that comes along?

Dr. Megan Leivant: No, that is a really, really great question. I would say, on the majority, physicians that are within reinsurance companies usually are coming to those companies with some direct experience. Now, I'm going to say that's not an absolute, because I do know of some directors that started out in reinsurance. And you're going to get that on-the-job training, no matter where you are. But I would say, on the majority, that's probably the path that you normally see is a direct to a reinsurer.

John: Now, in other industries that are similar, in my mind, to this, they have this whole hierarchy of medical directors and senior medical directors and executive medical directors, and then they get into the VP level. And again, kind of mirrors even the hospital setting. medical director is still involved in the clinical stuff a lot.

The VP or the chief medical officer is really an executive position. So how does that work? The physicians, because I did know one VP of a life insurance company. I haven't talked to him in many years, but I didn't know exactly what he did as a VP, which was different from what he maybe had done prior in previous roles.

Dr. Megan Leivant: Yeah, that's a great question. I think it really, at least what I've seen, is that it really varies per company. I know a number of medical directors, whether they're in a direct company or a reinsurance company in that core role, they have a VP title associated with what they're doing. And I can't speak to the full industry as far as how many are VPs, but I think generally you're going to see that title or you will have that title as a medical director coming into a role, but it's very company specific.

The step up after that, though, is that, yes, depending on how big the company is, then some of them do have a chief medical director, and that's where you start to see some of that delineation as far as the administrative duties etc. Usually the chiefs are probably doing less casework and they're more involved with maybe research or product development or kind of higher level higher level concepts.

John: Yeah, that makes sense. And we see that in a lot of other industries where they just they just have a cascade of titles just to recognize the skill, the experience, and so forth. And then in some cases, it really means you're part of the senior executive team, which does a lot of the strategic planning and creating new service lines and things like that. So each industry, I think, has its own specific ways of doing things.

Dr. Megan Leivant: Definitely.

John: All right. Well, have I forgotten any important questions to ask you? I'm going to let you go in a minute. I definitely shed a lot of light. So any last comments or other things maybe that we've missed in this last 20 minutes or so?

Dr. Megan Leivant: Sure. Well, I think one thing you asked earlier was about prerequisites in a way of getting into the industry. And while there isn't anything that you need to specifically do to get into the industry, there are definitely once you are in, like, we actually, insurance medicine is a boarded specialty.

After you've been in the industry for several years, and there are definitely other courses you have to take and criteria you have to meet, but you can be boarded in insurance medicine. I'm actually working towards that myself. So I did want to kind of add that. And we do what's called a basic morbidity and mortality course that is part of that board preparation. So there are definitely all these opportunities to get that teaching that is needed as just part of the core function of our roles as medical directors.

John: Yeah, I would bet 99.9% of physicians coming out of the training would have no idea that there's such a thing as board certification in life insurance medicine.

Dr. Megan Leivant: Oh, sure. And it's both a written exam and an oral exam. So it's a process that can take up to a year really to kind of go through both of those.

John: And I saw that there's some certifications. Again, I'm assuming that those kind of things are sought after you're in the industry, but I noticed that there are certain things maybe you can explain a little bit about that.

Dr. Megan Leivant: Absolutely. There's a lot of, like I said, a lot of different initials, you can get after your name, a lot of certifications. And these are the courses that the underwriters take. There's LOMA courses, which is Life Office Management Association. And then there's ALU, which is the Association of Life Underwriting. And there are a myriad of different courses within each of those groups.

And those you take those and they're great courses. They really help teach you about the life insurance industry, especially the LOMA courses. Those are definitely more geared towards life insurance, just basic knowledge financial underwriting, risk management all of that. So yes, you can take a number of those courses and then ultimately get different designations depending on what combination of those courses you've taken.

John: Very good. Appreciate that. Yeah, I don't know. I'm a little too old to apply for a life insurance medicine job, but it sounds like the course might just be interesting.

Dr. Megan Leivant: Maybe not. And it depends on the company not everybody needs to be boarded. I think that's very company specific. There are definitely companies that might lay that down as an expectation. But I know there are directors out there that might do this part time and that's not an ask for them. So it's not I think there's definitely a spectrum.

John: Okay. Well, that's really good to know. Maybe they could create a career where they're doing half clinical and half something like this whether it's in this industry or even UM, whatever, that sometimes can be very positive from a lifestyle standpoint.

Dr. Megan Leivant: Sure. And I know of directors that are still doing that very thing. I do know of some that are still practicing clinical medicine, and then they do their life insurance job as well.

John: Excellent. Well, you did mention earlier, this whole thing about networking, tracking down your colleagues and former co-residents and so forth. But one of the things that I'm sure that our listeners might want to do is reach out to you. Hopefully that would be okay to do on LinkedIn. At least you can control that somewhat.

Dr. Megan Leivant: Yes, I'm happy to certainly connect with anybody that would like to do that through LinkedIn.

John: Okay. I'll put your LinkedIn, a link to your LinkedIn profile in the show notes as well, although if they just input your name, they're going to find you. So, all right, Megan, I think we've learned a lot today. I know I have, and I've appreciated this. I really encourage people who are listening to consider this because again, it's a small number, but the people I've talked to, some of them, they just love their jobs, you know? And so there's just something about applying your medical knowledge in this way that just so lines up so well with a lot of our intellectual stimulation, what we love and challenges. And so, I really appreciate you for describing all this and sharing this with us today.

Dr. Megan Leivant: Thank you so much for having me. Yes. Medical directors in this industry are very happy.

John: Nice. All right, Megan, you take care.

Dr. Megan Leivant: Thanks, John. Appreciate it. Bye.

John: Bye-bye.

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Be Creative And Flexible And Love Your Career – A PNC Classic from 2019

John Jurica — Tue, 14 Jan 2025 12:39:22 +0000

Interview with Dr. Helen Rhodes – 387

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.

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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.

Supplemental Income

Helen recognized the need to supplement her income in private practice to match her previous salary. After doing file review jobs, sales, and legal testimony, she finally landed on locum tenens work.

