locum tenens Archives - NonClinical Physicians

Shifting from Medical Writing to the Locum Life

John Jurica — Tue, 23 Jul 2024 10:06:52 +0000

Part 2 of a PNC Classic from 2019 with Dr. Andrew Wilner – 362

This is Part 2 of my interview with Andrew Wilner about shifting from medical writing to locum life. You can find Part 1 at How to Blend Medical Writing and the Locum Life.

When he decided to return to clinical medicine, Andrew discovered a wide-open locum tenens market for all specialties, even neurologists! Lucky for him, the opportunities for finding work had exploded during the previous decade.

“I liked the idea that I would show up, work 100% of the time, and then stop,” said Andrew. “Then, I can go back to the Philippines, dive, and work on my next book.”

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The Downsides of a Locum Tenens Lifestyle

But moving from place to place to practice has its downsides. Andrew describes the tedious credentialing, licensing, and CME credit challenges that come with the bureaucracy of medicine. And you must plan well to avoid long periods without work. The locum life has its challenges.

At one point, Andrew had licenses in 10 states. It became a challenge to meet CME requirements and track different expiration dates and fees.

Medical Writing to the Locum Life

Wherever he went, Andrew’s experience with locums has been similar. The places have modern information systems, excellent imaging technology, and a welcoming attitude.

All you have to do is a good job and they love you. It's fantastic. – Andrew Wilner

The one thing about shifting from medical writing to the locum life was feeling very appreciated. You're showing up where they really need you. You're not angling for the job. They're signing you because they need you now: “Oh, welcome, Dr. Wilner. We're so glad you're here.”

According to Andrew, they're often ecstatic that you're there. Show up and do a good job and your efforts will be appreciated in most cases.

That's the second half of my interview with Andrew Wilner. You can find his book here: The Locum Life: A Physician's Guide to Locum Tenens.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 362

Shifting from Medical Writing to the Locum Life

- Interview with Dr.Andrew Wilder

Andrew: Yeah, I thought, you know, this is really tough. So, then I discovered again, locum tenens. And now I was back in the system, the locum tenens market is wide open for all specialties. It never dawned on me there would be locum tenens for neurologists. And it turns out that psychiatrists of all things are the most in demand.

John: Interesting.

Andrew: Yeah, so I called a couple of the companies and, "Oh yeah, we've got this. We've got that." Seemed kind of crazy. You just fly in somewhere, you show up, you're the doc of the week or the month or six months. But I liked the idea that I would show up, work 100% of the time and then stop. And then I could go back to the Philippines and go diving and work on my next book.

John: Sounds like a great lifestyle, but of course it's not as easy as just saying show up somewhere, right?

Andrew: Right. The downside, and I write about this in my book, is the credentialing and licensing and CME credits. The bureaucracy of medicine, you don't realize it once you're just, you're in practice and you kind of perk along and you do your CME and you renew your license. It's a nuisance but it's not overwhelming.

Andrew: But at one point, I had licenses in 10 states. And just applying for these and keeping them up and they all have different CME requirements and different registration dates and different fees. There's a lot of little secrets.

Andrew: I'll tell you one. DEA. Everybody knows that you need a Federal DEA number to prescribe scheduled drugs like Oxycontin and stuff like that. What everybody doesn't know, is that if you work in two states, say Massachusetts and Rhode Island, you've got a clinic in each one or you moonlight, you need another DEA for the second state.

John: Oh.

Andrew: Nobody knows that. And there's one guy already that lost his license because he didn't know that, who I corresponded with. You would think it's a Federal number. Now the complexity is you can transfer your DEA from state-to-state. Like, suppose I worked in Minnesota after I worked in Arizona, so I took my Arizona DEA and I transferred it to Minnesota. I don't have to get a new one. But one DEA is not good for two states at the same time. Why? I don't know. But that's a rule. And if you break that rule, you can get into major trouble.

Andrew: So if you do go from state-to-state within the same time period, bouncing back and forth which is not unusual. You might work six months in Arizona and six months in Nevada and go back to Arizona, you need two. So that's my little tip of the day.

Andrew: There's a lot of those in my book, by the way.

John: Let me ask you this, just to kind of help clarify it. So it seems like when I had to re-institute my DEA, because I had stopped clinical for a while. What they were really particular about your place of employment, so it's almost like it's linked. The DEA is almost attached to where you're working in a sense.

Andrew: Yes, exactly. That's exactly right.

John: So if you're in another state, you need another one, because you're working someplace else.

Andrew: Yes. Yes. So when I researched my book and also practicing locums all over the country, you kind of learn these things because you have to. The other thing I learned about locums, my first job, I think was in South Dakota. I never even thought about South Dakota. I'm kind of a coastal guy. You know, there's the east coast and west coast, South Dakota, I don't know. It's cold, it's somewhere in the middle. There's an air force base there. That's all I knew.

Andrew: So anyway, I drop in there and it turns out they've got a fantastic, modern hospital system, they've got residents. It's like, "This is a great job." And that was pretty much my experience with locums, wherever I went.

Andrew: The other thing about locums that you don't anticipate, is that you're appreciated, because you're showing up where they really need you. You're not angling for the job. They're paying an agency or you're contracting directly, usually with an agency, a lot of money because they need you now. So you show up and it's like, "Oh, welcome Doctor Wilner. We're so glad you're here." And it's like, oh wow, my reputation precedes me, that's great.

Andrew: But it's not that. They're just happy that you're there. All you have to do is a good job and they love you, it's fantastic.

John: A lot better than being taken for granted, I guess.

Andrew: Yeah, you're not just a cock because ... and that has pluses and minuses. Because everyone knows you're a temporary, so in terms of developing long-term relationships with your peers and fitting into the community and making changes in the hospital, you can't do those things. Because they know you're just passing through.

Andrew: On the other hand, because you're just passing through, you don't really have to take all these things to heart. You show up, you do your work. At night, I could do my writing and I know that when the thing is over, I'm going to do my very, very best because if it's a good job, I want them to ask me back, or maybe even offer me a permanent position if I really do like it. That has happened. And I know that's happened to other locums tenens physicians as well. Because you're really happy to be there. Well, you need the money because you've been goofing off, following your passion. But you're also, now it's a special thing that you've chosen to do as opposed to, "Oh, I've got to go to work. It's Monday again."

Andrew: So it's kind of all in the eye of the beholder. It's your mindset. But I found locums was just a really, really special opportunity.

John: Now in your book, you mentioned that the attraction of locums may be different for the early, mid- or late-career physician. So I wonder if that ties in or maybe you can explain a little bit about that?

Andrew: Yeah. No, I think that's really important. Most locums physicians are over 50. And many of them don't even try it until they're over 50. And that was my case as well. For that group ... well, there's sort of two groups there. There's the mid-career guy, which I guess, despite my age, I think I'm still a mid-career guy. And then there's the pre-retirement guy.

Andrew: So we'll start with mid-career. So mid-career guys are very often, will work locums as a moonlighting option, because they can't be bouncing around for three months here, six months there, I'll go to Alaska, I'll go to the Caribbean, oh let's try New Zealand for a year, because they've got three kids in school and they've got a mortgage and they've got this whole system that revolves around them. But they need some extra money. So it's a way of supplementing income on vacation time, something like that.

Andrew: Or I've also seen it as a way to explore a new clinical practice. It's like, "You know, I'm stuck here, I've got this job. I really need a full-time job, I'm not too happy with this full-time job. Maybe there's something better out there." So by doing locums, just as a temporary person, you can see how the other half lives and maybe apply for a different permanent job.

Andrew: In fact, I have one guy who's in my book. I interviewed a lot of other physicians. When I started writing the book, it was mostly because I had all these stories, some of which I'm sharing with you, things I had learned along the way that I wanted to share. Then I thought of, when I said, "Well, I bet there's a lot of other stories out there. I'm just one guy, I'm a neurologist. I wonder what the anesthesiologists, which is also a common locums thing. I wonder what their experiences are. I wonder what the residents' experience are, just graduated." So I interviewed a lot of other physicians and they're in chapter 20, called Tales from the Trenches. And I think that's the best part of the book. I asked them, "What was your best locums experience? What was your worst?"

Andrew: But one of those guys, oh, he was in a job that was just a disaster. He was a partner, but the group wasn't making money. And every month, they were making less and less, and working harder and harder. And this is not uncommon. And he wanted out. But he loved where he lived and he had a two-year noncompete. So he was stuck. And being stuck, I think that has a lot to do with burnout. It's not just the problem, it's the realization that you're helpless.

John: Right, exactly.

Andrew: That's what really makes you burned out is I'm powerless to fix this. And he just felt powerless. So against his better judgment, he finally talked to a locums agent. And I think it took him about a year of going back and forth before he decided to give it a try. Because he could work out-of-state. So he could work locums anywhere else, get out of his noncompete geographic restriction area and see what happened.

John: And he didn't have to sell his house or property and everything, yep.

Andrew: Right, he just let the clock run out.

John: Very nice.

Andrew: So he did it and not only did the clock run out, but he discovered a whole new world of opportunities. And he was the other guy, when I did every other week in Minnesota at the County Medical Center which was a wonderful job. It's a teaching hospital, it's a innercity hospital with lots of immigrants. Every other room, they're speaking another language and have some exotic disease. The residents are really good. I had a great time there.

Andrew: So he was the guy who did the other week. I did my seven days and then he would show up and do his seven. But we never actually met in person because I'd be flying out Monday morning and he'd be flying in Sunday night, and we probably passed at the airport, but I'd been in touch with him. And he has since landed a job in South Carolina as a neurologist and director of the stroke program, and he actually chose to move because while he was doing locums, he was talking to people and getting invitations to interview here and interview there. And he found the perfect job for him that he never would have found.

John: So he was networking?

Andrew: He was networking. So locums is a terrific opportunity to work and network at the same time. You just do it without trying, right? They drop you in a new place, you don't know anybody. You have to network just to find out where to get dinner.

John: Awesome. So what about the pre-retirement?

Andrew: For example, we've got a guy here where I work now, he must be in his late 60s, he's been doing clinical practice 40 years. He's an excellent, excellent clinician. I'm sure he's financially stable. And he loves what he's doing, but I think he doesn't really want to do it every day anymore. I think it's just a matter of stamina.

Andrew: The other thing is you get older, you see your days are kind of numbered. So there are some other things you wanted to do.

John: For sure.

Andrew: But he doesn't want to give it up. And the truth is it is very hard to have a ... like we talked earlier, to cut back. There just aren't that many opportunities to work four days a week or three days a week, because for physicians, they need a slot. You've got to fill the slot. Sometimes you can balance it with somebody else, if you're both half. But cutting back is very, very tough and usually at severe financial penalty.

Andrew: So he told me, "What about this locums thing?" So we started talking about it and he realized that this would be perfect for him. Because it allows you to work. You want to work three months a year, six months a year, nine months a year, two weeks a year? It's completely up to you. But you don't have to hang up your shingle. You don't have to give it up. And you can work it into the life that you want for however much time you've got left as a functioning physician. Maybe five or 10 years without the commitments and the routine.

Andrew: It's like, "Oh, I really want to go with my family for a month to Italy. We've all got time off but I can't go because I'm on call on Christmas." You can just get rid of that. Say, "You know what? Not working on December. I'll just work February and March and maybe April and I'll do September." And in the locums world, there's no stigma to doing that.

Andrew: When you're in the day-to-day, it's like, "Gee Doctor Wilner, you don't work full-time." It used to bother me as kind of a high-performing guy with high expectations of myself. And after a while, I realized that those people didn't know what they were talking about.

John: Right, right. They don't know what balance is.

Andrew: Right. So then the last group is after residency. And it was very interesting about that. There were two completely different opinions. One was residents don't know enough. You've just finished your fellowship or you're right out of residency, it can be pretty tough to get dropped in as the only neurologist in a community hospital. And you don't know who to ask. You don't know which consultant is really reliable. Who's telling you the right thing. So you have to be a very confident new graduate to do locums because it's quite likely that you're not going to be in an academic institution with others at your level or higher. You may just be the lone warrior out there and you've got to figure it out. And I think that could be overwhelming. That was the opinion of some of the doctors.

Andrew: On the other hand, I had at least two who told me that it was the most wonderful thing in the world. They knew what they were doing, they really didn't know what kind of practice they wanted. So they practiced in California, they practiced in Texas, they practiced in big clinics and volunteer clinics with indigene people, with American Indians, and they kind of figured out what they really, really liked. And were ready then to apply for the job they knew would be a better fit, for the permanent job.

John: Right.

Andrew: So that's the other tool of locums. I think when you say locums, people think, oh so you want a career of locums? Like me, I had a career of locums for a while, but it also allowed me to figure out that I really like teaching, I really like really sick people who don't have insurance. So I ended up, now I am an associate professor at the University of Tennessee in Memphis in a city hospital with just that combination. And I couldn't be any happier.

John: That's fantastic. We're going to run out of time here, so I wonder if you could walk us through in the last five minutes or so, the process that you followed to write the most recent book and publish it. Because I think it was done in a slightly different way than perhaps your earlier books were approached.

Andrew: Well, writing a book, I don't recommend it unless it's something you really, really want to do. Because it takes a lot longer than you think. But to answer your question, my first two books were published by traditional publishers and they have their process. Bullets and Brains that I published, actually I self-published it, because all of those essays had previously been published on Medscape. It was a collection. And I couldn't get a traditional publisher interested in publishing something that was basically already out there, although not in really any collected form. And I also updated all these essays. So I thought it was worthy of a book.

Andrew: So when it came time to write my latest book, The Locum Life, A Physician's Guide to Locum Tenens. I explored the market, who would want to buy this. It's not for people to buy it at checkout at the supermarket, it's only for physicians who are interested in exploring this path. It's kind of a guidebook. And I looked into traditional publishers and I didn't think it was really going to sell enough copies to get them all excited about it. And I had already self-published a book, that was with CreateSpace. And CreateSpace no longer does that.

Andrew: So I discovered Lulu which is one of the largest self-publishing companies. And basically, they just print it. They'll edit it if you want. I didn't have them edit it, I'm a professional writer and I'm used to editing. So I edited it myself. I had the cover designed by an artist, who I met when I was doing locum tenens.

John: Very good.

Andrew: She was doing paintings of her husband's adventure at the hospital. He kept coming in and out and she would draw and paint whenever he was admitted. And she had an exhibit and I thought her style was just wonderful. So I contracted with her, she did the cover, I wrote the text and then Lulu puts it together and gets your ISBN number and makes sure that it's up on Amazon and Barnes and Noble. So the beauty of that process is the only person you've got to wrestle with is yourself. So you want 20 chapters? It can have 20. You want 10? It can have 10. When you work with a traditional publisher, you get an editor or a team of editors and they all have their own ideas about how it should be done. I'm just one of these self-directed individuals.

Andrew: Doing it myself plus I didn't think the traditional publishers, even if they did accept it, would put their weight behind it to market it. Figured I'll just market it on my own, people know who I am. They know about locums. If they're interested, they'll buy the book. And it'll give me a forum, a platform where I can put everything I know that's useful about locums into a nice guidebook. So that's why I did it self-published.

John: Now just for some other tactics. As a writer, what kind of philosophy do you follow? Do you say okay, I'm going to put aside three hours a day every day for ad infinitum, or how do you manage yourself in terms of giving something like this together?

Andrew: That is a great question. If you're a creative person, a writer or an artist or a dancer or a singer, the chances are you're not going to be able to make your living doing what it is you really love. I'm lucky in that I also love doing medicine. But chances are, it can't be your number one priority.

Andrew: And then the other thing that goes with that is most people you know, who are not creative people, have no idea why you want to waste your time doing it.

John: I see, yeah.

Andrew: So you don't get much support. You're not going to get any support from your workplace, kind of like my partners when I was pursuing academics. "Why?" And then it's going to be very tough to get support from those around you, unless they really love you and they see that this is something that's so important to you, they don't really know why, but ... So it is very, very hard to carve out the time. I've discovered that, I used to stay up from 10:00pm to 2:00am was my best writing time.

John: Okay.

Andrew: Which is incompatible with having a regular job and being married and having a baby. So now I find that I get up very early. I get some help with that from my newborn son. And get breakfast together and then go hide for a few hours in my office on my off-week. That's what I'm doing right now. And I close the door, and I answer my emails and then I start hacking away at something that hopefully will be worth reading sometime soon in the future.

