Consider This Well-Compensated Career – 323

In today’s podcast, John shares invaluable insights on the critical areas of expertise for physicians seeking hospital leadership jobs.

John recounts his transition from a clinical role to leadership within his hospital. Like others, his transition started with physician advisor and medical director roles, which provide management experience.

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

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

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

Transitioning from Physician to Hospital Leadership Roles

Transitioning from a physician's clinical role to a leadership position within a hospital system is a significant and rewarding shift. It begins with clinical-administrative roles within the hospital, such as medical directorships. These roles offer valuable management and administrative experience and a bridge to more senior leadership positions.

As physicians move through these roles, they encounter a dynamic shift in responsibilities and gain a deeper understanding of healthcare systems. Through this transition, responsibilities shift to greater leadership responsibilities. These administrative positions often involve advocating for colleagues and patients, while enhancing healthcare delivery at a community level.

Key Areas of Expertise for Hospital Leadership

Several broad areas of expertise are considered critical for physicians transitioning into hospital leadership roles. They cover the skills necessary to lead and manage effectively in a healthcare setting:

1. Leadership Principles
2. Data Management
3. Business Management
4. Talent Management
5. Quality Improvement

Summary

John shares his transformative journey from family physician to hospital CMO. He explores the advantages of hospital leadership roles, where to start as a medical director, salary expectations, the impact of your medical specialty, and the crucial areas for developing new skills.

John also extends an invitation to listeners to explore the NewScript 2023 Nonclinical Career Summit, presented in April, offering all 12 lectures with Q&A sessions for a reduced price of $199, with a special discount for NewScript members. Join NewScript at nonclinicalphysicians.com/newscript to unlock this special discount and access a wealth of nonclinical career insights from our 12 expert presenters.

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

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Links for Today's Episode:

• physiciancoaches.com: This website lists coaches for physicians.
• nonclinicalcareersummit.com: This site offers access to all 12 lectures presented at the 2023 Nonclinical Career Summit for a special price.
• From Here to There: Leveraging Virtual Medicine (affiliate link) – Learn how to leverage telehealth to build your own business.
• NewScr!pt – Join today to get the best deal on the All Access Pass to the April Summit.

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Transcription PNC Podcast Episode 323

Why Hospital Leadership Jobs Are Both Challenging and Rewarding

John: This is what I'm talking about - Roadmap from Physician Advisor to Hospital CMO. I am going to first start by telling you my story. It seems to be a good way to start these presentations. I was a family physician. I joined two other physicians. We were in a private practice. They had full practices. I had no practice when I joined them. I had to grow my practice during that time. And as a result, I had some free time during my first two, three years of practice. And so, I looked for things to do that really was more to make some extra money. It was like moonlighting. I would work at the family planning clinic and I would work over at the local college health center. I worked in the STD clinic at the health department. And so, I got involved in other things as I was growing my practice.

And as a result of doing those things, I was often asked to become the medical director because the medical director that was there would leave, for example, the family planning clinic had a gynecologist and they got busy and so they left. And okay, I thought I would do that. And I got paid for doing it.

We had an occupational medicine clinic. Again, I started working there to make some extra money and lo and behold, they needed a medical director for that. So I thought I'll do that. I was learning as I went, and over time I became comfortable doing those kind of things. I actually kind of liked it.

Then as I got further into my career, 5, 10, 15 years in, we were all doing everything OB, pediatrics, working in the nursery, nursing home patients, routing at two hospitals. And we did cut back over time. But I found as I got into the stretch of my family medicine career became rather tedious. I had episodes of burnout and frustration. That was a time when things were changing and they were ramping up the tightening down on payment by Medicare, which continues to this day. And so, it seemed like we were doing more and more work rushing patients through, as many of you have experienced.

And I just started to think maybe I should do something else. One of the things I did in that timeframe, I was tended to say "yes" to most anything, and they needed someone to join the CME committee. I liked planning CME and providing it to my colleagues. I had done that as the chief resident at my residency.

And then when I came to my practice, I got the Illinois Academy Family Physicians involved, and they had a program where we could bring in speakers and continuing the CME for our colleagues. So I liked doing that. And then the chair of the CME committee left or he got sick or something. And so, then I was the chair. And then within six months of doing that, we were surveyed for our accreditation. So I had to learn all about that. And I guess we did well enough that the Illinois State Medical Society asked if I would join the CME committee that did the accreditation for the state, which is delegated by the ACCME. And I thought, okay, I'll do that.

And after being on that committee for a couple of years, I became the chair of that committee, all to say that it just gave me a lot of experience in running meetings and following agendas and communicating and working with people and meeting deadlines and all the different things that we don't necessarily do as physicians.

And so, at one point, I was really getting burnt out and I went to the CEO of my hospital. I said you don't have an executive level physician here. You don't have a VPMA, which was a big thing at the time. You didn't have a CMO. And so, I asked for a job and basically was given the job as a part-time VP for medical affairs. And I grew to really enjoy that job.

Now, part of the reason I'm telling this story is one of the first things I want to do today is what our other speakers have done, explain to you the pros and cons of this job because I talked to many of you when you have questions about non-traditional and nonclinical careers.

And one of the things that I find is that the last thing you want to do is to be around the hospital. It left a bad taste in your mouth because it's the administration of that hospital or a large system that employs you in a large group. It's part of this sometimes multi-hospital system. You feel like you have little control, you feel like you're being abused and you just want to get away from it.

I have found that while I thought my work was really good, and I'll get into that, what I actually did as a CMO. I want to just spend a few minutes talking about why you should consider it, and that's going to be on my first stop. But it leads into another story, and that's the story of one of the physicians. And when I was the VPMA and then moved into the senior VP and CMO role, eventually I was responsible for the medical group that we were growing.

It was very small when I started, but by the time I left, we had 80 physicians and another 40 PAs and NPs. And one of the benefits of me being the chief medical officer is I could really stand up for our physicians. I had an internist who was a geriatrician who was generating a lot of RVUs and the CFO had it in his mind that we really shouldn't pay that physician the same rate per RVU, which hopefully most of you understand, that's kind of how physicians can be compensated in certain contracts.

And in any event, he was doing the work of one and a half internists based on the population that he had, and he wasn't getting paid for it. When I took over the management of the group, over a period of five years, he got two significant raises because I got his RVU compensation rate brought up to the rest of where the rest of our colleagues were.

And so, that's the first big pro for me is that if you're in a position like this, you can advocate for your colleagues, you can advocate for your patients, and you can be the counterbalance to decisions that are made sometimes by the board, sometimes by the senior executive team to cut certain programs or to de-emphasize certain programs or to abandon certain types of patients because they're not lucrative. And when you're in a nonprofit hospital like I was and you're looking out for the community and for the patients, you have much more leverage in that position than as an employed physician or someone on the medical staff.

That's the first thing that I would think about in terms of why it's good to move into a position like this. There's other good reasons as well. And they're going to fall in the areas of leadership, income, intellectual challenges, and helping the community in different ways. That's kind of the way I look at it.

The title of this is From Physician Advisor to CMO. So, what are the jobs? I'm going to get into some of the jobs in a minute, some of the more entry level jobs, but let me just tell you what the higher end jobs are, where you get most of the benefits of working in the hospital system. That's where they accrue.

Obviously, most of us know what a chief medical officer does. We've maybe heard of chief medical information officer. Those are pretty common. But you've got chief quality officers. You've got chief clinical officers, which in many institutions, historically have been nurses. We've got chief patient safety officers, chief population health officers. The CMO can move on to become the COO, chief operating officer, or chief executive officer for that matter. And then there's even something called a chief patient experience officer, which sometimes is physicians in very large organizations.

There's a lot of good jobs, leadership jobs, high paying jobs in the healthcare system. The healthcare system is responsible. When we talk about mainly the hospitals part of it, approximately 25% of all healthcare dollars. It's the biggest chunk of money because we know that when people get ill at the end of their lives, they spend a lot of money. And that means there's a lot of jobs and there's a lot of jobs for physicians.

I mentioned salary. The average chief medical officer in any size hospital is going to make typically well above $300,000. It's not unusual for a CMO, especially one who's more seasoned to make $400,000 to $600,000 or $700,000. You can do your own research on this. You can try and find surveys that are difficult to find. Executive physician surveys. You have to pay a lot of money.

But you can go to something called guidestar.org, which is where all the 990 tax forms are put for nonprofit organizations. Every nonprofit organization has to report these things. And in those reports, they list the salaries of the most highly compensated members of those teams. Sometimes it's a board member, although most nonprofits don't pay their boards unless they're a big system. And then it's the CEO, the COO, the CFO, all those people. And usually you can go in there and look up the CMOs salary. There's less data available now because with a lot of the merging of different systems, you'll only get the top earners for the whole system. You might have six or 10 hospitals, but you might catch one CMO plus the CEO, the CFO and some of the board members.

But you can do that. Find a small community hospital or a medium sized community hospital near you that's a nonprofit, and go in there and just look up their salaries. They're published there every year. Guidestar.org is free. If you want to get more up to date report, you have to pay, but it doesn't really matter because the salaries don't change that much. So, it's a very good, well-paying job.

Now, as far as the intellectual stimulation, if you've worked in a hospital setting, I'm sure you've come across all kinds of challenges that would be very interesting to work on. Usually you don't have time, you got to get back to the office, you got to get back to the OR, you got to go to the ER. But some of the areas where physicians are really important, and you see this on the medical staffs because they ask you to get involved, but everything from quality improvement, patient safety, you learn about sentinel events and root cause analysis, lean process improvement, protocol development, top 100 hospitals, leapfrog, CMS hospital compare, health grades. It's all in the realm of quality improvement. It's all very important and it's interesting.