You've got to throw a lot of lines in the water. – Dr. Helen Rhodes

Initially, Helen had difficulty finding locum tenens work because she had been out of obstetrics for so long. However, with persistence and lots of time spent browsing recruitment sites and answering emails, she found work that enabled her to do prenatal care.

These unexpected opportunities encouraged Helen to be creative and flexible. And she continued to explore unfamiliar clinical and nonclinical options.

Business School

While managing her private practice, Helen decided to get her MBA with the goal of either entering administration or consulting. There she met several doctors from rural Kansas who offered her a locum tenens opportunity that would allow her to return to obstetrics.

That opened her eyes to the option of working out of state. After finding another opportunity in Kansas, Helen delivered her first baby in 13 years. So she pursued more out-of-state work, getting licensed in New Mexico. She ultimately found a rewarding, semi-permanent position at an underserved rural hospital there.

Be Creative and Flexible and Add Plasmapheresis

Soon, another business school peer introduced Helen to the world of plasmapheresis, where she became a medical director for a facility in Houston. She found the work stimulating and the compensation very reasonable. With a commitment of only 4 hours for any day that she worked, it fit well into her private practice and locum schedules.

Summary

Helen's story is a timeless one. Through her willingness to take risks, explore every opportunity, and work hard, she cultivated a successful, diverse, and rewarding career.

Most importantly, you just have to think outside the box. Look at many many opportunities…. Expect to get a lot of “no”s and don’t get discouraged. – Dr. Helen Rhodes

That's not to say that she hasn't experienced difficult times. She can certainly recognize areas where she would have done things differently. At its core though, her story is one of perseverance and the value of exploring every available option.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 387

Be Creative And Flexible to Love Your Career

- A PNC Classic from 2019

John: Dr. Helen Rhodes, welcome to the PNC podcast. I'm really glad to have you here today. I always like to give my audience a little, let's say, preview as to why we're talking today. We met through a mutual friend and from what I know, you reached a point in your clinical career where you were, just needed to make a change for reasons which I think you'll describe. I thought your story sounds quite interesting and hopefully very inspiring. Why don't you describe a little bit about your background?

Dr. Helen Rhodes: Well, I did all my training in Texas. I grew up in Texas and I finished OB-GYN residency back in the early 90s, so that would be last century, I guess, technically, and was actually recruited by an academic institution here in the Houston area to do GYN only. And it was an academic position without any obstetrics, so I was pretty fortunate and it was very unique to have that opportunity right out of training, but I quickly discovered that I really wasn't ready for academic medicine.

I wasn't even 30 years old yet and so, after a couple years, I left that institution and worked in the Houston community doing full scope obstetrics and gynecology, various practice opportunities, multi-specialty group practice. I worked part-time, I worked full-time, I worked at a managed care group, and then, interestingly enough, about 10 years after doing that, I really was having difficulty with the lifestyle of obstetrics, primarily, and actually went back to the institution that I left 10 years earlier into the same position of GYN only and stayed there for almost another 10 years, but I always wanted to have my own solo practice and after my youngest finished high school, I made this big leap and left academic medicine again and started a GYN only solo private practice in a bedroom community south of Houston.

It was pretty risky to do that because it's really hard to start a private practice, especially mid-career with really no patients to follow you, starting it from the ground up, and not doing obstetrics financially, it was very challenging, so I started looking for ways to supplement my practice income, looked at clinical and non-clinical options, and did medical file review.

I actually, for a little bit of time, sold supplements in my office, did some testifying for legal cases, and got into locum tenens opportunities. Initially, just outpatient locum tenens opportunities because without doing recent labor and delivery work, I couldn't get any jobs in L&D anywhere, and there's really no retraining for obstetricians once you've stepped away from it for a couple of years. There's no way to get back into it. The American Board of OB-GYN doesn't have a formal retraining program. You really have to get lucky.

John: Helen, let me jump in there for a second. You were trying to get locums without the OB, and did you have any success at that, or was it pretty much a wash?

Dr. Helen Rhodes: I did have some success. I was able to do outpatient gen-like physicals for an underserved area in town. They weren't a federally qualified health clinic, but they were state-funded health clinics, so I was able to do that on Saturdays and some Fridays when I was not seeing patients or in the operating room.

I did that for a while, and I just got an hourly rate and saw the patients that they had scheduled. They weren't my own patients. I also was able to get an outpatient job with Texas Children's Health Plan, which is affiliated with Baylor College of Medicine, and did OB and gen, so that was good.

That way, I was starting to at least see obstetrical patients in the outpatient setting and relearn prenatal care, high-risk prenatal care, but at that point, I wasn't able to do anything in labor and delivery. I did have some success.

John: How easy is it to find locums? Is there a clearing house? Is it word of mouth? Do you just go on Google? How do you even start to look for positions like that?

Dr. Helen Rhodes: You have to throw a lot of lines in the water. You get on a lot of the recruiting sites and submit your CV, answer a lot of emails, texts, phone calls. I had a lot of dead ends because of the lack of recent labor and delivery work.

John: Okay, so that was a challenge.

Dr. Helen Rhodes: Yeah, very challenging.

John: Now, as you were going through this too, you started your practice. Was the issue in terms of the gross revenues or what have you, was it the fact that it was a startup or did you look and say, even when I'm busy, this is not going to be something that is meeting the financial levels that I think I need?

Dr. Helen Rhodes: Yeah. I think there's a lot of reasons that the revenues weren't where I wanted them to be. I had come from this academic salary and that was my benchmark. It was a pretty high benchmark because once you're in solo practice, you don't have anyone paying your benefits or contributing to your retirement or paying your liability premiums, etc., etc. That all comes out of your revenue. You can either do a couple of things.

You can see more patients because we are reimbursed per patient in this fee-for-service world of OB-GYN. We're primary care, specialty care, stuck in between. I had already lived that life of seeing lots and lots of patients and not getting to spend time with patients.

When I started my practice, it was very important to me to spend time with my patients. I wasn't seeing the volume that I was seeing before and I didn't want to see the volume I was seeing before. The overhead is higher and because I wasn't increasing my volume and doing tons and tons of surgery, my revenues were less.

