In this podcast episode, John interviews Dr. Greg Gilbaugh to learn how to beat burnout for good. Greg is a seasoned dentist, practice owner, author, and business consultant.

His career involved overcoming multiple practice-destroying disasters and transitioning away from clinical work due to health issues. In addition to leading and managing his practice, he now helps other healthcare professionals build fulfilling practices that enhance, rather than compete with, their personal lives.

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The Missing Link in Healthcare Leadership

Most healthcare professionals receive minimal business training, leading to adopted rather than designed practice models. Dr. Gilbaugh emphasizes a fundamental shift: start with a vision, not a strategy.

What good is it to build the practice of your dreams only to find out it robs you of the life you always wanted? – Dr. Greg Gilbaugh

This approach has helped numerous practitioners, including a surgeon whose practice was crumbling, rebuild with purpose and direction.

Summary

Whether you're feeling trapped in traditional practice models or seeking meaningful transformation, the path to change starts with a clear vision. Dr. Gilbaugh's experience shows that healthcare professionals can build thriving practices while maintaining personal fulfillment.

Want to explore these concepts further? Check out Dr. Gilbaugh's book Letting Good Things Run Wild [Amazon affiliate link*]or visit kalosbusinessgroup.com for free resources, including practice development guides.

Links for today's episode:

• Dr. Greg Gilbaugh's book: Letting Good Things Run Wild [Amazon affiliate link*]
• Kalos Business Group's Website
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 376

How To Beat Burnout For Good Without Leaving Your Practice

- Interview with Dr. Greg Gilbaugh

John: I recently ran across a dentist, former pastor, and consultant who experienced many of the same challenges that many of you physicians have experienced over the years. I thought it'd be fun to get him on the podcast and ask him a few questions about how he has faced those challenges. So with that, I want to introduce a dentist, Dr. Greg Gilbaugh.

Dr. Greg Gilbaugh: Thanks, John. It's a pleasure to be here. I'm looking forward to a chat with you.

John: Yeah, because you're a business consultant, that's the thing that really piqued my interest and being a dentist, a lot of what you've experienced over the years is very similar to what we physicians go through. So I thought definitely we could learn a lot from you. So maybe you can start by just telling us a little bit about yourself and the story that brought you through to what you're doing now.

Dr. Greg Gilbaugh: No, thank you. Yeah, I came to the University of Iowa when I was a young lad. I came here on a football scholarship. I was an offensive lineman. I wanted to come here and play Big Ten football and go to dental school, and I was able to do that. Bought a small practice in the area, got married, and it was the start of a wonderful season of growth. My wife and I, we currently are standing at nine children that we love nurturing and releasing. But for me, I love the field of dentistry. I love leadership and business. The practice has gone through a lot of what I call significant growth strategies where seven years into the practice, the building was struck by lightning and burned to the ground.

John: Oh, boy.

Dr. Greg Gilbaugh: So that was a time where we said, okay, let's take some insurance money. Let's glean what we know is working well, and now let's next step of growth. So we found a place to lease, started practicing again, and then our community endured what was considered a significant 100-year flood, which brought eight feet of water into our clinic space. So we had to regroup, take an insurance check, rebuild, regrow, and then we had a nice location, nice facility. It was at that point in time out of debt. Personally, professionally, I was thinking about my next stages. We had 14 families that were working with us. And then we had the catastrophic 500-year flood that devastated the area of town where I was in, but this time, no insurance coverage for flooding.

So I was 50 years old. I came home to nine kids and a wife, and we were essentially wiped out. We had nothing left. Decided that at this point in time, I was too young to give up, and I really, really felt it was in my best interest to continue on. So we found a new location. We just restarted from scratch. And I knew at that time, it's like, this is now a much bigger office. Mistakes are costly, so I really took a deep dive into business and leadership. No margin for error.

And what we found was that in five years, we doubled our clinic space, doubled our number of doctors, doubled our number of employees, and significant growth was going on. We had learned a lot. Started to build then another clinic facility, and it was during that time that, real quickly, my hands lost their fine motor skill and fine sensation, and we found out that it was due to some brain trauma from playing football, and I had a significant mold infection from probably walking around and enjoying the floodwaters of the great Midwest.

So that was my transition out of clinical care and then into this world of coaching, leadership, helping healthcare physicians. I'm still at the two clinics four and a half days a week. I love coming here, but I think that what I have learned is of some great benefit to others. So that's where I find myself. I'm still in the game, but it's from a leadership perspective, and then branching out to help others.

John: Wow. Well, probably the pandemic for you is like nothing compared to those first two or three events.

Dr. Greg Gilbaugh: We were able to weather the storm well. It's like, and again, we had told the people, yeah, during the pandemic, "We've gone through stuff before. We've been able to come through on the side. We're going to make it. We're going to make it. So let's come up with a mission. How we're going to do this." And we got through it.

John: So now you're focusing on the business aspects of the practice. Can you give us an idea of the scope in terms of maybe how many are working with you or that kind of thing?

Dr. Greg Gilbaugh: Yeah, I've got a larger general care and orthodontic clinic where we've got four doctors and 30 staff here. This one has been in business for 38 years now. And then right across the parking lot, we purchased some space. And now we've got a pediatric children's clinic that works hand in glove with us at this location. And that one has just gone over four years. We started that from scratch. That now has two doctors working in there and a staff of 12. So I go back and forth. They're both very different. One's just starting out. One's a very mature growing one. So I get to see both ends of the stick, so to speak, keeps me sharp.

John: All right. So you've had to rebuild numerous times. Now you're involved in this. And so at some point, a couple of things happened I think from what I know about you, you decide to help others build their businesses, I think, other professionals in health care. And somewhere along the way, you also wrote a book about doing that. So you can take either one of those and just tell me how that all developed.

Dr. Greg Gilbaugh: Well, when I was out of clinical care and wanted to get my thoughts onto paper, that's where the book came from. I have a relationship with a gentleman. He's my personal executive coach. We've formed a great, fond relationship. He's wrote a number of books. He encouraged me to do the same. And so what I saw really was that there is for us in health care, we get very, very little training and exposure to how do we do the business end of this? We have to figure that out on our own. And then also like, how do we lead people? Very little exposure to that. Leadership can be taught, and it can be embraced and it can be learned and you can become very skillful at it.

The other aspect that I found personally and with many others is that when it comes to the issue of faith, I help them to be able to connect their faith to their profession. There's a big chasm, I think, there where they go to their local church. They're not getting the help they want. They're professional organizations. They're not speaking to it. And there's this big chasm. And when they can connect that, they feel that they have got something significant going on. So the book actually is like integrating your personal faith into your practice so that not only does your faith get deeper, but we talk about basic business fundamentals, and then leadership over a lifetime. And so it gives them a foundation that they can now start to build their specific practice how they want to in a way that will grow and be very fulfilling for them. That's how I serve my clients.

John: Well, as I was looking through the book, I mean, I just want to throw out some of the things that stood out to me for the listeners in case they're thinking of picking it up. But there was a lot in there about stewardship, integrity, service, vision, mission, leadership was a big part of it. So it's not just, okay, here is an integrity of how you do certain business practices, but more of a global and oversight in terms of why you're doing this business and how to do it and the values and so forth, principles that go into it. So that sounds very helpful. Now, what's the name of the book? So we can go find it.

Dr. Greg Gilbaugh: Yeah, the name of the book is Letting Good Things Run Wild. And that can easily be purchased on Amazon, whether an ebook or the paperback. They can also get a copy at my website, which is Kalos Business Group. That's K-A-L-O-S, kalosbusinessgroup.com. They can go there. I also have on there for people that are interested, just a free PDF on key performance indicators.

And I say, here are three, just three key performance indicators. You focus on these, and you will find that your revenues will increase pretty significantly over six months. That could be true in the dental field, that can also be true in the medical field. So there are some things that are free, there are some books to be purchased, I think that you'll find it very encouraging. Because it goes over essentials of building a business, which starts with what is your vision for your business?

This is where I find many people in business, but especially healthcare, when they sit down, and they first come to me, and they'll say, "I need some help." I'll give you an example. I have a physician, a surgeon that I'm working with right now. And I met him last year having a chat in a parking lot of all places, never met him before. We started talking. He had an incredibly a walk through hell of a private practice. Partner docs that left, partner docs, it blew up lawsuits, defamation, slander, disaster, and felt bad for him as he's a great physician. And so I said, "Okay, so how'd you get here?"

And he said, "Well, I hired this guy because I knew him from residency thought he was good." And I said, in essence, he said, "This is what other surgeons how they run their business. So I decided this is how you must run your business. No one ever taught me. So I'm looking at the veterans. This is how they're doing it. And it just totally blew up." And I said, "Okay. So what would you do differently?" And he goes, "I would do this, I would do this, I would do this. And I would do this." And I said, "Well, then, why don't you build that kind of a business?" He goes, "Well, can I?"

I go, "You absolutely can." And just saying, "What is your vision? You know, you've got a great opportunity to start all over here. So what kind of private practice surgical business do you want to build? What does it look like? Where are you going?" And then it's like, how are you going to get there? What's your current reality? Which looks like hell right now. But it's like things are, as I continue to meet with them, it's like, yes, now, our current reality is here, and it's already so much healthier, because he has a vision. There are people who left, but there are people who stay because they go, "I like the vision of this place, it resonates with me. This place is going somewhere, it's doing something." And it's like, okay, how are you going to get from where you're at to where you're going? And what are your next steps?

And then how are you going to help to encourage, lead, serve your team to get there? Whole perspective has changed. He's still in the same location. It's just that the guts of his business have radically changed. And all I've asked him is like, "What do you want to do?" He's never taken the time. And as physicians, you know what it's like, John, it's like everything is so busy, that we don't take time to say, "Where do I actually want this place to go?" That's what leads to burnout. That's what leads to frustration.

In some of our email exchanges, you asked a really good question where you said, "Can a group of physicians, can an individual physician, can they build a private practice that really offers excellent service, a personal fulfillment and a generous income without becoming burned out?" And the answer is a resolutely yes. But it hinges on this, personal fulfillment, what is it? What actually is your personal fulfillment? And so what I do when I work with physicians, dentists is I first work with them, I call them, "What's your life plan?" They go, "Well, what's that? No, what I need, Greg, is I need to know how to hire better staff. I need how to do this. I need new software."

And it's like, those are tools for the trip you're going on. Where are you going? And so we work with them, offer help. Sometimes I say, get away for a day. And I give them a tool. It's like, "What's important to you? What are your main responsibilities right now?" And then they list them. And I said, this is what's important to you right now in your life. And of course, business is one of them. How satisfied are you with all these things? But it gives them a snapshot of their life. And it's like, "What do you want these areas of life to look like in three years, five years, whatever?" Because this is what you're responsible for, like John. This is what's in your lap. What do you want this to look like? Too many times, physicians want to have a independent vision for their business that starts to compete with their life. That leads to frustration.

I remember about eight years ago, when I was talking to a group of about, I think it was about 16 dentists at a mastermind with the intention, all of these dentists want to build multiple practices. It's like the new way. It's like, look, if my profit margins are down to here, I'll have to build multiple so I can get it back up. They were going through an exercise about really their vision. What kind of practice do you want to build? And when I had a chance to talk with them I said, "What good is it to build the practice of your dreams only to find out it robs you of the life you always wanted?" And it was at that moment, I was early in this kind of stuff, but I remember it was like dead silence. Pens stopped working and everyone's eyes got big and they looked at me. I go, "I think I just struck a nerve." Which is like, yes, it doesn't mean you can't build the practice of your dreams.

But if it robs you of that life plan, it's like if it totally sucks you out, you know in medicine and in dentistry it's like we're up at the coaches AP polo, like with divorce and job dissatisfaction and alcohol abuse. And it's like, we're not a real healthy group when we get. And it doesn't have to be that way. And I think if early on, it's like, look, the practice of your dreams, maybe the practice of your dreams that you see like 30 years down the road, that's great.

But what is it going to look like in the next five years? Because your responsibilities are different. Time is God's way of making sure that everything doesn't have to happen all at once. Let's take the long view and make sure that you're genuinely fulfilled so that when you're at work, it's like, I like coming home or I like here. And then when you come home, it's a fulfilled life, not just a career with a bunch of zeros where it's like, I hate going to work. The only reason I go to work is for money.

And then it's like, it's not a very gracious master. When they say, look, this is what will give me fulfillment, which is very different from I'm working with a younger dentist who contacted me because he's like, "I'm in this group practice. I've got a four-year-old, a two-year-old and mum is seven months pregnant. And I feel like I've got no time for myself. I'm living out of fear." And it's like, "That's normal, young man. That's normal, okay? You're just transparent enough to admit it. Okay. You fear failure. You fear the future. You fear finances. I would say you're secure enough to admit it."

So we're working on his life plan. Eventually it's like out of a good, healthy life plan will come your vision for your business. Okay. So it doesn't compete. It enhances your life. So that when you have all of these things starting to grow that you're responsible for, that is fulfilling, that is passionate.

And yes, you can have an incredibly fulfilling life. Now, when you say like a generous income, financial reward, that's the fruit on the tree. That will come when you start serving your people, serving your practice, because when you are a fulfilled physician and you are, when you're fulfilled, you're passionate. That is where burnout starts to go out the back door. Because it's like, I love what I'm doing because I see what it's doing to enhance my life, my family, what I'm called to be, what I really, really, really want to do and become that's fulfilling.

That's why I say Monday is one of my very favorite days because I get to come back here. Because I find where I'm at and how I want to finish my life, I'm a young 65. It's extremely fulfilling for me. That's why we chose to build after natural disasters. That's why we chose to go on after becoming disabled. I find a lot of fulfillment .And the practices have built to such a point. It's not like, wow, that is so unique, Greg. It's like, no, this can happen to others.

John: Let me jump in for a minute here, because I want to reflect on some of the things you've said. I mean, first the vision part of it. So many professionals, they just don't really think about the vision. They think, okay, I'm going to get through school, residency, whatever it is to get that licensed, to get that degree and certification.

And this is the way you practice. And when they step back and say, what's really important to them, as you mentioned, they can see that I don't have to keep doing all of this stuff. That's not fulfilling. That's frustrating. That's not in the line with my principles and my values. And I've just been amazed by the way some physicians have focused more narrowly, maybe, on the part they really love.

Um, and again, that gets back to, you're talking about the vision. And we tend to think, well, these things can't change because it is the way it is. And they become afraid of having those conversations with their partners or their boss or whoever. So do you go into a little bit of that, how to communicate your vision, how to get everybody on the same page so that we're all rolling in the same direction?

Dr. Greg Gilbaugh: That is so key and so important because as let's say the leader, which I always, I make synonyms like you're responsible here. Okay. You communicate it. This is where I really want to take the practice. And if you're with others, you need to communicate. It's like, "Look, this is where I feel it really would benefit the practice." It's so much easier when you start at the beginning, when it's just you and you're starting out. And it's like, this is the trajectory so that when you hire other doctors, come on, it's like, "This is where I'm taking this ship. Um, would you like to join us? And do you bring something to enhance this journey? Don't bring in a competing vision. This is what we are. This is what we're about. This is what's important. And this is where we're going." And you keep communicating that to your people.

People want to come to a place of work that's going somewhere so that they can see what I do today is actually making progress towards what I'm here for. I'm not just going around the cul-de-sac over and over. Okay. And then checking out. I'm actually helping this place move somewhere. And it's a preferred future. It's something that's like, yes, I want to get there. And you repeat it over and over and over. And as the leader, you say, I usually stress to the doctors, find your team, your support people. And if they're doing something well, according to where you want to go, and then our core convictions, the six behaviors that we say are essential for success, you find someone doing that. And it's like, you know what, "Hey, time out. Do you see what you're doing? That's exactly what we're about here."

And then as the old football player say, "Helmet sticker, okay, really good job." And you reward those. You say, "This is what we're about." When you're bringing on staff, help people to join. If you're bringing on a partner, it's like, "I just want to let you know, this is what we're about." You will find that there are people out in your profession, in your lane, in your specialty, subspecialty, they're looking for a place just like that. That's who you want to join.

There are other people's like, might be highly skilled, brilliant, really good. But they have a different preferred future. And it's like, that's okay. Well, which one's better? Well, I'm not going to say which one's better, but this one's mine. This is what we're about. So God bless you and go over there and prosper. Yes. But we can't have competing visions for the limited time, resources, and energy that we have here. So let's all bring it to row in the same direction. When you've got a clinic that's moving in that direction, that is life giving, it's encouraging, it's passionate. And when you hit the bumpy waters, like reality gives us, it's like, we're going to get through this. Because I want to get through this. I'm determined to get through this. And we're going to keep going because there's something so fulfilling and satisfying by experiencing this.

John: Let me shift gears for a minute here. Let's say that I am one of those physicians, I'm in my 50s or 40s or whatever. And I do want to build something of my own. And it's not been working. What does working with you look like? What is an engagement with you in terms of what would someone expect? Because most physicians have never engaged a consultant to help them. So maybe you can just share how that looks.

Dr. Greg Gilbaugh: No, that's really good. First of all, we have a lot of conversations to onboard them, and what are you looking for? What is your desires? And I will, I start off with big picture life plan vision. What are you responsible for? You got a guy that's 50. And it's like I've got maybe two kids and they're college age. Okay. So the parenting is little, we're almost done. Okay. So where would you like to go? What's important?

Okay, and then these things. And then okay, and business is part of it. It's like, okay, where are you at? What's your current reality? Well, I'm a partner or I'm a partner in a practice where I'm solo practitioner and I do like this. I don't like this. What are my passions? What are your strengths? And we do some assessments. It's like, "Hey, you're really good at this. This is how you like to lead. These are your strengths. This is what you bring to the game. So what would that look like if you want to change? If time and money were not a problem, what would you do?" Oh, I'd probably do this. It's like, how realistic is this? Do you see you can do this. And I ask a series of questions like, "Are you willing to pay the cost for this?" "Yeah, because this is what it'll get." "Okay. How do we do this? How do you think, now you know where you're going, what are we going to do in the next year? The next two years? What are your next steps that are going to cause you the most success or the most progress in this journey?"

John: One of the things that I hear a lot from my listeners is that they would like to get to the point where you are now. Now you were sort of you didn't have a choice because of some of the challenges, the health and so forth. But can you encourage them or support them and give them advice for how to get to the point where maybe they just want to run the practice, have other physicians that are on the same page, but really focus on the business, the marketing and the growth and not really the grind of working in the hospital or that kind of thing?

Dr. Greg Gilbaugh: Yeah. That is a great transition, because I feel the greatest asset to a private practice is the people. I mean, as physicians, it's like, look, you're all smart. You all have access to you can go to the bank and get finances, you all have a good career, you can get like, training, equipment, whatever, everyone's got access to what differentiates your practice from another, and it's the people that are in it. When you are then saying, I want to move out of the clinical area, from being a provider, to now developing and leading people so that they are now the multiple providers, okay? You now have time to invest in developing your people and getting them actually better.

Now have more time to focus on the vision. Let the others, some business paradigms call them integrators. They're the people who love all the details. They love to get in there and do all the work. They love being on the front lines, let them do that. Then asking them, what do you need to succeed? I will do what I can to make this place even better.

You always have the commander of the ship, so to speak, it's like I'm going to take responsibility for making this place better. Some physicians, some people find like, wow, this is an avenue that I only thought was possible. This is exactly what I want to do. You think of someone in their 50s like that. Here's a person who's got more, probably discretionary resources, finances, wants more discretionary time and you are at the top of your apex of wisdom. Dude, now is the time to, you have so much to give. You have so much to give.

I just read a great book. It was called Full-Time about work. And the authors, one of the premise they said goes, "You know what happens when we ask people to retire in their 60s and get out of the marketplace, we are actually cheating the 30 year olds from great mentorship." And it's like, that was highlighted over and over. It's like, yes and amen. You have so much more to give now in developing people and really making your clinic, your practice become a place that is just exceptional, exceptional. And people want to work there.

John: I think a lot of us would love to do that. If we're in that situation, we can just figure out how to make it work. We're going to run out of time, so I guess just any closing remarks. So first, again, tell us about the book, where we can find the book and the website, and then any advice for again, mid-career physicians who are just feeling frustrated and they're not sure what their next step should be.

Dr. Greg Gilbaugh: Yes. Again, thank you, John. The name of the book is Letting Good Things Run Wild, the integration of faith into your business so that your faith deepens, your business actually gets much better, and your leadership impact becomes incredible. You can find it on, of course, Amazon Bookstores, but you can also get it at our website, Kalos Business Group. That's K-A-L-O-S businessgroup.com. You can order it there. Again, there's also the free PDF on the three key performance indicators, and if you focus on them, you're going to find some good results.

Again, I think that if they want to check out my website. It'll have a lot of stuff there, and if they want to set up a call with me, there's a place to set up a call, and we can just talk, because sometimes doctors in healthcare, dentists or physicians, chiropractors, whatever it is, they don't know what's actually possible. They only know what they have been experienced in their lane, and it's usually like, I'm frustrated, so I'm going to find a different line of work, or I'm just going to retire and get out of the psych.

That's only two options of a plentiful banquet, okay? There's a lot of stuff to choose. You just don't know what's being served, and what's possible. And again, I serve clients by not telling them, this is what you need to do. I try to ask them questions and try to pull out within them what their desires and what their passions are, and then ask questions to find out, is that something that you would like to pursue? Because then I think I can help you in this new journey.

And sometimes it's the second wind that many of them really want, because they, why did you get into this profession in the first place? Well, I want to help people. A lot of ways to help people, and you don't have to throw away all of this experience that you have gleaned over decades. Maybe it's being prepared to do this in your final season of life, which could be your most enjoyable, fruitful, and impactful season of your life.

John: Yeah, it's true. And we've experienced, you've seen people that have done it, obviously I have as well. So it's just a great message. Well, I want to thank you, Greg, for being here today, sharing your wisdom and your resources with us. Be sure I'll have those links for my listeners. They can go and take a look at the PDFs, the downloads that you have, and also learn more about your consulting business. So I guess with that, I'll say goodbye.

Dr. Greg Gilbaugh: Dr. John, one of the highlights of my day. Thank you for letting me come on and visit with you. It's been a pleasure.

John: Okay. Take care.

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Interview with Dr. Sharon Hull – 351

In today's episode, Dr. Sharon Hull explains why exploring what matters most is critical to designing your career.

From her early experiences in small-town medicine to her role as a pioneering leader in physician coaching, Dr. Hull's story resonates with professionals seeking greater fulfillment and meaning in their work lives. Today, she empowers listeners to embark on their personal journeys of self-discovery and intentional career design.

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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. 

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

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Navigating Leadership in Medicine

As a seasoned coach and mentor, Dr. Hull recognizes the importance of leadership development for physicians and other professionals. She discusses the unique challenges physicians face in leadership roles, from communication barriers to institutional politics. Drawing from her coaching experience, Dr. Hull offers practical advice on cultivating essential leadership skills, including effective communication, time management, and strategic decision-making.

Professional Careers by Design

Dr. Hull's forthcoming book, Professional Careers by Design: A Handbook for the Bespoke Life, serves as a roadmap for professionals seeking to design their careers with intentionality and purpose. Through a blend of practical strategies and thought-provoking exercises, the book guides readers through self-discovery and career planning. Dr. Hull emphasizes the importance of aligning career choices with personal values and aspirations, encouraging readers to embrace change and pursue meaningful work that reflects their authentic selves.

Dr. Sharon Hull's Mantra

Start with what matters and then figure out how you can get more of that in your life.

Summary

To connect with Dr. Sharon Hull and explore her insights further, you can visit her website at www.mettasolutions.com. You'll find valuable resources there, including her blog and information about her book, Professional Careers by Design: A Handbook for the Bespoke Life. Additionally, you can follow Dr. Hull on LinkedIn for updates and insights into career transformation and intentional career planning. Whether you're seeking guidance on navigating career transitions or crafting a purpose-driven career path, Dr. Hull's expertise and resources offer invaluable support on your professional journey.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Sharon Hull's Metta Solutions Website
• Dr. Sharon Hull's LinkedIn Page
• Professional Careers by Design: A Handbook for the Bespoke Life
• Dr. Debra Blaine's Coaching Services

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

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Transcription PNC Podcast Episode 351

Explore What Matters Most and Design Your Professional Career

- Interview with Dr. Sharon Hull

John: One of the things that comes up very often when I'm speaking with physicians who are looking for what to do with the next chapter of their life because they're unfulfilled or unhappy is they have this question, "How do I figure out what I should be doing or find out what my passion is?"

Anyway, they've never done that introspection before and that's why I'm so happy to have today's guest, Dr. Sharon Hull with me today. She's written a book, she's been doing coaching for years and she's addressed this particular problem many times with her clients over the years. With that, let me welcome Dr. Sharon Hull.

Dr. Sharon Hull: Thank you, John. It's a delight to be here. I've been following your work for several years and happy to talk to your audience of people who are trying to figure out how to make peace with this career choice.