John: Now one other question about that. This is really because a lot of the things we do here are how-to? So I want to get real practical. But you've got 20 chapters in the book and by the way, let me stop here and say that I've read the book from front-to-back, it is excellent book. It's very comprehensive, it's very well-organized and I could tell you're a professional writer. Because it's easy-to-read, it's enjoyable to read. So I'm just going to put that out there for you, the listeners, if you're interested in locums, you definitely want to get this book.

John: But with the 20 chapters, so do you create the 20 chapters ahead of time? Say, okay these are the 20 things I want to hit and then you can kind of come back within each and chunk it out, or do you start at the beginning and just start writing? How do you approach that?

Andrew: That's a great question. Some people can probably do that. I can't. In fact, so what I did was, as I was thinking about this, gee, this would be a great book, I would start jotting down topics. What do I need to talk about? What's important? At one point, I had about 100 chapters that were going to be topics.

John: Oh boy.

Andrew: Like the DEA thing I talked about. We didn't talk much about credentialing and licensing and then experiences getting the job and how to show up and there's a lot in the book about travel and running your own business and how to deal with malpractice and being an independent contractor and taxes. So I would start, say, oh this would be a chapter, and then I would start writing those chapters as isolated things. And I'd have to do a lot of research about malpractice, what are the options? Or for example, I learned that 80% of locum tenens positions use agencies, but 20% just contract directly. And I've done it actually both ways, but I didn't want it to be just a book about my experiences. I wanted to be able to generalize to everyone. So I just kept writing chapter here, chapter there, chapter ... and then I'd say, "Those two chapters, I've got this one about licensing and this one about credentialing and this one about DEA, those could all go together."

John: Right.

Andrew: So first I had to put it all out there and then I said, "Maybe I want to interview some other guys." I called some of the locums companies and said, "Hey, can you give me some names of docs who might want to talk about their experiences?" And people that I've met on my own experiences and I would do email exchanges or talk on the phone like we're doing and record an interview. And I said, "maybe that ought to be." So some of those I would plant in different chapters. So-and-so did this for his credentialing or had this experience or this is what they do with their 401K. And then I said, "That could be a whole chapter." So that became Chapter 20.

Andrew: So for me, same with fiction writing. I think there are guys that write mystery novels and they already know how it ends and they just block it all out. I kind of have to learn as I go.

John: Okay, no, that makes sense. Certain things occur to you in the middle of writing about another topic that relates to something else, "Oh, I've got to do a little more detail on that." That makes perfect sense. So you know what? We are going to run out of time here.

John: So I want you, if you could at this point, tell us how we can follow you if we want to follow you. Where's the best place to purchase your book? And information like that.

Andrew: The book is available at Amazon and Barnes and Noble and all major booksellers. But the best place is to come to andrewwilner.com. www.andrewwilner.com. Andrew Wilner is one word. Because a couple months ago, when the book was going to come out, I said, "You know, I ought to make a new website about Andrew Wilner as an author." If you search Andrew Wilner MD, you'll find some websites out there as Andrew Wilner as physician and Andrew Wilner as medic. We didn't talk about this but medical missionary in the Philippines and underwater, all these other things.

John: Videographer, right?

Andrew: Yep. I said, "We need an Andrew Wilner author site." So there's now an Andrew Wilner author site with all my books and I've created a blog, in addition to my Medscape blog, now I have my own blog and I blog about writing and locum tenens. There's a thing you can click on there on the website to get the book at a discount, right direct from the publisher.

John: Okay, at andrewwilner.com. That's where we find that.

Andrew: And you can also contact me. I try and respond to emails and if somebody has a legitimate question, I will do my very, very best to respond and provide some guidance on these topics.

John: Which email shall we use for that?

Andrew: Right at the website. Just go right to the website and there's a contact me. I'm happy to respond.

John: Very good. I'll put all those links in the show notes and anything that came up during the interview. So I'm going to give you a last chance here to give us any last bit of advice about locums or about writing or both? For the audience here that's been with us.

Andrew: They're both options. I think people tend to get into a rut. And they shouldn't be afraid to try locums for sure. And when you write, there's a lot of blog opportunities now, with KevinMD and Doximity. And writing is something that people are ... they find therapeutic or it's just fun thing to do. And I write because I learn. When you put something, it's like you want to learn something? Teach it, right?

John: Yep. That's true.

Andrew: [crosstalk 00:28:09] to paper, you say, "Oh, I don't really know that. Let me go find that out." And it's kind of fun. So I would say, don't be afraid to experiment.

John: Awesome, that's great advice. No, and I really like speaking with physicians like yourself who maybe earlier than some of us, came to understand that you always have options and if you're not happy in what you're doing, then you should definitely explore those. That's an excellent inspiration for us.

Andrew: Thanks very much, it's been great to speak with you.

John: Okay, Andrew, then with that, I will say goodbye and I hope to chat with you again sometime in the future.

Andrew: It was my pleasure.

076 Combined Tracks Jurica Wilner for Transcript... (Completed 02/20/19)

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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 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 Shifting from Medical Writing to the Locum Life appeared first on NonClinical Physicians.

How to Blend Medical Writing and the Locum Life

John Jurica — Tue, 16 Jul 2024 12:02:38 +0000

A PNC Classic from 2019 with Dr. Andrew Wilner – 361

Dr. Andrew Wilner discovered early that he could develop a career that would blend medical writing and the locum life. He has always been a dedicated writer. And he is passionate about medicine.

Writing has been a part of his life since high school. After medical school and internship, Andrew became an emergency room doctor while trying to decide the next steps for his career.

Using the flexibility that came with the ER job, Andrew continued to write. And that temporary ER job “was actually locum tenens. I never knew of it as such,” said Andrew. It not only allowed him to write books and continue his clinical work, but it helped him discover an interest in neurology. This led to his applying for a neurology residency at McGill University in Montreal. He was later accepted to the program and eventually completed an epilepsy fellowship at McGill.

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Full-Time Writer

In Andrew's opinion, there's not much “literature” in the scientific literature. Writing a scientific paper is just a skill and “pure drudgery.” It’s not a creative endeavor. But writing for online journals, news outlets, and blogs requires a creative mind, and satisfies Andrew's need to write.

As an epilepsy expert, he wanted to write a book about epilepsy, so he published Epilepsy 199 Answers: A Doctor Responds to His Patients' Questions, in 1996.

What is epilepsy?
Is it contagious?
What's an EEG?
Can I drive a car?

Later, he wrote a book for clinicians, Epilepsy in Clinical Practice: A Case Study Approach.

While between jobs, he started doing interviews at conferences writing news articles for written publications. He found he was quite good at it, sometimes turning a 3-day conference into twenty or more published articles.

He developed relationships with editors. As the Internet exploded, he wrote blog articles and news stories for online publications such as Medscape, KevinMD, and Neurology Times. He had to hustle and write a lot but earned a living with his writing.

He transformed his blog posts into his first non-epilepsy book, Bullets and Brains. It opens with an essay about the impact of a brain injury on the life and career of a very capable, high-performing congresswoman, Gabrielle Giffords. She was shot in the brain. And Andrew explored the idea that “bullets and brains (obviously) don't mix.”

Blend Medical Writing and the Locum Life

With the growth of the Internet and the ability to work remotely as a writer, Andrew decided to travel. “One of my passions is scuba diving, so I went off to the Philippines. I discovered that I could sit there with my little laptop and write my articles,” said Andrew.

However, he had to consider whether he wanted to “retire” from clinical work permanently. He found that as he distanced himself from the clinic and seeing patients, his knowledge became less relevant, and he became less desirable as a speaker.

I think if you've been a dedicated clinician, taking some time off is only a good thing. – Andrew Wilner

So he decided to give clinical practice another shot. After writing for a living for ten years, he decided to return to clinical practice. It wasn’t easy, not because he had forgotten anything, but because the system wasn't flexible.

He had difficulty obtaining malpractice coverage. However, a small hospital desperate for neurology coverage helped him return to clinical medicine by arranging temporary supervision that demonstrated his competence to practice.

He then sought to balance his clinical work and medical writing. He started by pursuing locum tenens positions. In the process, he began a whole new chapter of his life. And it eventually led to the publishing of another book.

That's the first half of my interview with Andrew Wilner. Next week we'll pick up here and talk about his experiences living the “locum life,” and how those experiences inspired him to write his latest book The Locum Life: A Physician's Guide to Locum Tenens.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 361

Shifting from Medical Writing to the Locum Life

- Interview with Dr. Andrew Wilner

John: Welcome to the PNC podcast. Doctor Andrew Wilner, thanks for being here today.

Andrew: Thanks, John. It's a pleasure to be here.

John: I am really happy to have you here today. I've been looking forward to this since Heidi Moawad introduced us a while back. She's another book author and writer and so, since we've been connecting since then, I've just been looking forward to this podcast and this ability to hear about your story.

Andrew: Well, thanks very much. Actually, I met Heidi at a panel discussion that we did at the American Academy of Neurology where there were three of us talking about non-clinical careers. I think it was the first time the Academy ever did anything like that and the room was full. It was a very interesting experience to see the interest that physicians have in expanding their clinical careers and branching out. I think physicians are a really talented group. They're looking for interesting things to do.

John: Absolutely. There's some really altruistic reasons for doing that. Although, I will say that there's this epidemic of burnout which is driving some of that activity as well. Yeah, it's becoming a very popular topic and people are just very interested in learning new things. I love it when we have people like yourself out here that can teach us something new.

Andrew: Well, I'm really excited because what I want to talk about is clinical careers and one way to preserve your clinical career and have work-life balance, which I think is everyone's goal. I've been able to do that using locum tenens, something not every physician is aware of.

John: No, I think that's an absolutely important topic because even though I focus most of my efforts on helping teach and inform physicians about non-clinical careers, I'm certainly in favor of being able to find balance and continue in a clinical career, whatever it might be, whether it's telehealth or cutting back or locum tenens like we're going to talk about today. This is going to be right up my listener's alley, so this will be great.

Andrew: Excellent.

John: Now, why don't you tell us a little bit about basically your educational background and how your career got started out. I have put a fairly comprehensive intro that will go with this, but I'd like to hear it from your own perspective as to the course you followed with your career and your writing and so forth.

Andrew: Yeah, okay. Well, I think probably important to start with my writing. Ever since I can remember, I loved to write. I would write, in high school, poetry. I wrote a couple of plays that were performed. In college, I published a short story in the Yale Review. Writing was always sort of integral to me and so I always had a non-clinical career from the very, very beginning. At the same time, I think I was passionate about biology and I became very interested in medicine and what makes people tick.

Andrew: It was clear to me that I wanted to pursue both of these paths. Not everyone understood that including some of the gentlemen I interviewed with in medical schools. In those days, you're just going to be a doctor. That's very demanding and it certainly is. I think it's partially responsible for this burnout epidemic. For me, it was never one versus the other. It had to be both. That guided me quite a bit.

Andrew: After medical school, I did my internship at the Long Beach Veteran's Hospital in Long Beach, California and I was exposed to everything. At the end of the year, I thought, "Oh, this is fascinating, but I don't know where to go with this." During my internship year, I cut myself a break. I said, "You know what? Internship is pretty hard. It's demanding. Don't knock yourself out and try and write part-time." So, I really didn't.

Andrew: Then, I had a book inside of me and I said, "You know what? It's time to write the book now." I got a job as an emergency room physician, which back in those days, ER docs, there was no specialty in ER medicine. It was just sort of anybody who showed up. I worked 30 hours a week in a small emergency room. I could probably write a book about that and I took the time and wrote another book. That was actually locum tenens. I never knew of it as such and that was way back in 1982.

Andrew: It not only allowed me to write this book and continue my clinical work, but it was while I worked in the emergency room that I discovered that it was neurologic cases that really interested me. In my internships, I loved everything, but nothing really stood out. In the ER, people would come in with paralysis or tingling or visual changes and every now and then a neurologist would actually come in. I was in a tiny hospital. It's tough to get them in, but they come in and do consult with all these fancy examination things that I had never really seen. I said, "Wow, the brain. That is really cool." That sort of year off, some might call it, really allowed me to focus on my future.

John: Very, very, interesting. I think a lot of us go through that process, but most of the people I know didn't decide to choose neurology 'cause they found it so challenging I guess. No, that's very interesting. That use of locums or that experience where you really weren't sure what you were going to do, but you just observed and that helped you decide your next career path I guess.

Andrew: I went back, I was still in internal medicine training and so I finished my internal medicine residency. Because, in those days, the internists were really the model of the physician with wisdom to me. The doctors that I knew that I grew up with that were friends of my parents, they were all internists. That, to me, seemed the pinnacle. I finished my internal medicine, but I still had this thing about, gee, this neurology thing, that's kind of interesting.

Andrew: On a lark, I applied to the neurology program at McGill. I had a friend there who was the smartest person I knew. She was doing pediatric neurology and she had been a resident when I was a medical student. In those days, the Montreal Neurological Institute did not participate in the match. I just went up there and interviewed and I kind of forgot about it. Three years later I got a phone call, "Hey, you're accepted into the neurology program."

John: Oh, man.

Andrew: No kidding. I figured, well, I'll go. I'll do it for a year. Worst case scenario, I'll be an internist who knows more neurology, right?

John: Yep.

Andrew: I viewed it as a fellowship and I would go back into my internal medicine practice. I took my exams in internal medicine and got boarded and went up to Montreal, which is a fascinating place to live by the way. The more neurology I did, the more I realized it was like, "Whoa, there's a whole world of neurology here that I never even knew existed." Of course, the MNI, Montreal Neurological Institute, is where Doctor Penfield started doing epilepsy surgery and mapped out the homunculus that all of us studied in medical school. I got very inspired and I stayed for three years. Then, I stayed another year and did an epilepsy fellowship. I really got kind of sucked into neurology.

John: Yeah, you went through the whole gamut.

Andrew: Then, I was doubled boarded in neurology and I passed the neurophysiology boards. In those days, I just gave a lecture to the residents here, what were your options in 1989? You either went into private practice or you became an academic. Maybe you worked for a drug company, although that wasn't very desirable. It was looked down upon by the people who trained us. Or, maybe you went and worked for the CDC or NIH or something. That was pretty much it.

Andrew: So, I went into private practice in Charlotte, North Carolina. I joined five neurologists who all really were great guys and loved patients and good at their ... They had clinical skills. I was going to be the epilepsy guy. Over the next eight years, we developed a true national epilepsy program where we did epilepsy surgery and drug trials. It was very, very, exciting.

John: Very cool.

Andrew: I'm still frustrated because I want to be writing. Writing medical publications doesn't really count. They talk about the literature-

John: Right, right.

Andrew: I've always thought that that was a real, not even a euphemism, it's just wrong. There's not much literature in the literature that we use for science. Writing a scientific paper is just a skill and pure drudgery.

John: Not really a creative endeavor using the so-called other side of the brain.

Andrew: Yeah, not for me anyway. Although, I did try and publish one abstract or paper every year in epilepsy on the side of my clinical practice. It occurred to me one of the tenets of writing is you've got to write something you know something about. Or, at the very least, if you're going to write about it, you got to go learn about it.

Andrew: I said, "Well, what do I know about? I need to write something." I said, "Well, you know, I know a lot about epilepsy," because I developed a pure epilepsy practice. My whole practice in Charlotte evolved into people with epilepsy or suspected epilepsy or some unexplained alteration of consciousness. It was pretty interesting. I ought to write a book about epilepsy. This was pre-internet. It wasn't that easy to get information for a patient.

John: Right.

Andrew: [inaudible 00:11:22] had to Google. I wrote a book called 'Epilepsy, 199 Answers', which were all the common questions that patients would ask. What is epilepsy? Will I have to take medicines all my life? Is it contagious? What's an EEG?

John: Can I drive a car?

Andrew: Right. Can you drive a car? We just dealt with that in the hospital just the other day. That continues to be a very naughty issue for patients, driving for sure.

Andrew: That kind of got that book out of my system and then I wrote another one for physicians on how to manage epilepsy, epilepsy in clinical practice. Both of those were with a traditional publisher and a lot of work but satisfied my need to write at least a little bit. I carried on a full-time clinical practice. After eight years of that, I said, "You know, I'm really an academic guy." You sort of self-discover over time.

Andrew: My partners, well, we were in regular clinical practice and all of whatever time I would put into my academic pursuits trying to write papers ... I was spending time reviewing charts and putting together the patient's story for an abstract or an article. My partners admired it on the one hand, 'cause they liked having an academic guy in the practice, but frankly, on the other hand, I could tell they ... You know, why don't you just see a few more patients?

John: Right, right.