John: Okay. You're looking at locums. You're trying some different things out. Take us down the next few steps in this process.

Dr. Helen Rhodes: It's an interesting story. For some reason, I wanted to go back to school and learn business. I did a hybrid program where we spent four residential sessions over an 18-month period and then did online coursework, lectures, projects. I did that between 2015 and 2017 through a business school and connected with some really innovative healthcare leaders in my class and the class ahead of me from rural Kansas. Until I met them, really my search for locums work had been confined to the state of Texas because that's where I had my license. One of the individuals that I met through the business program said, hey, we would love to have you come to Kansas.

Kansas is not that far. It's a couple hours. I ended up getting my medical license in Kansas. Well, that opportunity with my business school colleague fell through for various reasons, but another Kansas opportunity came up through one of the locums recruiters that I had been working with. This time, even though I hadn't delivered a baby in 13 years, the little hospital in the middle of Kansas said yes, and off I went. I did my first delivery in 13 years.

John: Oh, boy. Yeah. What was that like?

Dr. Helen Rhodes: I was very nervous. Very nervous. Of course, it happened at three in the morning, and I didn't have much time to get to the hospital and think about things, but that was the beginning of thinking outside the box in terms of, wow, if I can go to Kansas, I can go to other places too. I eventually got my license in New Mexico, and there's lots and lots of work in underserved rural areas of New Mexico, so one of those opportunities has actually turned into a permanent position.

John: Okay.

Dr. Helen Rhodes: Yeah.

John: So there was a locums opportunity in New Mexico?

Dr. Helen Rhodes: Yes.

John: And was it another sort of a smaller type location or?

Dr. Helen Rhodes: Yeah. It's definitely rural. It's about an hour south of Albuquerque, and the hospital is a critical access hospital, so by definition, it has less than 25 beds, but they have a very unique model for taking care of their OB-GYN patients.

There's a certified nurse midwife who lives in the town and knows all the patients on our service, and then there are four board-certified OB-GYNs. I live in Texas. Two others live in other parts of New Mexico, and the fourth actually lives near Washington, D.C. Yeah. So between the four of us and the nurse midwife, we cover the service. So I go there for just under a week, once a month. This small hospital is actually affiliated with a larger healthcare system in New Mexico, one of the bigger systems, so is able to keep things running because they they're a small hospital within a big system, so they can achieve economies of scale, et cetera, et cetera, from the business perspective.

John: Okay. Now, are you still balancing that with the other clinical activities in your private practice at home?

Dr. Helen Rhodes: I am. Because I don't do OB in my private practice, it's pretty easy for me to leave. As long as I feel like I can get all my patients seen in a timely manner here and get the surgeries done, it's really not a problem to leave and go work in New Mexico once a month. And having an electronic health record that I can take with me, essentially, as long as I have internet access, I can communicate with my patients here, check their lab results, communicate with my staff. I have two employees. Things keep running even when I'm not here. So it's wonderful.

John: That makes me think of, and I don't know if this is even doable, but would it be possible to do some kind of telehealth, telemedicine? Are there certain types of things that you could do? I've never talked to an OB about that.

Dr. Helen Rhodes: Yeah. So I've actually been talking about this with my office manager and my nurse that there are certain types of patient appointments that I think would be very amenable to the telehealth platform. It just became legal in Texas.

We really haven't had a lot going on with telemedicine until very recently. Some of the bigger hospital systems are now doing it and I'm looking to see kind of how they're doing it and to see if I can incorporate that into my practice. But I see a lot of young girls that I start on contraception and then they go off to college.

And I really like to see them two to three months into that rather than waiting for them to come home during the summer, the holidays. And so telehealth would be great because in the evenings or while I'm in New Mexico, or when I'm not seeing patients here, I could have a quick tele-visit with them or telehealth visit with them and see how they're doing. Similarly, my post-op patients, they could take a photograph of their incision and I could look at it and do a telehealth visit. Those are the two types of visits that I'm looking into for telehealth.

John: It wasn't that long ago I talked to an orthopedist and he came to realization because he was off visiting someone else. He happened to have a patient in the town who was a hundred miles away from where he did surgery. And while he was there, he just went to visit the patient to look at his wound.mAnd then when he got back, he said, this would be perfect for telemedicine. That was three or four years ago. So now that's what he does because he has such a large drawing area. He's a pediatric orthopedic surgeon. So he does a lot of his follow-up visits with telemedicine. So that'll be interesting.

I'll have to follow up with you down the road and see how that pans out. But you're doing some other things, right? Aren't you into something that is a non-clinical or it's sort of clinically related, but not patient care? Tell us about that and how that fits in.

Dr. Helen Rhodes: When I was in business school, I really had two main goals. One was to learn more about the business side of medicine and possibly go into administration. And the other was to teach others what I learned or become a consultant regarding healthcare economics, et cetera.

I found out from a friend of mine who actually, she's an OB-GYN that went back to law school about the time I went to business school. And she had told me about the plasmapheresis industry, whereby they hire physicians to be the medical directors for each of the plasma centers. So when I initially heard about that job, which was a couple of years ago, I wasn't very interested. I didn't think it was a good fit. But then after I finished my business school education, I thought, wow, this is, now I understand more about operations management, working in teams. So this might be a good fit. I ended up doing that to help supplement my income. And I really enjoyed it because it's completely different from clinical medicine. You deal with a lot of federal regulations and guidelines for the industry.

And you're dealing with a population of individuals that are extremely impoverished for the most part, don't have access to healthcare. And really your job as medical director is to make sure that the donors are eligible for plasmapheresis, that they're healthy, and also to keep the medical operations team credentialed. There's very specific credentialing that's required by the FDA and industry regulations. And you're responsible for that. And you're also responsible for medical education of the medical operations team. So it's very interesting work. Since I've gotten so busy with the work in New Mexico and other places, I've had to cut back on the medical director work. And I'm now a backup director for a couple of the centers around here.