And we all have a background in epidemiology and statistics. We learn that in medical school, sometimes in residency. We know what quality is. We've been on different committees. I think it's very intellectually stimulating. Then you've got clinical documentation integrity, utilization management and length of stay, case management. I was always involved in the pharmacy formulary decisions and medication errors and how to minimize those.

Informatics has been huge in the last decade in growing. And healthcare law because you got the regulatory, you got to deal with the DOJ, CMS regs. And then there's the contracting, which I really got into heavily during those last five years when I was in charge of the medical group for our hospital.

And I could pick and choose any of those to work on any given day. And they were all very interesting and mentally stimulating to me. And so, it's just fun to do those kinds of things. To me, seeing patients one after the other for a mundane problem, that worried well, the sixth influenza patient in a row, that gets boring. But there's so much more that you can get into in the hospital setting when you're dealing with some of these areas that they need physicians to deal with.

Now, I often get the question, "What are the best specialties for doing something in the hospital management, hospital leadership?" I actually get that question about other areas too, like UM, like pharmaceutical companies. Any number of jobs. What about nonclinical jobs? What specialties will have the best opportunities? And really what I usually tell people is it doesn't really matter. You can be in any specialty and do UM. You can be in any specialty and get through into pharma. Same thing in the hospital.

Now, the way that I went about it, and the easiest way to segue into a hospital management position is to be in the hospital. I wouldn't say that a dermatologist who's doing only outpatient or a pediatrician who hasn't set foot in the hospital in 10 years, probably would want to pursue something like this because they're not in that milieu.

But anybody else who's in that, whether it's full-time, you're an ER doc, you're a radiologist, you're another type of surgical specialty that's there several days a week, you're going to committee meetings, you're already participating on quality and pharmacy meetings and things like that. It's just a natural transition that you can make. And it does take time. And I'm going to go through the process that I would recommend you follow to do it.

But if you plan it properly, you can make that segue before you get too burned out, before you reach that point of no return where "You know what? I just can't step a foot in that place again." So, you want to do this, begin that process if you think it's something you consider a little bit earlier rather than later. Pretty much any specialty that's in the hospital.

Also, if you happen to be, let's say the managing partner kind of role, or the medical director for let's say a big medical group that's part of a hospital system, you could segue from that as well, because you're going to be going to meetings and rubbing elbows with the other leaders in that hospital system.

But in general, it's someone who's going to be in the hospital. Probably fewer family physicians these days than when I did it, because when I did it, I was in the hospital every day making rounds, going to committee meetings, and volunteering for some of those things. And then working, getting paid to do some of those medical directorships part-time. So, what are the areas that you need to learn as you're going from that physician advisor or even a medical director role into more of a leadership role?

Because the physician advisor role, really, you're not doing any management or supervision at all. Nobody reports to you. You just show up, look at charts, electronic medical records. You might call physicians. You might just approve things based on what you can find in the record and move on.

But when you get to a medical director role, now you're doing a little bit of management. You can be, and I'm going to list some areas where you can be a medical director, but now you're starting to get into that. And if you're thinking about that, let's say you're having a good time, you're working 20% time as a medical director, and you're thinking, "Well, I want to go further and I want to start to pull back on my clinical and increase my leadership", then these are the five areas you need to learn more about.

I get this from the AAPL, the American Association for Physician Leadership. I'm going to maybe talk really briefly in a minute about the CPE designation, certified physician executive. But the AAPL has a subsidiary called the CCMM, which puts out the CPE designation, and basically they describe what they feel are the five areas that we need to learn about as physician beyond the clinical that we know. So, it's pretty straightforward.

The first one is leadership principles. That one is a little bit nebulous, but it includes things like motivating people and persuading people. It includes things like understanding strategic planning and that kind of thing. And it's probably of the five areas, the least concrete, but you kind of know when someone's a good leader and not when they're good leaders. Most people now kind of follow the path of servant leadership where you're trying to create teams and motivate people and work together. If you have a little bit of charisma, or at least again, the ability to persuade people, that's a big part of it.

The second is what they call data management. Now, for us, that's usually quality improvement. Those are the data that we usually deal with. We already have some experience in that just from our clinical practice. We know that we're being measured usually in what we do. Most of us have been exposed to maybe some of the data that the hospital shares with us when we're admitting and discharging patients or when we're doing procedures.

And so, there are some part of data management spills over into financial management because finances are data too. But usually we consider that as separate. And basically what that is, just understanding basic accounting principles, maybe P&L, balance sheet. And for me, and for you, if you're going to be in a hospital setting, understanding hospital financial reports because they're unique, because of the way they're paid. You have your gross revenues, which is what you bill. Then you have your net revenues, which is sometimes up to a half of that. You can say some hospital has a gross revenues of $900 million, but their net revenues is closer to, let's say, $600 million. And then you have write-offs. These are just unique to the healthcare system. So you have to learn that if you're going to be a leader in a hospital.

And then you've got the business management part of it, and that is just the management skills that you need to motivate people. One of the biggest things I had to learn when I started moving up into that area, was all of a sudden now I've got three, four or five, maybe up to six or seven directors reporting to me.

Well, how do I interact with them and what's my role? It's a little different from, let's say, leading a team as let's say an ER doc in a code or leading a team in the OR or something. When you're leading a big organization, it's more of a vertical thought process. How are we going to help each other? How are the directors that are reporting to me going to work together to get our division working and moving in the right direction? It's understanding how to set goals, how to plan projects, and how to keep projects moving forward with timelines and deadlines. I would say that's an area that physicians need a lot of help with at first is in the business management sphere.

And then the last area, and it does overlap a little bit with the leadership and the business management, and that's the human resources, or you might call it talent management. That's when you're getting a little more into "How do you recruit people? How do you train people? How do you monitor their performance? How do you resolve disputes?" Those are all areas where most physicians have some knowledge, but not a lot. So you need to get more exposure to that, and you can do that by some of the ways I've mentioned already and then some that I'll mention shortly. I just wanted to point that out that you got to think about how you're going to get experience in those areas.

The other thing I like to remind physicians about is sometimes we can get pretty cocky. We're pretty confident people. We've had a lot of education, a lot of experience, and so we kind of feel like we know a lot and we do, but we don't really know everything about finances and business management and that sort of thing.

I think it's good when you're making this transition to be a little humble and just suck all the information, all the knowledge that you can from those around you. And they're happy to tell you and show you how to do things. They don't expect a physician moving into a new leadership or management role to know how to do that. We basically have 70 or 80% of the knowledge and the skills to do the job, but that last 10, 20, 25%, we have to sometimes learn on the job, even going to classes and courses.

Getting an MBA doesn't really teach you day to day how to interact and how to work on a team because you have to do it. And that's where doing those things I talked about earlier about managing a committee, being the chair, leading meetings, leading projects. They may be ad hoc projects that just come up, you volunteer and then, oh, okay, you can be the chair and you help us get this thing done. We got six months to do it.

Where do you start as you're going on that path to that senior executive position? Well, the most common jobs that I have seen in the hospital setting are the ones I've mentioned already with a couple of others. They always need UM docs to do the physician advisor, but then someone has to lead that group, particularly if it's a large hospital. You can become a medical director in utilization management. Clinical documentation, integrity. It used to be called clinical documentation improvement. Every hospital has to have a CDI team. They have to. If you're not documenting properly, you're losing a lot of money. And the bigger thing is the quality of your care is going to be misrepresented.

Quality improvement. I talked to one of my guests who was a hospitalist. He was in a big organization, a big group of hospitalists working at multiple hospitals, and he had a halftime job as a medical director for quality just for the hospitalists.

Now most of the time, if you're going to get into quality improvement, you're going to be the medical director for quality improvement at an entire hospital. But if the system is big enough, then you can have even multiple medical directors and associate or assistant medical directors working just on quality, just on safety, just on informatics is another one. Those are the big four that are sort of not clinical areas that I have experienced people starting in.

I hope you enjoyed that excerpt from my summit lecture. All of the other 11 lectures were even more inspirational, informative, and educational. They were really excellent. One of the reasons I chose to present that audio today is that we opened up the all access pass for lifetime access to the NewScript 2023 Nonclinical Career Summit lectures last week at a special low price of $199. The usual cost is $249, and for that $199, you will have access to all 12 lectures, which also includes their Q&A. I think there's also some bonuses with the all access pass.

Now you can get an even better deal. If you're a NewScript member, the price is just $139 for everything, for a total savings of $110 from the usual price. If you're not a NewScript member, you still have time to join NewScript at nonclinicalphysicians.com/newscript. And then once you're a member, you can use a special coupon code to get that $110 discount off the usual summit pricing.

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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. I only promote products and services that I believe are of high quality and will be useful to you. As an Amazon Associate, I earn from qualifying purchases.

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 Why Hospital Leadership Jobs Are Both Challenging and Rewarding appeared first on NonClinical Physicians.

Dr. Andrew Tisser is an emergency medicine physician and physician career strategist. He also hosts the Talk2MeDoc Podcast. 

Our Sponsor

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

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

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

Emergency Medicine, Leadership and Podcasting

Andrew has been featured on NBC, NPR, and MTV News. He is a popular podcast guest. He was recently named as one of the “50 Best Doctors to Follow on Instagram in 2021” and “Top 21 Medical Podcasts.” Dr. Tisser lives in Western New York state with his wife Alysia, daughter Marlowe, and dog Lillie.