Andrew: And, help with the overhead. There was a tension there. I tried taking an afternoon off a week to create writing time. We could talk about that later, about work-life balance, but it didn't work very well. I ended up being there until about 2:00.

John: Oh, boy.

Andrew: I ended up with two extra hours a week and it cost me about 25% of my salary.

John: Oh, man.

Andrew: That I've learned, is kind of the norm. So, I took an academic job, my first academic job, which on paper looked great and in reality, it turned out not to be so great. I left after one year. I didn't know what I was going to do, but I could stay there. They really didn't have the same quality metrics that I did and I wasn't happy.

Andrew: I moved. I moved back to my hometown in Rhode Island. All of a sudden, I found myself in Rhode Island, perfectly happy, next to the ocean, which I love with no job.

John: Yeah. Now, you had to get creative.

Andrew: Yeah, so now I had to get creative. I remembered I used to go to a lot of American Academy of Neurology meetings, America Epilepsy Society. Every now then, some guy would show up and want to interview you about your poster. I did a number of those interviews and I had met some of the editors. So, I followed up with one. I said, "you know, I've done that as a speaker. You think I could be an interviewer? Could I go to a conference and interview some people and write little summaries? I think I could do that."

Andrew: The guys said, "Sure. Why don't you give it a try." Well, the next thing I know, I'm going to about a dozen conferences a year, so I'm writing literally hundreds of news articles for magazines like, well, what became Medscape.com, Neurology [inaudible 00:15:17] Times, Neurology Reviews, CNS News, Long-Term Care. These, what we used to call in the trade, throw-aways.

John: Right, right. I remember those.

Andrew: [inaudible 00:15:28] them on your desk. What I found, and I was really stunned ... Well, two things. One, I was actually able to earn a living, which I never suspected. The second year I did this, my income doubled and the third year I did it, it doubled again. Then, it leveled out, but I was doing almost as well as I was doing as a physician. I had to hustle.

John: A question for you, the income, was that from the writing? Was it from doing the interviews or was it a combination?

Andrew: You get paid by the word, so the more words you write, the more you get paid. If you hustle and you write a lot ... I would discover that I would see other journalists, they could come to a meeting and spend three days and they would write six articles. I would come to a meeting and I would spend three days and I would write 20 articles.

John: Wow.

Andrew: Because, well, that's my nature to work hard and also I had an edge because, as a physician, I understood what the whole thing was about. As a journalist, if you're not a physician, you can say, "Well, what did you do and why was it interesting?" You can ask all the basic questions, but it's very hard to read in between the lines. As a physician, you already know what the limitations of the study were and why it was difficult, so you can really push and make the interview quicker. You can get right to it and also maybe a little deeper.

Andrew: Although, I will say, many non-physician journalists, I work with a lot of them, do an excellent job. I think you can't argue that being a physician does give you an edge to get the work done.

John: So, how long did you do it?

Andrew: I did that for 10 years.

John: Oh, okay.

Andrew: For 10 years. I was not seeing patients. I was doing some medical consulting for a company I still work with. Disease Management, on the side where I would get clinical cases and give my recommendations. That was all done remotely, so that was pretty easy. At the beginning, I did a lot of lectures for the pharmaceutical companies on the epilepsy drugs, but I discovered that as I became more and more distant from the clinic and from seeing patients, my knowledge was less relevant and I was less desirable as a speaker.

Andrew: That kind of faded out, but the writing allowed me to ... Blogs kind of exploded on the world and I started writing blogs for Medscape. I have a wonderful editor there who likes what I write and likes my creativity and my particular view of the world. He gave me a blog that I would write twice a month. I wrote probably a few hundred blogs over the years for Medscape on whatever showed up on the news or something that I read that had to do with neurology that I thought laypeople would be interested in.

Andrew: Those blogs became collected in my first sort of non-epilepsy book called, 'Bullets and Brains'. The title of that has to do with ... I wrote about Gabrielle Giffords. I remember when Gabrielle Giffords was shot in Arizona and I followed the news. Now, I'm a medical journalist, so I'm just watching the new every day. Of course, all the new media carried this story, but the story that they carried was that she was rushed to the hospital and in the operating room in 38 minutes and had a world-class surgeon there from the military. She was getting the best of care.

Andrew: It was a great story, but it just struck me that that was the wrong story. That's not really the story. The story was is that this very capable, high-performing women, a Congresswoman, was shot in the brain and that she, despite whatever we do, is never going to be the same and is probably going to lose her job, even if she recovers miraculously, may lose her marriage because that's what happens in these situations, and that we have so little to help the brain heal.

Andrew: Apart from the antibiotics, the neurosurgeons are doing the same thing that they did in the Civil War. You just stop the bleeding and rinse it out. Pour some antibiotics in and pray. That's what we do. That's the real story. The real story is the limitations that we have in helping the brain heal. So, I wrote an essay about that called 'Bullets and Brains', that they don't mix. That's followed by about another 102 essays, I believe, in that book.

Andrew: That was a lot of fun and researching topics. I wrote a lot about head injury in the early days when CTE, chronic traumatic encephalopathy, wasn't really well-known. That struck me as kind of a no-brainer, if you will, that getting beat up and hit in the head and knocked out cannot possibly be good for the brain. I didn't know that it would cause CTE, no one did, but it just didn't seem to make a lot of sense that this was a healthy thing and I pursued it.

Andrew: The other aspect of all this writing was, this is when the internet happened and all of a sudden, you could work from anywhere. I had my little desk and file cabinets and bookshelves. All of sudden, I realized I didn't have to be there. Rhode Island in the winter is kind of dark most of the time and cold and not very social.

John: Yes, it is.

Andrew: I discovered that I could travel. One of my passions is scuba diving, so I went off to the Philippines. I discovered that I could sit there with my little laptop and I could write my articles. I had access at that time, to the Harvard library through the internet. I could download articles and read them and I could email the experts. I thought, "Gee, people are going to wonder. Are they going to call me and I'm not going to be there?" Nobody cared! Nobody cared.

Andrew: This became a lifestyle and it was a lot of fun. I got to write and I got to travel and see the world. I was always interested in photography and so I was able to develop some pretty good expertise in underwater video and make some award-winning movies.

John: Very [crosstalk 00:22:56].

Andrew: That was my attempt at work-life balance.

John: When did the clinical come back in?

Andrew: Right, so I think this happens. I certainly wasn't retired, but I was non-clinical. That whole world, that constant tumult of the hospital and the demand of minute-to-minute and the pager and people coming and going and crises, started drifting away. It became more and more distant. I thought, "You know, probably, unless I want to retire," and I gave it some consideration, retire from clinical medicine. I was doing fine as a writer and consultant and I liked that. Then, I think I want to give this another whirl.

Andrew: I also felt like I wasn't lecturing anymore and I wanted to start doing that again. So, I looked around and it actually was, this is another topic, but it was not that easy to get back into clinical medicine. Not because I'd forgotten anything, if anything I knew more medicine after writing about it on a daily basis then I knew when I left, but the system is very inflexible and I would caution anyone who wants to sail around the world or take time off from clinical medicine and go back, be very, very careful and make sure that they do not lose continuity for more than two years.

Andrew: Because it's the malpractice people who say, "Oh, you've been out of here two years, you don't know what you're doing." I always thought that was insulting. I don't think if I stayed away for 50 years I would forget how to examine a patient and take a history, but that's not what everyone else thinks. It was very difficult for me to get back in until I found a hospital, frankly, that was so desperate to get a neurologist that they figured out a way to get me a letter of recommendation. I had to do a little extra clinical work under supervision for a few weeks and get me back on staff.

John: It can be hard.

Andrew: It was very difficult, the paperwork. It took a day. I was a little rusty. I do admit to that, but it's like riding a bike. I think if you've been a dedicated clinician, taking some time off is only a good thing.

Andrew: Yeah, so next thing you know, I'm working full-time again as a clinician and this is when they invented the every-other-week kind of thing. It was 24-7. I had no interns or residents or nurse practitioners. It was just me doing neurology on a 300-bed hospital every other week. The one saving grace was they did have telemedicine for stroke. Strokes at 2:00 AM were done via telemedicine. They went to Yale, I believe, and they didn't wake me up for those. I'd pick them up the next day. That was the one break I had, but otherwise, everything was mine.

Andrew: It was fun. It was so much fun because I'd been out for a while. In the meantime, they had invented computers. Now, the hospital is full of computers and you can get the x-rays on your desktop. You didn't have to traipse down to radiology and the labs would come quicker. Boy, it was like all of a sudden, I had stepped into the future. Of course, the patients were the same.

John: Yeah.

Andrew: Studies got done a lot faster because of DRGs. The hospital just can't wait to send people home. I'd go and I traipse down to the ER to see the patient, maybe it's a TIA or stroke, and say, "You know, we probably ought to get an MRI or a CTA and an echo. Oh, all done."

John: Yeah, pretty quick.

Andrew: It's like, "Well, I don't know if they really needed all those things." Well, they're done. People got stuff very ... You had to get down there quick if you wanted to stop the train from leaving the station. I really enjoyed it, but it was also ... Then, a Monday on my week off, I just rested and go shopping or something, get food. Couldn't really think and then pick it up again. I continued writing and going to conferences.

Andrew: I thought, "This is really tough." Then, I discovered again locum tenens.

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How to Find Fulfillment and Flexibility in Your Nontraditional Job

John Jurica — Wed, 27 Dec 2023 15:35:21 +0000

Interview with Dr. David Feig – Episode 332

In today's episode, John interviews a podcast listener who describes his search for fulfillment and flexibility in a nontraditional job.

Dr. Feig completed his medical degree and his Master’s Degree in Public Health at Emory University. Then he completed a Family Medicine Residency at the University of Michigan and a Sports Medicine Fellowship at Rush University Medical Center.

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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.

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Find Fulfillment and Flexibility

He worked for 4 years before branching out into chart reviews, and part-time medical director roles in various settings. He also tried locums and telemedicine along the way. David also explains why he decided to move away from full-time clinical practice to find fulfillment and flexibility in his work.

David has faced the challenges that many listeners face. He described how his attitudes and feelings about each new job can shift from enthusiasm to burnout or indifference. We heard the rationale behind the choices he made as he moved from traditional clinical practice to locums and telemedicine to his current nonclinical job.

Fully Nonclinical Position

In his most recent job, he reviews claims as a Medicare contractor. During our conversation, he describes his thoughts on the different jobs he has tried since leaving clinical medicine. And he explains how working as a Medicare claims reviewer is different from the usual utilization management positions.

Summary

If you have any follow-up questions about any part of his journey, you can reach out to Dr. Feig on LinkedIn by searching for David Feig, MD. A link to his LinkedIn profile and other related content can be found in the show notes below.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 332

How to Find Fulfillment and Flexibility in Your Nontraditional Job

- Interview with Dr. David Fieg

John: I invited today's guest because I think he represents many of you. He practiced medicine for a while, decided to try some other things part-time and full-time. And he tried locums, he tried telemedicine, and recently he's been performing claim reviews for Medicare. I'm really interested in hearing what he has learned from all these jobs he's done and what advice he has to share with me and with you. So, welcome and hello, Dr. David Fieg.

Dr. David Fieg: Hello, John. Thank you for having me today.

John: I'm really glad you agreed to do this because, again, so many of us reached a point where we thought, "Well, maybe I should do something else", or for whatever reason, we maybe get into your reasons today. And then we just look around and try different things. Sometimes part-time, sometimes full-time. And so, I think it's just going to be really interesting to hear what motivated you and what you learned along the way. So thanks for being here.

Dr. David Fieg: Oh, again, my pleasure. I was a listener before I became a guest.

John: Yes. And that's a good way to go for me because then it's so relevant to the other listeners to hear your perspective. But tell us a little bit about your early education and your clinical career before you started thinking about making a change.

Dr. David Fieg: I had a little bit of an atypical path to medicine in the sense that I went to college. I was pre-med. I thought, "Oh, I'm always going to be a doctor." Growing up I had a very gifted pediatrician who took very good care of me and my brothers. And he was definitely an inspiration. Just as an aside, I guess he was trained clinically as a neurosurgeon but apparently, he had some issue operating. Back in the day, I guess the way they did lighting and the ORs, it gave him sneezing attacks. And obviously during brain surgery, that's a big problem. And he had to retrain essentially in pediatrics because he couldn't operate. But that level of skill translated into his pediatrics because he was quite brilliant. And he always had a moment to answer my questions. And he was very much a great role model for me.

I went off to college, and was in the pre-med track. And I tried to distinguish myself by trying not to be as cutthroat as the stereotypical pre-med students. And I had some moments. I already had notions of taking a year off. I was going to take a year off. My mistake was looking back on it was, what was I going to do in that year off? Because if you're looking for a job, a lot of places are like, you're going to go in a year and start school, and not a lot of places are excited to hire you in those scenarios. So I was able to get some work and I did apply to medicine.

And I think for my first application cycle, I was very ill prepared in terms of where I applied. I applied to a bunch of very selective schools. Maybe I was a little over confident, who knows? I think I got two interviews and one wait list and it didn't work out. And then I'm like, "Oh, this is terrible. I didn't get in. What am I going to do?" And I applied one more time. This time I was a lot more broad in where I applied. I'm remembering, but I'm pretty sure I was on seven wait lists. And I thought "Seven wait lists?" This has got to be made and I'll get in somewhere. And seven became six and five and four and three, then two. And then I was like, "Oh dear."

I went back and got a master's in public health with the notion that either I was going to get a job in healthcare if I couldn't be a doctor or it would be enough to hopefully get me over the hump and an acceptance somewhere. I did that and I applied one last time. And after some trials and tribulations with two more wait lists, I got offers in both places and everything started. And it was quite the shock when I finally got accepted.

John: Well, we have more in common than I knew about even from talking to you before. I was not accepted. I was out for two years. What I did was I took a micro course because I think that was the area I was weakest in. And lo and behold, when I applied two or three years later, I got in. But who knew? And we both have master's in public health. So, keep going. Tell us more now. You've made it through med school. You went into family medicine, but then you did a fellowship after that, from what I know.

Dr. David Fieg: Yeah. Medical school was definitely really hard for me. And I think it's hard for a lot of people. Coming from probably very academically talented and most people that go on to medical school have great academic credentials that they wouldn't have gotten in. The one footnote maybe to this story that I do get a kick out of later on was at times, I think I caught the ire of some of my professors because of my yawning. I would yawn a lot on rounds, and it got enough that it was noticed and I really couldn't put my finger on it. But it definitely didn't make things simple, I guess what I would say. But I persevered, get to Michigan, get a fellowship, and then sort of go on from there. That was sort of everything. That's sort of why I gravitated a bit towards family because of the connection to sports.

John: How was that program?

Dr. David Fieg: Oh, that was a breath of fresh air. In medical school, depending on the size of your class, it could be 50 people, it could be 100 people. I'm sure there are some schools that have even larger classes. But it was a breath of fresh air and a lot of struggles that I had in medical school, really I think were different in residency. And then the funny thing is, after getting some concern, that I was on call and I was snoring so loud on call, in the call rooms, people would pick me up physically and move me to the outside of the call room and kind of lay me by the door. Other people began to notice and then the thought was "You also kind of stopped breathing when you're sleeping. Maybe you should get that sleep study." And I was like, "Oh, get out of town. That can't possibly be. I've been doing this since I was in medical school." And it's like, "Oh, okay, go get it."

I got a sleep study and they did diagnose me with very bad sleep apnea. Very bad. And I was the resident that when I was on call, I would carry my CPAP machine with me to the hospital in case I got a chance to lay down for a while. I would put my CPAP on because that way if I slept, I actually could get restorative sleep for a change. It was definitely a wake up call. And then everything got a lot easier after that, shockingly. I was doing better. My in service exams got much better, my performance on rotations got better.

I did finish up with my family medicine training and I went off to do a sports medicine fellowship. And that was eye-opening just in the sense of the nature of the practice and how you want to maximize how much you're getting out of that one year to get the skills you need to sort of build forward.

And I think at times it was a struggle because it is one year, it's only really one year to acclimate in some cases to a new city or a new environment. But all the while you kind of have to be on your toes in terms of dealing with a new system in some cases, and then also your professors, the athletes you're taking care of. So, it was a very busy year, and it definitely was a long year as well.

And after finishing up, basically decided I had enough for the winter being in the Midwest for a few years. That's when I was looking for jobs on the West coast to get away from snow at least for a little while. And lo and behold, I did find something and I was off to the west coast to try to hopefully escape the Midwest winters that I had gotten used to over a couple of years.