John: Do you have a sense for how much demand there is for that kind of a position in case someone might be thinking, well, this is interesting?

Dr. Helen Rhodes: There's a lot of demand. There's several companies throughout the United States. It's not just one company. And they pay an hourly rate. The training is paid. They pay for your mileage.

The commitment is four hours a week. I know one person in our group, I believe she was a pediatric emergency room physician. She's given that up. And now she handles five centers in the Houston area. She's a medical director for five centers. But essentially, she's working five, four-hour shifts a week and making good money. And she doesn't have any overhead. She just drives from center to center and takes care of her responsibilities and has a lot of time with her family.

John: Sounds very nice.

Dr. Helen Rhodes: Yeah.

John: For you, how does that compare, let's say, to the various clinical things you're doing? I mean, just from a payment standpoint without giving necessarily an hourly rate. But I mean, when you had the time, it was definitely worthwhile doing.

Dr. Helen Rhodes: Yes. Yes. I actually first took on that position because I had a small business loan for my practice. And I had this goal of paying it back in a certain amount of time. And that's why I originally took the position. Because all the money that I was earning from being medical director went directly to the loan repayment.

But then once I paid it off, it was a nice little extra check every month. But yes, I think the compensation for that work is very fair and very comparable to what you would earn in a clinical job.

John: Without any call?

Dr. Helen Rhodes: No call. And you only work four hours a day. I mean, there's nothing else. There's only so much you can do there. Now, I don't know anyone who's doing more than a four-hour shift. I don't think they allow it. But four hours is plenty. It's a very different kind of work.

John: You have to be very focused, very meticulous in doing that?

Dr. Helen Rhodes: You have to be focused. Yeah. You're basically reporting to the center manager and to the quality department. And it is a very tightly regulated industry. As it should be.

John: Yeah. It falls under the FDA, does it? Basically, the regulations?

Dr. Helen Rhodes: Basically, the plasma that's collected is actually sent over to various centers in Europe. Depends on which company you're working for. At one point, I was working for two different companies.

And one of them had a processing plant in Spain and the other company had a processing plant in Germany. And so in Europe, the plasma is made into pharmaceutical products, which are then sold back to the hospitals here in the United States. They also make a lot of vaccines, as well as fresh frozen plasma and all the clotting factors.

John: Okay. So, it's a pharmaceutical business, definitely. Now you've kind of reached, it sounds like at least for now, a point where you seem to have a balance. You've got some stability. The private practice is pretty stable. You're thinking maybe of adding telemedicine if it works out. And you have this pretty stable situation. It used to be locums, but now you're employed or it's more of a stable situation with the New Mexico practice. And you're working with three other physicians there. So how do you feel?

Dr. Helen Rhodes: I feel great. I feel great.

John: You're still glad you left that group?

Dr. Helen Rhodes: Which one?

John: Whichever group. The original, the one 10 years later. You don't look back and go...?

Dr. Helen Rhodes: No, no. I think I love the autonomy most of all, because I'm doing exactly what I want to do. There's things obviously I can't control. I can't control what I get paid by the insurance companies for the work that I do for my patients, but there's so much that I can control. And it's very rewarding when I go to New Mexico because I deal with some very underserved women who really have limited to no access to quality care. And it's great to be a part of that team. And I get to be in the mountains once a month. I live by the shore here, live by the beach. So I get the best of both worlds. I get to travel and I love it.

John: When you go and you're in New Mexico, I'm assuming that the organization, the hospital, the clinic, whatever, and the patients are happy to see you, right? They don't take you for granted, don't yell at you because you're five minutes late or anything like that?

Dr. Helen Rhodes: No. I feel very appreciated. I actually am developing my own kind of practice within a practice there. I have patients that wait for me to come and they're my patients. And then we all take care of the obstetrical patients, but the surgery patients, I'm starting to do some surgeries there. They're very excited about that.

They've worked with me in terms of which equipment I need. And there's a general surgeon actually that comes two weeks a month. He actually lives in Florida. He was doing what I'm doing now. He had his practice in Florida and he was working at this hospital in New Mexico. And then he decided to close his practice. Basically he works two weeks a month and has two weeks a month off. And he's very happy. But yeah, I feel appreciated. I have friends there. I have an apartment there. I have a social life there. And the climate is so much better than what I have here. There's no humidity there.

John: Well, okay. What kind of advice would you have for physicians who are kind of plugging away and maybe they're unhappy or they're frustrated or they're actually burnt out or whatever?

Dr. Helen Rhodes: Yeah. I think most importantly is you just have to think outside the box and look at many, many opportunities and cast many lines in the water and expect to get a lot of no's and don't get discouraged. Cannot underestimate the power of networking and mentorship.

That's so important. To connect with another professional that's doing what you think you'd like to do and brainstorm with them. I've been doing some mentoring of individuals who are burnt out. I've been helping a couple physicians transition. We can help each other. Don't give up your licenses. You hear a lot, people step away from it for a couple of years and then they go back. I think it's wise to keep your board certifications and keep your licenses active. And for an OB-GYN, I would say don't step away from OB for too long because it's really hard to get back into it.

John: Even if you were doing, let's say, OB maybe temporarily for a few months each year somehow, or backed up other people one week, a quarter. I mean, would those things you think would keep it up enough to satisfy the hospitals?

Dr. Helen Rhodes: Yes. I think doing what I'm doing, because I'm not only going to New Mexico, I'm still doing weekend locums at other places in Kansas and Texas. And there's such a need right now, especially in OB-GYN, especially in rural areas. They don't have enough doctors and there's lots of opportunity where you could do it one weekend a month. To keep your skills up. It's very feasible.

John: Now, I'll digress for one minute on the locums. Do you find that there's much flexibility in your ability to negotiate? I mean, I've heard horror stories of someone saying, well, they're only going to pay this much and turn around and found out they would pay like almost 50% more than that if you just asked or kind of held to your guns.

Dr. Helen Rhodes: Yes. We are terrible negotiators as physicians. It's very important to learn that you are really in the driver's seat. You are providing the service that they need and want. So, don't be afraid to negotiate for what you want.