John: Yes, and how to make the best of it maybe and continue it, maybe get rid of the bad parts of the particular situation and keep the good parts. Tell us about your background, what you've been up to and then we'll get into my questions and about what you've been doing. So tell us about your journey.

Dr. Sharon Hull: I'm delighted to tell you a bit of my story. I'm a family physician. I tell people by initial training and by my DNA. It was my natural fit when I went through medical school and had a wonderful 30-plus year career in family medicine, most of it in academic medicine but I did start in solo rural private practice near my hometown which was its own wild ride of an experience. People that were my second parents, my best friend and my babysitter as a child helped me paint the trim on my office the night before we opened. That's a classic small town family medicine story.

I had a great career as a physician and I realized that my life was going to need to make some shifts along the way to deal with family needs and for that reason I entered early a career of coaching kind of as a side gig with medicine. Everybody in my medical world and my academic world knew that I was doing it and I figured I would go full-time into it when I retired in my mid-60s. That was my mental plan.

And life happened and in my early 50s I got the opportunity to become a full-time coach within an academic center and build a program for coaching physicians and scientists in that center and had a wonderful time doing it but I found myself in my encore career about a decade before I expected to and I haven't looked back. No regrets about medicine and no regrets about an early transition to an encore. So, that's the short version of my story. I'll answer any questions you have.

John: That was very interesting and listeners, I recommend you look at Sharon's LinkedIn profile because you'll get a fuller picture in some ways. It's not the full story obviously but it just shows the number of transitions that Sharon has navigated. Before we get into my other questions, Sharon, can you just tell me the name of your hometown in Southern Illinois?

Dr. Sharon Hull: I grew up in a little town called Ridgeway which was the popcorn capital of the world as it claimed itself. There were 1,200 people in town and 23 people in my high school graduating class. It was a classic small town experience.

John: Do you have any idea how far away that is from Metropolis? Have you ever heard of that town?

Dr. Sharon Hull: I do. I know exactly where Metropolis is. Are you from Metropolis by the way?

John: I'm not but my wife's family is from there and some of them still live in that area.

Dr. Sharon Hull: I grew up probably about 60 miles from Metropolis, just a little bit north.

John: That's definitely Southern Illinois. It's almost Kentucky.

Dr. Sharon Hull: People think that Illinois is all Chicago and there's a whole bunch of the state left.

John: All right, let's get back to the interview. One of the things I wanted to comment on is it looked like because you're involved with academics and you're doing it with coaching, it looked to me a lot like it was leadership coaching and I think that the part they don't necessarily teach in med school and residency, you have to be some type of leader when you're a physician but it's not always the right type of leader. Any comment on that observation?

Dr. Sharon Hull: I have some comments about it. I don't think we get taught how to be leaders and I think leadership is a profession in and of itself that has a certain skill set that you might have if you're a physician and you might not have. I worked with a lot of physicians who found themselves in leadership roles because of their clinical expertise or their scientific expertise and they didn't know what to do with humans in a nonclinical setting.

Usually I wasn't working with people who were in trouble. I was working with people who were new to leadership roles and trying to build the skills. We focused a lot on communication skills, on time and energy management as a new leader and what I sort of jokingly call the institutional perspective or the politics of the whole thing. That's where I spent most of my time in leadership coaching. It's that perspective taking and communication skills.

John: Yes, as you know physicians are often put in leadership role for a team or a committee but if we work in a corporate environment, it's different, or any kind of big hierarchy. It's a whole different way of interacting with people. A lot of people are focusing more on servant leadership for the last 10 or 20 years and so that means it's not like the military approach, the way medicine used to be. That's an important thing. And you must have been contributing heavily to your organization. I don't think there are that many that were doing that kind of coaching at the time.

Dr. Sharon Hull: We were one of the early institutions. I won't say we were the first but we were among the first to really put in place a program that wasn't about people being in trouble. It was really an investment in mid-career talented people who were rising up the ladder and helping them be successful. It was a lot of fun.

John: Sounds like it would be fun. That was a thing that brought me to you when we connected on LinkedIn a month or two ago. And at the time I was setting this interview up with you I didn't actually realize you were on the verge of releasing your book and it addresses all these issues around leadership and designing one's career. I thought this was definitely something we have to talk about. So tell us what's the name of the book and why did you write it?

Dr. Sharon Hull: I'm happy to do that. The title of the book is Professional Careers by Design: A Handbook for the Bespoke Life. This book is kind of a distillation of about a dozen years of coaching professionals about how to help them make their career what they want and need it to be at that moment. Helping them realize that their needs and wants change over the course of a lifetime and that's okay. It's really kind of a guidebook to a lifelong process of being intentional about your career.

I came to write it because I kept coaching people who were asking these questions. How do I know what I want? What do I do? I've trained to do one thing and I can't imagine not doing it but I can't imagine keeping on this path. And I kept looking for the book that I could have them read and I couldn't find the book that covered what I was covering. And after about eight or nine years I decided I probably was going to just have to write it. And that sounds arrogant and I don't mean it to but I couldn't find anybody who was talking about it the way I was coaching people. So I decided to put that in print and maybe leave it as a guidebook.

John: I'm glad you did and the thing is the book hasn't been released yet as we're recording this but it's coming out very soon.

Dr. Sharon Hull: Launch day is tomorrow, John. April 30th. By the time your podcast goes live it will be live and released. We're going to do a big launch event tomorrow where I'm doing interviews of people about their career journey and we're going to have a lot of fun. By the time your listeners hear this it will be available to the public.

John: Okay, we'll get to how to get the book in a minute but it struck me as I was looking at the index for the book there's so many different areas they think are right on in terms of what we need to learn about it. Probably any professional in a similar situation. I don't know if you'd agree but there's a big group that's a lot like us physicians and that's professional athletes. They work really, really hard for a long time. They get burned out and they face things even more in a compressed way because their careers are usually shorter.

That's what I'm going to ask you about today. Some of the things in the book and you can educate me and our listeners and then go off in any direction you want but just to get things started you know what I hear a lot is that physicians say they're just unhappy. I can't really keep this kind of pace up forever. I'm just overwhelmed. I've experienced the same thing myself and that even if you enjoy medicine there's a certain point as you get older you just can't keep up that pace. You can't be on call and work long hours forever. And so, the question is always what do I do next? How do I find out or figure out what I should go towards rather than running away from something?

Dr. Sharon Hull: I'll respond to that first by saying it is good to go towards something rather than just run away. I think that's a hallmark of the early conversations when I meet with somebody who wants to think about changing careers.

The next things I do because I'm a family physician by training is I try to assess the degree of burnout and the degree of mental health compromise and assuming that people are stable and not in urgency about those things. Then we have a conversation about what matters to you. I remember asking one man in his early 50s that question and said "What matters to you right now?" And this was a kind of a classic stoic man who looked at me and just started crying and it surprised the heck out of him that he cried but when he was able to gather his thoughts he said nobody's asked me what I wanted in 40 years. And I think as professionals, it's not just men it's men and women, and it's not just physicians but as professionals we don't ask ourselves what matters very often.

And so, at the beginning of my book the front section is about discernment and it starts with that question, "What matters most to you at this season of your life?" I think that list changes over our seasons. It changes when you're early in your career when you have young children if you have children, when you have caregiving responsibilities or health issues. That's what I mean when I talk about the seasons of people's lives.

When I give them this exercise and it's the first exercise in the book, make your top 10 list of the things that matter. And I tell people, I quote a dear friend and mentor who's recognized in the book, personal and professional, it's all one life. You have a finite amount of energy. What you do with it's up to you. And so, that's kind of the ground state for the book and then I ask them to make that list of what matters and I tell them the only rule is you have to have some personal and some professional things. And there's no right ratio, just make your list. You can't be wrong it's your list.

I bring people back to talk about that and I ask them what they learned and what surprised them. And almost invariably what surprises them is the top five to seven things are personal they're not professional. For all of us, it's kind of near universal human experience with the exception of people who are very early in their careers or at a very high competitive time in their career. I have a professor who's trying to get tenure and trying to get their grants written or somebody who's trying to get through residency or fellowship. Those people it's mostly professional at the top. But for most of us once we're through that, it's about person and nobody gives us permission to do that conversation in our own heads. I feel like I'm preaching to the choir here, let me be quiet and let you do any follow-up if you want to.

John: Well, I think it's ironic sometimes when I talk to people, for example, someone who's working 60 hours a week they're trying to generate a lot of money so they can donate it or contribute it to some venture to be able to share the income to get access to and support that other thing that probably is what's important to them. And to me it's like "Well, why don't you just do something that somehow brings these together if that's really what matters to you?" And like you said life and the career aren't necessarily separate. So that's just an observation that I've made and I'm sure you've seen different versions of that same kind of thing.

Dr. Sharon Hull: Well, you do too. You reach a lot of people and you've talked to a lot of people. I have seen some of the online conversations you've had and these are common questions and you're seeing the same variations on a theme that I see. I will say they extend beyond just the profession of medicine and I tried to write the book or any professional however they define themselves but particularly people who have studied for a long time to enter a profession and have a set of expectations that they'll stay with it from society or from their family or from income needs or whatever. That's who the book is written for is the people who feel like they might be stuck.

John: I'd like to go back to something that you mentioned earlier and it's this whole idea of a life and a career by design. Maybe that's something everyone should be taught either in high school or college about actually taking time to try to design your career, design your life and maybe go back to it from time to time. Growing up I was good at math, I was good in science, I got good grades, so I guess I was going to be a physician. So, how should we really look at that? How should we conceptualize that?

Dr. Sharon Hull: I devote some time in the very beginning of the book to talking about the idea of design thinking, kind of the idea that you make the best first choice you can make and you keep tinkering. And it's people who design furniture or design machine parts do that. Thomas Edison did that when he invented the light bulb. He had 1,500 ways he failed and he said "I didn't fail, I had 1,500 ways not to do it." Sometimes I meet people that feel that way about their careers. And so, the idea that we're designing always gives people that sense of agency to reassess.

And my real unstated goal, I guess I'm stating it here so it will be out of the bag is to get this book in the hands of young trainees as early in their careers possible. I actually think that people younger than you and me have handle on this that we didn't have and they're going to reiterate their careers multiple times. This is just a guidebook to how to do it.

John: Well, I have to agree with you. I have seen some examples that I thought "Wow, they had so much insight in an early age and they were really thinking two or three steps further than I ever thought." Again we're such old school I think, we're from a different era but I couldn't see past that horizon so I just kind of plugged along and did my thing until maybe I felt like it just wasn't the right thing anymore.

Again, I mentioned this earlier but if people look at your LinkedIn profile I think it was a good example yourself and again it might not have all been by design at the beginning but it does demonstrate that you can make significant changes, you can evolve, you can shift from you know patient care to some non-patient care position but still doing what you love and maybe like you said what matters.

Dr. Sharon Hull: It doesn't have to be static but people do have constraints on their decisions. And we talk about that in the book. Perhaps when you're young you have fewer constraints. And we enter a time in our late 20s early 30s to maybe our 40s mid 40s where there are a lot of personal constraints. They might be financial, they might be child rearing, they might be geographic. There are lots of reasons people feel stuck in that period. But if they can see light at the end of the tunnel or see that they do have choice, they can come through burnout a little differently, I think. At least that's my hypothesis, we'll see.

John: I think that's right on at least from what I observed. You mentioned the term "agency" a minute ago. We don't use that term very often. Maybe in a corporate environment I might have heard it once in a while it's a bit of jargon but has a certain really applicable meaning to what we're talking about. So, can you explain what that means to you?

Dr. Sharon Hull: I will. I will first say that as a young family physician I was taught the term self-efficacy, the ability to believe I could do something about a problem I was facing. And to me agency is maybe a just a different term, maybe it's more corporate speak, maybe it's more ethical psychological speak. We are the agents of our own lives and we don't talk about that much. That doesn't make us selfish. It does make us responsible for the choices. I have a coffee mug on my desk over here that says "Never complain about what you permit." And when I first saw that quote it hit me right between the eyes. It's like yeah, if you don't like something, figure out how to change it without just creating chaos around you. And the book is about how not to create chaos but to do it intentionally.

John: Yes, it's odd to me that we feel that in spite of being part of one of the most educated professions on the planet we don't feel we have any options and we don't have any control over life once we get locked in and we've finished residency or fellowship, whatever it is. And you kind of feel like "I have to do this, I've invested so much into this role." And that whole thought process holds us back. But we're not actually obligated to do anything.

Dr. Sharon Hull: I actually have two things I'd like to say about that if I could. The first is that I spent a number of years as the dean of students for a medical school. And my job was to run orientation for the first year students and it was about three weeks long. And at the end of three weeks I would meet with them in small groups and I would say "If in the last three weeks you've figured out that this is not the place for you, and this is not the profession for you, could you say that?" And in eight years six or eight years of doing that job no one ever said yes. Three weeks in people felt stuck.

Now the second thing I want to say about that is our friends in law will tell you my law degree teaches me how to think but it doesn't mean I have to be in the courtroom. They see the skills as a doorway to do all kinds of things. And for a long time I was envious of my law colleagues and then I thought "Well, I have some skills that could open some doors for me too. I just need to think about it differently." So, I got fascinated talking to my law friends.

John: When you were just talking about that question you asked your students as a dean, I always kind of looked at it as a conspiracy. I can't imagine any of my instructors professors or other teachers would tell me "Oh, yeah, after you get into this or maybe eventually you want to do something else outside of medicine or something that applies medicine in a different way where you're not subject to being stuck with dealing with insurance companies and all the regulations and the long hours doing in the EMR."

It seems like they're part of that system and they want to continue this system. They don't want to let anybody out of the system and that might be overly cynical I'll admit. And at least you were there asking that question. I personally have never talked to anyone who's had a positive response to a physician in training who was thinking about leaving medicine. They'll usually do whatever they can to keep them there for a lot of practical reasons too.

Dr. Sharon Hull: Some of the earliest informal coaching I did was with medical students who really did figure out the answer to that question that they really didn't want to do clinical medicine. And much to the chagrin sometimes of my superiors I became a safe place for them to talk. And that may have been where I kind of learned my pathway was going to have a place here.

John: As I suspected your superiors weren't necessarily real enthusiastic about that.

Dr. Sharon Hull: There's this whole mentality of societies investing in your training and you owe society back. They've invested in you and this is a calling. There are lots of parts of that myth and it's not entirely mythical you have to decide what part of it applies to you.

John: It shouldn't be a surprise though when you consider that most of us made a decision to go into health care when we were children.

Dr. Sharon Hull: That's where the term agency comes in. I'm the agent of my own career. And sometimes the choices before us aren't great but we make the best one we can in the moment and get really intentional about what's next.

John: Well, there's more about that in the book, and I am going to ask you one more question before you go. But first let's talk about where they can find the book and then tell us the title and the easiest way to get the book when it comes out.

Dr. Sharon Hull: They can find out more about me obviously through LinkedIn and I'm assuming you'll put my LinkedIn in the show notes. But my website is www.mettasolutions.com. Metta, that's the name of my company, Metta Solutions. And on that website they'll find my blog, they'll also find a page devoted to the book which is titled Professional Careers by Design: A Handbook for the Bespoke Life. On the book page are several options for buying it. You can also find it in the common places like Amazon or Barnes & Noble or Goodreads. But that book page on my website collects all of those in one place.

John: Okay, excellent. Well, we are going to run out of time pretty soon now so I'll put those links to everything you mentioned in the show notes, of course. In thinking about your kind of typical clients or my listeners, any last words for any professional who might just be frustrated or unhappy in their career and how to maybe be better at designing it.

Dr. Sharon Hull: Start with what matters. That is my mantra. Start with what matters to you and then figure out how you can get more of that in your life systematically every day and let the list change as your life changes. That sounds like airy fairy kind of stuff but it's really not. It's common sense. My grandmother would understand it. Just start with what matters and the rest does come. The book can be a guide to the technical parts about what you need to deal with.

John: Yes, that's very helpful. Let's start with what matters. Maybe just sit down and start writing your list.

Dr. Sharon Hull: Top ten list.

John: And if you need help you can start by getting the book. All right, Sharon, this has been fun.

Dr. Sharon Hull: It has been fun, John. Thank you.

John: Thanks again for coming. Bye-bye.

Dr. Sharon Hull: Bye-bye.

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Interview with Dr. Joe McMenamin – 347

In today's episode, Dr. Joe McMenamin provides priceless advice for the new expert witness.

Dr. McMenamin, an attorney with an extraordinary blend of medical and legal expertise, shares his compelling journey from medical school to the courtroom. He describes the convergence of these two disciplines, offering insights into the integration of medical and legal expertise.

Our Show Sponsor

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

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

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

In only 1 week from today, the second annual Nonclinical Career Summit will be starting. It’s not entirely nonclinical in its scope, however. We have several presentations about starting and running a private practice without fighting the insurance companies.

It's called Clinical Practice: Make It Great or Move On

And beyond building your cash-based practice, our speakers will show you how to create an asset that can be sold later. Other experts will discuss MedSpas, Infusion Lounges, and other cash-only businesses, using Real Estate to diversify your income and assets, and several nonclinical side gigs including Expert Witness and Medical-Legal Prelitigation Consulting, Medical Affairs Regulatory Consulting, and remote SSDI Application Reviewer.

To learn more check it out at nonclinicalcareersummit.com. Remember that there is NO cost to attend the live event. And if you can’t participate in the Summit, you can purchase the All Access Pass videos for only $39 (until April 16, 2024, when the price increases to $79).

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Exploring Expert Witness Work: A Physician's Perspective

Joe delves into the need for expert witnesses, emphasizing their role in educating lay jurors on complex matters. He discusses the distinction between fact and expert witnesses. He also outlines the demands on the expert witness, including the need for clarity and credibility in communication.

Considering Expert Witness Work: Opportunities and Considerations

Benefits and Opportunities

John and Joe explore the potential benefits of engaging in expert witness work for physicians. They discuss financial rewards, intellectual challenges, and educational opportunities associated with this role. Joe highlights the satisfaction of contributing to the legal system and assisting jurors in reaching informed decisions.

Challenges and Considerations

Despite its advantages, Joe cautions physicians considering expert witness work about its potential challenges. He discusses the time-consuming nature of reviewing medical records and the necessity of navigating cross-examinations. Joe also addresses the importance of maintaining credibility and the risks associated with advertising one's services as an expert witness.

Exploring the Intersection of Medicine and Law: Career Considerations

Joe shares advice for physicians contemplating a transition to law, addressing common frustrations within the medical field, and the allure of pursuing a legal career. He highlights the significant commitment required to attend law school and cautions against making impulsive decisions driven solely by dissatisfaction with medical practice. 

Summary

Joe McMenamin offers valuable insights into legal careers, particularly in expert testimony. He mentions his law firm, Christian and Barton, and encourages interested individuals to contact him for more information. Moreover, he extends an invitation to connect via email for discussions on career transition or legal inquiries.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Christian & Barton Law Firm
• Joe McMenamin's Bio and Email Address at Christian & Barton
• Christian & Barton Phone Number: 804-697-4100
• How to Be the Best Expert Witness Consultant – 262
• Top Reasons to Become an Expert Witness Now – 163
• Reserve Your Free Spot at the 2024 Nonclinical Career Summit
• Dr. Debra Blaine's Coaching Services

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

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Priceless Advice for the New Expert Witness

John

I've always been interested in expert witness work as an attractive side gig. You know, it's interesting, it's intellectually stimulating, it pays well. And in fact, I've had a couple of physicians here on the podcast before, but I've never had an attorney who actually engages or hires or whatever you want to call it, expert witnesses for their cases.

So I'm really happy to have today's guest here. Welcome to the podcast, Joe McMenamin. Thank you, John.

I'm happy to be here. I appreciate the opportunity. I have to just say that it's hard for me not to call you Dr. Joe, because as Joe was going to explain, he does have both the MD and the JD, so he's going to get into why and how that happened. But again, his work has been, you know, as the attorney engaging the physicians to help him out on cases. So that's the perspective we really want to get today. So why don't you go ahead and tell us a little bit about your background and education, how you ended up where you are these days.

Joe

Sure, John. Yes, I went to med school. I'm not a young whippersnapper.

I went to med school between 74 and 78 at Penn, and then did internal medicine at Emory from 78 through 81. And towards the end of that residency, I applied to law school. It was a concept that I had been thinking about on and off since boyhood, and never really made up my mind for sure until pretty late in the game.

In fact, I was applying to nephrology fellowships at the same time that I was applying to law school. Decided on the latter and went to Penn once again, finishing in 85. It took me four years because halfway through the first year, I had to take a year off when we discovered we were pregnant and I had to put a few dollars together.

So I was a moonlight ER doc for a while. And then finishing law school in 85, I went to practice at a large international firm, was there for a good many years. And then about 10, well, in 2013, I did solo stint for about a year, which was, sorry, 10 years, which was quite a change.

And now I'm at a firm called Christian & Barton in downtown Richmond. Curiously enough, in the very same building where I began my career, but with a different firm. And health law is the main focus of what I do for what I assume are obvious reasons.

John

Very nice. Yeah, that must've been an interesting few years there. Have to jump back and forth, you know, in your education, work again clinically.

How did that year go?

Joe

Well, actually it was longer than a year. I mean, I began my ER moonlighting career as a resident, as a JAR and an SAR. Kept it up during law school, all the way through law school, which is entirely doable.

Law school's curriculum is a very different animal from medical school. The one year that was full-time was occasioned, as I say, by the impending birth of our firstborn and the need to put a few dollars together.

John

Since that time, when you took that first, I think full-time job as an attorney, you never then went back to clinical work part-time or moonlighting or anything?

Joe

No, no, I haven't touched a patient since, good Lord, 1985. And so as I tell lay people, if your back hurts or something, I am not the guy you want to talk to. I mean, Rusty doesn't even begin to cover me.

On the other hand, everything I do benefits from and utilizes in some fashion and to some degree, my education and training in medicine. And I've been fortunate to be able to develop a legal practice that capitalizes upon that stage in my education. And I'm grateful for it to this day.

Excellent.

John

Well, the first question I have relative to this, the reason you're here today to understand this work as an expert witness is really to get to your side of the story, your take on it as someone who's engaged physician. So why don't, let's see, why don't we just start by saying, telling us about, you know, why is there a need for expert witnesses? Why this should potentially be an interesting thing to do on the side for physicians, most of whom will still be practicing when they do this, although I understand not always.

And just kind of tell us about your perspective on those topics.

Joe

Well, the reason that expert witnesses exist and not just in medicine, but a great many other fields is that in US law, pardon me, which was stolen in large measure from the British, a lot of decisions are made by juries. And, you know, people wax eloquent about the wonders of the jury system. And indeed it does have a lot to recommend it.

But jurors are by definition lay people. They're chosen from the ranks of registered voters or from drivers or what have you. And it's not impossible theoretically that the next jury that comes along might have a Nobel Laureate in physics on it.

But the probability of that is pretty remote. And even if you did, that doesn't mean that this very bright, very capable person knows anything about how to work up an acute abdomen or what have you. So the idea is to bring in people who by virtue of their knowledge, skill, training and experience are able to enlighten the jury about the menace, about what is expected and whether in a given instance, the defendant, the person being sued did or did not comply with what we refer to as the standard of care.

And because we recognize that however intelligent, somebody with no medical training or background is not going to have any knowledge or at least probably has no knowledge or if he does, he has precious little about medical topics, we bring in physicians to serve as experts. Now, if the case involves, let's say toxicology, we might not want a physician, we might want a toxicologist or it involves a totally different field. I mean, there's all sorts of experts in all sorts of fields that limited only by your imagination but an accountant could be an expert witness potential or a geologist could be an expert witness depending upon what the nature of the claim is.

I focus of course, on healthcare matters. So naturally, the vast majority of the doctors, sorry, of the experts I've hired have been physicians.

John

Okay. Now, what is your understanding of why this might be interesting to do for a physician? I'm sure some of the people come in and do it maybe with some misconceptions but why would you think it'd be something that would be of benefit for a physician to pursue?

Joe

Well, I'll start by suggesting that it is not for everybody. You could be the best doctor on planet earth and perhaps not be a very effective witness. Reverse is also true.

You could be an extraordinarily talented witness but not necessarily a great doc. They're entirely different skill sets, at least as I see things. It may be useful to have a little background in evidence law to preface what my remarks on this.

There's a distinction in the law of evidence between fact witnesses and expert witnesses. A fact witness is just that, somebody who, for whatever reason, has knowledge of facts pertinent to the case. So I leave work this afternoon and I happen to see the Chevy hit the Ford in the intersection.

I don't know the driver of either one. I don't know what either one was doing. I frankly don't even want to be involved but I happened to be there at the time.

I saw what I saw. In the event a lawsuit ensues from that situation, then whichever side thinks my testimony would be useful to its version of the case, can require me if necessary, or can certainly ask me, and if need be, back it up by law, and require me to come to court to testify to whatever I saw. And this proponent, the side that has asked me to come, can ask me a series of questions designed to elicit from me whatever knowledge I have of this situation.