John: What did you find? Was it something that was geared mostly in sports medicine or was it family medicine too or something else?

Dr. David Fieg: Oh, definitely family medicine. And that was maybe the strange thing as I was going through my fellowship. I had realized that I still enjoy the practice of all spectrums of medicine. Maybe not as much obstetrics, but certainly the primary care component was what I think called to me the most. But I still enjoyed the musculoskeletal part two. Instead of trying to do sports med only, I had gravitated to more traditional practice.

In that particular group, it was me who had the sports background and then we had an orthopedist who had decided to stop operating. He was really doing non-operative stuff. So we sort of had a nice relationship, a synergistic relationship that we would sometimes see each other's patients and I'd ask him questions and vice versa. Although mostly I asked him questions when I was starting out. And he had to go out and about and he had patients that needed say synvisc injections on their knees or something. I'd be happy to jump in and help out with that. So, that was a great initial experience as my first job out fellowship.

John: Nice. Well, how long did you continue doing that and what caused you to make a change?

Dr. David Fieg: It was about four years. And I think I come to the realization that they say your first job out of training is going to be the job where you figure out what you want your job to be. And as with everything, there are some always some really good stuff. And then there's stuff that's not so good. And ultimately working in a big system carries a lot of benefits in the sense that there's a billing department, there are other departments that can support you, there's a credentialing department. All these things that you can take advantage of. They are often CME that they'll pay for and other benefits that you get from working in a large system. But you also have to realize that you also work in a large system with your other doctors and your other coworkers, nurse practitioners, PAs. Everyone that kind of forms the team. You definitely have to be part of that system.

And if you say have an entrepreneurial spirit or you want to maybe spread your wings or if you're like me and you're also very technical and you get very frustrated by maybe the electronic medical records that you use, and most physicians have strong opinions about it obviously, you're not really in a position where you can get them to give you your own system, you're going to use what they have. And you can do the best you can within it but flexibility is not something you get necessarily in those environments. You get the security of working for a larger system. The large system is going to pay your salary, whereas if you have your own practice, you've got to get a bookkeeper and make sure you get your bills sent out to get paid usually from the insurance companies, otherwise you don't necessarily have an income.

Having a more explicit understanding of that kind of trade off, I think after four years it became a little more clear just in the sense that you have to find a niche, I guess. And I do very much say that when you're out of training, finding what you want to do can be tricky. Definitely I wanted to point out systems and technology and how we use it to be more efficient, but also realizing doing that in a large system, I think change is never easy. And I think change in a large hospital system or any healthcare system is challenging. If we look at how our hospital systems have changed over the years, or even how they changed from COVID, we can kind of realize that kind of change is atypical. Usually it takes a crisis like COVID to get things to change. And that was maybe a big thing we'll talk about in a bit is how much telemedicine changed in that timeframe out of necessity. That it hadn't really changed a lot before that until there was like, okay, people need this care and we have to find a way to do it, and these are the places that are set up to provide that.

At any rate, all those things go on my mind and I realized that I did want to make a change and I had pursued some other opportunities and I found a job working more partly clinical, partly as an area medical director for an urgent care system. It was based out of Portland that had opened up some places in Seattle. I guess you could say it was my first official administrative role.

The funny thing is, and it's the other thing I learned the hard way, when you're a physician working in a clinic, whether you want to be management or not, you are one of the doctors there, you are a provider, which means that other staff will definitely notice when you say or do things. You have to be careful what you say, and you also have to realize that you might not necessarily... You want to just show up and take care of patients and go home, but I think it's rarely ever that simple.

I certainly learned that you have to be mindful of that when you're in your job. Now, I was in this new job and I was actually officially management in my title at least. I got to see patients also help oversee some nurse practitioners and some physician assistants to run the clinics and kind of keep things running smooth. And I was doing a lot of chart review and just being available for clinical support for the team, and practicing in a different way. Seeing how they figure out the account I think was a valuable insight that I hadn't had a chance to really experience before.

John: Now, was it at that location that you started getting into the telemedicine, or did that come later?

Dr. David Fieg: That actually came later. As much as I enjoyed the opportunities working in urgent care, I had this thought in my brain that launched the having relationship with your patients and having that longitudinal care was actually a good thing. And it is a good thing. Although, looking back on it, I think there are caveats you have to be mindful of too.

I wanted to get into a situation where there was more of a panel of patients that I'd be taking care of. Maybe shift from the acute stuff to more of the continuity of care that I enjoyed. I made one more shift to a startup that was doing more work in that field, more based out of employer healthcare model in which employers actually can have their own clinics that are managed generally, contracted by this third party, so that the patients, the employees can go thinking that they are not necessarily going to the company doctor. It's the company that the company hired to help provide some extra care.

And there are creative ways you can manage the finances such that you can provide services, the company can cover it. If it helps with utilization of your primary insurance spending, then it can often pay for itself. There's some interesting ways around it. I think the market has changed a bit over the years, but that was what it was when I came into that profession.

John: What was that situation like? Was it one or two of you in a pod or was it a large group? Was it centralized where employees were coming from all over?

Dr. David Fieg: It started out pretty small with only two locations. And over time it expanded to multiple locations around the Pacific Northwest. And then it kept expanding from there. The growth of the company was pretty huge. And it did go on to do some big things from what I understand. I learned a lot again. And I was hired to work there, as one of the docs. And there were some changes. And then I had the opportunity to get more involved in leadership again, which was nice. And I did do a lot more on the technical side, kind of working with the EMR system, got to see the nuts and bolts of it, and that was sort of exciting and also overwhelming.

The more you dive into it, the more you realize that it's pretty complicated. And it's sort of why hospital systems have entire departments of people trying to wrangle this because it oftentimes has that level of detail because humans are complicated, medicine is complicated. And to translate some of that stuff to the non-physician, but to the developer that's writing the program, these are complicated things that we don't often think about. I learned a lot from the other perspective about that. That was definitely a great experience and also very much overwhelming in the grand scheme of things.

John: Then what? You were about to segue either into another move or thinking about something else. What was the next step for you?

Dr. David Fieg: I think it was at a professional low point in terms of my health that I think the stress of keeping up with medicine is something that all physicians have to deal with. And actually almost anyone in a professional setting, whether it's a nurse, a lawyer, a doctor, a nurse practitioner, a physician assistant, I think you all experienced some level of burnout. And I think over the course of my career, I certainly had burnout several times. I should give it a little shout out to Dike Drummond who I did connect with at different points over my career. That was really one of the first people to talk about burnout amongst physicians and then other health professions in a really solid and very focused way that really tried to define it.

I had left that particular job and that's when I sort of did more telemedicine. I also started to do a lot more locums in the area. More opportunities came up where I had never really done locums before. The opportunity to leverage some connections I had, I built up over the years to help cover some clinics, to help cover some maternity leave for some larger hospital systems, but also still going back and then sometimes then doing a couple hour shift in telemedicine was an experience. And it went well enough that I kept doing the telemedicine for a while. And that's when I got to experience both, you can say, doing coverage physically in a clinic, and then also doing telemedicine from home.

And I learned a lot. This was actually still pre pandemic. It was just before the pandemic and that was where things got really crazy, I guess you could say. Only in the sense that I was doing a little bit of both. I was still sort of looking, experimenting, do I want to open my own practice? Should I open up my own telemedicine practice? How can I manage this? And that's sort of when I just focused a lot on telemedicine for a period of time. And that's sort of when my locums assignments had run out and I decided not to sign up for anymore for a while so I could run more with the telemedicine component. And then I was doing that for a while.

The one thing I learned is that when you're in primary care and you have a patient coming in for a visit, the first few minutes of the visit can be incredibly nerve wracking because you don't know how sick the patient really is. And then when you see them on the camera, if you can, that's when you get an idea, "Do I feel good about this? Do I not feel good about this?" And maybe the major thing I learned was if you have concerns that the patient maybe is too sick for telemedicine, you have to be very explicit about that. And no, they'll never be happy to hear that. But if you're firm and you communicate your concerns, vast majority of patients that I explained my concerns to were willing to go into an emergency room and get care, which was good. And I think you have to be very cognizant of that if you're doing telemedicine because it's not the same as in-person care.

And maybe that's the biggest difference. At least in-person care, you can see the EMS take the patient to the hospital, but in telemedicine, you have to trust that they're going to follow through. And that was always a point of concern.

John: People I've talked to, they seem to indicate that's the skill you need to know to recognize when they're sick, and then to be able to quickly and effectively communicate, okay, this is not a telemedicine visit. You need to see somebody and whether it's emergent or in the next six hours or what have you.

We're going to run out of time pretty soon. So I really want to hear about what you're doing now and how you feel that fits in with your long-term plans and do you enjoy it? I'd like to see what you think about it. I don't know that many people are doing the job that you're doing now.

Dr. David Fieg: Right. I'd say I'm from New York, so we talk a lot. It goes with the territory. As I was doing telemedicine, I did have some friends that were involved in doing more utilization management work. I was able to pick up some extra work on the side. I cut to halftime telemedicine, halftime doing utilization management. This is more the traditional nonclinical job in which you're usually reviewing advanced imaging and trying to make decisions about whether the MRI or the CAT scan should be approved. I did that for a while.

And that experience, particularly working with different insurances and how to interpret rules and regulations, did give me the skills to connect with where I'm working now, which is more about reviewing Medicare claims as a qualified independent contractor. Working from one of the companies that reviews claims, it's quite complicated, much more complicated than I ever realized.

But what it boils down to is that Medicare rules and regulations are quite complicated. And even though I've worked in big hospital systems, even though I've worked in small startups, even though I've worked in many places, I did take quite a few Medicare paying patients. The physician's knowledge of the intricacies of some of the regulations is maybe not what we thought. And then you kind of realize, well, everything's on the website, so if you really have a question about how to bill for X, Y, Z, you can go to their website and look up rules and regulations. And maybe that's sort of the takeaway for me was I learned a lot through practice, although I did mainly outpatient, so I was probably more in part B than inpatient part A.

But you learn a lot by practice, and since we have separate billers and coders, maybe you don't get into the same level of detail that you do when you're actually reviewing the cases. And you see how it was coded, you see how the documentation was, and then you compare what you have to, what the regulations for Medicare are, and you try to make sense of why it was denied, what the rationale is. You do an independent review. You basically start from scratch to sort of see what your concerns are. But it certainly makes you realize just that obviously billing and coding for medical care is very complicated. And know physicians really focus for obvious reasons on the clinical side.

But looking back on how Medicare does their guidelines, how they do national coverage determinations, how they do local coverage determinations, all that information is out there. And if you do have patients you're taking care of, it's really important to be aware of how you do your documentation. That's probably why clinical documentation improvement specialist or clinical documentation review is also becoming a hot field because if we all had time, we could probably document better. If our computer system was better, we would document better. But you have to be the most efficient and the tools you have at hand.

John: Now I have a question. The review of Medicare, was there much of an orientation or training? They just throw you some manuals? How did that work out?

Dr. David Fieg: Oh, no, I got some great doctors to work with. We actually did it virtually because I had started the job right when COVID hit for real in March of 2020. That was when Seattle had its first few cases right before. People finally realized that it finally had reached to the states. And certainly things changed a lot after that fact, changes in telemedicine and then changes with remote work. This was always a remote position interestingly enough. I was able to virtually sit, and of course, now we have the technology to do this. Sit and talk by phone, by video, by real time sharing screens, going over cases, going over the information, trying to read through the major case types, understanding the types of cases you'll see in different parts of Medicare, whether it's part A or part B. Understanding one's more inpatient, one's more outpatient. Certain drugs are considered the B of A, so they fall under more of the part A side. Getting a lot of minutiae of detail, and just understanding how the cases go.

But a lot of really good doctors that have been doing this for a while and have a lot of experience, were really helpful in getting me trained to pick up all these details. And then a lot of it, honestly, is also reading a lot of cases, reading the decisions and going back to the case and just looking through it back and forth and understanding seeing the patterns arise. Why was this denied? Well, they didn't document X, Y, Z. Well, why was this approved? Well, they did document X, Y, Z. Sometimes it can come down to that, sometimes it can be more of a judgment call. But document, document, document is what they say.

You want to be careful on what you put in the chart in the sense of just for certain conditions, you just need to be very explicit as to what you saw and document it. It also comes back maybe strangely to the systems that we use. And if your EMR, as you said, whether it's due to time, energy and money is more out of the box, maybe it's not as customized as it could be for your particular style or your clinic. And that could affect your reimbursement if it's not configured correctly to capture all the key things that you need.

It's funny how that's kind of a strange circle and that we don't have time so we run through with our computer systems to document what we need, but maybe we don't spend enough time making sure it's documenting enough of the things we need, whether it's private insurance or commercial insurance or is it Medicaid, Medicare. Because they do have requirements that are available for review. And we do want to be mindful of them because getting paid is important and not getting paid for even the large health system can be quite onerous.

John: Yeah. It catches up with you if there's too much of that going on. Well, we are going to be out of time here in about a minute. So, just looking back, maybe advice you have for other people that are at the beginning of the journey that you've made so far where you're trying to find the right clinical thing to do, or maybe they want to do two different things or maybe they don't want to do clinical. What advice would you have for people that just find themselves early in that process?

Dr. David Fieg: I think you do want to get at least some clinical basis. And when you're out of training, you want to practice for at least a few years. A lot of the best nonclinical work does often require anywhere from three to five years of actual practice experience. For a lot of people you might close some doors if you don't finish your residency, if you don't do some clinical practice for a few years.

But once you get through that point, that's a great time to reassess. And as I said, there's more and more opportunities, whether it's telemedicine, whether it's utilization management, whether it's clinical documentation improvement, whether it is doing case or claim review, whether it's legal consulting. There's a tremendous variety of things available. One of the struggles I think is just connecting to figure out what's out there because it seems to change all the time. A lot of people didn't know about the work I'm doing now in terms of review for Medicare claims. More were familiar with utilization management. I think more are getting familiar with certainly the legal consulting component, and also getting more familiar with the clinical documentation improvement.

That's maybe the flip side to what I do, is that they're working with the docs to make sure they understand if they're seeing case X all day long, that they know what the requirements are for documentation, if they're billing a lot of Medicare claims. So that everything is set up to set them up for success rather than confusion in a lot of physician queries. I see that they send a query to the physician, the coder sends a query to the physician. What was this? And I remember getting them when I was practicing more in a traditional practice and it's like, "What is this? Why am I filling this out?" It's like, no, fill it out and try to actually think about what you're going to write because it's really important and it may actually affect whether you get paid or not.

John: Yeah, absolutely. I think some people might have lingering questions, you've covered a lot of material here today. It's okay I assume maybe if they can just find you on LinkedIn?

Dr. David Fieg: Oh yeah, absolutely. I'm kind of an open book. David B. Fieg. There aren't too many Fiegs on LinkedIn. So, if you see the doctor, that probably is me.

John: Well, I will put that link in the show notes too. If anyone is really struggling to find you, they can go to the show notes for this episode.

Dr. David Fieg: Yeah. And if you see the one that went to Michigan for a residency, that's probably me. So go Blue. Hopefully, we'll bring home the big one for the playoffs this year.

John: All right. All of you out there, I hope you are Michigan fans. All right, David, this has been really good. I appreciate it. We might have to have you come back in a few years and see if you're still doing this or have done something else, but we have a lot to think about. I really enjoyed hearing your story today.

Dr. David Fieg: Sure.

John: With that, I will say goodbye.

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Why Locum Tenens Is the Best Way to Practice on Your Own Terms – 202

John Jurica — Tue, 29 Jun 2021 10:00:17 +0000

Interview with Dr. Stephanie Freeman

Today, my guest explains why locum tenens is the best way to practice on your own terms. This is especially true when starting your career following residency or fellowship.

Dr. Stephanie E. Freeman is a board-certified critical care specialist, best-selling author, speaker, and consultant. In addition, she is the expert in helping doctors discover alternative careers in medicine.

As Founder and Chief Medical Advisor of DrStephanieICU.com, Dr. Stephanie discusses real-world career strategies to help physicians “think outside the box” regarding their careers. By sharing advice on how to find alternative careers, Dr. Stephanie helps physicians practice medicine on their own terms.

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.

Stephanie earned her medical degree from the University of Alabama School of Medicine. She completed her Internal Medicine Residency at Wake Forest University Baptist Medical Center and her Critical Care Fellowship at the University of Pittsburgh Medical Center.