John: Okay, good. Good. That's what I have heard, but I've never done locums, so I don't know how aggressive one can get. But if you have information, if you've done it at other places, at least it gives you some benchmark. But if you're going in for the first time, you probably have no idea.

Dr. Helen Rhodes: And it's best if you can negotiate directly with the hospital system, if possible, and not through a recruiter. That's pretty difficult to do because of liability. Usually the recruiting company is going to pay your liability, which for OB is kind of high. It is high. But if you can get the middleman out of it and directly negotiate with the hospital, you're going to get a much higher rate of pay.

John: Awesome. That's good to know. Well, this has been very inspiring and very interesting and helpful for everybody. And you talked about you mentoring a few people. So if somebody would like to reach out to you just for a question or something, shall we use the LinkedIn? I know you're on LinkedIn.

Dr. Helen Rhodes: LinkedIn is great. Or my email address is hrhoads62@att.net. And I'm happy to communicate with people who are interested in my story and how I can help them.

John: I think especially people in your specialty everyone kind of naturally wants to hear it from someone that has had a similar training and background. So it's good to if there's someone who's doing OB out there that might be struggling, then hey, why not reach out? Like you said, networking is awesome. Mentors are great.

Dr. Helen Rhodes: Absolutely.

John: All right, Helen. Well, I really appreciate the time that we spent together today. And we'll have to keep in touch. And you can let us know if you ever get that telemedicine going or anything new that comes in with your practice. But thanks again so much for being here with us today.

Dr. Helen Rhodes: Thank you very much.

John: Hey, you're welcome. Bye-bye.

Dr. Helen Rhodes: Bye.

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How to Create A Fantastic B2B Business

John Jurica — Tue, 31 Dec 2024 13:47:19 +0000

Interview with Dr. Nicole Rochester – 385

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.

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.

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.

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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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First Consider 5 Proven Strategies To Save Your Career

John Jurica — Tue, 24 Dec 2024 12:05:41 +0000

Recent Trends Offer Options for Physicians – 384

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.

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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.

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.

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

This Physician Entrepreneur Offers a New Way to Find a Job

John Jurica — Tue, 17 Dec 2024 13:27:48 +0000

Interview with Dr. Zhen Chan – 383

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.

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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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Introducing a Fearless Medical Entrepreneur

John Jurica — Tue, 10 Dec 2024 12:32:05 +0000

Interview with TJ Oshun – 382

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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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.

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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.

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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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To Be a Better Physician Leader

John Jurica — Tue, 03 Dec 2024 14:30:38 +0000

Thoughts on Physician Leadership – 381

In this podcast episode, John shares his transformative journey from clinical practice to becoming a Chief Medical Officer, offering valuable insights for physicians considering leadership roles in healthcare organizations.

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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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.

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 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:

Accountability,
Optimism, and
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.

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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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How to Become a Medical Editor – A PNC Classic from 2020

John Jurica — Tue, 26 Nov 2024 21:23:13 +0000

Interview with Dr. Jennifer Spector – 380

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.

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.

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Transcription PNC Podcast Episode 380

How to Become a Medical Editor - A PNC Classic from 2020

- Interview with Dr. Jennifer Spector
John: Dr. Jennifer Spector. Welcome to the PNC podcast.

Jennifer: Hi. Thank you so much for having me today.

John: I'm glad that you accepted my invitation to be a guest here because I've had this interest in learning about medical writing and also about being an editor for a publication that would hire medical writers or engage them in some way or another. So, when I saw that's what you were doing I thought this would be fantastic to add to that story that we've been following for several months.

Jennifer: Well, great. Happy to help.

John: Let's see. I always give a little bit of background. I've done an intro and I've put in there your background training and so forth. But, I'd just like to hear from you, directly, how you got into medicine, what you do, and how did you transition into what you're doing now at some point?

Jennifer: Sure. Well, I was always interested in medicine from a very, very young age. No matter what career at any given stage I said I wanted to go into, it was always something health `care related. When I was in high school I ended up shadowing a general surgeon back home in Pittsburgh for a while in the days pre-HIPAA. I had a lot more free reign in that OR than a high school student would have today. But I really, really loved what these people were doing and I really felt at home in that environment. That led me to a pre-med track in undergrad. While I was an undergrad I ended up working for a group of podiatrists. Just as a summer job, medical assistant type of duties.

I loved that they formed a real connection with their patients. I loved that there was a lot of good that they did with patients with diabetes. I love that they never saw the same thing every day. I really liked the fact that it seemed that they had a pathway towards some work-life balance. They had families, they had outside interests, and it really was a great example for what my life could look like in the future.

That's how I got into podiatry. After my training, my four years in podiatry school post-undergrad, I did three years of residency in Delaware and began practice in the suburbs of Philadelphia. I was in private practice as an associate for 12 years, partially in Pennsylvania and then later in New Jersey. Really enjoyed my work. I did a lot of work with wound care and limb salvage. I became board certified in foot surgery. I did a lot of work in my latter practice in sports medicine, as the practice owner was a runner and climber herself.

I really enjoyed that work. But, as time went on, and I became a mother and medicine changed significantly, I realized that my goals and my long-term track that I wanted to be on was changing. I started to see what I might be able to do about that, and what was at first a very long-range goal turned into maybe a five-year plan, turned into a one-year plan, turned into, [crosstalk 00:03:26] "I'm going to do this now plan." The lucky thing was is in the last five years of my clinical practice I had a lot of great opportunities to flex some non-clinical muscles. That's what led me on my current path.

John: Okay. We're going to stop there because I always have to rewind and clarify some things-

Jennifer: Of course.

John: Yeah. I've been in practice a long time. I actually was out of practice for four years. But, and I would say that I'm just observing that the podiatrist's role in my world changed over the years. 30 plus years ago when I started, I think there were a lot of podiatrists that weren't necessarily residency trained or maybe they had a year or two. Maybe you can talk a little bit just for those that don't quite have that much exposure to podiatry. What is the current state of requirements for training, number one. Then also, I was just curious. Do most podiatrists work in the office doing minor surgery? Do they work in a surgery center? Do they work in a hospital? All of the above? That would be very interesting as well.