After that, the other side, the side representing whoever the defendant is, if I'm on the plaintiff's side of it, will cross-examine me, ask me a series of questions intended to suggest to the jury that maybe I'm not such a reliable witness. Maybe I didn't see things very clearly. Maybe it was a cloudy day and my vision was hazy because, I don't know, I'm not wearing my glasses.

Or maybe I'm not reliable. Or maybe I'm friendly with the driver of the other car. Whatever, all of that is perfectly kosher, perfectly legitimate.

And, you know, if I do well on cross-examination, the side that asked me to appear will be pleased, and if I don't, then the side that did the cross-examination will be pleased. But the point is that all I can testify to is what I saw or heard or what I know. I cannot offer an opinion.

I cannot say, I think the driver of the Chevy was at fault, even if I really do believe that, and even if, in fact, there's good basis to say that that's true. That's an opinion I cannot offer. Moreover, I don't get paid for my time.

It's expected of me as a citizen to show up when I need to and to testify. An expert witness is a different animal. An expert witness, first of all, is a volunteer.

Nobody can force you to be an expert. You have to willingly accept the opportunity if it is given to you. Second, you do get to charge for your time.

The law recognizes that every moment that you spend horsing around with some lawyer some place is a moment that you cannot be seeing patients or whatever it is you normally do, and as a result, you're losing money in this proposition unless you can bill for it, and so you can. And third is, yes, indeed, you can give opinions. That's the whole point, in fact.

The reason that whatever makes you an expert is that you have knowledge that most people don't, and therefore your views on a particular technical or scientific or medical or otherwise complicated subject are intended to be, and we hope are, useful to this jury of laypeople who have no prior exposure to these concepts, have very little understanding of them, and the biggest job that the expert has is to be a teacher, at least as I see things. You're there to teach the jury what the facts are. Now, even that's a bit of an oversimplification because although I think the distinctions I just drew between fact witnesses and expert witnesses are correct, there are also two types of experts.

There are so-called consulting experts, and then there are testifying experts. A consulting expert, as the name suggests, serves as a consultant to a lawyer, or maybe a group of lawyers, and is chosen presumably because of his knowledge, whatever his expertise may be in the judgment of those hiring him, is highly valuable, highly relevant to whatever is at issue. But that person does not appear in court, does not testify, and the side hiring him is under no obligation to identify him to the other side, nor to tell the other side, even that he exists, much less what his credentials are, or what his opinions might be, or what the basis for those opinions might be.

He's purely behind the scenes. The testifying expert, on the other hand, is the one that Hollywood will make a movie about, or at least feature an expert in a movie about a trial. This is the person who, yes, will indeed have educated the lawyer ahead of time, presumably, but will also be there in court, will take an oath to tell the truth, will then testify in response to questions posed to him by the sponsoring lawyer, and will respond in turn to the cross-examination questions offered by the sponsoring lawyer's opponent.

Now, both the plaintiff, that's the person bringing the suit, and the defendant, the person being sued, have the right to call an expert, or sometimes multiple experts, depending upon the nature of the case and its complexity. It's not unusual, for example, to have at least two experts on both sides. Why?

Well, because the malpractice theory proceeds on the basis of ordinary negligence law, which has four components, classically, duty, breach, causation, damages. Nothing novel here. I'd be disappointed in any first-year tort student who couldn't rattle that list off just as well as I can.

Duty. If you're my doctor, I'm your patient, you owe me a duty. It's pretty much that simple.

It's usually straightforward, not so much. If I'm an accident victim on the side of the road, and you are driving past, and you see me there, and you're able to help, and you decide to help, or you decide not to help, that's duty. Generally, that's not contested in these cases.

It's pretty clear that you do or you don't own a duty. Breach is, in contrast, highly contested. That's the heart and soul of the case.

Did you or did you not breach the standard of care at the relevant time caring for this particular patient? The plaintiff's expert's job on standard of care is to say the standard of care requires A, B, and C. Doctor so-and-so, the defendant failed to do, did do A and B, but he didn't do C.

That's a breach of the standard of care. The second expert that that plaintiff may call is a causation expert, because that's the third element of the story. Again, it's duty, breach, causation, damage.

It's causation is the so what question. I don't know. I'm a general internist, and you come into me with a history of a bad cough.

It seems to be getting worse. You're coughing up blood. You've lost a bunch of weight.

You've got some chest pain. Oh, and by the way, you've got a 100-pack year smoking history. And on examination, I discover that you have a hard mass in your left supraclavicular fossa.

And then on X-ray, there's a mass demonstrated in the left upper lobe, but somehow, I don't put two and two together, and I say, well, sorry, you've got the cough, nothing serious. Probably go away in a few weeks. I'll see you again next year for your annual physical.

But after that appointment, you leave my office, you cross the street, and you're run over by a bus, and boom, you're dead right on the spot. Is there a cause of action against me for medical malpractice for failing to diagnose what I hope was a reasonably clear case of lung cancer? The answer is no.

Why? I might have reached a standard of care in not being able to make that diagnosis, but I didn't kill you. My mistake didn't kill you.

The bus killed you. So maybe there's a claim against the bus company or the driver or both. Maybe there's a claim against the city for not putting a stop sign there.

I don't know. Use your imagination. But there's no claim against me as the doc because I had nothing to do with your death.

There are a class of experts who testify to causation, which is, from a medical point of view, often the most complicated and also the most interesting part of a malpractice case. Why did so-and-so develop condition X? Or why did he die at the age of whatever when he should have lived another 10 years or so it could be argued?

Now, one doctor could serve as both the standard of care expert and the causation expert, but it's not unusual to have one of each or, for that matter, more than one. And then just as the plaintiff gets to call experts to testify to these matters, the defendant can too, and the defendant will if he, as it descends, at least in my view, and you find somebody that you think is highly qualified, testify contradicting what the other side's experts said. Now, at the end of the day, who gets to decide the answer?

The jury. Now, philosophically, you may think that's smart or dumb. I'll leave that to you.

But we've been doing it this way. I'm using we in a grand collective sense, tracing it all the way back to England shortly after the Norman invasion in 1066, William the Conqueror and all that, for nearly 1,000 years. And that's how we decide these cases.

So for better or worse, the lay people sitting in the box are the ones who decide what the standard of care is and whether on a particular occasion, Dr. Smith did or did not comply with that standard. Now, I finally get around to your question was why would you want to do this? Well, you've already pointed out a couple of things, John.

First, you do make money doing this. You know, your time is valuable as a physician. And, you know, it's not at all unusual.

In fact, it would be unusual not to have an expert charge less than let's say $300 an hour. 400 is not unusual. 500 is not unusual.

600 is maybe pushing it a little bit, but not all that much. You know, the sky's the limit. There is a downside.

If your fee is so high as to put you out of reach, you may not get hired because you're simply too expensive. Or the lawyer is willing to bear the freight for whatever that fee happens to be and it warrants into many thousands, but the other side gets to find out what your fees are and can cross-examine you. And a skilled examiner will have no trouble suggesting that because you're $20,000 richer or having got involved with this lawsuit that you're a hired gun and therefore your credibility is out the window.

Now, the jury will not necessarily reject your testimony because of the 20,000 or 40,000 or whatever it is, but it might. So bear that in mind. But there is a source of revenue here and it's not trivial.

There are people who push this really hard. I had a, I mean, one of the most enjoyable aspects of malpractice defense work is cross-examining the other side's expert, at least when you've got some goods on. I mean, I had an expert who testified against me many years ago that I remember vividly.

He maintained a private airplane. The better to go from deposition to deposition to courthouse to courthouse all across the United States and made a handsome living doing this and simply didn't bother seeing patients. Well, it wasn't that hard to cross-examine this guy.

Maintaining airplanes is an expensive proposition. You have to earn a lot of money to be able to do that. And he did, he did it by testifying.

He would testify all over the country all the time and he didn't bother seeing patients because he was too busy testifying. Now here in Virginia, he would not qualify because there's a rule here that says that if you don't have an active clinical practice or at least have had one within two years of the relevant day, then you're no longer qualified. However learned you might've been 20 or five years ago, you're out of business.

Not every state has that rule. So more elaboration perhaps than was necessary, but income. The other thing is it will help you develop a better understanding of the legal system.

Doctors have extensive educations going for years and years and years as I don't need to tell this audience, but seldom do they get much exposure to or experience with the legal system. This is one way to learn about. As you pointed out, John, this is an intellectual challenge.

It is clearly an intellectual exercise here. When you're talking to a jury, remember these folks have no relevant education or training. The wisdom in the field is to suggest that you ought to assume that these folks have a seventh grade education.

Not to disparage anybody, not to put them down, but just because they really don't have much to go. So you've got to take concepts that you and other really smart people have spent a lifetime studying, understanding, agonizing over, and reduce it, translate it in a manner that lay people can understand. Got to keep it simple enough that John Q.

Public, listening carefully, can follow it. So teaching lay folks about complicated subjects is not necessarily an easy thing to do. It is definitely a challenge.

And then when you get cross-examined, if you weren't challenged before, unless the cross-examiner is really lousy, which is possible, then you're truly about to be challenged. I mean, that's the whole game. The game with cross-examination is to try to discredit this witness by whatever means you can come up with short of breaking the law.

And there are a lot of ways to do that. So you need to be on your toes if you're going to survive cross-examination. And if you don't survive it, your chances of being hired again are diminished a little bit.

On the other hand, if you come through it like a champ, the same guy that hired you last time is going to be interested next time if there is an opportunity. Or there isn't, but there's a network among lawyers on both sides of the V, as we call it, the plaintiff's bar and the defense bar. If I need an expert on some topic where I've never had to hire an expert before, I might call up one of my buddies on the defense side and say, hey, Charlie, I had a case coming up.

I need a pediatric neurosurgeon. Can you help me? Yeah, do you have any experience?

And he'll say, no, I'm sorry, I don't either. But he might say, but talk to Mary Smith down the street. I think she hired somebody like that.

And I call Mary up and Mary may be able to say, well, talk to Dr. X at Mecca University. Guy's terrific. And I do that.

Well, we talk to each other and we know about these things. You're also, and this might sound corny, you're also making a meaningful contribution to the justice system. Remember, the jurors, I'm convinced, truly do want to do the right thing.

They want to be fair, they want to be just, and they struggle to do this correctly. And if you're able to help them reach a logical, sound conclusion, not only will they be grateful, but you have genuinely contributed to our country, at least as I see things. And of course, if you testify on the defense side, and I never did and never will do plaintiff's work, you're helping your fellow docs.

Now, I don't know, John, have I, should I go over to the negatives or should I stop?

John

Good question. Well, I guess, yeah, why not? It's kind of addresses this issue.

If someone was thinking about pursuing this work, there's probably certain things you'd want them to know about it, what they should expect, the good, the bad, the ugly. So yeah, why don't you take that on now?

Joe

Well, I've already dwelled at some length on the cross-examination phenomenon. Cross-examination is tough, at least if your examiner is worth his pay. I mean, if he's any good, he'll do a good job.

And that means you've got to be very, very alert. It's time-consuming. If you're going to do a good job, you've got to review the medical records.

Many times in malpractice cases, the medical records are extensive. And the days when we relied upon paper, you know, you got two feet worth of documents to plow through. And granted, doctors read charts all day, every day, and they know how to do it.

But something that doctors, frankly, don't often do is they may not necessarily read the nurse's notes, or the PT's notes, or the OT's notes, or never mind the NA's notes in a nursing home case. You know who does? Plaintiff's lawyers.

So to be aware of what's in potentially damaging information in the nurse's note written at two in the morning, you probably need to read that. Even if in your actual work in clinical practice, you want to see what your consultant had to say in his note. You want to maybe see the progress notes from your colleagues who wrote a note in the chart yesterday.

And you're not necessarily going to pay so much attention to what the occupational therapist had to say. But in litigation, what the OT said might very well be important. So it takes a lot of time.

You're also going to spend a lot of time with lawyers. Some people would consider that cruel and unusual punishment. Depends on your point of view, but if you don't particularly like lawyers, and if you don't, you are not unique in the medical profession, factor in that you're going to spend a lot of time with people that you may not necessarily like.

Now, on the other hand, if I'm hiring you, one of the things that I will do my best to do is to make you happy, since I want you to cooperate with me, work hard with me, do a good job for my client. So I'm going to do my best to keep you happy, but I can't change the fact that I'm employed. Now, and of course, if you do plaintiff's work, you will run the risk of antagonizing your colleagues.

Now, flip side of that. Just as I can portray the guy with the private airplane as a prostitute, if you did nothing but defense work all day, every day, well, I'd be grateful, I would kiss your feet, but you wouldn't be vulnerable to cross by a plaintiff's lawyer who would point out that in the last 16 cases you've reviewed, all of them were for defense counsel. And you refused 17 opportunities to represent, not to represent, but to testify on behalf of plaintiffs, if that were true.

So factor that in as you're thinking about these things. So it can be enjoyable, but it also has its downsides. And one thing I would caution you about is you want to be careful about advertising.

Some docs are eager to do this kind of thing, make that very clear. When I was a baby lawyer a long time ago, I received a letter from a doc in the Central Virginia area addressed to me at my law firm and inviting me to hire him as an expert. No, I'm sorry, I got my story mixed up.

That's not quite correct. Instead, it didn't go to me directly, it went to a guy down the hall, one of my colleagues, one of my fellow lawyers in the firm, whose field was construction law, didn't do malpractice work at all. But he wandered down the hall, he said, Joe, take a look at this, I don't know if this guy's any good or if you're interested, can't help me, but maybe he can help you.

Well, I didn't hire him. And frankly, one reason was because I try to avoid hiring people who advertise. Why?

Because of the very thing that happened when the guy came to trial, by chance, a year or two later. At the right point, when my opportunity to question him came, I said, Dr. So-and-so, who is Ron Eimer? And he said, I have no idea.

I said, well, you write letters to Ron, don't you? I'm sorry, I'm not familiar with this person. I said, all right, well, let me show you Exhibit A.

And I show a copy, of course, to opposing counsel, and I show a copy to the court. Take a look at Exhibit A, if you would. Do you recognize your signature at the bottom of that letter?

Yes, I do. Is that your signature? Yes, it is.

Okay, and Ron Eimer is the person to whom this was addressed, is he not? Yes, and it says Ron Eimer Esquires. He's a lawyer, is he not?

Yeah, and beneath that, it says McGuire Woods and Battle, which was the name of the firm at the time. That's a law firm, is it not? Yes, it is.

So you were ready to Mr. Eimer to get the opportunity to testify, weren't you? And of course, you're getting well-paid for your time this afternoon, are you not? So your advertising really paid off pretty well, didn't Mr. Plaintiff's lawyer?

You know, I can be an SOB when I need to be. So think about that. Doesn't mean you never advertise, or you shouldn't.

Maybe you have to, but be careful because you're creating potential cross-examination equipment and believe me, I won't hesitate to use it if I think it's going to help my client prevail in the case. Also, be careful if you testify too much, as I indicated earlier, you undercut your credibility. Even if there isn't any rule that says you're out if you don't have an active clinical practice, as there is in Virginia, if I can portray you as somebody who testifies for a living, doesn't really take care of patients, then I have severely harmed your credibility because the jury wants to hear, almost always.

They want to hear from docs who actually care for folks who are sick or who are injured, not from people who don't do that for a living. It's too easy for opposing counsel to paint you as incredible, not worthy of belief. Also be careful of organizations that group experts together.

There are companies in the business, there are companies that will advertise to lawyers and say, look, we've got a whole stable of experts in every subject from A to Z, and they really do. They've got from anthropology to zoology or whatever. You need an expert in whatever field, we can help you out.

And they can't. And I won't mind admitting that at times I have relied upon organizations such as that, but be careful because if you get in bed with those guys, you'll have a contract with them. The contract will likely be discoverable.

Contract may very well have language in it that people like me will be able to use to hit you over the head on cost of examination. Think about proof sources. They're important.

You know, it's not an obvious thing. And I had to try a few cases before I began to understand really how important these paper trails may be. So, you know, think about these negatives as well as the positives.

I'm not trying to talk you out of doing this in the least. I've had some, I'm deeply grateful, and I mean that with the most profound sincerity to experts who helped me out and helped me get a doctor's chestnuts out of the fire in a way that was convincing to the court, convincing to the jury more important. And I'm indebted to those folks and I would help them any way I could.

And on the other hand, if you testify against me, I'm going to try and crush you if I possibly can. You may crush me, but that's the name of the game.

John

I do have two or three other little questions before I let you go. One is, you know, people always ask, okay, well, how much am I going to have to do with that massive chart review? How much am I going to have to do for prep and writing report?

And then, oh, do I have to, you know, go to a deposition, prepare for deposition? And what about how often will I end up in court? What's your experience been with that?

Joe

The amount of reading and preparation is largely a function of the complexity of the case and the scope of the medical record. If the chart is comparatively skinny and the facts are simple, well, frankly, there's a pretty good chance of mine I go to court, but if it does, then your prep will be comparatively painless. Now, you will have to spend time with the lawyer that hired you.

That's important. He needs to understand how you're going to answer a particular question, and you need to understand the rules of the road, and the lawyer's job is to acquaint you with them. The lawyer is not there to tell you to answer a certain question a certain way, but the lawyer can try to anticipate what some of the questions will be and can discuss with you various ways to handle them. In the end, it's your opinion, not the lawyer's.

You're the expert, not the lawyer, so you have to answer it as you see fit, but the lawyer can point out that, I don't know, if I look at my wall over there, there are probably six or eight adjectives I could use to describe its color, none of which would be incorrect or untrue, but one might provide in the mind of the listener a different image, maybe a better image, than choice number six, perhaps, and there's nothing wrong with discussing those possibilities.

As far as depositions, that's a matter of state law. All of this stuff is governed by, nearly all of it, is governed by state law. Some states do not make provision for depositions, and it's a matter of choice.

It's a matter of grace and agreement between the lawyers, but you can't force a deposition of the opposing expert in some states. In other states, you can. It's a matter of right.

You get to do it. You can count on the deposition taking probably a good two, three hours and another one or two before that for prep time. Remember, that's all billable.

You get to bill for all of it. I take the position that the prep time, you bill to the lawyer that hired you. The deposition time, you bill to the other lawyer because he's the one who determines how long that deposition goes.

Now, some depositions are endless. I mean, I've had them go for two days, but that's rare. That's unusual.

I've had them be 35 minutes. That's equally rare and unusual, but a couple of three hours, maybe four, that's not unusual. That's fairly typical.

Trial work, you may be on the stand for a relatively short period of time. Often, that's not the case. We'll get to that in a second.

What you may not realize, though, is you have to be available on call. The lawyer does not control the pace of the trial, at least not completely. The judge has the most control over that.

The judge is going to be sensitive to when the jury needs to get up and get a bite to eat or to go to the john or whatever it might be. Things happen. You've got a game plan before the trial.

You have six witnesses. You want to call them in this order. You think you're going to need an hour for this one, 30 minutes for that one, two hours for that one, and so on.

You make all those plans, but while the planning is a good idea, very often you can't stick with that plan. You think that you're going to call your expert at roughly two o'clock on the second day of trial. Well, you can tell him that and he can plan around it, but it might not be until the third day of trial, or it might be 10 o'clock that morning, or it might be some other time.

For a practicing clinician running an office or a hospital practice too, for that matter, that's really difficult to deal with. Yet, the lawyer needs you to have that kind of flexibility because he just doesn't have control over the point in time at which you're going to be needed. When he needs you, he needs you.

No joke. If you're somehow unable to put an expert on, chances are you lose that case. It's very, very difficult to prevail without your expert.

When you sign up, recognize that you're making a commitment and it may be very inconvenient to you. If that's not acceptable, I fully understand and respect that, but don't sign up. Now, discuss it, of course, with a hiring lawyer.

There are circumstances when the degree of control is a little better than I've suggested, and maybe it won't be so difficult. But do realize that trials are unpredictable animals, and things happen at a rate, at a pace that you may not be able to predict.

John

The other sort of short question I have is what's the demand like now, and is it related more to specialty and expertise, or is there an ongoing demand, or is the demand already kind of flooded with expert witness? What's that about?

Joe

Well, this is the United States, and it's 2024. We live in the litigation capital of the known universe, and our enthusiasm for litigation, we as Americans, does not seem to have abated at all during the course of my career. If anything, it may have increased.

And the national pastime is not baseball. The national pastime is litigation. Now, of the physicians out there, and what are they?

A million doctors, maybe, in the whole United States? There's a certain number of them, a fairly high fraction. You want nothing to do with any of this.

They flat will turn you down. And that's their right. They have every right to refuse.

There's no duty to do this. And that means that your pool to choose from is narrow. Of those willing to testify, there are some that I wouldn't hire because it's too easy for them to be cross-examined.

Of those that I am willing to hire, it could be that my number one draft choice is going to be on vacation on the day of trial. And so I'm out of luck. I can't use that guy.

And so for a whole variety of reasons, the chances are good, I would think, that the demand will be there. And there is a market for these services. If it is of interest to you, and you don't want to advertise, you can quietly over lunch or a game of golf or whatever floats your boat, mention it to Dr. So-and-so. Or maybe mention it to, if you happen to know a guy working for, a person working for a malpractice insurance company, who after all will be the ones to pay your freight at the end of the day. Say, you know, I'm curious about this. Tell me about it.

And you don't put anything in writing because that's too easy to find. But a little conversation like that could pave the way to opportunities. So you want to be discreet about it.

And I wouldn't go beating the drum, but let the word get out in subtle and not too obvious manner. And you might get some opportunities. You might find that you really like it.

Then again, you might hate it. So go to school on whatever opportunities you do get and judge whether to keep up with this sort of thing based on your initial experiences.

John

I do have one more question. And this is a tangent that we kind of discussed a little bit during a prep meeting that we did a while back. And it was this idea that as a physician, I get really frustrated.

I'm tired of people telling me what to do. And, you know, the heck with it. I'm going to go to law school and somehow take this out on somebody else.

What's your advice? Or have you heard that comment before? I have heard that comment before.

Joe

I get phone, not every day by any means, but I get from time to time, I get a phone call from Dr. So-and-so from out of the blue, somebody I've never heard of, probably will never speak to again. But somehow, he got hold of my name. And he says, tell me about law school.

Tell me about being a lawyer and all that. And I've developed, I'd like to think, a fairly accurate set of antennae for telling whether the inquiry results from a sincere curiosity about how you combine these fields and whether it would be of interest versus the kind of physician you just described, John, who's thoroughly hacked off because some person somewhere who doesn't have anywhere near his credentials or his training or his knowledge or his experience or the pressure or the responsibility of caring for a patient has just told him, well, no, we're not going to provide prior authorization for whatever it is you want to do.

Well, I understand why you would be very angry about that. If I were subjected to that, I'd be furious. And I don't mind admitting that, however, is not, repeat not, a reason to go to law school.

Law school is a three-year investment. Nowadays, you're looking well at six figures. It's a time when, yes, you can work part-time as I did, but you're not going to be able to earn the fees that you could in full-time practice in medicine.

And, you know, it's not as hard as medical school, in my opinion, but it's not a walk in the park either. There's a lot of reading to do. Some of it is fairly difficult sledding.

Some of the professors you'll like, and frankly, if your experience is anything like mine, some of them you won't. And, of course, you'll be in there with a bunch of young leper snappers, quite possibly. Now, not so much as years ago, but still, you'll be older than most, probably.

Those factors may not necessarily be to your liking, or maybe they will be, but it is a major commitment. It's not just something you decide to do on the odd Thursday for no particular reason. So, if you're angry about the way medicine is being practiced, I understand that.

React to it in some way that makes sense, but don't, on that basis and that basis alone, go to law school. One of the reasons, one of many, that I went to law school, quite honestly, is that I saw a lawsuit wreck the life, and I'm not exaggerating here, I think that's not an exaggeration, wreck the life of a young doctor who was a year ahead of me in training, a fellow that I truly looked up to, a fellow I consciously tried to emulate, because I thought he's the ideal resident by the time this happened, he was a fellow.

I'd like to be just like Dick. And something happened, and he got sued, and he just wasn't the same person. And frankly, I don't think his patients got, at least for a length of time, got quite the same service that they did before.

And I thought, this is wrong. Somebody ought to do something about that. But this was after having thought about it for, I don't know, however long it is from seventh grade to senior residency, a long time, on and off, and weighing many variables and asking people about it, talking to people who are in the field, etc.

You don't do it on the spur of the moment. You don't do it because you're ticked off, however justified your anger may be. You do it because you want to be a lawyer and practice law.

Otherwise, don't bother.

John

I tell you, looking back though, it does sound very interesting. I'm way past that hill. But anyway, okay, so last thing, how do we get a hold of you?

Joe

The best bet, frankly, is to either call me or send me an email, and we'll set up a time to chat. The firm's name is Christian and Barton, B-A-R-T-O-N. And if you Google McMenamin, Christian and Barton, you won't have any trouble.

You might not have any trouble with Joseph P. McMenamin. There aren't that many of us, even in Ireland, and it's still an unusual name.

John

And I'm more than happy to talk to you. All right, well, with that, I want to thank you so much for spending this more than half an hour here today talking about this very interesting topic. So, Joe, with that, I guess it's time to say goodbye.