She also completed a Geriatrics Fellowship at Wake Forest University Baptist Medical Center. And she obtained an MBA at Auburn University.

Locum Tenens Is the Best Way to Practice

Stephanie started working in a private medical group after completing her fellowship. The group attempted to transition from its traditional outpatient-based practice to an in-house hospital-based service. It did not go well, and ultimately Stephanie lost her job with the group as a result.

But that provided an opportunity for her to complete her MBA. And while searching for her next opportunity, she discovered locum tenens. She was amazed by the practice model. It aligned well with her needs and her desire to run other side hustles.

Coaching and Speaking

Stephanie's enthusiasm is contagious. So is her love of locum tenens as a way to practice on her own terms. If more of us would follow her example, I think we might enjoy our clinical careers much more. She has developed her speaking and coaching by teaching others about locums and other nonclinical careers.

To learn more about all that she does, you should visit her website at drstephanieicu.com. Better yet, if you want to access Stephanie’s Free 5 Step Process for getting a locums position, go to freelocumstraining.com.

Licensed to Live Conference July 16 & 17, 2021

I know that I’ll learn more about locums myself when I attend Dr. Stephanie’s presentation at the upcoming Licensed to Live Conference in Philadelphia. It’s not too late to join Stephanie and me there. I will be sharing my expertise about unconventional career options based on almost 4 years of interviews with experts on the topic.

You can learn all about the conference at www.licensedtolive.com. Don’t forget to use my Coupon Code “nonclinical” (all lower case) to get a $50 discount on the registration fee. That also lets Dr. Jarret Patton know that I invited you.

Summary

The passionate coach and speaker Dr. Stephanie Freeman explains her reasons for choosing locum tenens as the best way to practice. And she provides advice and inspiration for physicians looking to bring more freedom and success to their professional lives.

NOTE: Look below for a transcript of today's episode that you can download or read.

Links for Today's Episode:

Dr. Stephanie Freeman's Web Site
Free Locum Tenens Training
Licensed to Live Conference (Use “nonclinical” coupon code for a $50 discount)

Download This Episode:

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

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Episode 202

- Why Is Locum Tenens a Doctor's Top Career Alternative? - Interview with Dr. Stephanie Freeman

John: In less than three weeks from the release of this episode, I will be participating in the live licensed to live conference at the Marriott Philadelphia hotel, organized and presented by Dr. Jarret Patton. I can't wait. And one of the esteemed presenters at the conference is here with me today. She's a sought-after speaker, author of several books, expert on entrepreneurship, nonclinical careers, and locum tenens where she's done a lot of. So, Dr. Stephanie Freeman, welcome to the PNC podcast.

Dr. Stephanie Freeman: Thank you so much John for having me. I'm so excited and honored to be here.

John: Well, it's my pleasure because I love to hear about non-traditional careers. So that's where the locums come in. I also like to talk to other people who are doing coaching for physicians or with physicians and teaching entrepreneurship. So, we have a lot to cover today. Before we get into the nitty-gritty here, I need to know about your background a little bit and clinically what you have been doing, but where your education was. And then we can segue into what you're up to now.

Dr. Stephanie Freeman: Yes. So, I'm Dr. Stephanie Freeman. I'm a double board-certified critical care physician, born and raised in Alabama. So, the accent is a real accent. I am a true southerner. I was born and raised in Tuscaloosa, Alabama. I live in Houston, Texas. So, like I said, I am a true southerner.

I did medical school at UAB School of Medicine. I did an internal medicine residency at Wake Forest University School of Medicine. Then I did a geriatrics fellowship, and then I did a critical care fellowship at the University of Pittsburgh. And then I got my MBA at Auburn University and I'm double board-certified twice over. And it's about time for me to recertify in internal medicine in 2023. And so, those recertification years, whew, they kind of come at you quickly.

And I've been doing locums since 2008. And so, I am a locum's expert. I live the locum's life. I am currently on a locum assignment in Alaska right now. I work anywhere between 14 and 21 locum shifts a month. So, I am truly living the locum's life.

John: Awesome. So, we're going to definitely get into that because I have a lot of questions about just your personal experience with locums. But I do want to segue a little bit, or at least make a right turn here because I know you're doing other things. You're teaching other physicians, you're a speaker, you've written several books. So, tell us how those activities started out.

Dr. Stephanie Freeman: You know how in medical school and in residency, there was always that one physician that was always doing other stuff, that always had like a side hustle going on, that was always the one that was moonlighting? I was that physician. I was that girl. Because it goes back to how I was raised. My parents got divorced when I was young and my mother is a teacher and she just retired after 42 years of teaching. And so, my mother was the teacher and she was raising two kids on a teacher's salary and it was tough. But she always had extra jobs. In addition to the full-time teaching, she always taught extra jobs, always did extra stuff, just so that she could take care of us. And so, I picked up that from her.

And then my mom was also an entrepreneur as well. She always told us about the importance of owning your own business. Then she had always been a strong believer that entrepreneurship was the way to go. So as a matter of fact, my mother was the one who told me to go back and get my MBA because she's an English teacher. She reads, she knows about the different trends that are coming because she spends all day reading because she's an English teacher.

And so, she was like, "You really need to go back and get your MBA because I really foresee that that's something that physicians are going to need". So, I kind of had that in my bones. Always about, I love medicine, but I love entrepreneurship. And there are so many other things that I want to experience and do and be.

I would tell you that I fell into locums and that it was a fairytale story, but there are no such things as fairy tales. Actually, the way I fell into locums was the fact that after I finished my training at the University of Pittsburgh and John, you know how we are all so idealistic when we finished training. And we think that we're just going to save the world because we think that everybody's going to welcome us with open arms and experience, love us for what we have to offer as physicians who want to change the world. Well, we know it doesn't happen like that.

So, my first job out of fellowship, here I was finishing up a critical care fellowship at the University of Pittsburgh. The University of Pittsburgh was where critical care was born. So, we're all about critical care and right here, right now with the intensivist model, I had really fallen in love with Pittsburgh and I wanted to stay and there was this nice little community hospital 10 minutes from my house. And I thought I was just going to work there and settle down and get married and have a family. And that didn't work.

So, I take this job with the private group. And so, you know where I'm going with this. So, a private group, pulmonary critical care doctors, here I am coming from an academic center that was used to the intensivist model. This private pulmonary critical care group is not used to that, but they're trying to transition to an intensivist model, and needless to say it didn't work out. So, my contract was not renewed and I was devastated. Because you don't hear about physicians undergoing contract non-renewals are A.K.A being fired. Nobody tells us about that in residency and fellowship. Nobody tells us about that.

The traditional physician employment model is either you are employed as a physician or you're in private practice or you're in academics. And the traditional model is that you stay at one job forever. So, we weren't prepared. And I was not prepared for this churning of the medical marketplace. And I was surprised and devastated needless to say, but remember, I'd always been that fellow and that resident that always had a moonlighting gig. I always had something in my back pocket. So, I was just able to be like, "Okay, well this isn't working out. Let me just call so and so from the hospital down the street, I still have privileges. Let me just slide into their schedule". Fine. No worries.

Then I was trying to figure out what I wanted to do. And I had these other business ideas that I was kind of dibbling and dabbling in. And my mom was like, "You really need to consider getting an MBA if you're going to do all of this extra stuff". And I was like, "Sure, I'll do it".

And the way I fell into doing locums, it's the funniest thing. I was at a critical care conference with my critical care bestie. One of the locums' companies had a display and I was like, "Huh, what is this?" And they just started talking to me. I was like, cool. They explained to me what locum was, but you have to remember, I had always done moonlighting. So, I was used to that concept of sliding in, filling in for a shift or a couple of shifts where I'm needed, leave, get paid, rinse and repeat.

I was already used to that concept. So, I was like, "You can really do this". So, when I took my first locums assignment, I was like, this isn't bad because I went, worked, and had a nice time. Money was in my account the next 10 days. And at that time, I was transitioning to getting my MBA. And I was like, I'll just work enough shifts to pay my bills, to support what I need to do. And I can focus on getting my MBA. So, that's really just how I got started with my locum's journey. It was kind of by accident, but by design.

John: All right. I got a comment on some of those things. First, you're right, in terms of the traditional way that we practice, because we're the type of business as a physician that you have to usually build a practice. So, if you're going to be a hairdresser or you're going to be a barber, or you're going to be a plumber, or are going to be a physician, you want to build a practice over time. It's kind of gone out the window now with the way people are churned through, you got a two-year or three-year contract, "Oh, we're not going to renew it for whatever reason". So, there's a lot of that now. And it has changed a lot. So, you didn't know though what locums wasn't necessarily, other than what you were doing with moonlighting, but once you found out, you really were attracted to that model.

Dr. Stephanie Freeman: I had no idea that it was a thing. I knew moonlighting was a thing, but I didn't know it was a thing and an entire industry. And there were higher agencies who did nothing but that. Because where we're coming through, we weren't exposed to that. And if we weren't supposed to, it was kind of like, "Oh, what's wrong with them? Why can't they get a real job?"

John: What was that first one like? Was it something that was recurring like every month after month, certain days? Or was it like a set for six weeks or weekends? How was that whole structure of that first one?

Dr. Stephanie Freeman: Maybe in a critical care physician, we work in shifts. So full-time critical care is like fourteen 12 hour shifts a month. And so, the staffing model is kind of like seven days on, seven days off 12-hour shifts either day or night shifts or day shifts with call. So, for that first assignment, I went to Pikeville, Kentucky. That's a whole nother conversation. I went to Pikeville, Kentucky. I worked at this hospital seven days in a row and took call at night. And at the time, for me, the money was bonkers. It was ridiculous. I'm like, "Y'all are paying how much money? Sign me up!" And so, I went really in the middle of nowhere, middle of Appalachian, black girl, black doctor, and I came out alive, survived it.

John: So, was that recurring? How long were you doing those seven days shifts?

Dr. Stephanie Freeman: I think I did that assignment for maybe four, maybe six months. And that's kind of typical for these things because when you take a locum's assignment it is usually because of one or two reasons. It's usually because the place is trying to build a program or they just lost some physician. So, they only need you for a couple of months until they're able to recruit and onboard their new physicians. And that's exactly what locum is. Locum is Latin for placeholder. That's exactly what you are. You're holding a place until a permanent physician arrives. And usually, they only need you for two or three months, three or four months, and you just fit into the schedule like they need you. And then it's off to the next assignment.

John: You've been doing locums for a long time, from what I understand. So, you've mentioned some of the reasons you like it or love it. Tell us some of the reasons why it's a good option for physicians. Particularly I would think someone who was looking to do something different, wants a little more freedom.

Dr. Stephanie Freeman: Absolutely. It's a great option because it allows you time to transition. We are all so tired. We've been in school for 20 years. And then when you get out of school, it's this constant grind, not of just being a physician, but also of having to, like you say, build a practice or establish yourself, or build a rapport or get being an attending physician under your feet.

And then there are the finances that everybody deals with. But we're not honest enough about it. So, you got these loans or you have these other obligations you need to pay back. But then again, at the same time, you're tired of living in self-deprivation. So, then you want to have a nice lifestyle. You want a house in a nice neighborhood, in a good school district. You want to be able to start taking some vacations.

Locums gives you the opportunity to say, "Okay, this traditional medicine thing isn't working for me. And I may not have quite figured out what I want to do, but I need to figure it out. But meanwhile, I need to be able to pay my bills". Locums give you the opportunity to transition. So, you can go from being an employed physician that has a whole bunch of restrictions, because you know that the employer physician contract is very restrictive. You may not be able to moonlight. You may not be able to write a book. They want to claim your intellectual property. You may not be able to go speak anywhere. They want to give you permission. You may not be able to do case reviews or legal depositions.

When you're an employed physician, there are so many things that you can't do. Meanwhile, we are all multitalented and the whole world needs all of us. And you want to transition to some of the other things, but you still have bills to pay.

So, I look at sometimes locums as being that middle ground that's going to help you get to your promised land because you can leave traditional employment, transition to nontraditional careers, nonclinical careers, but locums will give you the finances that you can still do it. Because you can still moonlight. You can still do locums because you're an independent contractor. You're still making a great salary, but you don't have the restrictions of an employed physician.

So, these places where I go work, they know me as Dr. Freeman. They don't know me as Dr. Stephanie. They don't know that I do locum coaching. They don't know that I have books. They don't know that I have webinars. They don't know and they don't care because they've contracted with Dr. Freeman. Dr. Freeman is going to work these 14 days. Dr. Freeman is going to do her job and take care of the patients and not mix and mingle things.

While I'm working for them, I'm doing critical care work. But when I'm not at that hospital and when I'm not on the clock, what I do with my time is my time and they have no claim to it. And that's not necessarily the case when you're an employed physician. So that's what locums are able to help people do. Locums can be the bridge to, like I said, your dream life from where you're coming from.

John: Yeah, I hadn't thought about that before. I've talked to people who've done locums and it never occurred to me that it's ideal for those that are natural entrepreneurs. People diversify their income through other passive income or active income activities. So yeah, it really gives you, you just have to plan things out appropriately, obviously, during those times when you're not working as a clinician. And I would assume also it varies a little bit by your specialty. But yeah, it sounds pretty attractive.

Dr. Stephanie Freeman: Oh, it is. It's amazing. I was just on the phone the other day with a gynecologist who is going through a horrible time at her job. But she's an entrepreneur and she's building an amazing beauty brand. And I'm like, "Honey, let me help you do locums so that you can fulfill your real dream and your real calling with your beauty brand and your entrepreneurship. Let me help you with that transition". Because I'm like "You know it's time for you to go. It's time for you to leave that job and transition over. And that's why you're having problems on that job because you know you need to leave. Let me help you transition through".

John: All right. We're going to talk about some of the other things you're doing, but I do want to have you maybe give us two or three landmines to avoid, so to speak, or things that we need to be a little careful about if we decide to pursue locums.

Dr. Stephanie Freeman: The first thing that you really need to be careful about, I say your locum's experience is really made or broken based on the company you choose to work with. And so many physicians when they get started have a bad experience because they didn't work with the good locum's company or a good locum's recruiter who really explained the process to them. A lot of physicians ended up kind of feeling like they've been taken advantage of.

So, I would say the first thing you need to do is really vet these companies and vet these recruiters so that you can make sure that you're getting somebody who is going to treat you fairly. That's the first thing.

The second thing, and I think this is the biggest thing that a lot of physicians fall prey to, is not managing their expectations. A lot of physicians have either unrealistic expectations of what locums is, or they just don't know what to expect. And they think everything is going to go perfectly. And we physicians are type-A people and we expect everything to be done decently in order.

But one of my favorite recruiters used to say something to me that really made a difference. He said, "If these places that need your services had everything together, they wouldn't need you".

John: That's true.

Dr. Stephanie Freeman: So, think about it. If they had everything together, they wouldn't need temporary physicians because their physicians wouldn't have quit or they wouldn't have been in turmoil if everything was together. So, I have to tell my physicians who are going on these assignments to keep an open mind and to go with the flow because things are not going to run smoothly. Because if everything was going to run smoothly and be perfect, they wouldn't need you to be there.

And so, once you kind of lower your expectations and be like, "Okay, it is what it is. I'm just here to see the patients and make sure these patients get the care that they need and let everything else kind of fall into place".

John: Now, at the same time, I've heard from some of my friends who have done locums that they usually welcome you. They're looking forward to having you there because they really need you.

Dr. Stephanie Freeman: Yeah. Some of them are. They're like, "Oh my God, you're here. Thank you for coming. We need help". So, it's actually been kind of fun, but at the same time, you can walk into some pretty nasty political situations. And that goes back to getting a good recruiter who is giving you the 411 about what is actually going on and why you're actually there.

I've walked into some situations in which it's like the group that was there, unceremoniously lost their contract and it was a big deal. And then they're bringing locums in until they can bring the other permanent doctors there. And so, then it's a lot of chaos. It's lot of hurt feelings. People have chips on their shoulders and they're taking it on the locum's doctor. And you're like, "I'm just here to work. I don't know anything. I'm sorry". So, I've been in those situations as well too.

John: But you're there to take care of the patients, right? The patients need you. And so, you've got to fill in while they're trying to sort through their political messes.

Dr. Stephanie Freeman: Exactly.

John: We're going to be at the conference in a few weeks with Dr. Jarrett Patton. And so, are you going to be covering this topic? What are you going to be talking about at the conference?