Jennifer: Absolutely. As a requirement for admission into podiatry school you've got your standard pre-med prerequisites, all of those basic sciences, along with the MCATs for the vast majority of us. We do take that. Then it's four years of post-undergrad training. The first two years are pretty much on the same track as allopathic and osteopathic. The difference becomes in that we just specialize a little bit earlier in below the inguinal ligament, basically. Once we finish our four years of podiatry school, where there are rotations in non-podiatric fields, usually [inaudible 00:05:13] vascular surgery, trauma. All of those things. Then we move on to our residency. Which at this point is standardized to be at least three years of medical and surgical training, various sites throughout the country where that leads you then to board qualification. Once you're in private practice and working towards board certification like most young practitioners are, you could be practicing in a multitude of environments.

I'd say the probably the most common is someone joining a practice as an associate, and then having surgical privileges with a hospital system. I'd say the vast majority of our surgeries do take place in an outpatient ambulatory surgery center. However, we do have capability of performing some smaller procedures in the office. Also, some more complex procedures in the hospital environment. There are some podiatrists who are employed by a hospital or employed by a wound care center, perhaps. They do use that to be their focus. But I think the majority are still in outpatient private practices with inpatient capabilities.

John: Okay. I knew we had the same experience of as many of the other medical fields, I would assume, in terms of taking call and rounding on patients, post-op, and all those kinds of things. And of course we were always getting consults on our diabetics in the hospital, which you probably hated to see. I mean, it's like, "Okay. What am I going to do here when this patient's here for three days because their sugar's a little high?" But it was a good way, at least, to get them lined up with a podiatrist, I guess,

Jennifer: For sure. It's a great way to maintain that continuity of care.

John: Okay. You were doing that and then you had the long-range plan, or long-term plan, which became very short-term, I guess. It's makes me think that things happen a little quicker and you did make a transition sooner than you had initially thought. What were you looking for and what, I mean, what was the original plan in terms of not the timeframe, but what you were going to do? Or was that part of the issue? Like, "I got to figure out what I'm going to do."

Jennifer: I think in the beginning it was a matter of me figuring out what can I do outside of medicine? What am I qualified to do? I had been very fortunate to become involved with the American Association for Women Podiatrists, probably about six or seven years ago. I joined their executive board. I've worked my way through several positions on that board, most recently having finished my tenure as president. I really had the opportunity to do a lot of work with medical education, with medical writing, with editing, because we are a very grassroots DPM-led and run organization. We don't have anybody writing our newsletter for us, or editing our newsletter for us, or doing our social media for us. We do it all ourselves.

I really had a great opportunity to get some experience there. I realized that I had a real passion for medical education, for bridging that gap between the didactics and the people. I felt, over time, that that's where my strengths lie. Therefore, that led me to look for non-clinical positions in medical writing, medical editing, medical education, medical communications, and I was able to narrow it from there.

John: All right. Very good. You really had some on the job training in a sense. I mean, that position, I assume, was a volunteer position for the association?

Jennifer: Yes, absolutely.

John: And you guys were putting together these communications, whether it's newsletters or publications through the association. I guess the president had the responsibility and the ability to be involved with that very heavily, I guess.

Jennifer: It was more in the beginning actually, as our secretary does a lot of that portion of the job. But, I was also fortunate to be conference chair at one point, where we put on our own continuing education conference about every 18 months or so. That really was a great dive into the deep end as far as getting experience goes. But it definitely is what led me to some of the more current experience in that area.

John: Now, once you had already had the writing and editing experience then, and you started looking for something, did you look specifically for associate editor or editor jobs? Or were you thinking about becoming a writer or a freelance writer or something? How did that go through the process in your thinking?

Jennifer: You know, I think I sent my resume to half a million places. I would search for medical writer, medical editor, and medical education on LinkedIn and Glassdoor and all of those usual sites. Really, I just wanted to see where things would land. I was hoping to get some experience with the interview process and with the application process. I pretty much I cast a very wide net in the beginning, but it served me well in the end. When I actually applied for my current position, I did not know what publication it was with. I only knew the parent company, which I had recognized the name of the parent company as being the one that had a journal in my profession. But I also knew they had multiple other journals that I felt that my experience would lend itself to. I was excited about the opportunity regardless, but when I found out that it was actually for a journal in my specialty, I was ecstatic.

John: That really was pretty fortuitous then. You didn't know at the time that you tried to send your resume in. But let me back up again. As you were going through this process, you were learning a lot, right? Because as you were doing the applications, you were sending your resumes out, you were looking at all the job descriptions. Right?

Jennifer: Mm-hmm (affirmative).

John: To me, I mean, that's a learning process right there. Okay. What are they putting in that job description? Wow. There's things in here that are very similar from place to place looking for a writer or looking for an editor. Those kinds of things started to gel for you and it really made sense that you were looking where you would be happy?

Jennifer: Yes, it really did. I really enjoyed the fact that they're working with clinical information. Sometimes that clinical information was going to be conveyed to consumers or patients, and sometimes it was going to be conveyed to fellow health care workers. I have prided myself over the years on being able to be a connection or a bridge between that gap. Whether it be as a physician bridging the educational gap to patients or families, or to fellow practitioners when we're putting our heads together on a case. I felt that would translate really well into that education and writing environment.

John: The parent company for the journal or the magazine that you work for now, is pretty big, so they probably have a pretty standardized approach to interviewing and hiring. Can you tell us a little bit about that?

Jennifer: Yes, absolutely. I did initially have an interview over Zoom, an intake interview, with somebody from the HR department. It was just basic review of my application, review of my background, assessing my reason for wanting to transition, because that was obvious from my resume. Just talking a little bit about the requirements of the position and if I felt it would be a good fit. It was my first Zoom interview ever, so I was terrified of technical difficulties, but luckily that didn't happen. Then after that I was asked back for an in-person interview with multiple staff members at the publication.