Joe

Well, thanks very much for the opportunity, John. I enjoyed it, and I hope it's of interest to your audience.

John

You know, one thing that we forgot to mention, so I will throw it here at the end, is that we're going to be seeing you at the Summit, which is going to be in place, is going to be going on within a week or two of the release of this. So, I think my listeners know, because I've mentioned it in other podcasts, but Joe's going to be speaking on a different area of his expertise, having to do with the structure of corporations and starting a small business, those kinds of things. And that'll be running the 16th through the 18th of April of this year in the second annual Summit.

And, boy, we really look forward to hearing from you there, Joe. That'll be fantastic. Thank you, John.

Looking forward to it myself. All right. Bye-bye.

Bye now.

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

The post Priceless Advice for the New Expert Witness appeared first on NonClinical Physicians.

Episode 328

In today's episode, John helps listeners to decide whether expert witness or medical legal consulting best aligns with your needs.

From decoding the nuances of medical documentation to navigating the uncharted waters of depositions and court testimony, John shares a roadmap for physicians eager to diversify their careers.

Our Show Sponsor

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

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

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

Did you know that you can sponsor the Physician Nonclinical Careers Podcast? As a sponsor, you will reach thousands of physicians with each episode to sell your products and services or to build your following. For a modest fee, your message will be heard on the podcast and will continue to reach new listeners for years after it is released.  The message will also appear on the website with over 8,000 monthly visits and in our email newsletter and social media posts. To learn more, contact us at john.jurica.md@gmail.com and include SPONSOR in the Subject Line.

The Role of Physicians in Translation and Interpretation

John sheds light on the pivotal role physicians play in translating and interpreting complex medical concepts. He highlights instances where clinicians, whether employed or in a consulting role, act as bridges between the clinical and administrative realms.

Examples include positions in clinical documentation integrity (CDI), quality improvement, utilization management,  and informatics, where physicians serve as interpreters for those without a clinical background.

Nonclinical Career Paths: Expert Witness Consulting and Medical-Legal Consulting

Delving into nonclinical career options, John explores two distinct avenues—expert witness consulting and medical-legal consulting. He elaborates on the differences between the two, discussing the responsibilities, compensation, and prerequisites for each.

Expert witness consulting, involving legal testimony, is contrasted with medical-legal consulting, a role centered on reviewing, summarizing, and advising on cases without the necessity for courtroom appearances or depositions.

Both freelance consulting businesses offer the benefit of producing hourly revenues that exceed those of typical clinical activities. Yet, they can be done remotely, and with no risk of the kind of lawsuits that practicing physicians must endure. 

Summary

For those considering expert witness consulting, John suggests Dr. Gretchen Green's comprehensive course and SEAK, an organization that offers resources and directories for physicians learning to be expert witnesses. Dr. Armin Feldman's offerings cater to those interested in medical-legal consulting. Both courses cover essential aspects, from legalities to business setup.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Gretchen Green's Expert Witness Startup School
• SEAK's Expert Witness Courses
• Dr. Armin Feldman's Medical Legal Consulting Course
• How to Do a New Kind of Medical Legal Consulting as a Part Time Gig – 227
• Why You Must Consider Starting a Medical Legal Consulting Business – 281
• Top Reasons to Become an Expert Witness Now – 163
• How to Be the Best Expert Witness Consultant – 262
• NewScr!pt

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

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Transcription PNC Podcast Episode 328

Expert Witness or Medical Legal Consulting: Which Should You Pursue?

John: I am doing this on my phone. I think the clarity will be a little bit less than usual. I did a dry run earlier and it was kind of breaking up a little bit, but we'll do our best today. I just want to spend 10 or 15 minutes talking about a particular topic that interest to me, and it's something I've noticed. And then I will talk about the generalities and then work my way into two different nonclinical careers that one might consider to do either as a side gig or full-time, although only one of them can be done as a full-time job.

I'm in Scottsdale, Arizona. I normally am in the Chicago area where I live most of my time, but my wife and I bought a small house out here and it's been getting renovated and we're just kind of out here to check on things. And so, that's part of the issue. But let me get started.

One of the things I've noticed when physicians or other clinicians, anybody's looking for a new position, a new job, particularly in healthcare, even if they decide to do some consulting or even if they're employed, that the jobs that open up for physicians and other clinicians involves either translating or interpreting things.

Because what you do is you start with your one foot in the healthcare medical world and then you obtain some expertise in another area that benefits physicians, benefits healthcare organizations. And then as an employee or as a consultant, you can be the person who can educate and interpret the language and the concepts that maybe are foreign to one side or the other, just like the CEO of a hospital doesn't really understand what a physician goes through for their education, training background and all that. It doesn't really understand how nurses and physicians and therapists interact with patients and kind of bond that we have.

And this is why we get in trouble sometimes because we're trying to fit a square peg in a round hole because the CEO is thinking in terms of the bottom line and finances and making things as productive as possible, and the physicians, nurses, therapists and others are thinking about, "How can I make this patient better? How can I help this patient understand what's going on?"

That comes up a lot and I'll give you some just simple examples. These are jobs I've always talked about in the healthcare field, in hospitals. Let's say clinical documentation improvement. That is a position as a physician advisor or medical director where you are explaining to your colleague physicians the rules and regulations around using the ICD-10 or the DRG system or whatever it may be. It's not really intuitive, it doesn't correlate directly with what we do clinically. In the CDI world, there's different levels. Usually three levels on the inpatient side for heart failure, for pneumonia and so forth. But they're all based on trying to figure out the complexity and then paying a higher amount for the more complex.

But it doesn't directly correlate with what we've learned as physicians and nurses in terms of treating those patients. And so, the physician advisor or medical directors interpreting and translating the concepts from one group to another. That's a great place to be. And there's a lot of jobs and they pay very well when you can find yourself in that important position of making that translation and making that connection and helping others get what they need. And at the same time, capture the true medical information.

Well, the same thing is true in informatics. A medical informaticist is translating to his or her colleagues. Concepts that need to be understood in terms of using an EMR or even beyond that, tracking data. And then it kind of extends into quality improvement where we have to maybe explain the statistical factors that are used in analyzing billing data to measure quality.

And again, it's not an easy to understand topic, but a quality medical director would spend a lot of their time explaining the p-values we use when we're looking at those statistical differences. And the reason why we feel that these comparisons between patients, between groups of patients, groups of physicians and their quality is really truly statistically significant and at the same time is risk adjusted, which is the big issue a lot of times in accepting quality improvement data.

Again, these are all interpretations and translations between these groups of people and get them to buy in and understand then learn how to do it better. UM it's the same thing. We don't think in terms of utilization management or benefits management when we're trying to take care of our patients, but if we do understand it better, then we can actually be more effective.

But one area where this comes up, which we don't normally think of as specifically this issue, but it is, and that's in any kind of consulting. And the type of consulting I am going to talk about today is legal. Medical legal types of consulting. And when I think about that as a nonclinical job, I think of maybe two sides of the same coin. Probably the most common areas where attorneys and physicians interact. And that is on one hand being an expert witness consultant or starting on expert witness consulting business, and what many of us now call medical-legal consulting.

Those are two really different ways of interfacing with the legal system as a healthcare provider. There are some opportunities in both of those for let's say a nurse or a physical therapist, something like that. Probably more opportunities for physicians. That's what I'm going to be speaking about for the next five minutes or so.

Let's compare those two types of consulting. Expert witnesses. Most of us understand what that means. Basically, we will provide services to an attorney and usually picking one side or the other in this case because it's usually because of a lawsuit that has been filed. And in this case it's often a medical liability lawsuit. And so, as an expert witness, you can be on the side of the patient who's accusing the physician of doing something wrong or missing something or failing to document something or failing to communicate. There's a whole lot of reasons why you can get sued.

And other expert witness consultants are going to be on the acute side, the physician side, explaining why the physician really did follow the standard of care. And that sometimes things just don't go well because it's the nature of medicine. We all die, we all get sick, we all have injuries that hopefully we treat properly and within the scope of practice and within the standard of care.

Now, an expert witness, number one, it's a very highly compensated physician. Let's say that you're going to be an expert witness for a family physician. Let's say you're a family physician. Now many expert witnesses, of course, are board certified, fellowship trained even in specific subspecialties, but there are a lot of internists, ER docs, family physicians who do expert witness consulting because you just have to talk to the standard of care, which most of us know very well because we work in it every day.

But it's very good pay. So, we'll start with that. Let's say I'm on a three star scale. I would say its three stars. Really as a family physician or an internist, if you take all the hours you work doing your medical records and everything into account, you'd be lucky to make $100 to $150 an hour. Because usually, let's say you're making $200,000 to $300,000 a year. If you're working 60 or 70 hours a week, that doesn't come up to that much. As an expert witness, you are going to be charging 2, 3, 4 times that amount on an hourly basis, and you get paid for every minute you spend doing that work unlike in clinical practice, which is why the numbers don't look so good.

That's one good thing about being an expert witness. However, most expert witnesses have to be in practice, active practice because they start to lose their credibility if they start to do that full-time. You can definitely cut back on your hours in clinical. And what I often talk about is spending, let's say you could easily drop 20 hours of clinical practice to do 10 hours of expert witness care or expert witness consulting and make equal to or more than you would've clinically. So, it is very well paid, and the more experience you get and the more time you've done it, then the better the pay gets and you can charge higher levels.

As an expert witness, you're doing three things. Basically you are reviewing charts and writing reports about your opinion. And then you might be attending a deposition and you might end up testifying in court. Now, most attorneys don't like to... Well, it's not that they don't like to go to court, but they prefer to have a settlement if they can. I think the patients prefer that. Oftentimes the physician prefers that or whoever else is being sued.

When you're involved as an expert witness, you're doing mostly chart review and report, and then you're doing a smaller percentage of depositions and then some go quite a while before they ever have to testify in court. But eventually it will probably happen if you do it long term. You obviously need to be licensed because you need to be in practice and you probably need to be board certified to do that.

Now, there's a different type of expert consulting called medical-legal consulting, specifically as a terms coined by Dr. Armin Feldman, who to some extent has actually created this specialty. And what's nice about medical-legal consulting is it still pays very well, probably double what you would make an hourly basis as a physician.

But it does not require testimony in court. It does not require even doing a deposition. And you're not acting as an expert witness. What you're doing is you're reviewing records here, organizing records, summarizing records, and then providing feedback to the attorney about whether the case should be pursued or not.

And these cases, which usually fall into this category are personal injury cases, workers' comp, automobile accidents, which is a type of personal injury. And so, you're putting what can sometimes be a very complex situation and in which an insurance company has refused payment or the insurance company of a business has refused payment. You've heard of these cases, you've probably been involved in these cases where one of your patients gets injured and it's sometimes hard to know for sure how much is organic, how much is secondary gain, are there ways to sort that out?

And so, Dr. Feldman came up with this pre-litigation medical-legal consulting where you as a physician will help to sort through that. And the thing about this is you don't necessarily have to be in active practice to do this. You just need to have a medical degree. It helps to be board certified in something. You don't necessarily have to maintain your maintenance of certification because when you're doing these reviews, you've narrowed your focus now down to injuries. And really you just need to know the basic physiology and the basic approach to evaluation and treatment. You can learn as you go and you can become an expert in this area with just a little bit of time and effort. And you're not worried about having this go to court. If one of these does go to court and you need a medical expert, then that will be an expert witness consult that will take care of them.

But as a physician, you can analyze, and again, some nurses do this as well looking at it from the nursing standpoint, but physicians are in a particularly good position to say that within a reasonable degree of medical certainty, either A, this is caused by the accident or isn't. B, what are some of the unrecognized illnesses?

And your main goal is to try to maximize the support and the payments to the patient. And if you look at it from that perspective, you're not trying to gain the system or take advantage of the insurance company or the employer. Usually workers' comp covers this obviously, but you're just trying to make sure that all those things that resulted from the accident, from whatever happened, are fairly compensated. And we've all seen patients who have what seemed to be a minor accident and then a year or two later they're still having problems.

They might have developed some long-term complication, what we used to call reflex sympathetic dystrophy, which is severely debilitating. And there have been many times where patients were not compensated and didn't receive the care they needed for something that was a delayed result of an injury like that. So, it's really an interesting area.

Again, it involves interpreting and advising and translating information and then putting things into a report. Both of these that I've talked about today are good ways to reduce your burnout, do something that you enjoy, apply all the medical knowledge that you have garnered over the years to a particular field. And in the case of expert witness, over time you can cut back your clinical time to 10 or 20 or less hours a week, do some expert witness consulting and make a better income than you would have burning both ends of the candle doing clinical work.

And in the medical-legal consulting, again, you could do that part-time, you could do it full-time and you can definitely make a lot of income without the stress of working in a high pressure corporate style environment.

Now I want to talk to you a little bit about some resources that we have available to us. And some of these I have promoted in the past. I'm not an affiliate for either of these experts I'm going to mention, but let me just tell you what I know here. If you're interested in becoming an expert witness, there are courses you can take to build the business standpoint how to do that legally and how to set up things as well as understanding how attorneys think, how they speak and being able to talk their language.

I've had Dr. Gretchen Green on my podcast two or three times, and she produces a very, very good expert witness course. I think it's completed over four or five weeks. It's rather intense. It has a lot of homework, it has a lot of supporting materials. Really she's been doing this now for three or four years and I've spoken with some of her graduates and they are definitely pleased with it. So, you can find that at theexpertresource.com/enroll if you want to learn specifically about that course. Because I think she has some other courses.

Now, there's also another resource for becoming an expert witness, which is SEAK. It's the same organization that puts on an annual nonclinical career meeting on a weekend in October. I think they're up to the 14th or 15th iteration of that. But one of the things they're also well known for is teaching physicians how to learn to be an expert witness. They have resources where you can get your name put in these directories that they then share with attorneys.

There's a lot out there about becoming an expert witness. And rather than struggle through it, you'd probably be best to take advantage of one of these resources. I think the SEAK resources mainly are on a CD or online, although I think they also have a live version of that. That's just something to think about as you can kind of morph your practice into half expert witness, half regular clinical practice.

Now on the other side, medical-legal consulting, Dr. Armin Feldman has his course. He does it in different ways. I actually took his course over a period of four or five weeks. There was a series of videos although he also sometimes does a live version of that. He also has a one year coaching program where he'll walk you through the entire process. I think it's a combination of videos and a lot of coaching from him to where you can have your practice set up.

This could be something for people that are in active practice, something where you're maybe semi-retired and there are definitely retired physicians who do this as well. As long as you stay current in this particular field, you can write wonderful reports, really help your attorneys to decide whether to move forward, whether to settle and you help get your attorney client's patients all the help they need for some long chronic result of an injury that occurred either through an auto accident or work related.

Dr. Feldman's website is mdbizcon.com. If you go there, there is a little intro where you'll learn more about it and they'll give you an opportunity to learn in a really quick fashion. Again, I took the course. I have, I don't know how many files that I've downloaded and went through multiple times. He walks you through, he shows you how to create letters to generate business. So you've got setting up the business, marketing, and so forth.

A lot of things Gretchen Green talks about in her course. It's pretty similar no matter what sort of side gig you're doing, you got usually involved in setting up an LLC and setting up your accounting and then doing marketing, creating all the fields, maybe setting up a website. And these are the kind of things that they both talk about in their respective courses.

The other thing that Armin has, which is really interesting, is he created a podcast which is designed for the attorneys themselves so that they understand how to work with a medical legal consultant and help them understand the lingo that we're using. And that podcast is called Physicians Helping Attorneys Helping People, although if you look up Physicians Helping Attorneys, you'll get to it. I think it's got at least 30 or 40 episodes now. It was just started about a year or so ago. I've listened to just about every episode. It's extremely interesting and very helpful and for no cost whatsoever you can really get an idea of what a medical-legal consultant does in this role.

I'm just looking at my notes here to see if I forgot anything. Nope, I think that's it. Remember that in a lot of your nonclinical jobs, you're going to end up being in the middle as a consultant who does interpretations and helps other people understand the other side of the equation of whatever it is you're talking about. And specifically the medical-legal has a lot of opportunities. And you might consider expert witness consulting or medical legal pre-litigation consulting.

All right, with that, I will close for today and I hope to see you next week.

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

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

The post Expert Witness or Medical Legal Consulting: Which Should You Pursue? appeared first on NonClinical Physicians.

In today's episode, John presents a career not previously highlighted: healthcare management consulting.

John will focus on the role of employed physician consultants within the vast landscape of national and international healthcare consulting firms. These firms address hospitals' (and other healthcare organizations') needs and provide innovative solutions to tackle complex challenges.

Our Sponsor

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

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

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

Job Advantages Uncovered

When it comes to healthcare management consulting, there is often a focus on independent consulting roles, but the realm of employed healthcare management consulting jobs holds its own unique advantages. In these positions, professionals have the opportunity to leverage their medical expertise and practical communication skills to offer valuable solutions and advice to healthcare organizations.

1.  High demand for these services – so new consultants are constantly being recruited.
2.  Jobs are available for experienced and novice physicians, even those without board certification.
3.  The pay is good and the benefits are very good.
4.  Opportunity for professional growth and development.
5.  These roles offer exposure to diverse fields (start-ups, hospital management, pharma, practice management).

Industry-Leading Healthcare Management Consulting Firms

John provided a list of national and international healthcare management consulting firms that offer specialized services in these domains, including the demand for physician consultants within these teams in a list. But here are some of the larger consulting firms:

• IBM
• Accenture
• Deloitte
• McKinsey
• Huron

Summary

John sheds light on the lesser-explored field of healthcare management consulting jobs with prominent national and international firms. Drawing from his experience as a hospital CMO, he highlights the prevalence of consulting firms within healthcare organizations. And he notes that most of these firms employ physician consultants.

To further assist readers, he generously provides a complimentary downloadable list featuring 25 major healthcare management consulting firms.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• 25 National Healthcare Management Consulting Firms
• PNC Podcast Blast from the Past – No Residency Is No Problem – 211
• NewScr!pt

Download This Episode:

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 302

5 Reasons to Consider a Healthcare Management Consulting Job

John: Today before we get to our main topic, let me ask you a question. What do the following services all have in common? Coding and documentation integrity, health informatics, strategic planning, revenue cycle expertise, evaluating vendors. Let me add some more to those. New service lines. Operational efficiency, utilization review, and case management. Well, you may recognize that those are all very important topics. They're very important fields and expertise that will allow hospitals to perform well. You find those in other businesses as well, other parts of healthcare, but definitely hospitals.

Second thing is though there are national international healthcare management consulting firms that provide consulting services in those areas for hospitals and actually for other healthcare related businesses like large practices. And many of those consulting teams hire and employ physician consultants.

I've talked to you about physician consulting as like a small business. You can do expert witness consulting, you can help practices if you're an expert in marketing and promotion. But there's this whole other side of consulting where you are employed. So, that's what I'm going to talk about today, positions as an employed physician consultant.

The thing is, the physicians who do these jobs are employed by one of these typically large national or international healthcare management consulting companies. Sometimes I just call them management companies, sometimes just healthcare management companies. There's even the smaller kind of niche companies that will focus on one or two specific domains, but there are a lot of these firms. Actually later on today's episode, I'm going to list some of those for you. And I have at the end a downloadable resource with 25 of the largest and most well-known healthcare management firms. So, listen to the end and I'll tell you how you can get that.

But anyway, these consulting firms assist hospitals and other healthcare organizations in solving problems. The reason I'm kind of familiar with this, and in some ways very comfortable with and very familiar with it is because when I was a hospital chief medical officer, I interacted with a number of different firms that came in to help us. And it was interesting because we normally had 2, 3, 4 of these consulting firms in there helping us with something or another. At any given time you could come in and last year's firm is gone, and now we have a new problem and the new ones come in.

And so, I'll give you some examples. We had a firm come in and help us implement our first lean process improvement program. We did that for the laboratory. It was an inpatient laboratory, which also did outpatient labs. And that was an area where lean process improvement, which was adopted from Toyota, was first applied in healthcare. Now you see it all over the place. You also see Six Sigma. Sometimes they're connected or combined into a single kind of process improvement approach to the hospital environment and also other big healthcare firms outside the hospital. So, that was a big one.

When we were looking at selecting our first hospital-wide electronic health record, we had consultants come in and help us with that. When we decided to start an open heart program, which we didn't have at the time, we were a medium size community hospital. Most of the places we could send patients to that needed open heart were at least an hour away. We were a little bit isolated. So we decided at one point to start our own program, and we had a firm come in and help us plan that. So you can think about that.

Any new service line, it's likely you can hire some consulting firm to come in, help you do the groundwork and implement that program. Now you have to pay for that, obviously, but usually when you get these companies in, that allows you to implement a lot quicker because you're using a lot of expertise that they already have that you don't have.

When we were looking at selecting the best inpatient management quality tool that would integrate with our EHR sometimes we would have a firm come in and help us walk through that process. We had the same thing done by multiple consultants over a period of 10 or 15 years to help us with our CDI program, to help us look at the models we were using for utilization management and case management.

We had consultants come in and help us with our bond issue. Even as a medium size community hospital, yes, we could issue bonds and people would buy those bonds that would provide money for investments at the hospital. And now that was one that probably didn't have any physicians on the team since it was strictly kind of a banking and financial situation. But there's always something going on at the hospital.

When you're starting a new service line or a new program, like when hospitalist programs first came out, there were a lot of consultants helping with that. When observation units first came out. And now every time there's a new type of service line, I can guarantee you there's going to be a management consulting firm that can help you with that, and they're going to be physicians on that team generally.

It's a big area. And one of the things I wanted to talk about is really why you would consider a job on one of these teams and what of the advantages are? Because I really haven't spent any time on that particular topic, I don't think I've spoken with an employed management consultant on this program ever.

I ran into a physician who was working for McKinsey a few years back and talked to him about what he was doing, but he was not able to come on the podcast. I think at the time when I invited him, he was having some health issues. So, I never really found another guest. I'm just going to tackle this topic today. I'm not going to get into great depth, but I'll give you some resources and some advice and I'm going to start by talking about five benefits of this job, or what are the five good strong points that make this job attractive to physicians who are looking to get out of the grind of everyday clinical care.

Now the first thing I'm going to mention is most of these jobs are full-time. Most of them require a little bit of on-the-job training because they're going to utilize your expertise in medicine, your knowledge of healthcare, your knowledge of the system, particularly in the United States and what's specific to it. But it's like you already have some transferrable skills that can be applied. But let me tell you the five really interesting benefits of considering this job and landing a job like this that you might want to keep in mind as you're thinking about doing it.

First of all, there's a huge demand for these services. In other words, not just for the physician components, but there's always new things coming up in healthcare. A lot of it's been driven in the past by new regulations by the federal government. We are super highly regulated and every time there's a new rule, like when Medicare was putting in the new quality metrics and length of stay, penalties, and coding and documentation changes and when quality measures are implemented, it takes time to learn those things.

And you can do it on your own if you have enough expertise in-house, but a lot of times it's quicker, easier, obviously a little more expensive to hire a firm to help you do those things. So, there's always a high demand. These healthcare management consulting firms are very large, some of them billion dollar companies and they have different subgroups within them, different divisions, different departments that some address mainly the financials. Some address more of the quality, some address more of the informatics.

And then you also have the niche companies that really only focus on one or two of those areas. But someone might say, "Well, they do consulting for revenue cycle." Well, revenue cycle covers a lot of different things, and part of revenue cycle is directly related to coding, documentation utilization and so forth. Some of it's just financial in terms of accounts receivable and how to do billing better and so forth.

But there's always jobs there for physicians. Because of that, these things are changing constantly. There's always new types of consulting being developed to meet those demands. And so, there's always lots of new jobs. Partly it's because healthcare is complex and partly because federal government and other agencies are imposing new requirements for you to meet.

I think it's built in. They do that on purpose so they can pay you less, whether you're a hospital or a physician until you get caught up. And then once you master that, they add new rules to make it more difficult again. So it's not a great system, but there is a great demand for meeting the growing changes in the healthcare environment to get paid and to be able to remain in compliance with certain rules and regulations.

That's number one. Always a high demand for new things coming down the pike. Number two, consulting jobs for physicians in these companies include jobs for both seasoned, board certified, very experienced physicians. I've worked with them. And those that are fresh out of med school even that don't have residency. In fact, that consultant I talked about earlier, a few minutes ago, he told me that there are many times where they want the novice physicians, they just want the medical school education background, understanding of how to read articles and interpret research and quantitatively and qualitatively understand working with patients, but in some ways they don't want them to have bad habits that you can get in practice.

If you've been in practice for 20 or 30 years, you're going to have certain ways of doing things. You're going to be used to being in charge. And on a lot of these teams, they don't want you to be in charge. They want you to be a member of the team that can help to do your part, focus on your specific area, then work together with the rest of the members of the team, to provide the services that your client basically has arranged to get from the company.