Dr. Stephanie Freeman: What I'm going to be talking about in the conference is how do we locums and considering locums during this pandemic. And the reason why I'm talking about this is because, as you know John, this COVID pandemic has completely ended the way medicine is practiced. And I think a lot of physicians are now realizing that we are seen as disposable.

We have physicians who literally put their lives on the line, continue to work throughout this pandemic, which is still going on. We worked extra hours. We faced unsafe situations. We worked with a lack of PPE. We will call it heroes and some of us got thanked by what? Getting fired? Contracts not renewed and facing pay cuts? And that's because the market has changed because money has changed. Cash flow has changed.

And so, I'm here to really talk about how physicians who are in this churning of contracts are being renegotiated because hospitals and healthcare organizations are redoing their practice models and their financial models, how physicians can utilize locums as a way to kind of shore up themselves personally and professionally and financially.

Because even though we think the pandemic is over, we physicians know it's not over. The numbers are dropping, but we know this isn't over. And we're now seeing the financial ramifications of this. I've talked to many physicians who have just lost their jobs. I've talked to many physicians whose contracts are being renegotiated and not in a favorable way.

So, I'm going to talk about how we can use locums and the types of locums that we need to be doing in order to be able to navigate these market changes that have happened as a result of this pandemic.

John: Okay. So that's going to be awesome. I'm definitely going to have links later in the show notes for the conference. Licensedtolive.com basically is going to be where you go. But I'll talk more about that in my outline. But the thing is not everyone is going to be able to come to that conference. Although I want everyone to come and say hello to both of us if they can. So, they can get some more information and training about locums from you directly, from what I understand at www.freelocumstraining.com.

Dr. Stephanie Freeman: That's right.

John: So, tell us a little bit about that. What will we get out of that?

Dr. Stephanie Freeman: Yeah, this is just a little introductory course that really will give you the basics about what you need to do to get started doing locums right now. Just an easy five-step process. And I've had so many people get this and get started with it because I tell everybody the time to get started with considering locums is now. If it has crossed your mind, then it's time to get started now. And so, that's what that course is about. It's a free course, and it talks about just the steps you need to take in order to begin your locum's journey.

John: I'll put that link in there, but there is planning involved in doing locums from what I understand. So, you don't want to just jump into it and think you're going to have your first position in a week from now.

Dr. Stephanie Freeman: No, no, no. I will take you through the process.

John: That'll be awesome. But now with the locums that you've done, and you're obviously creating courses for people, but you're doing some other things. I saw that you're a speaker. Can you tell us some of the venues you've talked at?

Dr. Stephanie Freeman: Yes. I have spoken at The Momentum and Medicine conference, which was amazing. I've also spoken in The Women and White Coats virtual conference. And then I also did a talk about locums for the virtual conference for the American College of Osteopathic Obstetrician and Gynecologists. And that was amazing and it was extremely well-received.

John: Very nice. And then you've got some books. I read that your most recent book is about locums. So, we can get those on Amazon, right?

Dr. Stephanie Freeman: That is correct.

John: And of course, you have your website, which is drstephanieicu.com. Also, you're doing some coaching. So, tell us about that.

Dr. Stephanie Freeman: Yes. I am doing some coaching. And I have some online coaching programs and online courses because what I really want to do is to allow physicians to know that they have options. There are so many people that are on the verge of just hanging up their white coats and their stethoscopes. And I'm like, "You don't have to do that. There is a better way. Let's figure it out".

So, I do some one-on-one coaching and I also have some online courses that are designed to walk physicians through the process in more detail and tell them about not only how to get clarity about why you're doing locums, how to look for good recruiters, how to choose assignments, what is a good market rate to get paid for your assignments, but also some of the business issues and the tax issues and the legal issues that are associated with being a locums doctor and an independent contractor. So, I do have some online courses for those as well.

John: Yeah. I think that's a big thing that some physicians forget about is if you're going to be doing any kind of freelancing or locums, things like that, you really have to have your own LLC and set up the proper structure, protect yourself liability-wise.

Dr. Stephanie Freeman: And pay those taxes.

John: Taxes? Oh, yeah. You've got to make those estimated tax payments during the year, or are you going to be in for a big shock at the end of the year. But it's good. You're a natural entrepreneur and your mom pushed you for that MBA. That gives you a little head start than let's say the typical physician who's come right out of residency and never thought about those things.

Dr. Stephanie Freeman: You know what? I love working with residents. I do. And I think it's an excellent way for them to get started in their medical career. Because what I like to tell residents who are about to be attending is to say that "You don't know anything about your style as an attending. You don't know what you value. You don't know what's important".

And sometimes they feel a relief that they can just do locums and not have to worry about signing a three-year contract right off the bat. So, it gives them some leeway. It gives them some breathing room. It gives them six months, eight months to take some time to relax and know themselves as human beings and really a way through this job market and to make the right choice. So, anybody can do locums at any stage in their career.

John: It sounds like if you're doing it at the beginning, you get to check out some different geographic locations around the country, different structures, big groups, little groups, rural, big cities. So yeah, it makes a whole lot of sense, especially at the beginning, but I've known people that have done it at all parts of their career too.

Dr. Stephanie Freeman: All parts.

John: All right, now we're going to have to go soon. So, do you have any last bits of advice for our listeners who are thinking about nonclinical careers or locums, or other nontraditional careers?

Dr. Stephanie Freeman: I say, go for it. There are so many opportunities out there. And I say, do your research, keep an open mind, but don't be afraid to go for it. And the time is now.

John: Awesome. Great words of wisdom. I can't wait to talk to you face to face in Philadelphia in a few weeks. That's going to be fun and we're going to really try to inspire the guests that come and listen to the students and people that attend. And so, before we go, I will, again, recommend if you are interested in locums to go to www.freelocumstraining.com or go to drstephanieicu.com to see everything else that Stephanie is up to. And I want to thank you for being here today. It's been great. And I think my listeners are going to love this episode.

Dr. Stephanie Freeman: Thanks for having me and I'll see you in Philadelphia.

John: Okay. Bye-bye now.

Dr. Stephanie Freeman: Bye.

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How to Go from Retirement to Ardent CMO and Medical Expert – 189

John Jurica — Tue, 30 Mar 2021 10:00:23 +0000

Interview with Dr. Dan Field

In this week's interview, Dr. Dan Field explains how he went from retirement to ardent CMO.

Dr. Dan Field is the chief medical officer for MDstaffers, recently ranked the 49th fastest-growing company in the United States. There, he oversees all clinical staff operations and quality assurance. He also oversees the Medical Expert staffing component.

Dan is a board-certified emergency medicine physician who practiced for more than 30 years. He serves the California Medical Board as an expert reviewer and consultant.

He is an expert witness for cases involving personal injury, criminal law, standard of care, and malpractice, and is a featured speaker, panelist, media physician, and talk show guest.

Dr. Field received his medical degree from the University of California at San Francisco, followed by an internship at Highland Hospital in Oakland. He then completed his EM residency at University Hospital in Cincinnati.

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.

How to Go From Retirement to Ardent CMO and Medical Expert

Dan points out that most of us do not truly retire. We may phase out of clinical medicine, which can be intense and emotionally draining. However, by applying transferable skills, we can often move from retirement to ardent CMO or another equally rewarding position.

I advise you to listen as Dan talks about how he pursued interests that satisfied his desire for autonomy, variety, accomplishment, and reward. And he notes that humans are not made to BE happy but, rather, to PURSUE happiness.

Stacking New Skills

Then he provides practical advice about stacking new skills to prepare for your next career. A pertinent example he provides is to work as a state medical board reviewer to gain experience before embarking on a medical expert consulting business.

I think building a skill stack it's like opening up your tool chest and putting tools in it that are going to be useful to you. – Dr. Dan Field

We cover two important topics today: preparing for the transition from retirement from medicine to your next career, and how to prepare to do medical expert consulting. One way to learn necessary skills and find your first clients is to join a company such as MDstaffers.

Summary

I have no financial relationship with the company, but I think exploring MDstaffers at mdstaffers.com is a good place to look for locums jobs and medical expert witness consulting engagements. And from what Dan says during our discussion, he or one of his colleagues can help you to prepare to get started.

NOTE: Look below for a transcript of today's episode that you can download or read.

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Today's PNC Podcast Transcript

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PNC Podcast Episode 189

How to Go from Retirement to Ardent CMO and Medical Expert - Interview with Dr. Dan Field

John: I'm always looking for chief medical officers who don't work in the hospital setting. So, I'm really glad today's guest is here. And it's kind of a twofer because we're going to talk about his career as a CMO and talk about the company that he works for, which also provides opportunities for expert witness and other types of clinical, but some nonclinical. So, with that, I'd like to welcome Dr. Dan Field to the PNC podcast.

Dr. Dan Field: Good morning. Looking forward to our time together today, John.

John: I'm really looking forward to it because again, I use the term CMO. It's kind of like the term medical director. It just can mean almost anything, but the one thing it does mean is it's a physician. So, tell us a little bit about your clinical background. I've done a separate intro with a lot of the details, but if you want to give us a little bit about your clinical background and then how on earth did you sort of segue into this role as a CMO?

Dr. Dan Field: Okay. Well, I started out as a Kaiser baby and I went to medical school and came back and became a Kaiser doctor and now I'm a Kaiser retiree. So, in that time I did my premed at Irvine and Edinburgh University. I did a little diversity there. Medical school in San Francisco. And I finished up with an emergency residency in Cincinnati before returning home to California.

John: All right. And you did that for a few years, correct?

Dr. Dan Field: Correct. Yes.

John: And a lot of things along with it, right?

Dr. Dan Field: Yeah. Yeah. So, I did 30 years in the emergency department and when I say it like that, I feel like I'm saying I did 30 years in prison. But during that time, I kind of was trying to list some of the things that I did to kind of break out of the standard operating procedure. So, I ran for office, I started a manufacturing company. I engaged in a medical startup. I built a solar-powered home. I became a demo doc for a major CPOE company and I became a deputy sheriff on the SWAT team. So, I tried a variety of things.

John: Oh man, we're going to have to like have another three podcast episodes just to go into each one. But now that's a pretty broad spectrum of things. Now, did you actually completely retire and then kind of search out the CMO role? Or was this something that came up while you were still practicing?

Dr. Dan Field: It took retirement to find it. And it's kind of as serendipity. I was heading towards retirement, and I must have clicked on an advertisement. There are all these online things being thrown at us. And this one probably said something like work in the wine country, $200 an hour. And that probably went into a database and a nice young man, reached out to me and said, “Hey would you like to consider these things?” And he kind of took me by the hand and brought me back into some clinical because that was the contact locums. But then it turned out they had a spot open for a CMO and after our engaging conversation, he said, “Why don't we think about you joining us as a CMO?” And then I said, “Well, I have this idea for a med-legal panel”. And he said, “Well, let's see, we could call that MDexperts”. And we have a hundred thousand doctors in our Rolodex. So, if somebody needed a specialty, wow, we've got it.

So, serendipity led to the situation and I should say, the things that really made it work, is that I personally had a low barrier to entry. I did not say you need to start out with a quarter million or $300,000 a year and no defined value. So, I came into it with the attitude that I was going to create my own value stream in this situation because MDstaffers was a tiny company at the time. And they were rapidly growing and I was right there at the beginning, but there wasn't a way to really pay me out of sales or commissions or so forth. So, I developed a value-added stream sort of approach.

John: Okay. So that means this is kind of like a unicorn or a black swan event, I guess. But I've heard of actually many other physicians who either they're interested in startups, or after retirement looking to be on a panel, to be an advisor. So, in retrospect, MDstaffers looking at it online, it looks like it's into a lot of things. It looks like it's got a lot going on, but you're saying it was pretty much in the early stage when you found them and they found you.

Dr. Dan Field: Yeah. So, they had been growing steadily, but actually, with the advent of the pandemic, our mission is to plug the holes in the healthcare system, the manpower gap. We work mostly with physicians and advanced practitioners and now we do mental health as well. We all know there's a huge gap and it's our mission to fill that. And suddenly with the pandemic, we had a lot of doctors actually being idled, which was a stunning outcome of that to all of us and a need to shift to online health care. So, it was another serendipitous moment.

John: Yeah. When you look at companies like this recruitment and related things, it's always a chicken and egg. You need the bodies and you need the jobs and what do you get first and lots of companies just die because they can't do it. So, there you were, just boom. All of a sudden, we had a lot of people that were ready to look for something. And so, you could just soak that up as you built more and more opportunities. That's fantastic.

So, looking back, what kind of advice could you come up with in terms of someone who thinks “Wow, that sounds pretty interesting. Is there any method to the madness? How can I possibly try to do the same thing?”

Dr. Dan Field: There are so many ways of approaching that. And with our limited time, I'm trying to distill in my mind. I think that you have to know what it is that makes you happy, or at least satisfied. And keep in mind, we are not made to be happy. We're made to pursue happiness. But happiness never occurs. So, it's the pursuit. Now in that pursuit, what makes you feel the best? What tickles your brain and gives you a certain amount of joy and enjoyment? So, I think it's autonomy, variety, accomplishment, and reward. I think those are the four things that tickle my brain the most and give me the most satisfaction. So, something that gives me the autonomy to be able to get up in the morning and go for a run before I settle down, or get up even earlier and do some hard cognitive work and then go for a run and come back and do some more.

So that kind of autonomy, the variety. I'm coming at it from clinical ops, I'm doing med-legal, I'm doing clinical work, variety accomplishment. One of my biggest satisfaction moments came when I built my house because there it was, I did that. I did something. I brought all these parts together and I made something.

And then, of course, reward. Getting some money for what you do. Having people say, “Hey, doctor, you made a real difference on my LinkedIn”. It's especially rewarding. It’s ridiculously rewarding how pleased I am to have somebody just say like, or insightful, or go beyond and say, thank you for stepping out there and making these comments. So, my reward comes from so many different directions now.

John: Yeah. Well, people sometimes call it a purpose or passion and other rewards, but you're right. It's the journey, not so much like you've landed there. But I like you talking about your house because they have a physical representation. That thing is done. We don't always have that in medicine because our patients go away, they get better, they get worse. But if I could build a guitar or build a house.

Dr. Dan Field: Exactly, that's exactly right. Even a well-crafted medical-legal opinion to me where I took an issue. I refined it. I researched it. I made points. I justified those points and I presented them. That is something that's concrete. When I worked in the emergency department and I see the same person for a drug overdose three times, I don't feel like I've made a lot of progress there.

John: Yeah. Really, I can remember those experiences in my office as well. It's frustrating. That's kind of the patient you hate to see. You look at your schedule, you didn't have a schedule to look at, I'd look at a schedule and see the person who was coming back in two hours.

Okay. So, we're going to move to the meadow medical expert in a minute, but I want to ask you because I think this is an interesting transition. Physicians aren't really going to retire. I mean, they might retire from clinical, but our minds are going, we have energy, we have so much knowledge. Do you think that most physicians that practice as long as you did and that kind of environment, whether it's internal medicine, emergency medicine surgery, do you think we should pick up a few new skills at the end of that to anticipate this next? Should we do little pilots or do we have enough of the knowledge and skills that are really going to translate into some other jobs already?

Dr. Dan Field: I think preparation is the way to go. I think building a skill stack it's like opening up your tool chest and putting tools in it that are going to be useful to you. So, I knew that I liked med-legal. For some reason, I was attracted. In fact, when I applied to medical school, I applied, my thought was to do an MD/JD. That was 35 years ago. And it was too startling for most of the medical school admissions committees. And I didn't get accepted when I led with that. But I knew I liked it. And so, I began to add tools along the way. Kaiser doesn't allow you, TPMG, the Permanente medical doesn't allow you to do outside work for a monetary reward if it involves your license. But what they do allow you to do is public benefit.

So, I actually started working as a California medical board reviewer, and here they're asking us to look at medical cases and say was the standard of care met? Was there an education deficit? And I began to develop the evaluation capacity, which actually translated very well to my next stage as an expert witness.

John: Yeah. I think you don't always know where those are going to go, but those extra experiences can be very helpful. Not only because you've learned new skills, but then when someone's looking at you, they say, “Oh, wow, that's something interesting that might be useful for what we need”. So now, from what I understand when you joined MDstaffers and they had never had a CMO. They were small enough that they have a similar position.

Dr. Dan Field: They did have a CMO previous to me. It didn't work out the way they wanted it to and there was a parting of ways.

John: Okay. So, then there you are. And then you were the one I think that introduced this concept of adding the MDexperts to their growing kind of array of topical areas. So, tell us about that. I know you have that interest, but tell us how that transpired and what it is today.