Realize that you have options… The first step is figuring out who you are. The second step is what you want. The third is going and getting it. – Dr. Andrew Tisser

Today Dr. Tisser and I will be talking about his experiences with burnout, nonclinical side gigs he has done, how he is helping other clinicians as a career strategist, and three limiting beliefs that hold physicians back from finding their best career.

Physician Career Strategist Offers His Advice

I like Andrew’s approach to his career and to helping others with theirs. During our conversation, we covered several topics, including:

1) His experiences with burnout during med school, residency, and early practice years;

2) What he did to overcome burnout;

3) The part-time nonclinical jobs he has tried;

4) How he now balances clinical and nonclinical work;

5) His podcast and how it helps early-career physicians learn strategies to advance their careers and overcome burnout;

6) His work as a physician career strategist;

6) And three common limiting beliefs that hold us back and how to address them.

Summary

Andrew Tisser describes the burnout he experienced from medical school through his early clinical career. He then explains what he has done to overcome burnout. He still practices emergency medicine and provides leadership at his hospital. Finally, he assists other burned-out physicians as a career strategist.

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

Links for Today's Episode:

• Talk2MeDoc Podcast
• Dr. Andrew Tisser's Website
• Sisters of Charity Hospital in Buffalo, NY
• Dr. Andrew Tisser's Free Video Series

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 220

Three Top Tips from a Physician Career Strategist

- Interview with Dr. Andrew Tisser

John: Nonclinical nation, Andrew Tisser, DO, specializes in emergency medicine and is the host of Talk2MeDoc podcast. The podcast and Dr. Tisser's work as a career strategist focus on unique issues pertaining to the early career physician.

He works tirelessly with his clients to accelerate their goals to completion. Andrew earned his medical degree at the New York Institute of Technology college of osteopathic medicine. He then completed his residency at Upstate Medical University in Syracuse, New York.

He is currently the associate chair of emergency medicine at Sisters of Charity hospital in Buffalo, New York. Andrew has been featured on NBC, NPR and MTV News as well as multiple podcasts. I was actually on his podcast twice. He was most recently named as one of the 50 best doctors to follow on Instagram in 2021 and top 2021 medical podcasts. Andrew lives in Western New York with his wife, Alysia, daughter Marlowe, and dog Lillie.

Today, Dr. Tisser and I will be talking about his experiences with burnout, nonclinical side gigs he's done, how he is helping other clinicians as a career strategist, and three limiting beliefs that hold physicians back from finding their best career. Here we go.

Some of you may know Dr. Andrew Tisser because I have been a guest on his show twice, and I think I've let you know about that and you probably have listened and that's on Talk2MeDoc podcast.

I recently posted an episode about coaches and consultants and strategists. I mentioned Andrew as being a coach that I had interviewed. And then I realized looking when I tried to put a link to it, there was no interview. So, I felt like I've been talking to him so much off and on in the last few years that I had interviewed him and I hadn't. So, he's here today. Andrew Tisser, welcome to the podcast.

Dr. Andrew Tisser: Hey John, thanks so much for having me.

John: Yeah. I couldn't believe it. I felt like a fool, like, man, I thought I had interviewed him, but it was the other way around. So, this is going to be fun. I want to hear what you've been up to and also your background and everything else and get a lot of good information for the listeners today. And so, why don't we start as we usually do by just giving us a short summary of your background from let's say med school through what you're doing now and maybe touch on some of the things you're doing.

Dr. Andrew Tisser: Yeah. Thanks, John. I just want to start off by saying this is a real treat and a real honor for me because you were the first medical podcast that I listened to. When I found your podcast I went back and listened to every episode, and you got me through some really lonely, long drives in residency. So, I want to thank you for that. And really my interest in alternative careers started with you. So, thank you for that.

I was telling my wife this morning, I was like, "Oh my God, it's John Jurica". And she's like, "All right, yeah, but you talk to him all the time". I'm like, "I know". But anyway...

John: Thanks for that. I appreciate it. That's a good testimonial. I have to cut that out and use that somewhere.

Dr. Andrew Tisser: Oh yeah, please do. Anyway, I went to the New York Institute of Technology college of osteopathic medicine, for medical school on Long Island. Graduated and moved on to emergency medicine residency at Upstate University in Syracuse, New York. After that, I followed my wife out to Chicago, where she did her rheumatology fellowship. And I worked at a lot of different hospitals during that time.

I didn't really know what I wanted to do. I suffered from a lot of burnouts actually in med school and residency. And so, I decided I was going to take a whole bunch of different locums and part-time jobs to see what I liked. And I knew that we were only there temporarily. So, that's what I did. And so, I worked from little tiny places up to massive teaching hospitals and everything in between, that was all drivable from inner-city Chicago because there are just so many hospitals.

During that time, I was extreme, my burnout got way worse. I was at this point where I'm sure a lot of your listeners are where they're just like, if I could just replace my salary, I would do literally anything. I would put the labels on whiteout containers if that's what it took to get out of clinical medicine. And I had just graduated, so it was a little bit more jarring to me. And also, I had close to half a million dollars in student loan debt.

I started looking at everything. I had listened to all your episodes like I said. I knew certain things that didn't interest me like the pharmaceutical industry I had heavily researched and I just was not interested. I tried a whole bunch of different things. I actually shadowed an aesthetics person at one of their spas and that was not for me. I got into some utilization work.

I was doing everything. And my wife was getting really upset because it was like today, I was going to do this, and tomorrow I was going to do this and the next day was going to do something else. And she's like, "Just figure it out. And when we move back to Buffalo where we are now, you can go after it", which was really sage advice.

And then, following that, we moved back to Buffalo, New York. I took a position at a small rural hospital, which was actually a really good organization, and started working on getting involved in administration, which is something that I do enjoy. And then, I quickly became the urgent care director over there. I also continued to do utilization work on the side. I started my podcast. I started my consulting business. And really recently as of August, I took a position as the associate chair of emergency medicine at another hospital here in Buffalo. And so, that's kind of where I'm at now.

John: Nice, nice. Do you feel a little more balance and comfort with the clinical side now with all that you're doing?

Dr. Andrew Tisser: Absolutely. I think a lot of people, and we'll get to this later. But a lot of people think it's all or nothing, right? Like you have to either leave clinical medicine, or you have to stay. And that's not really true. I've hodgepodge a career together at this point that is financially good enough for me and my family, it's personally rewarding. I remember in one episode, you talked to somebody who does a whole bunch of stuff and you said, "Well, aren't you so busy?" And he was like, "Yes, but that also brings me personal fulfillment". Yeah, I'm about 50% clinical these days and it makes the clinical shifts a lot better doing all the other stuff.

John: Awesome. Yeah. That is a good plan I think for some people. It works out really well. I think it's difficult to keep having a different schedule once you can get to something that's a little bit more routine. Habits are good for humans. It helps make things go more smoothly and easily and lowers the level of chaos and stress. When you can get into that rhythm and have two or three different things that you enjoy doing, rather than one thing that you hate doing, it can really work out.

Dr. Andrew Tisser: Yeah, absolutely.

John: And then along the way you have other options in terms of saying, well, maybe 10 years, 15 years, whatever down the road, I'm going to segue into doing this

one really mostly over everything else as I sort of approach retirement. But it's not really retirement. It's just simply trying to get a little more freedom in your schedule after a while. And when you've paid off those bills and families halfway grown and you can think about other things and about yourself.

Dr. Andrew Tisser: Yeah. And what I've found along the way is that each of those things lends itself to other opportunities. If I didn't do the urgent care directorship, yeah, sure. That's some administrative work, but also, I was recruited for this job because of my consulting business and because of my social media presence. Because they wanted someone young and up to date, and someone who's got a finger on those types of things. That really granted me medical directorship, not just the standard administrative work.

And now I'm starting to do in-house utilization for my current place as well, which the utilization work helped with. It's just one thing that builds on the other thing. and leads to really, really fun opportunities I feel.

John: Yeah. Other people have told me that sometimes they don't know where it's going to go, but you stack certain scales, get certain experiences that don't seem to be directly related to what you might do in three to five years or so. But ultimately, they often come up as another good skill that will apply to a new position or even a hobby or a side gig or whatever.

Dr. Andrew Tisser: Absolutely. Yeah. It's been fun.

John: We try to be, as physicians, lifelong learners. I think that helps. And if we can stick with that, but just expand our horizon to other types of learning like maybe writing, I don't know, just different things that don't seem directly related. But even the whole thing, like understanding finances or understanding how to be a consultant. Those things will come in handy in almost any job that you decide to pursue.

Dr. Andrew Tisser: Yeah. It's stacking skills as you said. Physicians have a core set of qualifications that make them really marketable people in general, but then you start adding other little sprinkles on top and it really gets some opportunities open for you.

John: As you mentioned that you've been doing some either coaching or consulting. I'm using the term career strategist. Tell us about that. What interests you about that? Is there a difference between a coach, a strategist, and a consultant? Or do they all kind of overlap?

Dr. Andrew Tisser: Yeah, there is some overlap for sure. I don't call myself a straight coach because I don't only coach. Because coaching really entails helping people come to the answer from within so to speak. And there are a lot of times when I'm working with clients that I tell them what to do. That's more of a consultant. You put on your consultant hat or your coach hat. But a lot of the strategy is strategy. It's figuring out what the next best move is for the person and what that entails. And whether that is restructuring their current position, whether that is leaving their clinical job for another clinical job, whether it is profitable side gigs or leaving clinical medicine or whatever. There is just a lot that goes into careers. And that's why I feel strategist is the appropriate hat to wear, the umbrella term.