John: Was that anywhere near where you live or was that at a distance or-

Jennifer: I was very lucky that it's relatively close to where I live. It was actually closer than my last practice. I was-

John: Wow.

Jennifer: In my last practice I was commuting about an hour each way. By choice, because it was a great place. But this is probably about 35 minutes from my home and I don't have to cross state lines to do it. That was a bonus for me. It was a very comfortable process. They did a great job of making it clear that they wanted to get to know the applicant and what their strengths they could bring to the table.

John: That's awesome. I have more questions. I guess I should've asked you this before we started today, but is there any problem with us discussing the name of the company?

Jennifer: No, I don't think so.

John: Okay. It's Podiatry Today, and it's part of this large group, this large parent organization. It's very similar, probably, to other, these journals, these online and paper journals. Tell us about that process in terms of once you started and what that's like. I'm interested in whether it's something you do from home, or you have to travel there every day. All those kinds of things.

Jennifer: Right. Well, my answer is different both pre and post-COVID-19. Pre-COVID-19 I was in the office. In the beginning five days a week. A very regular schedule, which was a breath of fresh air for me. Having not had pretty much a regular schedule for my entire adult career. The office was a very interconnected and very team approach environment, which was fantastic. I had immediate access to so many people with such rich experience that I was made to feel welcome very quickly. I needed a lot of help in the beginning because it's a whole different world and a whole different language I had to learn between the editing process, the ... I know a lot of physicians struggle with EMR in the beginning. I felt like I was learning a brand new EMR.

John: Really? Okay.

Jennifer: As far as working with our publishing process. I did, over time, I was granted the ability to work from home one day per week, which was standard at our company. I loved it. It was a phenomenal flexibility that really helped me as a person and as a mom. Then COVID-19 came and our company made the decision to have all the employees work from home for a time. That was a big transition for everybody. But I think our team was phenomenal in making sure that communication lines were open and ready to go. We all became intimately familiar with our Zoom capabilities. Most of us have continued to work primarily from home at this point, although our offices are open. I believe after Labor Day we're going to reassess what our plan is in that respect.

John: Well, heck. You know, if you have to commute 30 or more minutes, then just think of that time saved and you can actually spend another hour working or not. I mean, that's just good now. Of course, I'd miss all my podcasts that I listen to if I wasn't in the car driving to and from work. Okay. What are the core responsibilities? I mean, we assume we know what an editor does. But I guess, what does an editor do? Maybe there's things that you're doing that maybe you hadn't thought an editor typically would do. Like to hear more about what you're actually doing in your job.

Jennifer: Absolutely. I love everything I've been doing. I've been able to learn so many new skills and I'm continuing to learn and improve on them every day. The basis of what I do in my position is I'm responsible for the first pass edit of any piece that comes across our desk. Whether it be intended for the print journal or as an online exclusive, I'm the first person to go through and make those edits, both for style of our magazine, for layout purposes, and also just general edits to improve a piece. It then gets passed onto my executive editor who takes the second pass at it. Then we go through a layout process. I had to learn multiple layout capabilities and software programs, and many different steps of the editorial process through a Word document to layout, to proofs, to the actual publication process.

I'm also responsible for the maintenance of our online website, as far as maintaining the content. Anything that's in our print journal will end up on the online website, along with online exclusives we have every month. We also have DPM blogs that run several times a week that we're responsible for putting through the editorial process and publishing. We've started a podcast ourselves too in the past several months. We've been really expanding our multimedia reach, so I've been learning how to edit multimedia, how to publish a multimedia. We also have a strong social media presence. We have a Facebook page, a Twitter page, and a LinkedIn group at this point, which part of my job is to make sure that we are posting twice a day, for the most part, on those websites. That's all our-

John: [crosstalk 00:19:16] you're responsible to make sure you have two posts on each of those social media platforms?

Jennifer: For the most part. I think one of them we do only once a day [inaudible 00:19:27] multiple times a day across multiple sites and always looking to improve our reach as well. We might be expanding our social media outlook for the next several months too.

John: All right. Well, let me go back to the beginning of the whole process. Who decides what is going to be published? It sounded like you were already in some a queue with these people, you're working with them, and making sure things are appropriate. You're doing the first pass. But who decided whether we're going to talk about topic X, Y, or Z?

Jennifer: It's a very collaborative effort between our editorial board, our contributing authors, various key opinion leaders in our field, and our editorial staff. We determine a loose editorial calendar very early in the process so that we have ideas of generally what each issue is going to look like for the year to come. We are working on 2021 as we speak. Then from there we see what else may fit along the way. We always want to make sure that we're representing a wide variety of topics across podiatry, including surgery, including limb salvage, including biomechanics, practice management, all different types of topics. Our executive editor is leading the charge on that, but it's definitely a collaborative effort among many people.

John: Okay. I'm assuming like when COVID came up then there had to be something squeezed in there that wasn't in the original plan from six months before. Makes good sense, obviously. Okay. That's really interesting. How would someone prepare themselves for a role like you're in now? How would it be different, if at all, than just, say, being a very good writer or having worked with other editors?

Jennifer: Yeah. I think learning a little bit more about the conventions of the American Medical Association style of editing, knowing a little bit more about that is extremely helpful. I think, also, getting to know what other publications are doing, especially in your field or in your area of interest. Having a pulse on what they're good at and what might need to improve for the future. I was very familiar with the publication that I currently work for. It was something that I read prior too, obviously. That was also a big help because I already had a first-hand knowledge of the types of articles that ran in the publication, the authors that generally tended to pop up more often. I think that really helped me a lot because I was able, I already had a grasp of the vision of what the end product should be.

John: Okay. Yeah. That definitely helps a lot. You're in the specialty to begin with and you've already been consuming that, so that's very helpful. But a lot of those things I would assume would apply to many other medical journals. There's so many things that overlap, I would guess.

Jennifer: Absolutely. I think so too.

John: If there's some writers out there, how much of your writing is done by in-house writers versus, let's say, people that just submit articles that might be working podiatrists, or what have you?