Dr. Dan Field: Let's go back a step to MDstaffers business model. So, they have two clients. They have physicians and advanced practitioners, and that's one group of clients. And on the other side, they have the Adventist selves or the major healthcare organizations who are looking for manpower or person power support.

So, we are recruiting on the one side for those big company clients who need volume and we're prospecting for the workers on the other side, and then we're going to match those. They might say, we need a hundred mental health care workers for our telemedicine product. And we'll say, okay, are you ready for a hundred of them next week? And we've broken the bank there, or the processes for some of our companies because we give them so many high qualities. Well, we now got a hundred thousand plus physicians in our Rolodex and it takes an older person to know what a Rolodex is.

The concept is really simple. Somebody needs a specialty in Hackensack, New Jersey. And they call us up and they say, “Who do you have in Hackensack who is a pediatric pulmonologist?” So, we just go into our tracker database and type in 50 miles from Hackensack and a pediatric pulmonologist. And I get four names and I have the CVs. I have everything ready and we shoot them a CV and they say yes. And then we match the two.

John: What's the experience for the physician? Are they a subcontractor for you and MDstaffers or directly for the attorneys that are looking for them or the insurance company or whatever it might be? How does that work?

Dr. Dan Field: Well, that's a good question. In many of these circumstances, it's a handoff once the connection is made and somehow the value has been extracted before that stage. And then it's up to the physician to work out with the requester. Our model is that we manage the process. We do the invoicing, we guarantee the payment, we pay the liability in this case. And in exchange, we take a less than typical market share. So, it'll be less than 30% for our margin. So that's the model.

John: Do you have a sense of the physicians? Do you get many physicians starting out that haven't done this before and contact you about signing on, or do you generally use more experienced people or both? What feedback do you get from the physicians that are involved?

Dr. Dan Field: A lot of physicians come to us through the recruitment process. So, on MDstaffers side, where we're talking to them and we're engaging in conversations, our recruiters are really good, and we really develop a nice relationship with their doctors. And along the way, we say, “And by the way, are you interested in this line of work over here?” And a high proportion of the people that we talked to say, “Yeah, yeah, I might like to do that, but I haven't had any experience”. Well, we have a little process that we go through to help them begin to build the experience. And in those cases, you can volunteer for your in-house quality assurance committee. You might get paid for that in-house, and you begin to build some variety inside your current practice, which is a very nice longevity tool because again, variety and autonomy and reward.

So, you begin to build some of those inside your current lifestyle. You reach out to your medical board and see if they have a reviewer program. You touch bases with the public defender's office. They're dying for experts, but they can't afford them. And so, we created a government rate basically to help the justice system, and it's much lower than the commercial rates, which we charge at-large criminal product, liability, and so forth. And that is beneficial to society and its benefits to us because it builds experience and volume. So, that's what I tell the new physicians. I say, take them through this route.

John: I had a conversation with one of my colleagues who does a lot of telemedicine. He's licensed in multiple states. And he said that he had discovered that many of the state licensing boards need physicians to review records, review quality, review complaints. So, you're saying that kind of thing could set them up to take the next step and move maybe more directly into an expert witness type of activity.

Dr. Dan Field: Yes. And since a lot of physicians are not looking to leave clinical practice entirely, they're trying to build a side gig inside their current lifestyle, where they can take some of their non-program time and turn it to a monetary reward and then perhaps reduce their clinical. And as we all know, when you reduce clinical, you reduce exposure.

John: That's a good part.

Dr. Dan Field: Well, it's a great part. And it has two parts to it itself. This is a little segue, but not only are you reducing your personal exposure, but the very act of studying these things teaches you how to avoid exposure. So, it's a total win-win and perhaps triple win situation.

John: Yeah. I guess if you're gaining expertise on how to be an expert witness and then you know “Oh, my documentation needs to be spruced up a little because obviously, this is what they're asking me to look at”. Or if you happen to go through a deposition, you learn those things pretty quickly.

Dr. Dan Field: Okay. So, let me throw one more thing at you along these lines, because you were asking how we prepare our new doctors for this kind of career. Another thing is just an education on what an actual expert witness is and does. So, we all have kind of our TV imagery. Yep. But what is the reality? And my reality is that I have found that I am an interpreter. That's how I look at my expertise as that of interpretation.

So, I take a medical record and other information that might be confusing and are out of the area of expertise of the judge, the jury, and the attorneys. And I interpret this for them in an ethical, and, what would be a good word? It's somewhat of a blinded fashion. I kind of walk into these cases without a preconceived notion or with the openness that my preconceptions and biases might be changed by the facts of the case. And that happens a lot. I had a great case with the Air Force, where I went in thinking “This guy's a scumbag and I'm here to defend him”. And in the course of the case, it turned out not to be in my opinion. So, you were an interpreter.

John: Now, what I've heard others ask about as well, “How much actual record review am I doing as opposed to actually ended up doing a deposition? And am I likely to ever end up in court in a trial?”

Dr. Dan Field: The answer is no.

John: It's pretty rare.

Dr. Dan Field: Yeah, just like with malpractice cases, mostly favoring the physician. Probably 95%, something like that. That same applies to your chances of actually getting into the court. So, I've probably reviewed a hundred cases by now. Not huge, maybe even 200. And I probably made it into court a total of 15 times, and I love depositions. I love sitting in court. I love that part of it very much. I don't like malpractice. I don't think anybody does, but personal injury and criminal is really nice because I go there as a nonpartisan and I'm here to help and advise.

John: No, I think that's a good picture of how things go. You have to have a certain personality, I suppose. You can't be a hothead that flies off the handle. You have to be able to listen, stop and be calm basically, and give a measured response. But if you can do that, I mean we're well-trained, we should be able to do it in most cases. So, I think it's something that practicing physicians rather than just, say, dumping clinical completely, maybe cut back on the clinical because you need to stay in clinical if you're going to do this anyway, most likely because they want you to know the standard of care. And do this. It's a good side gig. And like you said, it could balance out things.

Dr. Dan Field: Variety and reward and some autonomy. You know what? You really hit upon it, John. I think you were touching on a valuable tool - You need to be a team player. And think, for instance, a physician such as yourself, a family practice person, perhaps with an office or a team, have some nurses, you have an assistant. They're your team and you're working with your team to bring about an end. And when you are an expert witness, you're part of the team. You're not house. You're not the prima donna that everybody's going to come and bow to. You are part of the team and you're working to get to the end to go deliver a product.

John: So, if I was interested, I could get on the phone and call MDstaffers, MDexperts, and just talk to somebody about what it would take to become one of your physicians that do that. And if they have to do some other work first, that's fine. But at least I can learn more about how to get there.

Dr. Dan Field: I'm happy to talk to anybody who wants to discuss this. I've benefited from those who have gone before me. And I will be paying it forward as the phrase goes and helping the people along the way. I’ve got some good ideas for them.

John: All right. I want to remind everyone that the website is mdstaffers.com. That's one word and everything that you've talked about and everything that MDstaffers does is somewhere on that website. And there's probably a contact form to reach out if you'd like to do that. Is there any other thing? Like the mention about MDstaffers, you say you've got a locum’s component as well. So, a lot of people use that as a temporary or permanent change from what they're doing.

Dr. Dan Field: Yes. You should keep in mind, those of us who are near retirement. And if you think, “Well, I might take a couple of years off and travel to Fiji and Bora Bora” and so forth. At least in emergency medicine and probably the same for surgery and some other areas. If you haven't practiced in the clinical setting in the last 18 months, you're out. The process to get back in and to get on staff becomes much more onerous than people would consider.

So, I really advise people to keep their foot and their toe in the bathtub here and keep a little side clinical going. And that can extend your career until as long as you want it to go. I frankly don't know what I would do if I didn't have this to get up to every day. I mean, I could not sit there and read the paper and drink coffee all morning, and then go meet my buddies at the coffee shop for more coffee. I need more than that.

John: No, everyone I've talked to, I haven't really seen a physician. Most of us either practice till we drop, or we do something else. And that's healthy. You need that, I think. All right, well, we're going to run out of time here. So, I guess I would ask you if you have any other advice, maybe for a physician who's maybe not quite ready for retirement, but thinking about those few years down the road. Any specific advice or other comments you would have for us?

Dr. Dan Field: Yeah, yeah. Realize that failure equals experience. Don't be afraid to go out and try something. You're going to learn. You're going to learn as you go. So, when I went out and worked in the business world, I learned some business concepts and I learned how important it was to be a team player. Don't quit your day job. Find a way of diversifying your day job internally and pick up skills so that you have something to offer when you get out.

I think you should try to find out what tickles your brain and then make that the direction that you're going to move. So, you're going to build your skillset around those things that bring you that happiness or satisfaction. And there are ways to do that by taking baby steps. So, I'm an incrementalist. I like job security and a paycheck, so that's my advice.

John: All right, Dan. Well, this has been very interesting. We've learned a lot about the two major topics that I think we're going to be able to learn from and apply. So, I really want to thank you for spending the time. Again, that's mdstaffers.com. I'm sure they can track you down there, or you can go on LinkedIn and probably get a hold of you and contact you that way.

Dr. Dan Field: Absolutely.

John: All right. Well, with that, I guess I'll just have to say goodbye.

Dr. Dan Field: Okay. Thank you.

John: You're welcome. Bye-bye.

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Disclaimers:

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, career counselor, or other professional before making any major decisions about your career.
The post How to Go from Retirement to Ardent CMO and Medical Expert – 189 appeared first on NonClinical Physicians.

Why Should I Invest in a Passive Private Real Estate Deal? – 154

John Jurica — Mon, 03 Aug 2020 16:31:55 +0000

Interview with Dr. Peter Kim

In this week's PNC Podcast episode, we learn why private real estate deals are a great way to diversify income. And investing in real estate makes a very nice part-time side hustle.

Earlier this year, I was a participant in the Leverage & Growth Virtual Summit, organized by Dr. Peter Kim from Passive Income MD. It was a unique experience with about 50 experts providing valuable teaching over 2 weeks. I had a lot of fun participating as faculty. I also enjoyed watching the other videos that were posted. Many of you told me you found it helpful and inspirational.

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, with over 650 graduates. And, unlike other programs, which typically run 1 – 1/2 to 2 years, this program only takes a year to complete. Recently, Economist Magazine ranked the business school #1 in the world for the Most Relevant Executive MBA.

While in the program, you'll participate in a company project, thereby contributing to your organization. As a result, the University of Tennessee PEMBA students bring exceptional value to their organizations.

Graduates have taken leadership positions at major healthcare organizations. And they've become entrepreneurs and business owners.

By joining the University of Tennessee physician executive MBA, you will develop the business and management skills needed to find a career that you really love. To find out more, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Private Real Estate Investing Is a Great Side Hustle

I wanted to get Peter on the podcast to learn more about his background, and his online ventures. Is he still practicing? Why did he create Passive Income MD? What new projects has he developed? Why is passive private real estate investing such a good side hustle?

As I have interacted with physicians seeking nonclinical careers, I found that many achieve fulfillment and balance by starting side hustles to complement their clinical careers. You’ll remember, perhaps, that Peter Steinberg really loved his work as an expert witness, while still practicing urology. And Dave Draghinas balances his practice with his podcast and short-term real estate investing. Ideally, we ought to be passionate about these endeavors and they should help diversify our income.

Today, Peter discusses several important topics:

Why we should diversify our income streams;

Why private real estate investing is such a popular choice for passive income;

Which real estate investing options are ideal for busy professionals; and,

The Passive Real Estate Academy that he and his team have relaunched this month, and why you should enroll.

Peter really knows real estate, and it is so cool that he has spent the time and energy to create a place where we can learn from his successes and failures.

To learn more about his course, go to nonclinicalphysicians.com/prea (this is an affiliate link).

SUMMARY

Peter provides a brief explanation as to why generating passive income using private real estate deals is such an important topic to consider. It is easy to learn. Most physicians have incomes to make it an appropriate investment. It will help us hedge against possible job loss or cutbacks as we've during the COVID-19 pandemic.

And for a very short time, you can have access to a free Webinar, or consider joining his Passive Real Estate Academy, where he'll teach you everything you need to know about creating a passive income stream with certain types of real estate investments.

Links for Today's Episode

Peter's Passive Real Estate Academy Free Webinar

Passive Real Estate Academy Information Page

Passive Income MD Blog

The Passive Income MD Podcast

Passive income Docs Facebook Group

Download This Episode:

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

The Clinicians Career Cooperative Is Live

This is the ONLINE MARKETPLACE OF IDEAS for nonclinical and unconventional clinical jobs and side gigs. It's a FORUM where you can ask questions of experts in multiple careers. We have some of the most influential names in career transition to mentor members in the Cooperative, including Maiysha Clairborne, Michelle Mudge-Riley, Tom Davis, Marjorie Stiegler, Phil Boucher, Mike Woo-Ming, Jarret Patton, Jill Wener, Christopher Loo, Lisa Jenks, Mandy Armitage, and Brent Lacey

There is an automatic Free Trial. So, this is a no-risk opportunity to connect with experts and begin your career transition today.

To check it out, head to the Clinicians Career Cooperative.

Imagine what it will be like 6 to 12 months from now to start a fulfilling career, and leave behind the headaches, long hours, and constant threat of a lawsuit. Joining the Cooperative is the first step on that journey!

So head over to the Clinicians Career Cooperative.

The Nonclinical Career Academy Membership Program recently added a new MasterClass!

I've created 16 courses and placed them all in an exclusive, low-cost membership program. The program provides an introduction to dozens of nontraditional careers, with in-depth lessons on several of them. It even includes my full MSL Course. There is a money-back guarantee, so there is no risk to signing up. And I'll add more courses each and every month.

Check out the home page for the Academy at nonclinicalphysicians.com/joinnca.

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It is just what you need to prepare for that fulfilling, well-paying career. You can find out more at nonclinicalphysicians.com/physicianmba.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

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

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

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as 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 Why Should I Invest in a Passive Private Real Estate Deal? – 154 appeared first on NonClinical Physicians.

9 Excellent Books That Will Help Launch Your New Career – 153

John Jurica — Tue, 28 Jul 2020 11:30:59 +0000

Getting Back to Basics

In this episode of the PNC podcast, John describes nine excellent books that will help educate you as you begin your career journey.

The first two books will get you in the right frame of mind. And they provide tools to help you to overcome the self-limiting beliefs that might hold you back. Then John presents four books written to assist you in your selection of a nonclinical career.

The last three of these excellent books are written to assist in your transition to a personal-brand business, freelance consulting, a cash-only business, or locum tenens. A locums job can be permanent, or a bridge to your nonclinical career.

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, with over 650 graduates. And, unlike other programs, which typically run 1 – 1/2 to 2 years, this program only takes a year to complete. Recently, Economist Magazine ranked the business school #1 in the world for the Most Relevant Executive MBA.

While in the program, you'll participate in a company project, thereby contributing to your organization. As a result, the University of Tennessee PEMBA students bring exceptional value to their organizations.

Graduates have taken leadership positions at major healthcare organizations. And they've become entrepreneurs and business owners.

By joining the University of Tennessee physician executive MBA, you will develop the business and management skills needed to find a career that you really love. To find out more, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Links to the Nine Excellent Books

Here are links to the nine excellent books described in this episode (most of these are affiliate links):

SUMMARY

If you're just getting started on your career transition, these nine excellent books will provide the tools you need to take your first steps.

At a minimum, you should first read either Jenny Blake's Pivot or Gay Hendricks' The Big Leap. Then move to Michael McLaughlin's book, followed by Hiedi Moawad's book Careers Beyond Clinical Medicine and Sylvie Stacy's 50 Nonclinical Careers for Physicians. Finally, if you decide to follow one of these paths, then read the book listed below:

Personal Brand Entrepreneur – Rise of the Youpreneur by Chris Ducker

Freelance Consulting or Cash-Based Clinical Business – The Positioned Physician by Michael A. Woo-Ming

Locum Tenens – The Locum Life by Andrew Willner.

Links for Today's Episode

See the above book images to learn more about each one.

Download This Episode:

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

The Clinicians Career Cooperative Is Live

This is the ONLINE MARKETPLACE OF IDEAS for nonclinical and unconventional clinical jobs and side gigs. It's a FORUM where you can ask questions of experts in multiple careers. We have some of the most influential names in career transition to mentor members in the Cooperative, including:

Maiysha Clairborne

Michelle Mudge-Riley

Tom Davis

Marjorie Stiegler

Phil Boucher

Mike Woo-Ming

Jarret Patton

Jill Wener

Christopher Loo

Lisa Jenks

Mandy Armitage

Brent Lacey

There is an automatic Free Trial. So, this is a no-risk opportunity to connect with experts and begin your career transition today.