Like I said, I started talking to my own mentors, my own coaches when I was so burnt out, to figure out what I wanted to do. And I did a lot of soul searching and kind of inner work when I was trying to figure out what it was that I wanted to do. And then after I started designing a career for myself, once we got back to Buffalo, some of my colleagues and friends from growing up and from medical school were like, "Hey, you're not miserable anymore. What happened?"

I started talking to them through a similar process that I had done and it worked well for them. And then after a while, my good friend from growing up was like, "Hey, you could charge for this". I was like, "That is true". I've always loved getting people jobs. Even all the way back to college. I love making connections. I love the networking and the strategy itself that goes into getting someone a job. That's really what my platform is based on. Getting people their next job and figuring out what will be the best fit. And it goes to career design more so than just what's the next job to add to their resume, so to speak.

John: Whether it's with some of the informal mentoring you've been doing and the actual career strategist activity, does it seem like the people that you're working with have similar challenges or is it just unique to each individual when you kind of step back and look across who you've been working with?

Dr. Andrew Tisser: Yeah. I think there's a theme. I mostly work with early-career people. And I define that as like 7 to 10 years out. And I've worked with a couple of non-physicians as well, that also are in the early career space. But right now, student loans are a big hot-button topic.

I've asked this question before, "If your loans are wiped out tomorrow, but you were never allowed to be a doctor again, would you take that deal?" And a lot of people say yes, which after a million years of training and how much time you've spent and sacrifices you made, it's kind of jarring to hear that. But I was in that place.

Student loans are big. Increasing hours and decreasing compensation. Increasing administrative oversight and requirements. I think my generation was brought into medicine with this kind of charting. So, I think that's just expected. And then people don't want to work 80 hours a week and be on call every third day anymore. That was the expectation back in the day. But people want to have time with their family and they want to have a couple of weekends off here and again and enjoy life once they've deferred it up until their thirties at this point. I think that's a big one.

And the other really big thing I hear as well is "All right. Well, what do I do?" That's the biggest question I get. "I don't like this, but what do I do?" And that's not an easy question to answer. I was like, "Well, I don't know, but let's try to figure that out". And that depends on a lot of different things.

John: Interesting. Interesting. I don't know. It seems like I'm kind of put aside because I'm in an older generation. A lot of times with the people I'm talking to are kind of closer to retirement, so they don't have the student loan issue. It sounds like that's kind of an integral part. Like you've got to deal with that while you're dealing with the other emotional things. And I'm assuming having those monstrous loans doesn't help just the emotional state of somebody because you just feel like you're trapped.

Dr. Andrew Tisser: For sure. I think golden handcuffs apply here too. But it's certainly the case and I try to work with people there too, to just get a plan together. Whatever the plan is, whether it's all the different things you can do with your loans. And then it becomes like another bill instead of like, "Well, I have this monster. - Nope, this is how you're going to pay it off and now let's move on". And that may be a 15-year plan and it might be a 20-year plan. it really just depends on your situation. But yeah, it does not help.

John: You kind of compartmentalize that it exists, but it's not good or bad. It's just something you have to deal with and deal with the other issues at the same time.

Dr. Andrew Tisser: Exactly. Yeah. I think that's the main thing right now with the student loans. They are. And I don't think anyone assumes that we're ever going to get student loan forgiveness for doctors unless you're in public service loan forgiveness. I don't think that's going to happen. It needs to be dealt with, and then you got to move on.

But I think the other big issue I run into is this "all or nothing" effect that we talked about before. It's that I have to leave or I have to stay and there's no in between. And sometimes when you bring up this issue to people like, "Well, what about cutting back and trying something else on the side?" A lot of people are like, "Oh, I can do that". Like, well, yeah, you can do anything. You can do anything you want.

John: I know some of us are so indoctrinated. We just have one view of what medicine is. Like you said, it's the 80 hours, it's the being on call. Or if you're doing, let's say more shift work, well, it's doing three or four or five, 12-hour shifts until I get my loans paid off. Yeah, there are situations where you can say no. Maybe I'm going to do eight-hour shifts. I'm going to do something else. Or I'm going to work only two or three days a week in that setting like an ER. Lot of people do maybe a little bit of emergency medicine, and some do maybe urgent care which I don't know how that feels going back and forth, but it's just something different.

Dr. Andrew Tisser: Yeah. There is literally an unlimited amount of options. And that's the point of your show. There are so many options for people. Whether that's part-time, per diem, whether or not you're trying to find a non-clinical job and you do locums as a bridge, or what have you. There are just so many options. And people want to be told what they should do.

A lot of people want to be told, "Well this is what's going to happen". And I can't tell people what's going to happen. I could just help them realize that there are other options and there are an unlimited amount of options. There are people that completely change. I forgot her name. There's that one doctor who decided she was wanting to sell cars instead of being an OB-GYN. She makes more doing that because she loves cars. You have to figure out what's right for you and what's right for your family and not get pigeonholed into "This is all there is".

John: Well, I hadn't heard that one. That one sounds pretty interesting. I know a lot of docs have gone into real estate and left medicine. I know one who became a disability insurance broker and she's doing very well. But yeah, pretty much we can do anything. I kind of liked that. That maybe physicians will go into something related to healthcare, but they don't have to, of course.

One of the ways I like to look at this sometimes when I'm talking to someone who's helping others is to turn it around and kind of look at it from, "Okay, what are the three mistakes or blunders?" And you may have touched on it in talking about the people that you've helped, but are there trends in terms of the big mistakes, if everyone could just deal with this and just know not to do this would help with their career transition or not even transition, but improvement?

Dr. Andrew Tisser: Sure. I think the big one is to not just assume that you're just screwed. For lack of a better term. I hear a lot of physicians that are like, "Well, I hate my specialty but this is just how it is. And this is what I picked. It's just my life and it sucks. But I have these financial obligations and I have to make X amount of money. Or this is just how the administration is everywhere or they won't be willing to work something out with me where I cannot work on Fridays and exchange for longer days".

People don't even try. And you never know until you ask. A big one is just remaining stuck, and remaining in your position where you just feel like there's no hope. I heard it a lot also, "You're too young to be burnt out", which is a really kind of annoyance to me because I hear it all the time. I used to hear that at every stage.

When I was a medical student, they're like, "Well wait till you get on the wards, then it will be better". And then you get on the wards and they're like, "Oh, well, you don't have any real responsibility. Wait until you are an actual resident, that will be better". And then in residency they're like, "Oh, it's residency. It's supposed to be terrible. Wait until you're out there and then it'll get better".

And then you get out and a lot of people have this existential moment where they get out of residency and they're attending and they don't like it. And they're like, "Oh my God, I got to do this for 50 years. What now?" And then it's like, "Oh, you're just a first-year attending. So, it's really hard. It'll get better". And it just goes on and on and on and on, or maybe it won't get better and you have to change your current situation because it doesn't fit with who you are as a person, or it's disparate to your core values or your belief system. So, maybe it won't.

John: I can't really think of too many other professions where it's just that awful. It just doesn't make sense. How could there be any kind of longevity in this business when medical school residency and practice for many people are something that you just despise? You think that it's just the way it is and you can do it, but you can only survive that for so long. So, it's just sad.

Dr. Andrew Tisser: It is sad. And you see it all the time from, again, your supposed superiors that are just like, "Oh, well". I don't understand that either. I think the lawyers are also kind of miserable, so they have it with us too. I was talking to my brother-in-law who was miserable at his corporate attorney job. And we did some of this stuff too. And he actually got a new job as an in-house counsel at a food company. And he's super happy now.

The first big issue is remaining stock. Number two is saying you're too young and you get burnt out and just grin and bear it. Because I hate that. The next thing I see with people is that there's only a couple of other things I can do, and I don't like any of them. And they tend to be the big three of utilization, pharma, and medical writing. They tend to be the ones that people say, "Oh, that's the only nonclinical career I can do". Well, have you listened to John Jurica's podcast? There are a lot more. But people get stuck in, and then you see these threads on Facebook groups with somebody posting a utilization job. And there are like 5,000 replies in 30 seconds.

John: That's true. People don't know what they don't know. And people have said to me, listeners and others, "Why don't they teach us this in med school? Why don't they tell us about these nonclinical careers in residency?" It's like, well, I don't expect them to do that. Number one, there's no time to add that to the curriculum. The curriculums are already packed with more than you can possibly learn. So, they're not going to even carve out an hour just to explain that to you, unless it's something on a weekend when you do it on your own. So, that's not going to happen.

But it is unfortunate that if you don't know those exist, then you feel fairly hopeless. And so, it's people like you and me and others. That's just part of the whole process, just opening their eyes, the fact that there are lots of options. And if we were really scientific about it, we might sit down and do some personality tests and checklists and try and figure out what fits with your personality and your desires, your mission in life, and all that. But I don't know too many people that have gone through that kind of a process. Basically, it's a matter of just starting to do your research, starting to dig and learn and getting a coach or a strategist or consultant or someone to help you if you need it. Just find out what's out there, take control of your life and then see what you can work out.

Dr. Andrew Tisser: Yeah. Careers should be designed in my opinion. A lot of people just let their career or their job happen to them instead of going out there proactively and designing a career. I'm happy where I am right now, but it could be even better. And that's a process. But I know my trajectory and my clients know their trajectory. And even if after 8, 12 weeks of working together they're not in their dream job, they've moved so far along that they know where they're going.

And don't get me wrong. I want people to stay in clinical medicine because I want somebody to take care of us, take care of me when I'm older. I don't want all the doctors to leave. And that's possible too, to stay and just restructure, like I did.