Anyway, you can be at any stage in your career and you'll probably be able to find a company that's looking for a physician with your background, expertise and amount of education. The pay is good, it's competitive. If you go in straight out of medical school, of course, you're not going to make the same as someone with a longer history of employment. But the only way they're going to get a physician with 20 years of experience is to pay them a salary that makes a commensurate with that.

Now, the salary is what I tell people of course, always, is consider the time you're spending and the other aspects of work. You're not going to need liability insurance. All your expenses are paid. So you might want to compare let's say a $200,000 job in consulting and be equivalent to a $250,000 job clinical where you're actually working 60 hours a week and doing charts at night and being on call and so forth. So, always keep that in mind. But the pay and the benefits are really good.

There's a lot of room for advancement. So, that's the fourth issue. A lot of room for advancement. As you learn these new skills which I'm going to talk about in a second, you'll have the ability to move up and be a senior member of the team, more pay, more benefits, things like deferred compensation and more vacation, things like that.

And then that brings me to the fifth benefit of working for one of these companies is you will learn a lot of new, very useful transferable skills that will set you up to do things in other companies. It'll set you up to work and move to. Maybe you start a niche company and then you move up to a larger company where you can head a department or lead a division if you're talking about CDI or something like that.

But you'll learn how to do project management. You'll learn how to work on an interdisciplinary team other than a healthcare team where there's a different relationship. You might learn sales and marketing, you'll learn about finances. You'll probably learn something about human resources. These are all skills that would become very useful if you go to another company that does healthcare consulting.

If you go to hospital management or large group management or maybe a startup, these can be very valuable skills and attitudes that open up doors to the business world that wouldn't normally come from just say working as a clinician.

Those are five of the big benefits that I'm aware of. I think you should consider a job in one of these large firms. And what I would do to get started, if you're thinking about this, is just start to look at some of these firms. I'll mention some of the companies now that hire consultants and hire physicians to be consultants. IBM has all kinds of divisions doing consulting, and some of it's in healthcare consulting. The big names we usually hear are Accenture, Deloitte used to be Deloitte & Touche, McKinsey, Huron. Really there's at least 25 very large national and some of them are international.

And so, I have created a list of those firms. You can go to them, look at their websites, go to their career sections or career pages, start to look at the job descriptions, look at what the requirements are. Again, depending on the niche and the area that you're looking at. Some will require more experience than others. There isn't really any special degree that you would need. You don't have to have an MBA or an MHA. That's not necessarily going to help you. They've already got the finance people and the sales people.

Oh, that's another thing, maybe I mentioned. But sales and marketing you'll learn because a lot of times you'll be doing pitches. And so, that might come in handy for starting your own business or heading up a startup or something like that, or being on the board of a startup.

That's pretty much all I wanted to say today. I would say go to nonclinicalphysicians.com/healthcare-management-consulting. That's the blog post for today's episode. And then I'll have a link there to related content as well as a link to this free downloadable list of 25 national and international healthcare management consulting firms with links to both their main site and their career pages. And you can use that.

You can also look them up on LinkedIn and learn more that way, or search on LinkedIn for healthcare management companies or healthcare management consulting companies. Before I go, I want to let you know that we're running a promotion for access to the 2023 New Script Summit recordings. We finished the summit a month or so ago. We have 12 fantastic lectures with a live Q&A for 10 of those, actually 11. The other one was a recorded Q&A. They're really fantastic. There's a lot of information there. I don't expect you to buy it just based on this, but if you go to nonclinicalcareersummit.com you will get the page where you'll see that you can get all 12 of those lifetime access to those recordings for $249.

You can get a discount if you join NewScript. You can go to newscript.app. Join NewScript and there will be some promotions going on in the near future where NewScript members can get a discount 15% on that. But either way, if you want to just buy it directly, go to nonclinicalcareersummit.com and buy the all access pass for $249.

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The post 5 Reasons to Consider a Healthcare Management Consulting Job – 302 appeared first on NonClinical Physicians.

In today's interview, Dr. Eleanor Tanno explains how her consulting business grew directly from the needs of some of her patients.

She received her medical degree from the U. of Maryland School of Medicine. Then she completed her residency in Family Medicine at Virginia Commonwealth University. She works as a full-time primary care family physician as a partner in a multispecialty medical practice. She founded Advance Directive MD as a side project to assist people in creating meaningful advance directives.

Our Sponsor

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

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

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

Dr. Eleanor Tanno's Journey on Side Business

The concept for this firm occurred to her very early in residency, while she was at the hospital working in the Intensive Care Unit. She observed that many families were unprepared to handle queries concerning end-of-life care. And most did not have an advance directive in place.

And those that did have advance directives had been prepared with the help of an estate attorney. They were frequently outdated and didn't contain the information to make end-of-life decisions in the hospital setting.

That's when Dr. Tanno started to envision a part-time business devoted to addressing this issue. Towards the end of the COVID pandemic, she started educating patients and helping them complete their advance directives 

How Her Consulting Business Grew

She began listening to podcasts regarding nonclinical careers. And took online courses to learn how to start a small business. She learned how to create a website, create a business plan, and market her business.

She marketed her services through word-of-mouth, presenting to groups, writing articles for the public, and holding workshops to teach patients and their families about advance directives. And she collaborated with attorneys to help their clients complete the medical portion of their advance directives. She was very pleased by how quickly her consulting business grew.

Dr. Eleanor Tannor's Advice

We're so locked into this idea that we're in clinical medicine and that's all we are doing. But the more people I talk to about this, the more physicians I meet doing things that are out of the box. 

Summary

You can get a look at what Dr. Tanno has built by visiting advancedirectivemd.com. There you will find articles and workshops, webinars, speaking events, corporate events, and lectures for medical professionals.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Eleanor Tanno's Website
• Dr. Eleanor Tanno's LinkedIn Page
• How to Validate Your Business Idea
• The Best New Business Solves a Problem – 171
• How to Select the Best Online Business Niche – 110
• How to Employ Powerful Online Strategies with Dr. Marjorie Stiegler – 084
• NewScr!pt

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 289

How This Consulting Business Grew Directly From a Patient Need

- Interview with Dr. Eleanor Tanno

John: I connected with today's guest several months back on LinkedIn, and I found her side venture so interesting that I thought I had to have her join me on the show. So, Dr. Eleanor Tanno, welcome to the show.

Dr. Eleanor Tanno: Thank you. Thank you for having me. It's such an honor.

John: Well, it's going to be fun because I find myself interviewing physicians who are practicing and they're happy in their practice. Not everyone that comes on this show is seeking the exit. But it seems like physicians are curious and when they find a problem, they want to solve it. And so, many physicians do something on the side like you're doing. And I thought it'd be very interesting to hear your story and walk through how you got involved with this and how things are going.

Dr. Eleanor Tanno: Thank you.

John: With that, first, tell us about your educational background and clinically what you've done since finishing your residency.

Dr. Eleanor Tanno: Sure. Since finishing my residency, which is in family medicine, I joined a large multi-specialty private practice in Rockville, Maryland. I practiced with about 20 internists, mostly a few family physicians are sprinkled in there and then some subspecialists. So, we have, I think three or four other subspecialists that work all under our roof. And so, that's mostly what I've been doing essentially full-time.

And then I've had this idea since the beginning of my residency, but really sort of hit the road about a year and a half ago at the tail end of the pandemic when we all had a little more time and some of us had some breathing room. I started this side venture in helping people put together their advanced directives.

John: That's very interesting. What happened that prompted you to do that? Apparently there's a problem that was needed to be solved. And in that, tell me, did you have some special relationship with that whole concept? Do you work for a hospice or any of those kinds of things? Explain that in more detail.

Dr. Eleanor Tanno: Yeah. The idea came really early in residency when I was in the hospital and doing time in the ICU. I'm sure as many physicians have seen end-of-life care in this country, the pendulum has swung. And so, we do a lot of aggressive end-of-life care and find ourselves asking, "Is it worth it for this patient? Are they getting anything out of it? Are we actually solving a problem?" And also I found that a lot of families are completely unprepared to answer the questions about end of life care and next steps.

And if they did ever talk about it with their family members, which most of the time they hadn't, it was in the form of an advanced director that had made with an estate attorney that was often extremely dated by even honestly, decades. And it didn't actually have any practical information for physicians. If I'm in a persistent vegetative state, pull the plug or something. They wouldn't actually say that term, but no heroic measures.

And I just found myself asking why are people making these documents with an attorney and not with a physician? And how can I potentially be the physician who makes that document with them and has these conversations? This idea sort of mulled around in my head for years. And I thought, "Well, one day I would love to help people put their advanced directives together from a clinical perspective."

And then when I got into practice, I just realized during a primary care session, you could briefly go over these things, but there just isn't time to really get into this information. And there's so many misconceptions out there about end of life care that I decided to really dive into this more and create a more robust system.

And I did at one point investigate doing a palliative care fellowship, maybe two years into practice. I thought maybe I should go down that road. But what I found, and I did go as far as actually to shadow a palliative care fellowship program and really see what they do all day. I found a lot of it was symptom management, which was not really a piece I needed.

And a lot of what people need is they just really need the clinical perspective and just really basic misconceptions to be corrected. A lot of people, they think that withdrawing care at the end of life is the same thing as say do not resuscitate. There's a lot of just really basic stuff that really any physician who's been in a hospital could help people with. And so, I thought, "Well, I think I can do what I want to do without the fellowship, and if I need to, I can always go back for it."

I started doing this and getting into it more, and the more I got into it, the more really of a need I realized that there is, and people are thirsty to know about this stuff. It's a little bit of a black box, which as physicians, that's our fault too, but there's just so much light to be shed in this area.

John: No, absolutely. And you mentioned the attorneys. My wife and I did the same thing. We went and did this plan. It was kind of a life plan. It was really more for the financial side. And one of the things that was in there were the documents for advanced directive. And so, we filled out what we did. Luckily, she's a respiratory therapist, I'm a physician. At least I understood pretty well what I was doing.

The other thing that it makes me think about too, when you said about being trained in palliative. The reality is even most of the physicians doing hospice care are not palliative care doctors. There's very few of those. Mostly, it is internists and family physicians like you that are doing it anyway. And you're taking care of patients that are seniors and are older. So, it's something that they all need. So yeah, it makes perfect sense. And I think you're right. The MD, DO, whatever, is plenty to understand how to make something that's a lot more specific and useful. So, that's interesting. What happened? There was a point where you said, "Okay, I'm going to do something about this." Take us down that path. What did you start doing?

Dr. Eleanor Tanno: Well, I started listening to a lot of podcasts, actually. Nonclinical career podcasts. There are so many out there, but a number that really sort of resonated with me. And one of the ones that I found was Marjorie Stiegler's podcast. And she's very practical.

My background is in engineering, and I just felt like she was speaking to me, actually like nuts and bolts how to do it. So, she talked about how to make a website. She even had a whole episode on how to create a podcast down to what kind of a camera and what kind of a mic to get. These little really, really useful nuggets.

And so, at some point I just listened enough and enough and then I felt like I was ready to launch. And I did that and I started writing and I thought, "Well, while I'm getting all my prep work, at least I can be writing down my ideas and creating, so that when I'm ready to hit go, I can." And then I created my website, which I did from scratch myself, which was a whole lesson in everything you can learn on YouTube, which I thought was fantastic.

John: Yeah, YouTube is great.

Dr. Eleanor Tanno: I know. Really, I mean, it's amazing. And that was really great because now I know how to change it and edit it and do things. And just all these little things along the way. When you get into practice after a number of years, I'm sure you hear this a lot from your people, you plateau a little bit, right? I answered the same 100 questions a day, right?

John: Right.

Dr. Eleanor Tanno: And I see the same 50 clinical diagnoses and 10 of those I see, I don't even know, 15 times a day. And so, it was really fun to start to learn something and get out there, and it's almost like you put these breadcrumbs. You leave something and you forget about it, and then a couple weeks later you get an email, "Hey, your article was accepted into wherever." And so, that's what I was doing and reaching out and making connections with senior communities, which is sort of my target audience. Most people who are thinking about advanced directives are generally in their sixties and seventies, but some of them are younger.

John: Now I'm sure that with your individual patients, of course, this was something you were doing all along in terms of trying to get that done. Although, like you said, there's not enough time in a normal visit. But the other thing that occurs to me is there's probably opportunities just to do lectures. Were you doing that before this became an idea to be a business? Or are you doing more of that now?

Dr. Eleanor Tanno: That was sort of like the building. I reached out, I thought who would be interested in this? I live outside of DC. People are very highly educated and then they retire and then they're looking for something to do with their brains. And so, there's a lot of these senior lecturers in communities. And so, I reached out to them, and honestly, they were delighted to have a physician. There aren't that many physicians who have the time or energy or interest in doing something like this or anything in terms of the lectures.

And so, I reached out and I said, "Hey, are you interested?" And I think as I did them, I got more comfortable, I realized what questions people had. I refined things. I get great feedback from my students, and I think it's just nice to have something practical. The lectures were born out of that. And as I go one day I hope to make probably an online course that people can individually take online and just purchase basically like an hour, two hours, whatever ends up being.

John: Yeah, it seems like the progression is okay, do some live events and keep doing them forever if you like. And those are usually in person, then you have the online events, and then eventually you do that so many times you're like, "Okay, well, I could definitely turn this. I can just record the darn thing because I've done it 20, 50 times." And then that's just there for people to purchase or have access to for free or what have you. So, that sounds like the process that you're following.

Dr. Eleanor Tanno: Yeah. And then the other client base that I hadn't considered when I first started was actually working with attorneys. So, I reached out to a local estate attorney, and I had asked her basically if she could see a place where we could essentially partner where she could do the legal part of the advanced directive, and I could help people with the medical part.

And she owns her own practice and she was like, "To heck with meeting one-on-one, I would love for you to come and train my estate attorneys on how to do advanced directives." Because apparently this is their least favorite part of doing the estate planning is the medical part. Because they don't feel comfortable. They don't have the training and any questions they get, they basically say, "Go ask your doctor." And so, that would be a really interesting thing is to go and train attorneys on advanced directives.

John: That's interesting how you can find a new niche that you didn't know existed, but you just get out there and network and reach out to someone that you might know or maybe that somebody refers to you and these things can develop.

One of the things I've noticed in the past is that at first it didn't make sense to me that somebody who was working full-time, who is maybe a little burnt out, just as we all are, or bored. Like you said, you're seeing the same diagnosis so many times a day. Well, let's just add another 10 or 12 hours of work a week to my plate. But it seems like people that do that, either they somehow know how to balance it but they feel they enjoy it so much and actually life seems more fulfilling and really not so much of burnout. So, is that what you've experienced in this process?

Dr. Eleanor Tanno: Yeah. I find this whole process extremely creative. Like I said, creating a website, reaching out to people, creating lectures, trying to find materials that make something that can be extremely complicated, much more user-friendly. For me, it's a lot of fun. And sometimes it's a small thing, like you're sending an email to somebody or something, and so, you might do 10, 15 minutes on that day. And other days I'm sitting down, I'm like, okay, I'm about to give a talk. Next week I have a talk for a hundred people in an advanced directive workshop. I really need to put aside a number of hours to get that done." So, it ebbs and flows, but in terms of how I find the time, it's something I enjoy. Anything you enjoy, you find time for. And I guess part of it also, I have a two and a half year old.

John: That doesn't take any time, does it?

Dr. Eleanor Tanno: No, but when she started going to bed about the same time, I felt like I could breathe. And suddenly it was eight o'clock at night and I thought, "I think she's sleeping for the night." Rather than maybe watch TV for an hour, I was like, "Well, let me write for an hour." And I enjoyed it. So, it didn't seem like that. It doesn't feel like work and it's so creative.

And I think the other thing is, and I tell this a lot of times to my medical students from Georgetown. You get into this job and there's kind of like a limit on what physicians can do in clinical practice, right? Unless you're in a hospital and you move up. Once you're in private practice, and I'm a partner at my office, there's not a whole lot of growth from an employment statement point that could happen there.

But with this side venture, it feels like the sky is the limit. I was listening to this one podcast where they said "You don't need to think outside of the box, just the box is bigger than you think it is." Something to the effect of that. And it just feels like there's so much out there and you just stumble into interesting people and ideas and fields and training the attorneys on the estate planning aspect of it. It's like you almost stumble into these new worlds and you're like, "Wow, there's something here for me to work on." I don't know, it's very open and creative.

John: Well, you said it earlier about how we spend so much time in our education and we're learning constantly. We're just programmed to learn and then you reach a plateau in your practice. And so, okay, well, I'm going to learn something new. For me, over the years, I remember I was three or four years into my practice and we didn't have a retirement plan. And I knew nothing about investing. So I spent the next year learning about investing. It was interesting, it was something different from medicine. I never became a stockbroker or anything, but it was just like, "Yeah, I can just take my attitude towards learning and apply it to this, and then it'll be something else after that."

Now this has been fine though, right? It's meshing with your practice, you're still covering and practicing full-time and doing this. Are there certain aspects of this where you can actually earn income from it that are, I don't know, maybe with this recent conversation with the attorney that opens up a whole different venue? But what part of it do you think it is really? Because we all want to diversify our income, right?

Dr. Eleanor Tanno: Yeah.

John: So, what part does it seem like has the most potential for that for you right now?

Dr. Eleanor Tanno: Right. I think there's a lot of potential. If somebody's going to sit down with a state attorney and pay them, I've heard, easily $5,000, $10,000 to put together their estate documents, why wouldn't they as part of that package or on top of that package, meet with a physician to do their advanced directive? So, that's one place that for sure income can be earned.

A lot of these lectures I give, they are at paid venues. So, assisted livings will pay for speakers. Recently, I have one that a hospital gave a grant to a local senior community to get more advanced directives in the community. And then if I did an online course, which I do want to do hopefully in the nearest future, I imagine people would be very happy to pay a nominal fee for that. As opposed to what it would cost to sit down one-on-one to then to pay for a two hour course or something. And then if I did more speaking, especially at the attorney level, that for sure could be another paid speaking audience essentially.

John: It sounds good. Sounds like a plan. I failed to mention your website or the URL for that. It's called advancedirectivemd.com. Correct?

Dr. Eleanor Tanno: Yes.

John: Yes. And so, if our listeners go to your site, because I think it's good to look at what someone has created in this process of doing a side venture, side gig, whatever. What will they find on the website? Because you created it yourself, and it is a very good website. I definitely looked it over and it's awesome really. It's better than mine. And I'm paying somebody.

Dr. Eleanor Tanno: Well, I did get professional photos, which I think was something that was highly recommended. I took a course through Marjorie Stiegler's online class. And so, that was one thing that she had talked about.

John: I'm going to ring the bell again to hers.

Dr. Eleanor Tanno: I know, I know. She's a common name at my dinner table. My husband asked me if I was secretly sending her money or something. I was like no. In terms of the website, the homepage is basically make an advance directive with a physician. I put out there what I am.

And then really there's articles that I've written that I think are really helpful. And I often when I teach classes say "I can't cover everything in this lecture, read more." And so, I have an entire article on dedicated to do not resuscitate orders. And then I have something in Maryland. I'm in Maryland. And we have the MOLST form.

John: Right.

Dr. Eleanor Tanno: And so, people have a lot of questions about that form because it's confusing. I have stuff on the pitfalls of choosing your medical power of attorney, specifically focused around adult children who are arguing over their parents' advance directives.

John: That's a good article. I got to read that one.

Dr. Eleanor Tanno: I think that was something I saw a lot in the hospital. Maybe they talked to their spouse about their advance directive, but they never talked to their kids about it. I've tried to make the most basic questions people ask, the most user friendly things. And then that's pretty much what my website is there for. And then I have obviously the ways to connect with me and then some of the things I do with speaking.

John: Yeah, I think you list workshops, webinars, speaking events. Not that those are all active at any given day, but I think it's good. It's a good mix. And then from what I'm hearing, \it seems like you're a resource for patients and for physicians and now for attorneys.

Dr. Eleanor Tanno: Well, my target client is patients, people, not physicians. I don't think that there's much I say that most physicians haven't encountered in their lifetime or their training. But really the step-by-step guide of how to make an advanced directive for patients and like I said, the power of attorney. These are questions that I get a lot.

What's interesting is when you start teaching and seeing questions people have, you learn things that you didn't even realize were pain points for other people. I was teaching this course and about a third of my students did not have an obvious medical power of attorney. They were single, they were widows. Their kids had complicated medical problems, whatever the story was. And that for them was the reason they hadn't made an advance directive because they didn't know who they would have as their power of attorney, and therefore they were paralyzed over this. And I found out later that apparently 20% of people are in this case.

So, now when I talk about naming a medical power of attorney, I make sure to say, if you don't have an obvious person, 20% of the population don't feel alone in that. And then I talk about some things that people might do to mitigate that. And so, that's the kind of stuff, that really working with people and patients that I learned along the way that I thought was surprising and interesting.

John: Very nice. Well, we're getting near the end here. We wish you all the best for sure. Another question that I typically ask my guests before they leave is, if you were talking to a physician who's in the middle of their practice, they're kind of burnt out maybe or just frustrated, bored, all the above, what advice would you have for them?

Dr. Eleanor Tanno: Really, the sky is the limit. We're so locked into this idea that we're in clinical medicine and that's all we are doing, but the more people I talk to about this, the more physicians I meet doing things that are out of the box. And so, you just have to find what interests you. I feel in some ways that I'm sort of reinventing the wheel with what I'm doing, but a lot of times there's tons of things outside of clinical medicine that are not as starting from scratch. And so, you just have to find something that excites you. And that's the community that you can then just build.

John: Well, I do surveys of my listeners every once in a while and one question that keeps coming up is "Well, how do I start a side business?" Obviously, listening to our conversation, Eleanor, would be helpful just to see "Okay, how you walk through that?"

I think it's good to look at your website and say, "Okay, this is a website of someone who started something new. It's not rocket science. Here's what you put out there as part of your marketing plan." And so, I would definitely advise people to check out advancedirectivemd.com.

Now, if they happen to be a patient that needs it, also go there for sure. But I think we can learn a lot. And even looking at your LinkedIn profile, which I'll put in our show notes as well. So I appreciate you taking the time and explaining all this to us today. It's been fun.

Dr. Eleanor Tanno: Thank you so much for having me. It's very exciting.

John: We're going to have to swing back in about a year or so and see what's going on. I think it will be very interesting. Again, thanks for being here. And with that, I'll say goodbye.

Dr. Eleanor Tanno: All right, thanks so much. It was great talking to you.

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In today's episode, John offers his opinions on email marketing. And he describes a particular email strategy he has been using. He explains why email is a great marketing tool, and why starting early in your business is important. 

Email marketing should be a fundamental part of most small business marketing programs from the beginning.

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

What is Email Marketing?

Sending a commercial message via email, often to a group of people, is known as email marketing. Every email that is sent to a current or prospective customer is part of your overall email marketing strategy. Using email appropriately enables the small business owner to build authority and trust that generates sales at a very low cost compared to other marketing methods

However, it significantly differs from social media marketing since it focuses on bringing in fresh prospects and defining a business brand. And email marketing emphasizes and develops ties with devoted clients

The Advantages of Email Marketing

1. You own your list. It is not subject to manipulation or being “de-platformed” the way social media is.
2. It can be automated to a great extent, with the ability to create sequences of emails in advance and target specific segments of an email list with different customized messages.

[See Below for a Special Offer for Podcast Listeners]

Unique Email Strategy

John describes a unique email strategy that he has been using. After implementing it, his open and click rates improved dramatically. These parameters generally reflect the degree of engagement, trust, and likelihood to buy.

This strategy incorporates the following features:

• higher frequency, up to 5 to 7 days each week,
• shorter, taking less than 1 or 2 minutes to read,
• includes an amusing or thought-provoking personal story,
• ties the story to your product or service, and
• eliminate “dead weight” from the list (those that never open or click your emails).

Summary

Using this approach leads to much higher engagement, as demonstrated by higher open and click rates. This enables those online marketers with even small lists to build an engaged audience that buys more products and services.

You can learn more about this approach to email by purchasing access to this course from the League of Email Marketing Heroes.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Stop Making These Business Email Mistakes

  EMAIL MARKETING HEROES’ Bottomless Email Strategy Course (I am an affiliate partner for this course)

• NewScr!pt

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 284

Why Adopt This Email Strategy in Your New Business?

John: I just want to tell you a short story today before we get into the main content, but it's apropo. About a year or so ago, I started looking at a new way to work with my emails. And I was doing what we normally do. I was doing weekly or biweekly newsletters, mentioning what's going on in my business, or things I've talked about on the podcast. I usually send out an email every week to announce my latest podcast episode and that kind of thing.

But I came across a couple of partners that were teaching a different email strategy, and I started to use that strategy. Now, my email list, it got up to about 1,400 - 1,500 just to put everything on the table. I don't have a big massive list of 5,000 or 10,000 or 15,000 people. But the engagement seemed to be quite small. It seemed like the open rate was low. The click rate was low. And I could tell that there were probably hundreds of those listeners, or followers rather subscribers who really never even opened an email.

I looked at their approach and I adopted that, and I started doing emails much more frequently. And as a result, my open rate increased. Well, actually more than doubled. My click rate improved quite a bit, and it seemed like there was a lot more engagement. People were responding to my email.