To check it out, head to the Clinicians Career Cooperative.

Imagine what it will be like 6 to 12 months from now to start a fulfilling career, and leave behind the headaches, long hours, and constant threat of a lawsuit. Joining the Cooperative is the first step on that journey!

So head over to the Clinicians Career Cooperative.

The Nonclinical Career Academy Membership Program recently added a new MasterClass!

I've created 16 courses and placed them all in an exclusive, low-cost membership program. The program provides an introduction to dozens of nontraditional careers, with in-depth lessons on several of them. It even includes my full MSL Course. There is a money-back guarantee, so there is no risk to signing up. And I'll add more courses each and every month.

Check out the home page for the Academy at nonclinicalphysicians.com/joinnca.

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It is just what you need to prepare for that fulfilling, well-paying career. You can find out more at nonclinicalphysicians.com/physicianmba.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

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

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

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as 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 9 Excellent Books That Will Help Launch Your New Career – 153 appeared first on NonClinical Physicians.

What is the Expert Surgeon and Inspirational Podcaster Up to Now? – 152

John Jurica — Tue, 21 Jul 2020 11:00:36 +0000

Interview with Dr. Nii Darko

In this episode of the PNC podcast, inspirational podcaster Dr. Nii Darko shares his story and his advice about following your dreams.

Nii Darko received his medical degree from Kansas City University of Medicine & Biosciences, and an M.B.A. in Health Care Leadership from Rockhurst University. He completed his General Surgery residency at Morehouse School of Medicine and a Trauma/Critical Care fellowship at the University of Miami. Nii is a Fellow of the American College of Surgeons.

He hosts Docs Outside the Box, an Apple Podcasts Top 100 podcast. There he highlights stories of doctors doing extraordinary things outside of medicine. He also runs his locum tenens business, Equal Access Health, where he empowers physicians to achieve the lifestyle they deserve.

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, with over 650 graduates. And, unlike other programs, which typically run 1 – 1/2 to 2 years, this program only takes a year to complete. Recently, Economist Magazine ranked the business school #1 in the world for the Most Relevant Executive MBA.

While in the program, you'll participate in a company project, thereby contributing to your organization. As a result, the University of Tennessee PEMBA students bring exceptional value to their organizations.

Graduates have taken leadership positions at major healthcare organizations. And they've become entrepreneurs and business owners.

By joining the University of Tennessee physician executive MBA, you will develop the business and management skills needed to find a career that you really love. To find out more, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Dr. Nii Darko's Podcast

Dr. Nii Darko is a trauma surgeon who decided to work locum tenens early in his clinical career. He soon found that the recruiting agencies were taking a large percentage of his pay when they arranged jobs for him. So, he soon started negotiating his own contracts, and then started his own locums company.

He is also one of the first physicians to start a podcast not dedicated to clinical topics. At the time, he had very few physicians to emulate. But he soon became an inspirational podcaster, presenting interviews with “ordinary doctors doing extraordinary things.”

Docs Outside the Box has become a very popular podcast, inspiring many physicians to pursue their dreams. As an inspirational podcaster, Nii has also motivated other physicians to produce their own podcasts.

Nii has recently decided to slow down his clinical activities and focus on his online businesses. He is passionate about helping physicians earn more as locums doctors. And wants to expand his coaching and teaching.

You really have to love what you do and be passionate about it. – Dr. Nii Darko

He would also like to promote more collaboration between physician podcasters. And he loves to show the pre-meds and medical students that there are many ways to apply their medical education.

Inspirational Podcaster

As an inspirational podcaster, he encourages others to be open-minded. He advises us to take a passion project and make that a business. Although you didn't go to residency to develop a nonclinical vocation, that doesn't mean that you should shy away from it.

Career Options Are Limitless

Today, there are many platforms that one can use to get out a message or sell a product. You might consider the following options that Nii mentions:

YouTube channel;

Podcast;

Blog;

Coaching; or,

Combinations of these, including patient care.

Whatever it is, it's not going to be perfect. If you wait, you might miss your opportunity. It's okay to start off small, in your basement or garage. That's fine. Take the opportunity to start and get better with practice. When there's something that you really want, go after it. It's okay.

SUMMARY

During the discussion, Nii talks about how he tries to live his life now. This inspirational podcaster thinks physicians should stop worrying about the “what-ifs” and take more calculated risks. It may not turn out the way you expect, but even so-called failures are excellent learning experiences. And, if you wait for your product to be perfect, you waited too long.

Nii's key message is: “just start.”

Links for Today's Episode

EqualAccessHealth.net

drniidarko.com

Nonclinical Career Academy

Clinicians Career Cooperative

Download This Episode:

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

The Clinicians Career Cooperative Is Live

This is the ONLINE MARKETPLACE OF IDEAS for nonclinical, and unconventional clinical, jobs and side gigs. We have started with some of the most influential names in career transition to mentor members in the Cooperative, including:

Maiysha Clairborne

Michelle Mudge-Riley

Tom Davis

Marjorie Stiegler

Phil Boucher

Mike Woo-Ming

Jarret Patton

Jill Wener

Christopher Loo

Lisa Jenks

Mandy Armitage

Brent Lacey

There is an automatic 7-day Free Trial. So, this is a no-risk opportunity to connect with experts and begin your career transition today.

To check it out, head to the Clinicians Career Cooperative.

Follow 4 Easy Steps:

After clicking the link and heading to the Cooperative and watching the Welcome Video…

click the Teal Colored JOIN NOW button, then,

select the annual or monthly membership by clicking the Sign-Up Link, then

add your registration information, and

click REGISTER HERE to join the Cooperative.

It's that simple.

Imagine what it will be like 6 to 12 months from now to start a fulfilling career, and leave behind the headaches, long hours, and constant threat of a lawsuit. Joining the Cooperative is the first step on that journey!

So head over to the Clinicians Career Cooperative.

The Nonclinical Career Academy Membership Program recently added a new MasterClass!

I've created 16 courses and placed them all in an exclusive, low-cost membership program. The program provides an introduction to dozens of nontraditional careers, with in-depth lessons on several of them. It even includes my full MSL Course. There is a money-back guarantee, so there is no risk to signing up. And I'll add more courses each and every month, addressing:

Mike Woo-Ming's 4-Part Masterclass about freelance consulting.

Writing Masterclass with Charlotte Weeks.

Locum Tenens Masterclass with Dr. Andrew Wilner

Nontraditional Careers: Cash-only Practice, Telemedicine

Hospital and Health System Jobs

Pharma Careers

Home-based jobs

Preparing for an interview, and using LinkedIn

And more…

Check out the home page for the Academy at nonclinicalphysicians.com/joinnca.

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It is just what you need to prepare for that fulfilling, well-paying career. You can find out more at nonclinicalphysicians.com/physicianmba.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

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

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

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as 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 What is the Expert Surgeon and Inspirational Podcaster Up to Now? – 152 appeared first on NonClinical Physicians.

Why You Will Love the Locum Life – 140

John Jurica — Tue, 28 Apr 2020 10:30:12 +0000

Interview with Dr. Andrew Wilner

On this week’s episode of the PNC podcast, Dr. Andrew Wilner explains why he believes you will love the locum life.

Andrew Wilner is an internist, neurologist and epileptologist. He is also the author of The Locum Life and a locum tenens expert. This Latin term basically refers to a person serving as a fill-in, such as a substitute teacher. In the medical world, a locum tenens doctors fill a temporary role, replacing physicians on a short-term basis.

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, with over 650 graduates. And, unlike other programs, which typically run 1 – 1/2 to 2 years, this program only takes a year to complete. Recently, Economist Magazine ranked the business school #1 in the world for the Most Relevant Executive MBA.

While in the program, you'll participate in a company project, thereby contributing to your organization. As a result, University of Tennessee PEMBA students bring exceptional value to their organizations.

Graduates have taken leadership positions at major healthcare organizations. And they've become entrepreneurs and business owners.

By joining the University of Tennessee physician executive MBA, you will develop the business and management skills needed to find the career that you really love. To find out more, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Will You Love the Locum Life?

For many, the career of a locum tenens doctor has the benefits of more freedom and more control over where and when you work. The locum life allows you to:

Fight physician burnout by making your own schedule;

Stay in a clinical practice on your own terms;

Travel and work in various hospitals, in sometimes exotic locations, if desired; and

Customize the kinds of jobs you accept.

Locums is the way to balance my outside interest, my personal life, with maintaining my identity and role and income as a physician.

However, not every one will love the locum life. Before you embark on this form of practice, you should consider:

You are responsible for arranging new contracts, which requires intentional planning months in advance;

Sometimes, despite your planning, contracts fall through at the last minute;

Constant travel may mean leaving your family behind for extended periods of time; and

Credentialing is a tedious but necessary process.

The Three Kinds of Locums

Andrew categorizes doctors into three types of locum tenens situations, based on the stage of their career.

New Graduates

Some doctors choose to work as locums fresh out of residency. They may still be unsure of where they want to begin their careers in terms of geography and culture. Locum tenens work is a great way to get test out different practice settings.

They may have a spouse still in training. So, they wish to explore one or two temproraty positions until the spouse completes their training so they can relocate together.

Mid-career

Doctors who decide to work as locums mid-career are often planning a career change. Perhaps they want to switch to a nonclinical career. Locums allows them to maintain an income as they work on their new venture. Sometimes mid-career doctors take a locum job during their vacation time to earn extra income.

Retirement

Lastly, some doctors become locums when they aren’t quite ready for retirement. Rather than cut back the hours they work at their current job, they may want to retire “in glory,” take a break, and then take temporary positions they can schedule as they wish. This way they continue working on their own terms, and often find that the love the locum life.

Summary

Although locum tenens work is not for everyone, it is always greatly appreciated by those using your services. Locums are often filling a desperate need. So the overworked doctors and underserved patients will always be thankful for your help. That's another reason physicins come to love the locum life.

During our conversation, Andrew also prvides ticps on how to successfully schedule your jobs, and his perspective on how the Coronavirus pandemic has affected locums around the country.

Thanks for listening today. I appreciate your interest and support. Next week, join me here on the PNC Podcast as I desribe Affiliate Marketing, and how it can be part of a modern online business.

Special Offer

Today's episode is a brief excerpt of a long tutorial by Dr. Wilner, in which he provides much more detail about why you will love the locum life and the freedom it offers, and how to plan for your new practice model.

But access to all of those value-bombs is only available to members of the Nonclinical Career Academy. If you join the Academy (using any of the links on this page), by May 15th, 2020, I will send you a copy of The Locum Life: A Physician's Guide to Locum Tenens, Kindle Version, for free (terms and conditions apply).

Links for Today's Episode

AndrewWilner.com

Nonclinical Career Academy

Download This Episode:

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

The Nonclinical Career Academy Membership Program is Now Live!

I've created 15 courses and placed them all in an exclusive, low cost membership program. The program provides an introduction to dozens of nontraditional careers, with in-depth lessons on several of them. It even includes my full MSL Course. There is a money-back guarantee, so there is no risk to signing up. And I'll add more courses each and every month, addressing:

Nontraditional Careers: Locum tenens, Telemedicine, Cash-only Practice

Hospital and Health System Jobs

Pharma Careers

Home-based jobs

Preparing for an interview, and writing a resume

And more…

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It is just what you need to prepare for that fulfilling, well-paying career. You can find out more at nonclinicalphysicians.com/physicianmba.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

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

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

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as 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 counsellor, or other professional before making any major decisions about your career.

The post Why You Will Love the Locum Life – 140 appeared first on NonClinical Physicians.

How to Leverage the Locum Life with Dr. Andrew Wilner – 076

John Jurica — Tue, 05 Mar 2019 12:30:16 +0000

Use Locums to Balance Nonclinical Work
This is Part 2 of my interview with Andrew Wilner about living the locum life. You can find Part 1 at How to Weave Medicine into a Dedicated Writer's Life.
When he decided to return to clinical medicine, Andrew discovered a wide-open locum tenens market for all specialties, even neurologists! Lucky for him, the opportunities for finding work had exploded during the previous decade.
“I liked the idea that I would show up, work 100% of the time, and then stop,” said Andrew. “Then, I can go back to the Philippines and go diving and work on my next book.”
Downside of a Locum Tenens Lifestyle
But moving from place to place to practice has its downsides. Andrew describes the tedious credentialing, licensing, and CME credit challenges that come with the bureaucracy of medicine. And you must plan well to avoid long periods without work. The locum life definitely has its challenges.
At one point, Andrew had licenses in 10 states. It got to be overwhelming to keep them up, renew them, meet CME requirements, and track different expiration dates and fees.
No Longer Taken for Granted
Wherever he went, Andrew’s experience with locums has been similar. The places have modern information systems, excellent imaging technology and a welcoming attitude.

All you have to do is a good job and they love you. It's fantastic. – Andrew Wilner

The one thing about the locum life that he didn't anticipate was feeling very appreciated. You're showing up where they really need you. You're not angling for the job. They're signing you because they need you now: “Oh, welcome Dr. Wilner. We're so glad you're here.”
According to Andrew, “They're often ecstatic that you're there. All you have to do is a good job and they love you. It’s fantastic!”
Our Sponsor
This podcast is made possible by the University of Tennessee Physician Executive MBA Program offered by the Haslam College of Business. You’ll remember that I interviewed Dr. Kate Atchley, the Executive Director of the program, in Episode #25 of this podcast.
The UT PEMBA is the longest running, and most highly respected physician-only MBA in the country, with over 650 graduates. Unlike most other ranked programs, which typically have a duration of 18 to 24 months, this program only takes a year to complete. And, it’s offered by the business school that was recently ranked #1 in the world for the Most Relevant Executive MBA program, by Economist magazine.
University of Tennessee PEMBA students bring exceptional value to their organizations by contributing at the highest level while earning their degree. The curriculum includes a number of major assignments and a company project, both of which are structured to immediately apply to each student’s organization.
Graduates have taken leadership positions at major healthcare organizations and have become entrepreneurs and business owners. If you want to acquire the business and management skills needed to advance your nonclinical career, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or going to vitalpe.net/physicianmba.
Attraction of the Locum Life
Depending on your stage in life, doctors are more attracted to certain locum tenens opportunities than others. According to Andrew’s book, The Locum Life, A Physician's Guide to Locum Tenens, most locums physicians are over 50, or don’t even try locums until they're over 50.
Sometimes, physicians work locums as a moonlighting option because they can't be bouncing around for months from place to place. They've got kids, a mortgage, and a whole system that revolves around them. But, they need to make some extra money. In that situation, it's a way of supplementing income.
It’s also a way to explore a new clinical practice. Do you feel stuck? Don’t work enough hours or too many hours? Are you burned out or unhappy?
Maybe there's something better out there. By doing locums, you can experience other options and possibly move to a different job. You can use locums to achieve a healthy work-life balance. It worked for Andrew, allowing him to continue writing and practice medicine.
Guidebook to Locum Tenens
Andrew’s book, The Locum Life: A Physician's Guide to Locum Tenens, is for doctors interested in taking the locum tenens path. He offers practical guidance drawn from his own experiences on what to expect and what to do. It's a very comprehensive “rule book” for successfully integrating locum tenens into your life.

Andrew advises us: “Don't be afraid to experiment. Understand that you always have options. If you're not happy in what you're doing, then you should definitely explore other opportunities.”
Links for today's episode:
Dr. Andrew Wilner
Epilepsy 199 Answers
Epilepsy in Clinical Practice
Bullets and Brains
The Locum Life, A Physician's Guide to Locum Tenens
Medscape
Lulu
KevinMD
Doximity
Thanks to our sponsor…
Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It might be just what you need to prepare for that joyful, well-paying career. You can find out more at vitalpe.net/physicianmba.
I hope to see you next time on the PNC Podcast.
If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.
Podcast Editing & Production Services are provided by Oscar Hamilton.
Disclaimers:
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.
Many of the links that I refer you to, and that you’ll find in the show notes, are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you, that I have personally used or am very familiar with.
The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as 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 counsellor, or other professional before making any major decisions about your career.
Right click here and “Save As” to download this podcast episode to your computer.
Here are the easiest ways to listen:
vitalpe.net/itunes – vitalpe.net/stitcher
The post How to Leverage the Locum Life with Dr. Andrew Wilner – 076 appeared first on NonClinical Physicians.