Jennifer: The majority of what goes into our journal is preplanned. Not in house, per se. They're all docs that are out there practicing, researching, lecturing, really involved in the field and in their areas of expertise. But we do have writers that send us submissions for consideration. When they are applicable, and when they're right, a good fit for us, we do accept those. They could end up being online exclusive pieces. They could end up being a guest blog depending on the format and the topic. But yeah, we do work with both channels of submission.

John: If somebody was interested, they could go to podiatrytoday.com, which is the online website, which also has the blog in there and everything. But they could find someone to contact there if they wanted to submit or get some information about how to submit an article or something.

Jennifer: Absolutely. There is a brief explanation on our website along with our contact information as the editorial staff. Many people have contacted us through that route with no problem.

John: Then, if there are other clinicians listening that would like to just get a better idea of some of the other journals that are being published by the parent, the parent's name is what?

Jennifer: It's HMP Global. There are multiple publications and medical conferences throughout multiple fields of health care.

John: If they looked them up they would see the different publications and maybe one would appeal more than another if they're writing articles of a certain nature or certain clinical topics and so forth.

Jennifer: Yeah-

John: Okay. Well, that's good to know, for those out there that might want to pursue that. Because I get questions all the time from writers. Like, "How do I get started?" And, "Where do I find publications to write for?" And, "Do I always get paid?" Which, at some point you better get paid. But there are things you can submit and not get paid just to establish some kind of authority. But once we're talking about writing for a medical journal or publication like this, hopefully there's going to be some standardized payment that would result. Very useful information. That's great.

All right. Well, let's see. What other advice would you have for physicians who are thinking about they maybe have done some writing, but they're really thinking, "This editor position sounds pretty interesting." Any other advice you would give them that would help to get them moving along a little bit?

Jennifer: I think potentially working [inaudible 00:25:31] physician [inaudible 00:25:32] if it's a good fit, could be a fantastic way to go when you're looking into this type of thing. I did work with one and it was immensely helpful for me. I knew I had skills that would translate into a non-clinical environment, but I didn't exactly have a clear vision of what that might look like or where that might best fit. Someone like that may have the background and tools to help you move forward in that respect.

I also think that just writing anywhere you can, and editing anywhere you can, is a great tool to have a portfolio. When I was asked for writing and editing samples, for the most part, what I was able to give was blog posts for my previous practice, the newsletter from the organization that I mentioned, both from a writing perspective and an editing perspective. The other [inaudible 00:26:32] I would also say is don't sell yourself short. As physicians, we develop such deep and diverse skillsets that I don't think we realize we're developing. There's distinct leadership capability. There is distinct organizational skills. And, depending on the individual practice and person, there could be regulatory, research, writing. There's so many things that we might have dipped our toes into in clinical practice without realizing how they can apply outside of actual practice.

John: I think that's great advice. That's very helpful. I was going to ask you earlier, but you got a little bit of the coaching. Did you do anything along the lines earlier in terms of anything formal in terms of the writing side of things? Any courses, or did you have anyone look at your writing? Anything like that?

Jennifer: I didn't, but I was certainly willing to. I did research those opportunities and I was very open to pursuing them. Had I not been successful at the stage that I was in, it certainly would have been another step I would have readily turned to. I was willing to obtain additional certification, additional courses, whatever it would take to make my background more appealing to those looking at the resumes. I think it's a great tool. I was just fortunate that things worked out at an earlier stage for me.

John: I think it's about 50/50 in people that I talked to. Though many physicians have, they've been writers their whole life in one form or another. They've always been writing something and a certain percentage just like it. They'll just write because they like to write and they'll contribute. They just learn and really don't need the formal training. But there are courses you can even take at a local community college that matter. They'll look at your writing and give you feedback if you're feeling a little rusty.

All right. Well, I think we're going to run out of time here any minute. I always say that. We could probably go on for another half hour. But I think it's only, I should respect your time. I think I've got a really good idea about pursuing a job as an editor, and at least in this particular type, as opposed to say technical writing or something like that. I really appreciate it. This has been very eye-opening and it really helps us all think more about where we would fit in, in terms of writing or editing and how to pursue a career like that.

Jennifer: Well, thank you. I am so happy that I made the leap when I did. I'm so happy with where I ended up. I really encourage anyone that's looking into a non-clinical career to not give up, to believe in themselves, and to continually search for what is out there. My husband used to tell me when I was going through this process, that I shouldn't get frustrated because the right job for me wasn't ready for me yet. Although [inaudible 00:29:36] in the end he was totally right, so I have to give that credit.

John: You know, t's just amazing because people have some of these limiting beliefs and some fears about making the transition and have almost no idea where to start. Then I find similar other people that were in your position. This perfect job just showed up. I think they're out there, but we're not looking so we don't know they even exist. They're just flying by us every day and we have no idea. But as soon as we start to turn that part of our brain on to look and be open to these opportunities, they just show up.

I mean, I can tell you about other people who made a decision to switch and the job showed up a week later. I mean, just really remarkable things that you can't count on that. It might take some work. It might take some time. But boy, there's so many opportunities for physicians. It's just amazing. you're a really good example of that. It's great. I'm sure we all love to hear that you're happy doing what you're doing now.

Jennifer: I am, I love what I'm doing. I love the company I work for. I hope that other people wishing to make this transition have that opportunity as well.

John: Yeah. It's so inspirational to hear someone that's done it and it didn't take 20 years to make the transition. Okay. Now, someone might want to get ahold of you. I know they could probably track you down at podiatrytoday.com. But you're also on LinkedIn, correct?

Jennifer: Absolutely.

John: If we look for Jennifer Spector, we're going to find you there? DPM and ask a few questions without being overly burdening to you. But we really appreciate that you've made yourself available for us today.

Jennifer: Of course. I'm happy to answer questions that anybody might come up with.

John: All right, then. With that, Jennifer, I will say goodbye. And thanks again.

Jennifer: Thank you. Have a nice day.

This transcript was exported on Sep 01, 2020 - view latest version here.

PNC Episode 160 Jurica Spector Combined Tracks -... (Completed 08/31/20)

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