I want to share with you what I know about using email as a marketing method and what I've been doing for the last year or so, how it's different from what I did before, and why you might consider using this very same technique.

For those that are watching on YouTube, you'll notice I'm using slides today. It doesn't really matter to the podcast listeners here. You're not missing anything because I don't really have any content on my slides that I'm not talking about. But for the YouTubers, it provides some variation. You get to see the slides and breaks things up a little bit when you're watching a video instead of just watching a talking head. The objectives I'm following today are the following. What is email marketing? Why is it important? When should you start? How do you set it up? And what are the metrics to follow? Those are kind of the general areas that I want to cover today.

So, what is email marketing? Well, I'm not going to go through a long history of where email came from, but as you know, email when it first came out, we probably didn't think about it as a marketing tool. I'm sure there were businesses that did, but we saw it as a way where we could communicate with people in an asynchronous fashion electronically. We could send notes out at will. They arrived instantaneously, and it enabled us to connect with friends and family on a regular basis. It was essentially free of cost after we got through the first year or so. AOL and others have very low costs. Some are free. Yahoo I think is free because they sell other things on the service. But it was just an interesting and brand-new technology. And now we take it for granted.

Well, early in the process of adopting email across the world, people saw, "Wow, we can use this as a marketing tool. We can send notes to clients, to customers, to followers, to readers, and we connect with them. We can actually sell things through our email." And so, a marketing approach started to develop. You'll remember in the past when we first had Google and the internet and emails, everything had a lot of flashing brightly colored symbols and giant letters, and it was pretty gross. It's become more and more sophisticated over time and we came to find out that we shouldn't be crazy with our email. Let's just connect and communicate with people.

What happened as email is being used more and more is there were more and more features that were added to email providers. Most basic email providers like AOL, which still exists actually, I still have my AOL account. It's probably an antique now. I have a Gmail account too. And then there's Yahoo, and then there's a bunch of other email marketing. You'll see them after the ads. There's iCloud and even if you have a website today, you'll have probably an email type of program associated with it. It's usually at even a more basic level than just your AOLs and your Gmails.

But anyway, it's a way to communicate with customers, readers, listeners, followers and develop some rapport with them. The thing is, it's become much more easy to use because the tools we're using now where they're emails, unlike what you can do with Gmail and AOL and so forth, is you can start to automate some of the functions and streamline some of the functions. Now, you can also keep track of multiple audiences and you can do other things that I think I'll be talking about in a minute here. I just wanted to give an overall description of what email is and what email marketing is.

Email marketing is using your emails to sell ultimately, to market and sell. But it's not that simple and there's lots of ways to optimize it. Why is it important? There are several reasons here. I think it's super important. When you use email, it has advantages over other types of marketing approaches. It's often compared, for example, to social media. Can you do similar things on social media? Yes. Can you do things on Facebook where you post things like sending an email? Yes. Can you sell on social media? Yes. Can you do advertisements on social media? Yes.

But let's look at some of the advantages of email. In fact, I think these advantages make it like the foundation of your marketing. Probably email should be the basic first thing you try for marketing before you try paid ads or other ways to promote your services. There's nothing wrong with let's say promoting yourself on LinkedIn for free but there are limitations, and that is the following two that are the bigger ones.

First, social media can be manipulated in the sense that they can be changed over time. They can change the rules, they can make it difficult for you to succeed. You adopt one set of rules, they change the rules. People that have monetized social media have been demonetized. People that have depended on social media for major amounts of income have been taken off that social media site. Unlike that, because you own your email program, you own your email list, it can't be taken away from you and it can't be manipulated in that way, and it can't be shut down. Those are two big reasons. The rules don't change really over time, except some of the different government entities put some regulations on it. But other than that, the rules stay the same. It becomes easier to use over time as the technology improves and it's not subject to being shut down or taken away.

Can you imagine if you had 100,000 followers in a Facebook group and Facebook just canceled the idea of a Facebook group? Pages used to be very popular in the past, then the pages went away. Now the groups are better. But every day you're getting more and more features on, for example, Facebook that make it more and more difficult to use. And in fact, while someone's in your Facebook group, they're looking at competing ads constantly, which are thrown up on the site by Facebook. And the same is true of other social media sites. That's the first thing. It's part of your basic marketing strategy, and it's a foundational part in part because you can't be stripped away from you.

Now, what does email do for you? Well, with the emails you're sending to your list on a consistent basis, whether it's your entire list or subsets of your list that we can call segments. It gives you an opportunity to demonstrate your authority in whatever it is you're teaching. You can do it on social media. I can do posts. I used to do posts all the time on Facebook or on LinkedIn talking about I'm starting a small business, nonclinical careers, how to become a CMO, et cetera, et cetera. Well, you can do exactly the same thing in your emails and over time, that helps you build your authority in whatever business you are trying to promote.

Now remember too, this applies even to a brick-and-mortar business. I went to a bakery the other day to buy a cake for my wife's birthday. They were beautiful. And after eating it, the one that we had was delicious. And I thought, this place has got to have an email strategy because people are coming and going every day, and they may not think to come back next week or next month, or six months or a year from now.

And I'm going to talk to you about a process where the way you use your email would have those customers coming back on a regular basis, probably double, triple, quadruple their sales in a very short period of time. Anyway, that's because it enables us to demonstrate our authority, whether a coach, a consultant, whether we're selling some service, or even online products or brick-and-mortar types of products, because you can communicate on a regular basis. You have to do it the right way though.

And so, then what that does is it creates a warm audience or a warm customer. When you go out and do ads, let's say on Facebook or Instagram or Twitter, whatever it might be, Pinterest, you pretty much have a cold audience there. You're just picking an audience, you're defining it, you're paying a bunch of money and you're sending ads out, and a tiny percent will respond to those ads.

And usually, and when you're doing those ads, you're actually not selling the product directly. You're bringing them into a so-called funnel. And it's to get them to sign up for your website, for your podcast, for your email list. Then you can start teaching them, supporting them, encouraging them and inspiring them. And that's where you are nurturing this warm audience. It's an audience that knows you, loves you, and is already primed to buy, which you can actually enhance by using your email in certain ways. And the cost is almost free.

Obviously, you're paying for a service to enable you to manipulate, monitor and write these emails, but it's a lot lower than paying for advertising on social media like LinkedIn or Facebook or Instagram, any of those things. It has a lot of obvious advantages over the social media and other forms of marketing. That's why it should be sort of the first thing that you really start doing other than maybe word of mouth.

All right. When should I start my email list? I'm thinking about a business, maybe I've just started a business, or I've got a business. Where in that path, where in that transition, should I start using email? Well, from the very beginning. It's like when should you plant a tree? Well, 10 years ago, because you want the tree to be mature. It doesn't start giving you shade until it's grown for 10 or 15 years. The same thing with email. You're not going to get a result with it quickly. You have to build something first.

And part of the whole thing about starting your email is not only what you should use as an email service provider or a CRM or how it should look and all that. It's when should I start and do I plan at the beginning and what do I do with it? There are some things you have to think about, but the thing is, it should be integrated into your marketing plan from day one.

And if you're selling online services or if that's where most of your activity is, let's say you have online courses or you're doing coaching, which can be done remotely or something like that, then you should start from the very beginning. I'm not going to spend a lot of time talking about how to build an email list, but let's just suffice it to say that you need to use some kind of reward for people jumping on your list. That usually means you're giving away some kind of what we call a lead magnet or an opt-in bonus or something.

Let's say you're trying to build your business. You find that it aligns with somebody's podcast. You go on the podcast as a guest, and at the end they allow you to promote your business. And you say, look, if you go to my website and click on this button, I'll send you a free list of something they're interested in. And in exchange, they give you their email list. And by doing that in different venues, you can do it on social media, you can do it on these podcasts, you can do it on blogs, you can do it on your website. You get people to sign up for your email list, but they're going to drop off quickly unless they get something worth reading. And we'll talk about that in a minute. That's why you have to start early because it's probably going to take you six months to a year to recruit, to develop a decent size email list that you can then begin to nurture, and then later we'll get to actually selling through email. When to start? As soon as possible.

All right. Well, how do you set it up? I'm not going to go through a long litany of how to set up an email program, email marketing plan. The basic thing to tell you is there are tools for creating your email market and marketing program. How do you set it up? What I mentioned earlier was a CRM, which is a customer relationship management system. Now there's really sophisticated CRMs which are integrated across all kinds of things from selling and billing and just keeping vast records. But the basic ones are designed to help a small business owner stay in communication with their customers and potential customers. And it automates a lot of things in a way that you can't really do on your usual email platform.

If I go into Gmail, I guess I can create different groups and I can send mass mailings out, but it's not really designed to manage that and to track all kinds of metrics on who's opening, who's clicking, who's responding, our sales attached to that email. That's why these other systems were created. One of the early ones, and I've still used it to this day, is Mailchimp. It was fairly rudimentary when I signed up with it five or six years ago. But it really has all the features you need, pretty much ConvertKit and Keap, which I think used to be Infusionsoft. A little more sophisticated. ConvertKit is actually newer, but it was designed specifically to work for those people that use online businesses and has a lot of automation.

Keap Infusionsoft is really a much more expensive program. It's been around a lot longer, but it is very sophisticated and you can create all kinds of protocols for sequences and if then statements in your marketing. If the customer does this, you go this way. If it does this other thing, you send this email and so forth.

But I've been happy with Mailchimp. You can just go to Mailchimp.com to check it out. Also convertkit.com to check it out. It's one that's been supported and I think is on the board is Pat Flynn, some online expert you might know. And Keap who used to be Infusionsoft is more expensive. Actually, Mailchip and Convert Kit both come in a free version until 300 to 500 members or subscribers. And then you have to start paying a fee. Also, it only has certain features. Keap is a two-week trial that's free, but after that you do have to pay significant dollars. It's kind of hard to justify when you only have a few email subscribers. So, you want to build it up very quickly to justify the cost.

So, that's how you set it up. You just find one of these CRMs. There are others, but if you find one of those, I will recommend Mailchimp.com. I don't get any payment or I'm not an affiliate for Mailchimp, but it seems to be working for me. So, that's why I mentioned it.

Now, once you have that system, it allows you to track metrics, which I'll mention in more detail in a second. It also allows you to add tags, create segments so you can segment your list. It allows you to keep all kinds of metrics and follow. Most of them will allow you to do A/B testing where you create one email, change it in some way, and you've got A, you've got B, some have more. You can then send both of those out simultaneously and compare which one has a higher click rate, for example. And then that'll tell you, "Oh, this factor should be used in future emails."

A good example would be, let's say you have two emails, exactly the same, 10 paragraphs, a hundred words, and one has subject line A and the other has subject line B and that's it. They go out and you find subject line A works a lot better than subject line B. Well, then next time you can go ahead and use that one if you're going to use it again or some version of it.

The other thing that these do, they also automate the process where you can take let's say a third of your audience send out A and B. And then after three, four hours, whatever length of time you want to use, the system automatically tracks the open rate or the click rate and whichever one's higher, the rest of your list, the other two thirds are sent to that one. So, it actually optimizes the process of sending an email out while it's being sent out.

The only problem I didn't like with that was that the timing would change. Maybe you think the optimum time is to send at 08:00 in the morning. Well, into this scenario, then you would send it at 08:00 but the next batch wouldn't go out till let's say noon. If the day of the week or the timing doesn't make a difference, it can work fine. You can send the test email out in the morning today and then 24 hours send the next batch to the winner.

But the metrics you should follow. I've kind of alluded to the open rate, the click rate, the sales that come from it, which you cannot usually run measure directly, although in ConvertKit you can do that and probably in Keap as well. And then the AB metrics where you can compare so you can measure that. That's kind of four basic things. I usually look at open rates and click rates. However, I will say this. Open rates are notoriously inaccurate. Some email providers like the AOLs and the Gmails and others of the world, Yahoo and so forth, if the email that you send goes into their inbox, it's counted as being read even though it's not been opened.

In other cases, they may count everything that's in your email box as unread for some reason. So, they're very unreliable. The only thing they're good for is looking over time or comparing as long as within your system, two different emails, then if one had an open rate of 30% and the other 40%, you could say, okay, the second one definitely did better. But whether that was really 30% and 40% or 20% and 25% you really don't know because there's other reasons why those things are not consistently applied to every email that you send out. That part is inaccurate.

Click rate on the other hand is fairly accurate, close to 100% accurate. Let's say in the past I've had open rates of 20% and I had a click rate of 1%, and then I make some changes. My open rate goes up to 30%, but my click rate goes up to 2% or 3%. That's a big difference. And I'd be more interested in that change in the click rate than in the open rate because again, the click rate is much more accurate. So, when I get up to let's say a 2% or above click rate, that's extremely high for me. It's one thing for someone to open an email, but to actually go in and click on something, they've got to take action. That's a good thing. That's what you want. And so, those are the metrics that you should measure.

Then you can do the A/B testing later when you get much more sophisticated. And it probably doesn't even make sense to do that unless you're up over 2,000 email subscribers. Because again, you're comparing, let's see what did I say, it was one third and split those in half. So, you're taking 500 compared to another 500 or even less in my case when I've only got a thousand email subscribers. So, there's no sense getting into that.

And then as far as sales, right now, the only way I can tell is I can just look and see how the timing is. Most things are going to be sold out an email within a day or two after it's sent, obviously, because after that it just kind of disappears into the ether as new emails come in. All right, those are the metrics I recommend you follow.

Now, email marketing philosophy. This is the crux of what I want to talk to you about today. I was talking about why adopt this strategy in your new business. Like I said, people send out newsletters. It's not uncommon for people to only send out emails when they have something to announce. It's not uncommon for people to build and build and build their email list and only use it when they have a product to sell or some kind of course to promote. And that could be very infrequently to the point where it's not uncommon for people to be on your list, my list, who haven't opened one of our emails in over a year or two. That's completely dysfunctional. It's completely a waste of time and you're missing a huge opportunity.

So, what is the alternative? Well, let's look at it in a new way. What we want to do now these days, and it's been shown to be very successful, and I'll give you some more examples in a minute, is that we want to have regular frequent connections with our audience. In other words, we don't want to be a stranger to them. We want them to know us, feel comfortable with us, and look forward to reading our emails. Oh, is that possible?

And at the same time, as we're doing that, as part of that, and maybe before starting that process with intensity, we should get rid of those that are already unengaged, although we need to do something to maybe allow them a chance to become reengaged. I'm not going to go into detail on this, but basically what we need to do is get rid of the flack, the dead weight, but we have to give them a chance to show that they really aren't dead weight, that they're out there waiting to hear something.

So, here's what you do. This is an abbreviated version of how to do this without going into every step. Most email providers or I'll say CRMs like Mailchimp can tell you how engaged your readers are, and they will look at open rates and click rates and they'll look at how many, what percentage they've responded to and when was the last time they actually opened one, when was the last time they actually clicked on one. Was it a month ago? Was it within the last two days? Was it six months ago? Has it been over a year since they've opened one or clicked one? Again, given the constraints of open rates, and they will tell you ranking.

In Mailchimp you get a five star, four, three, two, one. One is like get rid of them. A two is pretty, pretty unengaged. And they'll define what that means. They call each email a campaign in Mailchimp, but how many campaigns have they opened?

So, what I did before I started this new way of doing a more frequent email approach was, I didn't just use the system that Mailchimp has, but I defined what it was. It was three to six months. They hadn't clicked on a single email, but I didn't just get rid of them or put them aside in sort of suspension. I sent them a series of emails that said, "Hey, I see you have not clicked on any of my emails in six months. It doesn't appear that you are interested in what's going on here. I'm getting ready to kick you off my list. Before I do that though, I have a link here to a free download that has 70 nonclinical jobs on it." It's the same download I use for my lead magnet to build the email list. And I give them an opportunity to click. If they click, they automatically are off that list. There's a group that doesn't click any of those. So, let's say it's 20% of my list. Actually, for me it was almost 35% of my list that hadn't done anything in like a year.

So, I sent them that first email. The next email I sent was kind of a different approach or different comments. I said "You know what? I see you haven't been opening my emails in a long time, you haven't been clicking on them, but I have this free course in my academy. And if you do this course, it could have been anything, but I would say I would teach you about how to become a medical writer." And then I would send it out. If they click and open that again, it's free. They don't have to give me their email address because I already have it. So, it's a pretty low barrier. Then they get off the list.

Maybe the last one was, "I've got a webinar that I recorded for you, and it'll tell you the five myths of nonclinical careers and why you should not believe those myths or those myths are being dispelled. It's a 25-minute video, click here, you'll get the free video, you can watch it whenever you like." I go through that. Of those 35% that had not responded in a year, maybe half of them will click on one of those, then they're off. The remaining 17.5% or whatever that is I just eliminated them. Boom, cleaned them up.

Now that by the way is automatically going to increase your open rate and your click rate because you basically have removed many other people that never opened and never click. But it also focuses down on a group of people that are interested. And again, on my podcast, I usually say what I want to do, I want to inspire you, I want to encourage you and I want to teach you. So, these are people that want to be encouraged, inspired, and taught by what I talk about, which is nonclinical careers.

When I did that, I pretty much brought my list down to a thousand ultimately, after I went through that process a couple of times. But the open rate is currently run above 50%. Now, they were running about 20% back then. And my click rates are consistently somewhere between 0.6-0.7 all the way up to 1.9-2.0. Sometimes depending if some special things will get as high as 2% or 3%.

When I send my Tuesday emails out there mostly about my podcast, sometimes 3.5% of people will click those either because they want to click to go to the podcast or they're clicking on something I'm talking about or promoting, or a freebie or one of the links. There are so many links in my emails for my podcast to other episodes that the click rate is much higher. Now that's an engaged audience, but that's only part of it.

Once you find the audience that does want to hear from you, now remember, if you're only sending an email out once a month or so, the fact that they even click on that once a month is pretty amazing because you're so much out of their mind. The big part of this strategy is sending more frequent, shorter, funny or interesting or inspiring emails. You want to do all those things at the same time. All right, I'm going to give you a resource in a minute on that.

Here's how I do it. I try to send an email almost every day. Actually, my goal is to send five emails a week. Now, one of those is automatically a Tuesday email about my podcast. Now I only have to prepare four emails. But the emails are much shorter, they're funny, they're to the point I sent and they come from my life. There's always a story in there pretty much every time about something in my life. Something happened when I was a kid. Someplace I've visited, I've traveled a lot, so I have a lot of stories about travel.

I did a lot of things in my 40s and 50s. For whatever reason I went on kind of a binge of trying new things from golf to scuba diving, to rock climbing, to traveling, to you name it. International travel. I went to Jerusalem twice. I went to Nepal and track in the Himalayas. Anyway, a lot of stories that we can use and everybody has those stories. It's not unique to me. But I tried to do an email every single day during the week. Five a week. One was for my podcast, the other four were new. And I would do them on weekends. Sometimes I'd skip a day and then I'd do one on a weekend instead.

Emails like these can be prepared all at once, batched five in a row or five at a time, 10 at a time if you want. Because they're not really related to timing unless you're talking about something in the news. But I would do that. They would be shorter and I would try not to spend too much time developing them. And I would jot down ideas for emails as they came to me. I might be brainstorming sometime or doing something and all of a sudden, I've had a good cup of coffee or two and I came up with ideas for three or four or five different emails. Things that happened before I went to med school, things when I had roommates. Just all kinds of ideas. And I would always tie them back in some way with something that was informative or inspirational or encouraging. Things I have experienced like they have.

At the top right of the email, I put in that it's going to take less than one to two minutes to read. And the other thing is, it usually has some clickable links in it because you can't really measure the success unless you have something to click. Now those clicks might really not go anywhere except like I said to a podcast episode, a blog post, me being interviewed by somebody else's podcast host. It's all kinds of things you can do, but it's more frequent and it's shorter. It's to the point.

The other part of this philosophy is not a lot of pictures or a lot of colors. It's basically like a short note you're writing to somebody that can be read quickly, digested quickly, and usually get a little chuckle, a little insight, something like that.

Like I said, my metrics just doubled in terms of the open rates and the click rates. I really started seeing more engagement. I recommend you do that. And the idea here is they're getting to know you. Now as a podcaster, it's funny because people listen to my podcast consistently. They know me because my voice is in their head just like it is right now if you're listening to this, which you obviously are or watching it on YouTube.

But you may not have a podcast. Maybe all your engagement is on a website or maybe you do some videos, YouTube videos, another way to do it. But if you're doing this email thing, you are going to really start to connect with those people and you will see that those rates will be quite high. And if you're a really good writer, and again, don't use that as an excuse, but I do say when I do write the emails that I go back a couple, two or three times, sometimes I sent them aside for an hour or two or even the next morning if I'm writing them the day before and I go through them and I really try and get rid of all the unnecessary language, all the extra words.

Get it down to the core message, the story, and then whatever call to action you want them to take, if any. Ask them just to reply to the email with comments or suggestions or requests. And that's it. You'll find over time that that is about as warm an audience as you'll ever get when it's time to start selling. Basically, that's what I want to talk about today as far as a new approach to email marketing strategy.

I usually like to put resources in. I would say Mailchimp is the one I would just recommend you check out because you can try it for free for months at a time until you reach a certain level. And even after that, it remains very reasonably priced.

The only other resource I would give you is the nonclinicalphysicians.com/emailstrategy. That's a link. And if you go there, you can buy the course that I learned this approach to with the League of Email Marketing Heroes. If you go there to my link, nonclinicalphysicians.com/emailstrategy, it'll take you there. And for $39 you can buy their course on how to implement this. And it goes in a lot of detail about everything I've talked about and then a whole lot more. That's the one resource I would mention today.

Thanks for joining me today. You can find links for today's episode at nonclinicalphysicians.com/adopt-this-email-strategy. And there you'll find the link that I just mentioned as a resource. And again, that link is nonclinicalphysicians.com/emailstrategy where for only $39 you'll learn exactly how to implement the bottomless email strategy is what that's called. It's the approach I use in the product that teaches a tried-and-true email framework that helps business owners create psychological connections. That's what it does. It helps create that psychological connection that their lists are looking for. That's basically it today.

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The post Why Adopt This Email Strategy in Your New Business? – 284 appeared first on NonClinical Physicians.

Dr. Laura Kaufman shares her thoughts on advanced degrees and other decisions as she moved from traditional practice to consulting.

She recently quit her full-time clinical position and launched her consulting business. And she enrolled at the Johns Hopkins Bloomberg School of Public Health to pursue a master's degree in patient safety and healthcare quality.

Our Sponsor

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

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

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

Pursuing Advanced Degrees and Other Decisions

Dr. Kaufman began her private practice because she values its efficiency. Since completing her residency, she has mostly worked in obstetric anesthesia and served on quality and patient safety committees.

She was concerned about treating patients properly and safely. And she became frustrated when her patients seemed to be rushed through preoperative evaluation in spite of her concerns about their medical readiness.

So when her employer was acquired by another company, she began her consulting company and reduced her clinical hours. She started her nonclinical activities by providing medical opinions in legal proceedings and worked as a consultant for a respiratory therapy device company and an infection control consulting firm. But her main area of interest is improving quality and safety for obstetrical anesthesia care.

Choosing her Master's Degree

As she made those changes, she evaluated master's degree curricula that would support her transition. The Johns Hopkins program provides the coursework and the flexibility she needs.

Dr. Laura Kaufman's Advice

Build your connections, link to other people on LinkedIn because that's how those people find you.

Summary

When Laura became increasingly frustrated with constraints on her ability to practice the way she preferred, she took steps to make a shift in her career. She focused on a consulting business that would meet her desire to improve patient care quality and safety. And she took steps, including evaluation of advanced degrees and other decisions, that would improve her knowledge and authority in her chosen field. 

You can reach Dr. Laura Kaufman on LinkedIn.

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Laura Kaufman's LinkedIn Page
• Johns Hopkins Bloomberg School of Public Health
• Physician Leaders: Top 10 Reasons to Pursue a Business Degree
• Which Advanced Degree Will Be Right for a Nonclinical Career? – 191
• How to Use Consulting and Advising to Find Freedom – 249
• How to Build a Terrific Freelance Consulting Business – 145
• NewScr!pt

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 283

Advanced Degrees and Other Decisions on the Road to a Nonclinical Career

- Interview with Dr. Laura Kaufman

John: I connected with today's guest on LinkedIn a little while ago because I was drawn to her interest in patient safety and quality improvement. Something I was always interested in when I was a CMO. But anyway, she's a little bit earlier than a lot of my guests in her transition, but I thought her story is interesting and I thought we can learn from her. So, I would like to say hello and welcome to Dr. Laura Kaufman.

Dr. Laura Kaufman: Thank you. Thanks for having me on the show.

John: I'm glad you took the time to join us. We're going to learn a lot from you and. I think it's interesting to talk to someone who's kind of still feeling their way for part of it and making that transition. And so, I look forward to really hear what your thought process has been in this transition that you're in.

Dr. Laura Kaufman: Well, thank you. Yeah.