John: That's a good point too, about planning your career. Because I'll tell you, when I was working as chief medical officer, of course, I got to be exposed to a lot of nonphysician CFOs and CEOs and COOs. Many of them had a plan. They really knew when they were just coming on as a director of some small department, that they wanted to move up to the next directorship and then they wanted to be a VP, and then they wanted to do this and they wanted to do that. And it was a lot more planned out.

I guess when you compare it to clinical while we plan to go to med school and then pick a residency, maybe a fellowship, that's basically as far as it goes, I think. And it should continue as you're saying.

Dr. Andrew Tisser: Yeah, I agree. Especially when we are talking about the administrative pathway too. I know many people encourage others to join committees. But you just can't just join a bunch of committees and expect something to happen. You want to target committees that you have an interest in so that you can potentially chair. There is a pathway instead of just letting things happen. I recently gave a lecture at my wife's residency, she's a program director for internal medicine, about career design.

And I had a resident come up after the talk. She was like "Thank you because I just assumed that this was the path that I was on and I didn't really have any choices. And now it's given me so much to think about". And she was I believe either a first- or second-year resident. And I was like, yeah, start thinking about this stuff now so that your first job could be planned very well. And not just like, hey, give me the biggest sign-on bonus or something.

John: Yeah. Oh, man. I think they are probably just so happy to have their eyes opened by hearing what you had to say. All right. We're going to run out of time here. I want to talk a little bit about some other things just for a minute.

Now you've been doing a podcast for quite a while. And so, I know it started out initially with more talking about communication, and that sort of thing. What is the theme of your podcast for the last 6 to 12 months or so?

Dr. Andrew Tisser: Yes. We've shifted into just issues relating to the early career physician in general. The communication topic was great. And we had a lot of really interesting speakers from all different disciplines, but it got kind of stale just because everybody is saying the same thing. Everybody's part of the team. Everybody has a voice. And I agree with all that. It was a great first season, but then as my interests have changed and I realized that my demographic has certain other challenges I moved into just talking about everything and anything that could be related to the early career physician.

John: Okay. That's good. The thing we're talking about today, if people are interested, they should just go to Talk2MeDoc podcast and listen in on those. And mostly it's interviews. Is that right?

Dr. Andrew Tisser: Yeah. A couple of solo shows, but the vast majority are interviews.

John: Okay. And then you've got a website that probably links to that as well as other things that you do at andrewtisserdo.com. Correct?

Dr. Andrew Tisser: You got it. Everything's there.

John: All right. I will definitely put links to those two for sure. And if the listeners want to learn a little bit more about either what you do or get a little more advice from you, just an entry-level, I think you have some kind of video series. Tell us about that.

Dr. Andrew Tisser: Yeah, thanks. I have a four-part video series on my website. It's andrewtisserdo.com/video or there are links all over the site you'll find it, which really describes my pathway through burnout, where I am today, starting from medical school. Each video is about six, seven minutes long. It's just talking about what I went through and then I give a career strategy tip embedded into each video, and it's totally free.

John: Okay, awesome. I will put a link to that directly too, in case someone just wants to take a look at that. Well, before I let you go, any last advice for physicians who are feeling just frustrated and burnt out right now that might sum up a little bit of what we talked about today?

Dr. Andrew Tisser: Yeah, thanks. Just realizing you have options. The options are unlimited for what you want to do, what you want your career to look like. You just have to figure out what it is you want, and then you can go get it. The first step is figuring out who you are. The second step is what you want and the third is going and getting it. So, don't remain in your position, go change your life.

John: Excellent. Words of wisdom. I love it. And I liked the three steps. That's a little in a nutshell how to do the process. Of course, each step might take a little while, but it's a good summary.

All right, Andrew. I'm so happy we had a chance to talk today on my podcast for a change. This has been great and I hope to maybe see you again in the future.

Dr. Andrew Tisser: Yeah, John, thanks again so much. I'm honored.

John: All right. Best of luck. And I'll see you down the road.

Dr. Andrew Tisser: Bye-bye.

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The post Three Top Tips from a Physician Career Strategist – 220 appeared first on NonClinical Physicians.

Today I will present factors affecting your decision to become a Certified Physician Executive.

Our Sponsor

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

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

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

What Is the Business School Mindset?

Dr. Patty Fahy states that the BSM reflects these beliefs:

• “…graduates are assured that an MBA degree has prepared them to manage in any industry: a tattoo parlor, a government entity, or a hospital system (emphasis mine – JJ).
• “Managers are an elite caste, separate from those who are managed, monitored, and controlled.
• “Efficiencies gained by controlling the behavior of professionals and other workers garner financial rewards…
• “The principle that… an action is rational only if it maximizes self-interest…”

Not all hospitals are managed in this way, all of the time. But, when I was Chief Medical Officer, there were definitely times when I could feel the BSM “vibe” coming through… even though I worked at a non-profit hospital.

This leads me to believe that Business School Mindset leads to a different kind of BSM… Bulls**t Medicine. – Dr. John Jurica

To counter this, I implore my colleagues to pursue a career in hospital management. Such a career is intellectually stimulating, pays well, and is the only way we’re going to steer this industry in a new direction.

Getting Ready to Become a Certified Physician Executive

One way to accelerate your career progress as a leader is to become a Certified Physician Executive.

The Certifying Commission in Medical Management grants the Certified Physician Executive designation. It demonstrates to employers that the holder of the certification has the knowledge, skills, and core competencies to be an effective manager and leader.

Listeners have asked me to compare earning the CPE to obtaining an MBA. However, one should not compare the two, because the CPE can only be obtained after completing the MBA or equivalent business and management training.

Summary

There is evidence that employers use the CPE as a factor when considering job candidates. And there are several ways to meet the requirements for the CPE. But they all include getting the basic business and management education, plus real-world healthcare management experience. Physicians should consider several factors when deciding how to best acquire the CPE designation if they choose to pursue it.

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

Links for Today's Episode:

• 3 Reasons to Pursue the CPE Qualification – 033
• The Ultimate Resource to Spark Your Transformation to Physician Leader with Dian Ginsberg – 024
• Certifying Commission in Medical Management
• Canadian Certified Physician Executive Website

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 219

Are You Ready to Become a Certified Physician Executive?

John: Today, I thought I would discuss another topic related to the pursuit of a job in hospital management. I mentioned this topic in a recent daily email and episode #33 of the podcast back in 2018.

Let me paraphrase what I wrote in the recent email related to this topic. It's really related to physicians working in the hospital environment, both as a clinician and then possibly as a leader. This is what I wrote about. I had read an article on Kevin MD by Patty Fahy MD. So, Dr. Patty Fahy. In it, she said that she was talking about BSM. It's an acronym for Business School Mindset. She thought I had a big impact on physicians and how they're working and the environment that they're in, which oftentimes is not very favorable.

The author, Dr. Fahy gives examples of the BSM mindset. Here are quotes from her article.

"Graduates are assured that an MBA degree has prepared them to manage any industry, a tattoo parlor, a government entity, or a hospital system. Managers are an elite cast, separate from those who are managed, monitored, and controlled. Efficiencies gained by controlling the behavior of professionals and other workers garner financial rewards. And the principle that an action is rational only if it maximizes self-interest".

Those are the characteristics that Dr. Fahy says represent BSM or the Business School Mindset. I don't know if all hospitals are managed in this way all of the time, but when I was chief medical officer, there were definitely times when I could feel the BSM vibe so to speak coming through, even though I worked at a nonprofit hospital.

This leads me to believe that the business school mindset leads to a different kind of BSM, what I call BS medicine. The approach that doesn't recognize a physician-patient relationship, or that puts quality safety and dignity behind the bottom lines. That's the BSM that I'm talking about. And I think we're caught in that. We're caught sometimes in that business school mentality and it leads to really miserable working conditions.

And so, the question is what are we to do? And I see three logical answers to that question.

The first is to keep working in the medical-industrial complex until we can't take it anymore and then retire. I think I've had a lot of colleagues that have done that. They've toughed it out and then just retired as soon as they could.

Number 2 is to leave for a nontraditional career, which of course, that's something that I talk about all the time.

And number 3, is to work your way into hospital management as either CMO, COO, or CEO and fix the system from within. And you probably already know that I'm partial to option number 3 because I believe we need a whole lot more physicians leading health care if we want to reduce both forms of BSM in our healthcare system.

Please consider a career in hospital management because it's intellectually stimulating, it pays very well and is the only way we're going to steer this industry in a new direction.

And by the way, as far as the income goes, I just went to salary.com today. And the median salary for a CMO is $418,000 with a range of $319,000 to $549,000. When I say it's lucrative, I'm really serious. It pays well over any primary care practice. And even for specialties, it's a much better lifestyle and you still make a good income.

One of the things that I'm convinced of is that if you want to consider a hospital management career, it's important for you to understand what the CPE is. That's what I want to talk about today. We all know what an MBA is. An MBA is a business degree. And then there is the MMM and MHA and other types of business degrees.

But the CPE comes up from time to time because it represents something that employers are sometimes looking for in the hospital setting. CPE stands for Certified Physician Executive.

As I was going through some CMO job descriptions before preparing for today's presentation, I looked specifically to see if the CPE was listed. And I found two hospitals in North Dakota and one hospital in Pennsylvania, just in a short review of the job ads that I saw. And they listed the CPE as a preferred designation. And the reason is that it represents something that puts the holder in a position perhaps a little bit better than simply having completed a business degree.