John: Okay. Why don't you tell us some bit about your background, your education and clinical experience before we get into some of the other things that you're doing.

Dr. Laura Kaufman: Yeah. I did my residency from 2007 to 2011. I'm a little over a decade out from residency. I'm an anesthesiologist by training. I did my undergrad and my med school at University of Missouri in Columbia. My husband and I are both physicians, kind of corny. We're the couple that met in training and we both went up to Rochester, New York then for residency. He was finishing up his neurosurgery residency, I did my anesthesia residency up there.

And then we went down to Atlanta and I started private practice work. I thought I was destined for private practice because I like efficiency, I like speed. I thought that's where I'm going to keep things rolling. I went into private practice then, and I've done private practice ever since. And my husband did his fellowship at the time, and then we came back to Kansas City where I'm from. I did mostly OB anesthesia, it was kind of my area of specialty, kind of 50% or more. That was basically what I did for a decade plus after residency up until May of 2022.

John: Very good. So, you've got a lot of clinical experience, you know what it's like to practice. But for some reason you decided, "Well, maybe I should try something different." I like to hear what was it that triggered you to start thinking of trying something outside of clinical medicine or something in healthcare that can be helpful obviously to patients and to physicians, but is not necessarily giving direct patient care all the time?

Dr. Laura Kaufman: Yeah, I've always been interested in patient safety and quality. I've served on patient safety committees, quality committees, really since finishing residency. But there have been times throughout my career in residency and especially post residency where I thought I really don't know if this is being done as safe as it could have been. I wish that this patient had been more optimized before surgery. I wish that this process was better standardized for the patient. And a couple of patient cases where I got really frustrated and thought, "Wow, I just really don't think we're doing this right for the patient."

That came to a head a couple times in 2021. So, the year before I stopped practicing full-time clinically. While we were on family vacation, I reached out to a few master's programs and I thought "I can get frustrated, I can get mad, I can just say that's it, I quit. I'm not going to do this anymore because it's not safe, it's not the way I want it to be. I don't like it. It's not what I want it to be. I'm not going to do it."

But I found the master's in patient safety and healthcare quality at Johns Hopkins, and I spoke to the advisor there, and it really just seemed to click, it seemed to be what I wanted healthcare to be or be able to take me in the direction of when I wanted healthcare to be. And so, I started working on that master's last year. Honestly not knowing quite where it would take me, but just kind of excited about what that course of study was. And then the unit where I was in charge of OP anesthesia had a corporate buyout in May of 2022, and that's when I transitioned to the master's full-time.

John: Oh, okay. There was an obvious sort of draw the line somewhere because you would've had to do something different or acclimate even to a new system. That's where a lot of people find it's really tough.

Dr. Laura Kaufman: Yeah, yeah. A forced transition of sorts.

John: Yeah. Now I wanted to clarify too, most of us have a combination of things that are pushing us away and things that are drawing us to it. And so, you described that to some extent. For a lot of us, it's burnout. would you say you were affected or by that much at all in terms of just the volumes and the pressure to see more patients, that kind of thing?

Dr. Laura Kaufman: Yeah, for sure. There were moments, especially because of the pandemic, we had not enough staff. We were working 72-hour calls. We were Q2. Every physician has their moments of stress when there's a lot going on. But we were trying to hire, and it's hard to hire when you're showing someone a Q2 schedule.

John: Yes.

Dr. Laura Kaufman: And so, I think that on top of changing to a system where we're transitioning out of the unit where I was in charge, you pile all that on top of a situation where you're already frustrated and it's only a matter of time.

John: Right, right. I was impressed we were talking offline before, and it wasn't just the fact that maybe there were times where it got busy or that kind of thing, but you were really concerned about doing the right thing and treating patients appropriately and in situations where it wouldn't necessarily have really caused a problem to delay. Tell us more.

Dr. Laura Kaufman: Yeah. There were a couple of cases that really prompted me to call or to look into the master's programs where they weren't even necessarily my patient cases, but I was as aware of them or became aware of them. And I wanted to have conversations with other people about them. I talked to my colleagues, talked to other people in the hospital, talked to administrators, and I said, "Look, I really feel that maybe this patient would be better served if they were optimized before coming in, or if they saw other specialists or if they were able to see their primary care doctor before coming in in this context. Or maybe if they weren't treated at this hospital, but they were treated at a different hospital that was more specialized for it."

It wasn't that people weren't willing to listen, but it was more "We hear you, but we still think that we can do it without taking those steps." And I didn't feel that was appropriate and I wasn't personally involved in the care after voicing my concerns, but I just thought this isn't the way it's supposed to be. I need to find a way to fix it. And I'm probably not going to fix it overnight but it needs to be fixed. This isn't serving the patients in the long run.

John: Right. And particularly when you're in a situation where you're asked to maybe give an opinion or you just happen to have to be part of the care for that patient at the time, you definitely want your concerns to be listened to. I think in general, and maybe this isn't true of your institution, but a lot of institutions we get a sense of they just don't appreciate us. They're not really grateful that we're here. They just have us here because we have to be there. We have to sign off on things.

Dr. Laura Kaufman: Right. Right. And you're not trying to be a barrier to getting things done, and you're trying to get that across. That it's not that I don't want to work, it's just that I want to make sure that everything is done safely and, in the patient's best interest.

John: All right. That was one of the things that helped you make that decision. And then you mentioned the other things that went into that. So, what do you think long term? I'm trying to get what your mind is thinking in terms of do you feel like you will maintain your license that you'll be still seeing some patients? Or is that kind of up in the air at this point?

Dr. Laura Kaufman: It's a little up in the air. I have two state licenses because I live really close to the state line of Missouri and Kansas. And I have renewed both of those state licenses into 2023 for both. And I've spoken to a couple of groups around town about doing just some kind of vacation PRN coverage because I don't know that I'm fully ready to step away from clinical work.

But when some other folks have offered me a part-time job, that's not what I'm looking for right now. I like the consulting work. I like working on the masters. And I would like to head more in the direction of the consulting and patient safety and quality work. So, I know some people when they head in the direction that I've headed in are ready to just fully abandon clinical work and send it out the doorway, see you later. But I like keeping that door open.

John: Well, I know a lot of physicians who basically balance the nonclinical and the clinical because they get bored with either one, honestly. They like doing both. And particularly if you're in quality and safety, well, it doesn't hurt to have continued exposure to patients and seeing what is happening in the real world because you're still doing some as opposed to being out completely. And even like the CEOs of Cleveland Clinic and Mayo still see patients or worse, seeing patients one day a week or something. So, it's not like you can't do any kind of even high-level job and not still do...

Dr. Laura Kaufman: Yeah. Yeah.

John: Now on the consulting side, consulting is like this giant possibility. Everybody means different things by consulting. Some do some coaching, they call consulting. Some actually are employed by healthcare consulting firms. Of course, we're talking about freelance consulting type of thing.

Tell us a little bit of what you've done and at this point where you hope your consulting goes, because I think it'll probably evolve, but it's good to hear where you are and what you're planning on doing going forward.

Dr. Laura Kaufman: Yeah, absolutely. The easiest thing, or the first step for me, was legal chart review. I come from a family of lawyers. Much more of my family are lawyers than doctors. And I have friends from growing up and from school that were lawyers. And so, over the years I had family and friends ask what do you think about this case? Or what's your take on this case? What would you have said about this case?

You have enough of those conversations and then maybe someone says, "Can you look at this chart? If I sent you this chart, could you look through this chart, give me an opinion as to whether we should consider settling this or whether we should move forward with it?" And you get a big chart on a CD. Or even before the CDs, it was the giant stack of paper.

And so, I started doing it that way. I really haven't even moved past just doing chart reviews or opinions. I don't do them directly for family members. I think that would probably be a conflict of interest, but my family members and friends have referred me to other lawyers. I haven't done depositions or done court appearances. I'm not opposed to it, but it just hasn't gotten to that point.

But that was what I did mostly in the beginning. And that doesn't take long. It's usually a few hours, but it's nice. It's like a big puzzle. And then I'm usually telling them like, "Yes, I think you're good. I think this is a case that you can easily argue or oh gosh that didn't look good. You might want to think about whether you want to settle."

And that was what I did a lot in the beginning. In the last month I talked to a company that's trying to start out with some anesthesia CME. They're in business doing other types of CME, but they were trying to break into the anesthesia world. So, they wanted to talk about how to structure anesthesia CME, what anesthesia CME is already out there, what I like about anesthesia CME, what I don't like about anesthesia CME, what price points I thought would be appropriate for CME, which was a good question, how the CME could be delivered that people would and wouldn't like. And that was over the course of five hours.

I spoke with a company that wanted consulting for a respiratory therapy device, which I thought was interesting at first. Why are we talking to an anesthesiologist about this? But because we used other devices. That was about an eight-hour job of just talking through respiratory support devices in the recovery room and whatnot.

I've done a little bit of infection control consulting as well. So, it's kind of been just a little bit here and there. When people reach out to me and they have something that I really don't think is in my field, I am going to be honest with them and say, "I'm not sure I'm the person for you." And every once in a while, that's happened and they'll say, "Well, why don't we talk through it anyway?" Or they'll just say, "Well, thank you. I appreciate the honesty."

John: Yeah, yeah. Boy, there's so many things we could talk about. One thing that a lot of beginner consultants talk about is, "How do I price my services?" I think sometimes it's a negotiation. Sometimes it's like the person looking for your help just has that idea in their head "Look, this is what help I need, this is what I'm willing to pay. Is that okay?" So, what have you found so far in trying to come up and especially if you're doing different types of consulting?

Dr. Laura Kaufman: Yeah, that is an excellent question. I will say that I think you should ask for double what you would charge for locums. I think that's a good rule of thumb. And then come down from there.

There was a company that was looking for a physician. By this description, people might be able to find them on LinkedIn, but there is a company that's looking for a physician consultant for a health and fitness app. And I gave them a number and they wanted to pay like a fourth of that. And I said, "Well, good luck." Because they're looking for someone for five to 10 hours a week, and the rate they're looking for is so low. I was willing to negotiate with them for maybe two-thirds to even half of the rate that I would've charged that they were just trying to get a physician for a ridiculous amount of money. And I think they just wanted to be able to say they had a physician on staff.

John: Yeah. I think a lot of startups especially, they'll even try and get you to work for free and they'll maybe promise you some kind of payout when they go public or something crazy, which is years down the road. I know of people that have done that, but it's something you have to have other sources of income and a lot of patience.

Dr. Laura Kaufman: Yeah. And they'll negotiate with you and sometimes they'll even give you a number. The respiratory company, they said, "Can you send us your CV and then we will send you our quote?" And their quote was twice what I would charge for locums. So, I was like, "Wow. Sounds good. Thank you."

John: Now let's go back to the other thing, the educational, that you're in the middle of it now, the master's degree. Explain what the master's degree that you're doing is, the title of it, what is being taught? And also, how you ended up at this one? And I'm trying to think in my head. If I'm in the east coast and I happen to be around a lot of medical schools and it would be really easy to find a master's with pretty good quality, but there's so many things online now too. So, I'd like to hear a little bit about how you decided. I mean, Johns Hopkins is a big name. It's a good story. But tell me more.

Dr. Laura Kaufman: I honestly just started looking at master's programs. Who has masters that I can access? Because there are universities here in town, here in Kansas City. I could have looked for an in-person program. I didn't think I was looking for an MPH. I wanted something that was geared towards quality and safety. And so, it was kind of great that that was all in the title Masters of Patient Safety and Healthcare Quality. At least when I started looking, there were two to three programs around the country.

The nice thing about the Johns Hopkins one is it is fully online. Because some physician's masters do require you to travel a few times a year. Not that if the masters that you really want to do, that should necessarily prevent you from doing it. Because I've met some people that were working on MPHs or MBHs or MBAs that traveled and they thought it was definitely worth it for that degree. But I really loved that this was fully online, that most of it was asynchronous except for a few live talks. They were willing to work with you if that live talk time that was at 7:00 PM really didn't work for you, that you emailed the professor and explained it and it was okay.

And also, their goal is that you finish it within two years, but it's a soft two years. If you need to stretch it out, your advisor is pretty reasonable. It's not easy coursework. The statistics and the epidemiology, it's graduate level. They're not softball for you just because you've already done an MD, which is fine. Because the degree should mean something when you're using it later. But I also really liked that the advisor talked me through it. She said, "These are the other master's programs we have. What is your goal?" And then when we finished talking about it, she's like, "Yeah, I don't really think any of the other masters would be right for you."

John: Let's see. I have other questions about that. In an MBA it's typical, of course, that is a business degree, it's a little different, that usually you end up working in a team on some project or something like that. Is there anything similar to that in this kind of master's program?

Dr. Laura Kaufman: There are a couple of classes that have group papers. There is some online collaboration in Google classrooms and then there's some chat boards in the classes that are interactive sharing of articles and topics and things like that.

John: Okay. Because one of the things I hear on the MBA side is that the networking sometimes is as valuable as the actual education. In other words, you might come out with a cohort of 15 or 20 contacts all of whom are going into something. And for the ones that I'm know of, that involves physicians.

Dr. Laura Kaufman: Oh, sure.

John: There might be like the UT PEMBA is a Physician Executive MBA. Not only do they learn all those things, but then they have these contacts that over time may help with their careers if they're working in their system or something. So, it seems like a lot of the masters do. I did a master's in public health many, many years ago and it was remote. But there was very little kind of collaboration among the students in the program I did. I missed out on to some extent. But it's just amazing what's available now for people to start looking.

The other advantage, of course, of being in a program, not so much for someone like you who is kind of starting their consulting business, but to get a job, it demonstrates your commitment and it shows that you're really interested in that particular thing. Even though you don't have the degree when you're looking for let's say a job with an institution or something, even just being in the program can be very helpful.

Dr. Laura Kaufman: Yeah. Yeah.

John: Well, let's see. That's all useful. Now what about LinkedIn? I'm just curious because that's how I found you or you found me. We found each other.

Dr. Laura Kaufman: Yeah.

John: And we've talked many times about how useful it can be. Anything going on there with you at this point yet? Have you found it? You have a good profile. I looked at it and it's there. And if people that are listening want to reach out to you, they can definitely just look for Laura Kaufman MD on LinkedIn and find out more about what you're doing. But anything about LinkedIn you'd like to share at this point?

Dr. Laura Kaufman: I definitely would say I learned a lot about LinkedIn from the Physician Nonclinical group on Facebook. I knew nothing about it or resumes before that group. I used Heather Fork's resume builder to build myself a resume because I had a CV. I had a CV, not a resume. Very different. I made that mistake for a month or so.

John: Do you hear that? Do you hear that bell? That's my acknowledgement to plug for Heather Fork. Sorry, go ahead.

Dr. Laura Kaufman: Yeah, absolutely. I was not using a resume before I used that. And my LinkedIn did not look good before that. But the legal review stuff, because I had the connections, I think I could have done without the LinkedIn, but the companies that have found me have found me through LinkedIn. I think that's huge. I think you have to figure out how to build your LinkedIn in order to find the consulting, especially if you're doing the freelance like I am right now. Otherwise, I don't know how you would find those people. So, definitely build your connections, link to other people on LinkedIn because that's how those people find you. And so, that's great.

John: Yeah. I think if you even just connect with people that seem to be doing similar things in your industry or in your line of work or that kind of thing, see if they're posting things, maybe start posting things. I've known people that have done that as a way to just generate some interest and collaboration when they see what you're actually doing. But I think what you've put in there already shows your interests and people can definitely find you on LinkedIn if they're interested in getting some consulting for quality improvement in patient safety.

Is your focus to get back to that, the consulting itself? Is it focused on any particular setting? Is it mostly because of anesthesia and OB anesthesia and so forth? Is it more in the hospital setting? Is it large groups? I don't know, there might be things in public health, I don't even know. But what have you found so far to be the opportunities other than being the medical expert?

Dr. Laura Kaufman: Oh, sure. Mostly inpatient, really, because that's what I know. Yeah. I've got to be honest, I'm not as familiar with outpatient ambulatory clinic. Inpatient is more where I'm comfortable. Inpatient ORs, I love OR consulting. That's where I'm most comfortable. Absolutely. Yeah.

John: Well, that's good to know because there are a lot of people that listen to the podcast, so someone that's in that setting might even pick up on that. I will say this too, as a CMO, in my prior life, we hired a lot of consultants.

Dr. Laura Kaufman: Oh, yeah. I bet.

John: Every time we had a new project, we wanted to start a new service line or we needed to adopt a latest trend or whatever it was in patient care or coding and documentation, you name it. And that's where the money is for sure, because groups really don't have money to spend on consultants for the most part. But there's other agencies that do. Okay, that's very useful.

So, where do you see things going? Do you have any big plans for the next six months? Are you going to keep plugging away on the masters and just keep lining up new clients? Anything new that you're going to be trying?

Dr. Laura Kaufman: Yeah, that's a great question. I think I'm just going to keep plugging away. I've got two classes signed up for the spring and I've told a couple groups that I can do some vacation coverage for them here and there. Trying not to get too over-committed clinically though. But it's actually really refreshing to not have a definitive "This is where I will be Monday, Tuesday, Wednesday, Thursday, Friday." Especially as type A physicians, it's kind of fun to have it be a surprise what the next project is. Yeah, let this ride for a little bit.

John: Yeah. For some people that might be too scary, but I think I would enjoy that too. There are different things, you're being sort of tested in a way differently in different environments. Let me ask you this one side question though.

Dr. Laura Kaufman: Sure.

John: Have you been able to charge more for your clinical work as a part-time fill-in as kind of like a mini locums?

Dr. Laura Kaufman: Yes, I have. Yes. And I don't know if that bubble will burst, but yes.

John: When they need someone, it's like supply and demand, right?

Dr. Laura Kaufman: Right, right.

John: Now you not only have an easier clinical time of it because you're not doing so much, but you can actually get paid at a higher rate.

Dr. Laura Kaufman: Yeah. Yeah. And it could be location too because the Midwest is probably a harder place to bring people into.

John: Yeah. Especially when you get out in the country.

Dr. Laura Kaufman: Yeah, that's for sure.

John: That's really hard. All right, Laura. Well, this has been interesting. We're going to have to have you come back in a year or so.

Dr. Laura Kaufman: Yeah. To give an update.

John: I think it's been very interesting and I think the listeners will get some good insights if they're a little leery about doing something like you've already started to do.

Dr. Laura Kaufman: Hopefully it'll encourage some people to take some chances or to think about taking chances if they don't feel as adventurous.

John: I think it will. And if they want to reach out to you, again, connect on LinkedIn, Laura Kaufman MKD. I guess that's it for today. I want to really thank you again for coming on and sharing this with us.

Dr. Laura Kaufman: Yeah, thanks for having me.

John: You're welcome. All right. Bye-bye.

Dr. Laura Kaufman: Bye.

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

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

The post Advanced Degrees and Other Decisions on the Road to a Nonclinical Career – 283 appeared first on NonClinical Physicians.

In today's episode, Dr. Armin Feldman returns to update us on creating a medical legal consulting business, and new resources for learning how to do so. He first appeared as a guest on Episode 227, which was released a year ago. 

Dr. Feldmman attended the University of Colorado Health Sciences Center for his psychiatric residency after graduating from the University of Wisconsin Medical School. For more than 20 years he practiced psychiatry and ran outpatient head injury rehabilitation centers around the nation.

Our Sponsor

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

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

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

Medical Legal Consulting Business vs. Expert Witness Consulting

Dr. Feldman started formal consulting of this nature 15 years ago. His unique pre-litigation/pre-trial consulting aids attorneys in managing the medical elements of cases, raising case value, and saving time.

By supporting medical opinions with documentation from medical literature, he assists attorneys in helping their clients negotiate and settle legal disputes. In most cases, this enables patients to obtain necessary medical care.

Launching a Medical Legal Consulting Business

You need two skill sets to successfully pursue this career.

First, you must be able to research the literature regarding evidence-based medical care and explain your medical knowledge and experience to others. Second, you will need the business skills necessary to launch and sustain a long-term medical consulting firm.

During our interview, Armin describes how to obtain those skills.

Additional Resource – Dr. Feldman's Podcast

Armin and a former student, Dr. Michael Bummer, also produce Physicians Helping Attorneys (Helping Patients) a podcast that helps attorneys understand this new medical forensic field. It is also a great place for physicians who are interested in studying this type of work to learn more about it.

Dr. Feldman's Advice

If you love medicine and you want to… help people, injured people that really need this help… this is something you should consider.

Summary

In today's interview, Dr. Feldman helped us to understand this burgeoning new medical field.

He also describes his new online course, Start Doing Medical/Legal Consulting, which opens later this month. In it, you will learn how to start your own medical legal consulting business. The 16-video course is divided into 4 modules, each lasting two weeks, with a live Q&A with Dr. Feldman following each module.

If you want to begin this lucrative nonclinical full- or part-time consulting business, learn more by clicking this link. (This is NOT an affiliate link.)

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Feldman's Course
• Physicians Helping Attorneys (Helping Patients) Podcast
• How to Do a New Kind of Medical Legal Consulting as a Part Time Gig – 227
• NewScr!pt

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

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Transcription PNC Podcast Episode 281

Why You Must Consider Starting a Medical Legal Consulting Businesses

- Interview with Dr. Armin Feldman

John: About exactly a year ago, I had today's guest on my podcast for the first time, and I was really interested and enthralled by the conversation because what he discussed was something I had never really been aware had existed. And since that time, he's been doing some new things, he's been increasing the availability to teaching other physicians to do what he's done. So, I want to welcome back Dr. Armin Feldman. Thanks for being here today.

Dr. Armin Feldman: It's a pleasure, John. It's always good to see you and it's always fun to be on your podcast. Instead of just listening, I actually get to do one.

John: Yes, I always find it fun to be a guest on another podcast. It's just like a normal conversation, just getting to know somebody. So, it's a lot of fun. You were on last time, about a year ago, and we were talking about this career that you have had for the last 15 or more years and a career teaching others to do it. So just tell us what that is and then you can segue a little bit into what's kind of new with what you've been doing.

Dr. Armin Feldman: Okay, great. As you know I do medical legal consulting. And what that really means is I work as a medical consultant in legal cases. I don't work as a medical expert. I'm working pre-trial, pre-litigation on those approximately nine out of 10 cases that these attorneys negotiate and settle. So, we work as medical legal consultants on the strategic development of medical issues in legal cases. And we're primarily working with personal injury and worker's compensation attorneys who work on the claimant side.

Now, although I'll say that any physician in any specialty can learn how to do this work. As you know, I owned outpatient head injury rehabilitation clinics around the country. I was fortunate enough to sell them. Thinking about what I wanted to do next. This was 15 years ago. I had testified as an expert witness more times than I want to remember, and I was thinking about what to do next, I thought maybe I could consult attorneys on any kind of medical question that comes up in a case. And I guess now the rest is history.

I've done over 3,000 cases. 13 years ago, I started training other physicians how to do this kind of work. And I've now through my coaching program, my conferences, my online training, I've now trained a little over 1,600 physicians around the country. We always work on the side of what I call the little guy going up against the insurance companies. These are injured people, injured no fault of their own, who then need to acquire legal counsel to get the appropriate damages and more importantly, from our point of view, to get the medical care that they really need. And this kind of consulting, really, in a formalized way was not done until I started doing this years ago.

John: Okay. That is definitely a different kind of animal from the usual expert witness consulting. And so, I want to tell you the way I look at it, some of the differences between this medical legal consulting and expert witness. And you can tell me if I'm right or you can add to it. So, let's do that. The expert witness generally is going to be involved in either a chart review, case review, and or a deposition rarely, and then even less rarely, testifying in court. And from my understanding the second two of those never happen in medical legal consulting that you do. Is that correct?

Dr. Armin Feldman: Yes, that's right. Another big difference is obviously if you're working as a medical expert in a legal case, you're working in your specific field. As a medical legal consultant, you're a generalist. You're answering any kind of medical question that comes up in a case. And our legal system allows and actually encourages this. A physician can answer medical questions in legal cases. And what makes what we do viable in many ways, is not only are these cases negotiated and settled, but we always back up our medical opinions with evidence from the medical literature.

In fact, when I first started doing this, my reports would go over to opposing counsel and the opposing counsel would call the attorney that hired me and say, "Why should I pay any attention to this? Dr. Feldman isn't an expert in, whatever, rotator cuff injuries." And the attorney would say, "Well, Dr. Feldman acts as a medical consultant for me in my cases, and if we can't get this negotiated and settled and you forced me to take it to trial, when I hire my retained orthopedic specialist, they're going to say exactly what Dr. Feldman said in his report. In fact, Dr. Feldman is relying on the same medical literature that my medical expert will rely on."

John: Yes. Very interesting. So, let me distinguish another thing here. Medical experts generally are still in active practice, not a hundred percent, but most of them are. And it's usually sort of expected. In this situation, do most of the people doing this, the physicians doing what you do, are still in practice? Still in practice, not in practice. Some are, some aren't. What's that like?