But the thing is, it takes more time and it takes some money to achieve. And so, I want to talk about this. And part of this came from a question that I received from a reader or listener back a few months ago, specifically asking whether I thought it was important to proceed with getting the CPE.

I want to try and answer that again. I addressed this, like I said, back in 2018, but let me bring things up to date today and really take a moment to walk through this for those of you that might be interested. This is how I look at the CPE as compared to an MBA. And it's not a fair comparison, I'll explain why in a minute. And these are my thoughts. These are my opinions as a holder of the certification and a former CMO and a member of the American Association for Physician Leadership, which is the AAPL, which originally created the certifying commission in medical management to create and to provide the designation of CPE.

Keep in mind, I am not speaking for the AAPL, although I've been a member of the AAPL for more than 25 years. And I have actually been involved in several of the committees that are involved with evaluating those that are sitting for the CPE, so to speak, by participating in the capstone.

Let's back up and talk about some definitions, and then we'll get into some more detail on this.

What is the CPE? The Certified Physician Executive designation. It's granted by the certifying commission and medical management. And it's designed to show that the holder of the certification has the knowledge, skills, and core competencies to be an effective manager and leader.

And to me the CPE is valuable because it demonstrates that not only does a holder have that MBA training. Now, remember MBA is a degree. It's kind of book learning, but the CPE has the MBA or the equivalent degree or the equivalent training and demonstrates experience in management and or administration.

And also, has sat through what they call a capstone, which is an opportunity for these applicants for the CPE to demonstrate that they can apply all of these principles in real-life situations, rather than simply take some curriculum and pass a few exams.

Let me get into a little more detail on it. An MBA is granted like any other degree. You complete a certain core curriculum plus some electives, and it ensures a certain level of knowledge. It's usually finances, marketing. In the programs that address physician executive MBA, they do focus on things like healthcare finances and the situation that we find ourselves in, the business principles in healthcare itself. Some programs do have a mandatory project that gets completed during the term of the schooling. So that gives them a little bit of real-life application of what they're learning.

But again, I'm going to mention why the CPE is distinguished from that. Because the CPE requires not only the knowledge base, which you can get from an MBA and MMM, and MHA or a similar degree, but it also requires that you have at least a year of clear management and leadership experience that does not include running a small private practice. And it has to be in a setting where you're really in a matrix with lots of other people. You're interacting. You're applying your communication skills, your marketing skills, your finance skills in a real-life situation. And so, it's more than just the book learning.

And in fact, you have to get a letter acknowledging and attesting that you have demonstrated these skills that are being sought for the CPE during those activities. If you've served as a medical director for a year or two or three, or you've been a CMO already, or you've done other things, let's say chair of a big committee at an academic institution and you've had exposure to management, to finances, to HR issues, to legal issues, then you can qualify for the CPE.

And on top of that, then you also need to spend four days doing what's called the capstone where you're getting a little bit more education about some of these topics, just to pull it all together. And you're actually being assessed for your ability to communicate and to lead teams and other skills of that nature.

To compare the CPE to the MBA is not really valid. The MBA or its equivalent is required to be even qualified to request certification for the CPE. That's why it's different. It does give you a little edge. If you have the CPE, it indicates that these skills are demonstrated, and it gives you a little edge. As I said, there were at least three hospitals just to my 10-minute review earlier today that said that the CPE would be recommended or preferred.

If you're competing with two or three or four people, and they all have the equivalent of an MBA or an MMM or something like that, and you have the CPE designation, which really attests pretty well to the fact that you've got the skills and experience to apply those skills, then you're going to have a bit of an edge over those others. That is I think primarily where it comes in handy.

The other thing to keep in mind, though, when we talk about this is that you can meet the requirements without having one of those degrees. In a way, if you were going to get the MBA or the MMM, or MHA, anyway, my case was actually an MPH. I got some credit for that. Well, then that's fine. And you can use that as the basis for proceeding onto the CPE if you're in some kind of leadership or management position.

But sometimes you can meet the same requirement by taking the equivalent courses through the AAPL. The AAPL is known for providing education and training and management and leadership for physicians since it was called the American College of Physician Executives.

They have a lot of ultra-high-quality courses that many physicians have taken. You can use this alternative pathway. Many hospitals and health systems provide leadership training through the AAPL, or physicians themselves will seek the training on an as-needed basis through the AAPL. And so, they do these courses and over time, there is a core curriculum through the AAPL, that if you accomplish that, then you've basically shown that you have the equivalent book learning that would be obtained through the MBA or other similar degree.

You can think of different scenarios here. If you've already taken, let's say one half to two-thirds of the CPE coursework through the AAPL, it may definitely be quicker and less costly to simply complete the curriculum through the AAPL than to enter an MBA program and spend $50,000 - $70,000.

I'm not saying that the AAPL courses are cheap, but even if he had to do another 5 or 6, 7, 8 courses, it's going to be much quicker and less expensive than matriculating in a business degree program.

The other thing to keep in mind is that sometimes the AAPL, or actually the certifying commission on medical management, which grants the CPE will accept courses done for a business degree that maybe you didn't complete. That's the other way that that can be effective.

You want to be efficient. You want to use and get the information you need. But there is no reason if you've already taken a course in healthcare finance to take another course in healthcare finance as part of your MBA or vice versa. You should be able to get credit for that in whichever direction you go.

It can be complicated. If you find yourself in a situation where you have some of the AAPL courses and you're contemplating going to a degree program, then you would check with the degree program, see if any of those courses would apply to the degree, and then you might get a reduction in your tuition, and it would speed things up.

And vice versa, if you've done let's say six months on a business degree, and now you've already got some other AAPL courses and you want to apply for the CPE, you can find out if those courses from the other business degree would apply to that.

There are certain business degrees that are aligned with the AAPL. For example, the master of medical management is a specific program geared for physicians only. And there was a lot of overlap in the content of the MMM and the courses through the AAPL.

So, you would want to really ask both sides of that if it would apply. In other words, you would check with the AAPL. They have a career or education department that will tell you if you've done some of the work for the MMM that would apply for the CPE if let's say you decided to finish it up with the AAPL courses.

Now, if I was just getting started, I would investigate my options. I would look at the cost, the location, the time commitment, and I would just figure out which one is the most efficient way to go. If you haven't been exposed to any of those, then you can make a valid decision.

On the website at the AAPL, which I'll put a link to in the show notes, for those that are listening to this on the podcast, you can go there and it will give you pretty clear which direction to go in. And it explains which of the business degree programs have courses that would cross over, or which ones would accept the AAPL courses.

Again, to find out for sure, it'd be best to check with staff at the AAPL. I think if I were starting out, this is like the master plan you might have in your mind if you were going to do this. I would look around, find a good low-cost convenient option to get your business degree. I would probably go to something like the University of Illinois, or even a smaller public university.

There's one nearby that's called Governor State University. And I know many people that have gotten their MBA through that. It's a four-year college. It's not a big-name college, but you get the MBA. And then if you want to go ahead and move on to the other requirements for the CPE. And then while you're doing that, you should acquire some clear management experience either by finding a paid medical director position, being on one or two really important, big committees where you're involved in big projects, let's say in a hospital.

And that way, when the degree is done, or the coursework is done, then you'll have the management experience. And then you can apply for the capstone and things will move forward very smoothly. If you get the MBA, but you really don't get any management experience in the meantime, you can't apply for the CPE.

Before I go, I do want to mention, I found this just recently. I didn't know this existed, but there's something called the Canadian Certified Physician Executive - CCPE. I don't know that it's exactly equivalent to the CPE that we're talking about today, but I know it does exist and you can look that up online. I will put a link in the show notes, again, for those who are listening to the podcast.

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

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

The post Are You Ready to Become a Certified Physician Executive? – 219 appeared first on NonClinical Physicians.

Today I will describe my experiences with the assignments of a hospital CMO. These are based on my 14 years as a senior hospital executive. There was a lot to like about that job, with lots of fond memories. More than I can cover in one podcast episode.

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6 Assignments of a Hospital CMO

In this episode, I will describe in detail my experiences with typical assignments of a hospital CMO, including:

1) Leading the CME program, supporting the residency program start-up, and working with Lisa Zipsie, Director of Physicians Services.

2) Selecting and implementing the first Quality Management Tool, achieving Top 100 Hospital Status, and working with Mary Schore,  Director of Quality Improvement.

3) Implementing the hospital’s first Lean Process Improvement Initiative and working with Stephanie Mitchell, Director of the Lean Process Improvement and Laboratory Services.

Each CMO in any given organization will fit into the org structure in a unique way. – Dr. John Jurica

4) Overseeing the implementation of physician order entry, the medication safety program, and working with Jim Shafer, Pharmacy Director.

5) Establishing the first hospitalist service.

6) Recruiting physicians, purchasing local physician practices, and expanding the medical group to become the dominant multispecialty group in the county.

Summary

That’s a glimpse into the life of the CMO, and a sample of my assignments while in that role. It was exciting, challenging, and impactful. The CMO in each organization will fit into the org structure in a unique way, with different direct reports and areas of responsibility.

In the hospital setting, they will usually have QI and Patient Safety, Physician Services, and CME (if there is a CME program). But beyond that, it can vary considerably.

In a future episode, I will share more about the day-to-day work of the CMO, and what it is like working with a senior executive team at a not-for-profit hospital.

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

Links for Today's Episode:

• 10 Reasons Why You Should Pursue a Hospital Management Career – 20
• How to Become CMO in a Year – 052
• 5 Steps I Took to Be a Hospital Executive – 175
• How to Pursue a Nonclinical Career in Hospital Management – 080

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 218

6 Important Assignments of a Hospital CMO

All right, Nonclinical Nation, today I thought I would discuss my work as chief medical officer. I spent 14 years as a senior VP at my hospital, and there was a lot that I liked about that job. Actually, much more than I can cover in one podcast episode. I already spoke to you way back in episode number 20, about the positive aspects of hospital management that I think you should consider if you're looking for a nonclinical career.

But today I'm going to focus on something a little different. I'm going to talk about the specific projects I worked on and the directors I worked with while I was chief medical officer. And I think this will give you a better idea of what a CMO does and how enjoyable the work can actually be. And I'm hoping it will inspire you to consider a hospital management career.

Even for those not considering such a career, you should listen anyway, because what I'll be describing applies to a senior leadership position in almost any industry, certainly many healthcare industries such as pharma companies, medical device companies or the insurance industry, but even in your own business in other non-healthcare related fields.

I think I'm going to come back again on a future episode where I'll focus on the other aspects of the job, such as what it's like to work as a member of a senior executive team. The so-called C-suite. That will be interesting as well.

For today, I'm going to just focus on six assignments that I had over my career as a hospital chief medical officer. And really in some ways, it's just scratching the surface. Although the areas that I'm going to be talking about today are definitely areas that I was involved with for almost my entire career, while I was CMO with a couple of them coming in later in the final 5 to 10 years.

Now, for two of the six, there is definitely no distinct director to mention for reasons I'll explain when I get to those assignments, but the other four definitely include working with the director for the whole term of my employment there and sort of how we work together on these major projects that I'm going to highlight during the rest of today's discussion.

Let me just give you the list of the six assignments right now, and then I'll go into them in more detail individually. Number one is leading the CME program and supporting the residency programs startup and other things related to physician services, which was led by the director of physician services, Lisa Zipsie.

The second is selecting and implementing the first quality management software program and achieving top 100 hospitals status while working with Mary Shore, the quality improvement director.

The third is implementing the hospital's first lean process improvement initiative and working with Stephanie Mitchell to help the lab expand and improve its services. She was the director of the laboratory services department, and she recently retired.

Number four is overseeing the implementation of physician order entry and medication safety programs at the hospital while working with the pharmacy director, whose name is Jim Schafer.

Number five was establishing the first hospitalist service. Now there wasn't a particular director that handled that with me. I was the lead on that, and I had to work with various departments at the hospital to get that project up and going. And so, I'll describe that.

And the number six is something that I took on during the last four or five years of my tenure, which was the multi-specialty group. I spent a lot of time in those years recruiting physicians, purchasing local physician practices, doing all the negotiation, all the contracting, and working with the attorneys. And again, there was no individual director that helped lead that, but I had to work with a number of directors over the areas that impacted or were impacted by the growing group, including the facilities department, which had to find space for us.

You may have already noticed that all of these activities involve big projects that have a direct impact on the safety and quality of patient care and the financial success of the hospital.

In all of the projects, I will describe where major initiatives straight out over our annual strategic planning and management goal-setting process. We did that every year. We began by developing a set of goals for all 80 plus directors and VPs running the hospital. And some of them span more than one year if they are especially costly. But that's what drove us to do what we did.

Also from a process standpoint, the way that these goals were met, generally involved me and other VPs sitting on committees and teams addressing the initiatives, meeting with our directors regularly and keeping forward progress. We'd receive updates on their progress, provide them with feedback, lend them support by shifting resources from one area to another one that was needed.

My other role, doing all of this, also involved helping each director who reported to me to prepare a yearly operational budget that we would present and defend to the CFO and COO.

There was also a capital budget with requests for major and minor equipment. And this could include everything from a multimillion-dollar information system, let's say for the pharmacy to new carpeting for the medical staff lounge. And every year everybody had their requests. And of course, there was a cap on the capital that would be spent. So, we had to demonstrate why ours was worth funding.

Now, the other side of that coin is that I was then responsible for reporting back to the CEO and to the senior management team in our weekly meetings on the progress being made on the management goals that we had all agreed upon at the beginning of each year. Let me get into some of the specifics and I'll start with number one, leading the CME programs, supporting the residency program startup, and working with the director of physician services.

This is normally a core responsibility, the CMO, because we interact so directly with the medical staff through its governance, through facilitating and supporting the medical staff structure. But we had a CME program. I was the chair of the CME committee, even before I became employed by the hospital. I continued in that role.

And so, if you have a CME program, then you're probably going to have it fall in this area and maybe standalone. But oftentimes, it's under the medical staff department.

We were responsible in the committee and under this director for maintaining our accreditation as a CME provider. And of course, all the credentialing and staff appointments were done by this department.

Now, late in my tenure, it was decided by the senior team and particularly the CEO was interested in doing this, was to help us with our recruitment of physicians, which seem to be getting more difficult every year by adding an internal medicine residency and fellowships in GI and cardiology. Those were added in part to help drive people to come to the IM residency because then they would have a slight advantage at getting into one of the fellowships, which were definitely very popular.

Now we were not an academic institution. We had affiliations with some institutions, one of which Rush University Medical Center, and particular of course is an academic medical center. But we chose to align with an osteopathic medical school. We were able to get our internal medicine residency and fellowships going through them. And of course, now all of those are going to be blended into one entity under the ACGME. That was fun. That was great. That was part of my core responsibilities for many years.

The second big project and an area that I had responsibility for was quality improvement. And it was one of the things that I really wanted to be sure was happening when I joined back at the beginning of my tenure there, was to be sure that we had a tool to measure risk-adjusted complication rates, mortality rates, quality measures that we could then share with the medical staff and monitor our progress and making improvements in quality and to some extent patient safety.

That was one of my first projects. I had a chance to look at what was available then, and we purchased a tool that was very effective and gave us some really good results that we could share with the medical staff individually and as groups or departments.

By using tools and creating protocols and teams to address any quality issues that we identified, we were able over a period of time, along with help from the CDI department and utilization management become a top 100 hospital. Because to do that, you must have really good measures in your quality metrics, you also have to have a good financial standing and good length of stay. All of that also depends on excellent coding and documentation.

So, just like in management, you manage what you measure, also in QI and patient safety, you manage what you measure. When other tools came out later, we actually adopted some of those as well because they were a little easier to use. And then we started working with other organizations to combine our data so that we'd have a larger pool to compare outcomes to.

Over a period of time that led us to achieve top 100 hospital status. I think it was originally through Solution and then Truven, and now I think it's under a new moniker, but we had five or six years in which we achieved that. And that was very rewarding. Again, that was through the help of the QA director, Mary Shore, and others in her department.

The third big area is the laboratory. I worked with Stephanie Mitchell, the director of laboratory and lean process improvement. That was the most exciting project that we did. Now I had a laboratory the entire time I was there. It was obviously very important that we had a lab that was efficient, that was accurate, that had good turnaround times. And so, that was the first lean project we ever took on at the hospital. It was one that was really typically geared for laboratories. There is always a very good one that could benefit from streamlining and changing from a batch process to a sort of continuous flow process.

And so, we learned how to do lean performance improvements. We implemented that. We got our routine lab results to a point where they were being returned within 30 to 40 minutes, no matter what time of day or night that they were ordered. And it was awesome. It also helped a lot, obviously with the quality improvement projects that I mentioned earlier. So again, a very rewarding project.

We moved on to other departments, including the pharmacy to do some lean projects. And so, that's the next one, number four, that I want to mention. I did have the pleasure of having Jim Schaefer, the pharmacy director, report directly to me for my entire term at the hospital. We work mostly on improving medication safety.

Although we also had to be certain that we kept our formulary up, that we had access to the drugs that our physicians needed and that we can keep the costs down.

In other words, you can't necessarily stock 10 different versions of the same medication. You usually have to pick one or two. And it does lead to some problems when patients are being admitted and discharged, because they may be on a medication, a different version of the medication that you've gotten your formulary in, and you have to make those substitutions, which can be difficult.

But the best projects that we did we're eliminating essentially many forms of medication errors resulting from physician handwriting by basically implementing a mandatory physician order entry, which meant that everything had to be built. And once it was built and implemented, physicians go order their labs and their meds. And the issue of someone having to read the handwriting was almost completely eliminated. There were some instances where people might send in written orders that had to be transcribed, but we pretty much eliminated that.

I think it's great when the CMO and the director of the pharmacy worked together because the pharmacy and the others I've mentioned so far, really have a lot of clinical implications without having to stretch the imagination. They have direct clinical implications and of course, medication safety also improves the quality, which also helped reach that top 100 status.

Now, the fifth project I want to talk about is the establishment of the first hospitalist service. And this is not something that the hospital medical staff came to us and requested. In fact, it was one of those things that they probably didn't really want to see. They really weren't ready for it, but we had so much data showing that the performance at other hospitals was improving so much. And that particular delays in care could be avoided if we had an on-staff in-house hospitalist service that we decided to implement.

I had to communicate that to the medical staff, of course. I think I sent a recent email out about that process. And we had to figure out how to staff it and how to bridge that gap from going from none to what we felt we needed at the beginning was at least six plus somebody to cover vacations. So, we struggled with the idea of whether to hire our own. The problem there is if you hire someone, but you don't have a hospitalist service to put them into at the moment, then how do you pay them for not working? How do you keep them waiting while you're trying to get the rest of your team together? So, we decided after looking at the options to contract with an established group, which was nationally doing what we needed and had a very strong recruitment arm, and then we designed the way it would be modeled.

And I did most of the work on the contract with the group, again, working with the attorneys and the CFO. And ultimately, we were able to get that off the ground. It's been very successful. It has morphed over the years to different groups and different staff.