Dr. Armin Feldman: Some are, some aren't. But I'll tell you the majority are. Some physicians do this full-time. Some do it in lieu of retiring, but the vast majority of physicians do it as a part-time gig and they continue to do clinical work, and then they add this piece of nonclinical work to what they're doing. So, most of them are practicing.

John: Okay, good.

Dr. Armin Feldman: It makes a nice transition too for people that want to transition to nonclinical medicine. You can do it on a part-time basis. What I always say is you really need to have a minimum of about eight hours a week in order to do this justice and make it fly. And then from there, you can do it as many hours a week as you see fit and as you enjoy it and build up your medical legal consulting business.

John: Now, it seems that for the physicians that I know that do expert witness consulting, the rate of pay is significantly above their usual clinical pay unless there's some very subspecialized thing. A lot of them, when they do the expert witness, they will like you said, do that part-time too, work fewer hours, generate enough that they can cut back on their clinical. Would you say the same is true of this aspect?

Dr. Armin Feldman: Yes.

John: Okay.

Dr. Armin Feldman: Both things are true. Yes. The remuneration is handsome, and it does allow you to cut back on your clinical work.

John: Okay. Now I know that you have been teaching this and coaching people and so forth. I'm kind of interested in maybe a high-level view of what it would take for a physician to do this. What kind of training, what do they need to learn to do this? You can obviously get into much detail, but what kind of things are important in doing this kind of career?

Dr. Armin Feldman: Yes. I think for me and for the physicians that do this, this is what makes it interesting is that there are really two skill sets that you need to learn. One, of course, is you need to learn the medicine that you need to know to do this. Now you can do that as on the job without training. And when I say the medicine, you also need to understand how the legal system works, how law offices work, what things to do, what things to watch out for.

And I often tell physicians that are in my coaching program, my training program, almost everything that I teach is based on mistakes that I made over the years that you won't have to make. That's part one. And part two is you have to learn how to successfully not only start up, but successfully run a long term medical legal consulting business.

And the training is really on both of those things. So how do you go from zero, no business to up and running with your medical legal consulting business? How do you market that business? Meaning how do you get your attorney clients, how do you keep them long term? How do you operate your medical legal consulting business on a daily basis? That kind of thing. And then on the other side, how do you write the reports? What goes into the reports? What are the services that you're going to offer? Medical service, medical consultation services you're going to offer, and so forth.

John: Yeah, there's a lot of nitty gritty in there. I think I gathered from our last conversation and from listening to your podcast, which you can mention here in a minute. As a physician, we can understand what goes into a particular case. Doing this, you would've to research and oftentimes share that with the attorney you're working with. But like you said, it's something that each case is a little different. And so, I think the training that you've done in the coaching shows people how to do that too, how to collect that and put it together for the attorney.

Dr. Armin Feldman: Yes, yes. There are actually 15, 16, 17 different types of services that I've developed for attorneys over the years. And so, every case is a little different. Every kind of service you're going to offer is different. So, for example, one attorney may want you to put together a comprehensive medical summary report that talks about the entire case, the medical damages in the case, the future medicals that are going to be needed and so forth that they'll submit with a settlement demand, a letter.

Another attorney may want you to do liaison with a treating doctor. Let's say the person develops severe migraine headaches after being rear-ended in the accident. And you get to the medical records and they had some headaches five years ago. And so, you might need to talk with the injured person's PCP or gynecologist or whatever, and say, "Hey, that headache that you treated them for five years ago, is that really a preexisting condition? Was that something different than what, well, I would call them a client, but their patient is experiencing now?

John: Okay.

Dr. Armin Feldman: A client of the attorney. There are a wide variety of services that you can provide as a medical legal consultant. That will depend on what the attorney wants, what the case indicates, and so forth. You're speaking about medical expert work. One thing that makes it different is our average case takes maybe somewhere between five and 12 hours. It's not as involved as being a medical expert. I would say probably maybe 80%, 85% of the time you're going to be writing a report. And that report, it's not behind the scenes. They'll be seen by insurance adjusters. They'll certainly be seen by opposing counsel in every case. They're often seen by judges treating doctors, IME doctors and others.

John: Very good. You are kind of really filling an important niche, an important step in this process. And like you said, most of the time they don't go to any kind of trial which most attorneys try to settle, almost every case at least in my recollection. One of the things I want to mention or ask you earlier, because you're so passionate about this, you spend so much time developing this, it's like a new specialty. And so, why do you love this so much? Why do you like this? You seem very enthusiastic.

Dr. Armin Feldman: Yes. Well, that's a good question. And I think the absolute bottom line on that is, I think as physicians, one of the big reasons we all get into doing this is we want to help people. And this is a way that you can really, really help injure people in a way that they never had helped like this before in a nonclinical setting. And you get to see the tangible results of that help. The other thing is, if you love medicine, when you were in medical school, if you were enthused about it and you love medicine. This is a way to get involved in all kinds of various aspects of medicine and learn. Of course, the attorneys are paying you to do your research, but learn about all kinds of very interesting things.

Now, obviously, I'm in no position to do any orthopedic or neurosurgery, but I would put my knowledge base of spine injuries, rotator cuff injuries, complex regional pain syndrome, you name it, up against anybody because this is what I do day in and day out. I learn about various things that have come up in accidents and then what are the conditions? How do you treat them and stay up to date on all of the medicine?

I'll tell you a very quick story. I was talking to an attorney client last week and he said, "Hey, I have a case in which a woman developed a very bad hiatal hernia and esophageal reflux after being reared. She had two surgeries. She still can't swallow properly. Is that accident related?" And I said, "Well you don't know this, but I've done over 3,000 cases. Nobody has asked me that before." And so, I said, "I don't know if that's the case or not, but I'll go do some research for you."

I did that research, and sure enough it's well documented in the medical literature that trauma, and sometimes in some of these articles specifically, auto accident trauma can cause... I thought it would have to do with physical wrenching, but actually has more to do with internal pressure that's developed in the abdomen and pushes on the diaphragm and tears it.

And so, I was able to go back to this attorney and say, "Hey, yeah, you got a case here. Let me do some more research on this and write it up." And I was kind of thrilled because I learned something new, that physical trauma like this could actually cause these kinds of problems. And that was a damage in the case that this poor woman needed to be compensated for and get treatment for.

John: I bet even though your family and other friends know that you're maybe not practicing, I bet they still come to you with all the medical questions.

Dr. Armin Feldman: My sister-in-law flew in from Minneapolis for the annual Christmas cookie baking experience here in our house with my wife and her other sister who lives in Boulder. And she showed me, she twisted her ankle before she came. She asked me to take a look at her ankle. And I had some suggestions for her.

John: Of course, you did. Yeah. Excellent. All right, now I want to learn more about how we can learn more from you in various ways. And let's talk about the podcast for a minute. I believe that was developed really for attorneys, perhaps, but I think it can be useful to anyone who's thinking about doing this kind of work.

Dr. Armin Feldman: Yes. I developed this podcast with one of my former students who is Dr. Michael Bummer in Pittsburgh. He is just going gangbusters. I'm doing medical legal consulting, and he's a smart and awfully nice guy. We teamed up and we're doing this podcast. It's called Physicians Helping Attorneys Helping People. The URL is physicianshelpingattorneys.com or any place where you listen to podcasts. But it was initially intended for attorneys so they could understand this better because like you said, it's a new field. But what I've learned is that there are a number of physicians that actually also tune in to the podcast and as you suggested, John, particularly physicians that might be interested in learning to do this kind of work.

John: Yes. The podcast, it's not been out all that long, but I had at least a dozen episodes that I listened to while I was on a recent trip. Yeah, it really helped clarify for me really what you do. And it was nice hearing the cases that you described in the podcast because it just makes it more real. If there's someone listening, and again, my audience typically are physicians thinking about various nonclinical careers or pseudo clinical careers, part-time side gigs and all that. So, this definitely fits into that. And just listening to the podcast will give you a much better understanding of what we're talking about in this short interview today.

Dr. Armin Feldman: Great.

John: Yes. But now you also have an even more direct way of helping us learn how to do this. I know you've been sort of coaching and teaching for a long time. Tell us what's new in that venue.

Dr. Armin Feldman: Right. Yes, that's right. I do have a training program, coaching program that physicians have been participating in for years. Last year I started a new online course, and this is really a crash course in how to do medical legal consulting. It's all online, do it at your own pace. And the next run of this course is coming up on January 30th, 2023.

The course is 16 videos. The course is broken into four modules of two weeks each. So, only four videos every two weeks. It's really tailored for a physician schedule. You can certainly watch four videos in two weeks. And the associated downloadable materials for each topic is there for you.

And then at the end of each two-week module, I do a live Q&A where everyone participating in the online course can save up their questions over those two weeks and I'll answer questions for an hour. The course is worth 15 category one CMEs.

John: That helps.

Dr. Armin Feldman: Yeah, it does help. I'm happy to say that the first two rounds of the online course were well received. I'm happy to say the technology actually worked. No problems there. And so, I'm expecting a nice turnout for run number three starting in January.

John: Well, I can't wait because I did sign up for the course.

Dr. Armin Feldman: Yes, you did.

John: If you knew that or not. But I'm going to tell my listeners, look, I'm going to put my money where my mouth is and I'm not an affiliate for this thing. I just think it's so interesting that I'm going to take the course and ask you a few questions. So, if anyone wants to join me, just let me know that you've joined and we'll be in it together.

Dr. Armin Feldman: Oh, that's just great. That's just great. When you're running an online course like that and it's on-demand videos, it's so nice to do a live Q&A because you actually get to interact with the physicians that are in the course, answer their questions and get to know who's actually taking the course.

John: Yeah, that's great. And I've got some courses online, but I'm currently not doing a live version of any of it, including a Q&A. That sounds like it's definitely a value and will help the students immensely.

Dr. Armin Feldman: Yeah. In fact, one thing I say right at the beginning is when you finish this course, you will have all of the tools and all of the instructions that you need to go out and actually do this. It's not just a cursory introduction. It's, "Hey, here's how you do it."

John: Yeah. I think that people, professionals that have made a decision to change and to do some coursework or something, they really want to get into the details. They want to know "Do I have everything I needed? If I truly want to do this, I can do it." And so, I know other course creators that do the same thing, and it's always well received. So, I've got to hand it to you.

Dr. Armin Feldman: Good.

John: All right. Is there anything else you need us to know? We talked about the podcast, the course. Either any other information or just advice for us? You've talked to a lot of physicians who've done transition.

Dr. Armin Feldman: Yeah. I think if you love medicine and you want to learn a lot about medicine, help people, injured people that really need this help, I don't want to sound too grandiose about this, but help the lawyers and help our legal system to some degree who are looking for some kind of nonclinical work, that you can sink your teeth into, and know that not only is it going to be helpful in terms of the income, but also helping people and something that's fun and you can enjoy, then this is something that you should consider.

John: I get a lot of people that are just early in the course of trying to find something new to do and they feel like "I've wasted my education or I'm not going to be helping people." But this is another really excellent example where "No, you are going to be using your education a lot." Reading these research papers, trying to figure out which ones really apply to this case, learning something new, because we're not all experts in every field, but we have that medical background and you're helping somebody. It's not so much that you're helping the attorney, it's the next level, which there's a patient behind that attorney that maybe has been unjustly denied certain services or treatment. Again, it's just a great thing to do and it keeps us still the mind going and using our medical skills.

Dr. Armin Feldman: Yeah. Right, right. That case I mentioned earlier, her medical bill so far to date had been denied by her own insurance company. And that's why she had to hire the attorney. And now that attorney is going to help her to say, "Oh, no, no, this was accident related."

John: Excellent. Yeah. And I bet you had a real sense of accomplishment when you discovered that, in fact, that's a real thing.

Dr. Armin Feldman: Yeah. Right. That's true. Yeah.

John: All right. Well, I really want to thank you again for being here, Armin. This has been fun. I'm going to get the word out to my listeners about this and we'll see what happens. But I hope all the best for the coming year with this iteration of your course, and I'm sure it gets better every year.

Dr. Armin Feldman: Yeah. Thank you. Thank you, John. You always ask such good questions too.

John: All right. That's because I'm really interested. So, thanks again and I'll be looking forward to seeing how things go with your course.

Dr. Armin Feldman: Great.

John: Bye-bye.

Dr. Armin Feldman: Bye.

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Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.

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

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

The post Why You Must Consider Starting a Medical Legal Consulting Business – 281 appeared first on NonClinical Physicians.

In today's episode, John shares 5 unique careers to learn about that you may not have previously considered.

This episode will be devoted to sharing with you the careers that were the most unusual and fascinating and why.

Our Sponsor

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

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

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

5 Interesting and Unique Nonclinical Careers to Learn About

Here are the 5 fascinating and distinctive careers to learn about with some of our favorite guests.

Founder and President of a Professional Organization

There are hundreds of professional organizations, often called associations, societies, or colleges. New organizations are founded every day, generally in response to a need of a particular group of potential members. And for those involving physicians, the leader of the organization is usually a physician as well.

Examples of such nonprofit professional groups include:

• American Association of Gynecologic Laparoscopists
• Association of Extremity Nerve Surgeons
• American Academy of Medical Acupuncture
• American Orthopaedic Foot and Ankle Society

Dr. Lynn Marie Morski, the founder and president of the Psychedelic Medicine Association, exemplifies such a guest. Our interview originally aired in Episode #247.

Online Coach and Course Creator

There are many physician coaches. It is common for a physician coach to add group coaching to their individual coaching business. Some go on to write a blog or produce a podcast or YouTube channel. And some eventually build popular well known online courses.

Dr. Katrina Ubell, who produces the website and podcast called Weight Loss for Busy Physicians, represents a very successful online physician coach. Dr. Ubell's interview can be found in Episode #35.

Part-Time Consultant

This is a tried-and-true strategy for applying your abilities and passions once your practice is well-established. If you have special skills and an interest in helping others with a  nonclinical challenge, you can be a part-time consultant. Once established, you can decide how much of your time you want to devote to each aspect of your professional life.

Dr. David Norris is a classic example of a physician consultant. His side business gradually grew to be the dominant part of his career. My conversation with David is available in Episode #111.

Independent Disability Insurance Broker

Dr. Stephanie Pearson left clinical practice because of her own disabling injury. She found that many of her colleagues did not understand the importance of disability insurance, nor how to select the best policies. So, she decided to assist residents and other physicians understand such insurance and how to protect themselves from the effects of a disabling injury. She is now a successful full-time disability insurance broker.

You may learn more about this in Episode #23.

Chief Medical Officer for a Medicare Administrative Contractor (MAC)

As the CMO at a hospital that was heavily reliant on CMS funding, I became very familiar with MACs. But I didn't recognize that MACs employed Chief Medical Officers until interviewing Dr. Meredith Loveless in Episode #165. The work is mostly done remotely, which gives the CMO a lot of flexibility, and it pays well. 

Summary

These are 5 of the most interesting and unique nonclinical careers to learn about that also generally pay well. 

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

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• How Do I Prepare for the Use of Psychedelics in Clinical Medicine? – 247
• First, Optimize Your Attitude – Interview with Dr. Katrina Ubell – 035
• How to Be a Shrewd Business Coach and Consultant – 111
• The Journey From Career Loss to Physician Advocate with Dr. Stephanie Pearson – 023
• What Is It Like to Be CMO for a MAC? – 165
• NewScr!pt

Download This Episode:

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 275

5 Interesting and Unique Nonclinical Careers to Learn About

John: I was recently interviewed by Dr. Bradley Block on his podcast Physician's Guide to Doctoring. It was a lot of fun, and I'll be sure to put a link in the show notes to that podcast because I think you'd like it. And as of this recording though, the episode's not been released. So, what it is, I'll be sure to mention it here and in an email.

But during our interview, after telling a little bit about myself, you can imagine that I answered a few questions about nonclinical and non-traditional jobs. And one of the questions Brad asked me, actually, was more than one had to do with specific jobs. Like what was the best paying position, what was most esoteric or unique, et cetera, and things like that.

That got me thinking about devoting an episode here to discussing the jobs that I find most interesting and why, and include links to the episodes for those who want to do more investigation into those jobs. These are jobs that one wouldn't necessarily think about right away. So, that's what I'm going to do. What follows is a list of the jobs that physicians are doing that surprise me and why I find them so interesting. So, let's get to it.

Now, there are some jobs that are pretty well known to any physician who has started to look around at a non-traditional position. Those jobs are such as utilization management, and physician advisor, that's a common entry-level job. Or in the hospital world, medical director or chief medical officer. Most of us have encountered those kinds of positions just in our daily practice sometimes if we enter the hospital. Or in the pharmaceutical industry, the medical science liaison, it's a very popular entry-level job, or the medical director in medical affairs.

Those are kind of well-known. But now I like to present a short list of nonclinical jobs that I've learned about that I think are interesting, often unique, and not commonly encountered when starting to learn about nonclinical jobs. Maybe I can get you thinking about these and maybe one or two of these will be of interest to you such that you can do a little more digging into them.

And so, let's get going here in no particular order. The first is the founder and president of a professional organization. Now, there's a broader group, and that's just any physician leading a professional organization. But the reality is there are several opportunities out there apparently for us to create our own professional organization. And then most of the time they're nonprofit, and you can be then the president or CEO.

There are thousands of organizations like this in the United States, and I often came into contact with them when I was volunteering as a CME site surveyor for the Accreditation Council for CME or the ACCME. I did that for I think about 20 years. I interviewed folks from at least a hundred different organizations, and many of them were associations or similar organizations. They obviously catered to physicians and they produced educational content for which they wanted to provide CME credit. So, they had to be surveyed basically every four to six years.

We'd review the programs and collect information about their compliance with the requirements of the ACCME. Now, many of these organizations that are credited are medical schools or large medical publishing companies, CME companies, and hospital systems, but a significant number of them were academies, societies, and associations. Sometimes they were called colleges whose members included physicians. And I was just intrigued by this because I could see their background when we were doing the survey. Some were pretty unique, pretty small, and were recently started. They're mostly structured, as I said, as nonprofits. And sometimes they represented members in some pretty narrow fields.

I'll give you just some examples of the titles of these organizations just to show you that they're not like the AAMA or the ACP. We're talking about niche areas. Examples. American Association of Gynecologic Laparoscopists, Association of Extremity Nerve Surgeons, American Academy of Medical Acupuncture, American Orthopedic Foot and Ankle Society. I'm just scratching the surface here.

So, you get the idea. There are new organizations that are started every day, usually in response to a specific need. I was asking a colleague the other day who's in locum tenens if there was any organization for locum tenens physicians. And he said, as far as he knew, and he was active in locums, he actually spent on my podcast a couple of times as a guest. That's Andrew Wilner. He wasn't aware of any, so that kind of shocked me.

But anyway, most of these organizations for physicians will have a paid physician leading them. And I wouldn't have brought this up unless I had a guest that had done this very thing. So, the guest who best exemplifies this job was Dr. Lynn Marie Morski, who is a founder and president of the Psychedelic Medicine Association. You can find our interview in PNC podcast episode number 247 from May of this year, 2022. You can imagine why she started this because there have been some really interesting studies in using psychedelics to treat depression and PTSD with some pretty remarkable results.

And so, it's becoming mainstream and there are physicians who would like to participate in some way. And so, this is a very interesting job, and as far as I know, she's still in that position. Something you might think about is either stepping into an association or society that already exists or developing your own and meeting a need. And all you need is 20, 30, or 40 people who might join and it'll probably be self-supporting until it grows even larger. All right, that's number one. And you can find that at nonclinicalphysicians.com/psychedelics-in-clinical-medicine. But of course, I will put links in the show notes.

The second job I wanted to mention is that of an online coach and course creator. Now, a lot of us aim for that kind of thing. There are obviously many, many physician coaches. I'm familiar with dozens of coaches, and I've seen lists of up to 200 physician coaches for different types of coaching. It's common for successful physician coaches to add group coaching to their individual coaching business.

Some go on to write a blog or produce a podcast or a YouTube channel. Some create a community via Facebook or other means to support and teach their clients and to generate sales leads for their services. And some also develop their own online courses or combinations of live and recorded online programs that can really reach a much larger audience.

This group becomes very small because it's difficult to become highly successful in this. There are a select few who create a sustainable online presence using some or all the previously mentioned online services. They put it together so that they can scale it and then somewhat automate part of it so that you can generate some income and not get burnt out in the process of doing it.

Some of these people who are really successful generate income that meets or exceeds that generated in their career as a physician. And I find it really inspiring and compelling when I find such physicians. And the one that's represented among my interviewees is Dr. Katrina Ubell of Weight Loss for Busy Physicians. That's the name of her website and of her podcast. She's been offering now for several years a comprehensive six-month program called Weight Loss for Doctors Only, which is very popular and successful. I don't have access to her books or anything, but I know that she's successful because others have mentioned it, and kind of as secondary support for that.

I know she's extremely busy and very successful. It has a lot of clients. She practiced pediatrics for many years, but now focused primarily on her coaching and her weight loss programs. And on top of everything else, she recently published a book called How to Lose Weight for the Last Time. It just came out in September of 2022. You can find that on Amazon and every place else. And it's really quite a remarkable accomplishment because it was traditionally published. And so, you've heard from authors and writers here in the podcast before, that's not an easy task. You can listen to my interview with Katrina in episode number 35 from May of 2018. If you want to go directly to that, you can go to nonclinicalphysicians.com/optimize-your-attitude.

The third interesting career today is that of a part-time consultant. I've interviewed several physicians who are doing consulting of one type or another. You can be employed as a consultant, you can start your own consulting company, part-time, full-time, remote, live, face-to-face and what have you. It's all kinds of things, and it's a common business that physicians do create. But really to do it well and to demonstrate that you can practice first full-time and then transition slowly over time as you build this part-time clinical or nonclinical consulting firm, it's really unique when you can find someone who has accomplished that and has made it work for an extended period of time.

I found that my interview with Dr. David Norris was very compelling because it represented such an iconic part-time side gig, which he's continued to do since he was interviewed back about three years ago. David continues to practice anesthesia along the way. He obtained an MBA and a certification as a physician executive because he's interested in those kinds of things. It's not necessary to do that to be a consultant. But he offers business and management consulting services to medical practices and other healthcare businesses, and he produces a podcast called the Financially Intelligent Physician. He is gradually increasing consulting over time as he's reduced his clinical hours.

Again, it's a classic way to leverage your skills and interests once your practice has been well established. And then as it does so, you can decide how much balance you want in one versus the other. It's kind of like expert witness consulting. You can do very part-time or do a lot more, cut back on your practice, but you can find that balance that works for you. Anyway, you can listen to my interview with David in episode number 111 from October 2019, which can be found at nonclinicalphysicians.com/business-coach-and-consultant.

The fourth career that I found interesting and compelling, to me at least, is that of an independent disability insurance broker. Dr. Stephanie Pearson was a busy obstetrician when she suffered a work-related injury. She discovered that her injury, and after her injury, the disability insurance coverage was not always as it appeared to be. And we get into that a lot on the interview. I'm not going to go into that now but what happened was she wasn't able to go back to do her same clinical work. And because of the struggles that she had with disability insurance coverage, she became committed to helping residents and other physicians understand the importance of such insurance and what to look for in a good policy that would fully protect them in the event of a disabling injury, such as the one she had.

She was giving people advice about this for free for a while, but then she jumped through all the hurdles that enabled her to become an independent broker, and she continues to promote and sell insurance mostly to physicians today. And I've yet to meet another disability or life insurance broker who's also a physician. So, I think it was quite unique. And my interview with Stephanie is in episode number 23 from February 2018. And if you go to nonclinicalphysicians.com/physician-advocate, you'll be able to find that episode and I think you'll find it very interesting.

The fifth and final career for today's episode is that of Chief Medical Officer for a Medicare administrative contractor. It's also known as a MAC. And I was well aware of MACs because they're very important to my role as Chief Medical Officer for a hospital, which like most hospitals, was heavily dependent on CMS payments.

Medicare and Medicaid payments are critical to most hospitals, and you really need to understand what the MACs are expecting so that you can get paid properly. But before speaking with Dr. Meredith Loveless, also a former full-time OB-GYN, it never occurred to me that there were physicians working for the MACs and at that leadership level position. So, it was an interesting interview. I've not interviewed anybody doing anything like that since.

The neat thing about the job too is that it does pay well as most CMO jobs pay in almost any industry, and it's performed remotely for the most part. The reason she took the job and found that job and took it was because it gave her a little more flexibility so she could be home with her family, not because she was burnt out. She really loves the job. She says that it's interesting, it's fulfilling. And you can listen to our conversation episode 165 from October of 2020, and that's at nonclinicalphysicians.com/cmo-for-a-mac.

Those are the five I wanted to mention today. Again, if any of those five are interesting, you've got episodes you can listen to. There are a lot of links in each of those episodes. I'm pretty sure I have transcripts of those for each episode as well, which you can use if you prefer not to actually listen to it. You can just read through it. And you can get all those resources at nonclinicalphysicians.com/careers-to-learn-about.

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The post 5 Interesting and Unique Nonclinical Careers to Learn About – 275 appeared first on NonClinical Physicians.