The other thing is the planning meetings that we were using to develop the program, morphed into management meetings with the medical director and others involved and seeing to it that the hospitalist service was efficient. It was prompt and had good outcomes.

Finally, something I got involved with for the last four or five years of my tenure, which you would think maybe I would have been involved with earlier, was the medical group. The thing was we had a small group. They were very independent. And so, they weren't really treated as a group. They were more or less treated as individual small practices in some of the outlying towns. Maybe one or two actually near the hospital itself.

But once we made a strategic decision to expand the group and add other specialties that were lacking in the community, then we really tried to find some super-qualified directors to run that process. However, we went through two or three, and at some point, the CEO thought, "Well, I'm going to have John take it over. We'll continue to try and get a director to work under John. But in the meantime, we can get things moving". And so I went on a binge, so to speak of hiring new physicians and of purchasing current practices, usually, they were one-, two-, or three-person practices, did a lot of contracting, a lot of employment agreements and renegotiating of contracts. I learned a lot.

And over time we added a lot of new staff, new physicians, many specialists that were not previously on the staff. And we also expanded the group geographically to a much larger area where we could help patients.

Well, I think I'll call it quits at that point. I think I've given you somewhat of a glimpse into the life of the CMO. It's kind of hard to separate the day to day from the project-oriented activities. Although I think in a future episode of the podcast, I'm going to talk about the day to day and how I interact with directors on the one end and on the other side, how I reported up to the CEO and the kinds of reports and discussions that we had as well as the regular meetings of the senior executive team, which usually were at least once a week and how we did some strategic planning and also did operational activities in that process. But that'll be for another episode.

I think it's important to acknowledge and remember that each CMO in any given organization will fit into the organization structure in a unique way with different direct reports and different areas of responsibility.

While what I've discussed today applies to many chief medical officers, if you're in hospital management and you get to that point where your CMO or chief integration officer or chief safety officer or anything like that, you're going to have different direct reports and different responsibilities.

But for most of my tenure, everything rolled up into what we called the medical affairs division. And sometimes I had to go to the nursing home. Sometimes they had home health. Sometimes I had the radiology department. The ones I talked about today are most of the core that I had ongoing. But I had to back off a little bit, particularly when I became very involved with the multi-specialty group.

In a hospital setting, usually you're going to have QA and patient safety, physician services, and CME, if you have a CME program, but beyond that, it can vary considerably.

All right. Thanks for listening today and I hope you've enjoyed it. If you have any questions as usual, just reach out to me at john.jurica.md@gmail.com.

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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 6 Important Assignments of a Hospital CMO – 218 appeared first on NonClinical Physicians.

This is a solo bonus episode about pursuing a career in hospital management. It's a summary of the presentation that I'm giving at the first Physicians Helping Physicians Nonclinical Career Conference. The conference is being held in Austin, Texas in April 2019.

Important Questions

During the discussion, I answer the following questions:

• What are the most common senior hospital management positions for physicians?
• Why is a career in hospital management so attractive?
• How can we discover the salaries that nonprofit hospital executives are being paid?
• What are the five domains in which physicians typically need training and experience?
• How can physicians acquire those experiences?
• What specialties most easily lend themselves to moving into hospital leadership?
• How do we find openings in the field?
• How do we prepare ourselves for the interview process?

By applying the ideas presented in this episode, you can begin your journey to a lucrative and fulfilling career in hospital management.

Here is an edited transcript of my comments…

Common Hospital Executive Positions

When I talk about working in hospital management, I'm referring to senior executive positions in the so-called C-suite. Jobs starting from the top level include:

• CEO – Chief Executive Officer
• COO – Chief Operating Officer
• CMO – Chief Medical Officer
• CMIO – Chief Medical Information Officer
• CQO – Chief Quality Officer
• CCO – Chief Clinical Officer
• CPSO – Chief Patient Safety Officer
• CPHO – Chief Population Health Officer

As a physician, you're on equal footing with executives managing multiple departments, the hospital, and health system. Being an executive is not an entry-level job, but an ultimate goal.

Why Is a Career in Hospital Management Attractive?

Why would you want to go into hospital management? Here are four main reasons:

Displays Leadership Skills

I believe that physicians are natural leaders. The training that we go through helps  us overcome challenges and puts us in a position to be excellent leaders. Applyng our leaderships skills is fulfilling and meaningful.

Compensation

According to the Medical Group Management Association (MGMA) and other resources, physician executive salaries and total compensation is usually about $300,000-400,000 annually. You can definitely make more as a senior vice president/CMO than you would  clinically in primary care. There are only a few nonclincial jobs where you may make more, such as an expert witness or entrepreneur.

Intellectual Challenge

It is stimulating, keeps you on your toes and lets you develop new skills. Physicians are lifelong learners. Once you've spent your life learning and settling into a clinical career, it can become  boring and tedious. And so, doing something like this can definitely be interesting and stimulating.

Opportunity to Help More Patients

Executives have advanced knowledge and experience regarding quality improvement and patient safety. They’re able to identify and fix errors and implement lean processes. Their efforts save hundreds of lives, if not more. Their work helps lower mortality, injury, and accident rates in operating and emergency rooms.

Use GuideStar to Determine Possible Salaries

There are surveys of hospital executive salaries you can review.. But I like to visit GuideStar.org, which publishes information about non-profit hospitals, health systems, and other organizations. Included are 990 Form, which hospitals are required to submit every year to the Internal Revenue Service (IRS). They report financial information, including salaries for its executives and other employees.

GuideStar charges a fee to view the more current forms submitted, but not to access forms from past years. However, a CMO or CEO's salary in 2016 is not be much different than it would be today.

Independent Hospital

For example, a 990 Form for a large hospital with more than 600 beds in Illinois reported the following top annual salaries in 2016 for some of its leaders.

• Executive VP/CMO: $900,000
• Chief Quality Officer: $400,000

Multihospital System

In comparison, a large system that employs hundreds, possibly thousands, of physicians and runs a multi-hospital system, reported the following salaries in 2016:

• Executive VP/Chief Medical Officer $1.948 million with a $310,000 bonus
• Chief Nursing Officer: $900,000
• President of Physician and Ambulatory Services and Affiliated Medical Group: $1.3 million

Some of those salaries may seem extreme, so don’t expect to make that much in most situations. But it demonstrates the opportunity that exists in some fo these positions.

If your goal is to get a job with ever increasing responsibilities, intellectual challenges, and potential compensation, then you're not going find a much better opportunity than working in a hospital or health system.

Best Positioned Specialties

Which specialties are best for moving into a hospital management career? It's difficult if you're an outpatient-only dermatologist or pediatrician who hasn’t set foot in a hospital for 10 or 15 years. That probably won’t work. CMOs mostly come from the ranks fo hospital-based physicians.

When I started as a family physician, I spent a lot of time in the hospital doing obstetrics (OB). I took care of newborn patients. At that time, I also did medicine and some pediatrics.

These days hospitalists, general and cardiac surgeons, anesthesiologists, pathologists and emergency medicine physicians would be well positioned to move into management positions in the hospital setting.

Physicians in major surgical specialties sometimes find it difficult to strike a balance for a potential salary. For example, if you’re a neurosurgeon and make $800,000 a year, you may have to take a pay cut initially.

If you're doing internal medicine, gastroenterology, or cardiology and don’t generate lots of relative value units (RVUs) or very busy, then you’ll be fine. Your salary may start lower, but will catch up quickly.

New Skills

How many management and leadership skills do you have as a physician ready to pursue such a career? I estimate about 70 to 75%. What employer would not want to hire someone who's accountable, responsible, and takes their job seriously? That's how physicians are trained. They can focus, learn quickly, and are very intelligent.

To make it into college, medical school, and residency, you've overcome many challenges. Also, you know a lot of disciplines, especially because of your science and math background. You know medications, anatomy, physiology, and health care. So, you're partially prepared for these jobs.

How Do I Gain Experience?

There are skills and things that physicians need to learn more about along the way.

Talent Management

Most of it, you can learn as you go. You interact with other people in the hospital setting. As a physician, clinician, or executive , you have to learn how to work with direct reports, keep people accountable, meet with them, run meetings, and report to your supervisor, whether that's the COO or CMO. It takes  practice. You don't just show up to your meetings and wing it.

Financial Management

This is another area where most physicians don’t have a lot of experience. Getting an MBA may help, but it doesn't help as much as  looking at profit and loss statements (P&Ls) and balance sheets. Physicians are not usually expected to be that knowledgeable, until after they accept the position.

Management Skills

There are basic business practices that are different from leadership skills. Things like running a meeting, project planning, project management, lean processes, and SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis.

Data Management

Understanding quality improvement reports. Learn how to view, analyze, and share quality improvement and patient safety information to create action plans that address deficits or opportunities. Other types of data to review and understand include growth, including volumes in different service lines, flow, throughput, turnaround times, root cause analyses, and never/ sentinel events.

Leadership Skills

Understand that certain skills that leaders learn and apply are different from management skills. A leader must do strategic planning, and know how to develop the mission, vision, and values for an organization, and interact with board members and community leaders.

Those are the five areas that physicians should brush up on through additional training.

Getting Started

How do you get started? The easiest way is to get a part-time job in the hospital setting that allows you to learn some of these skills, while providing value to the organization. Such positions could be in utilization or case management, clinical documentation improvement, informatics, and medical directorships over specific units.

Once you're hired, apply existing skills and learn new ones. Don’t just coast into the job and do the minimum work needed. Try to learn as you go and always expand your influence and management activities.

Other areas where physicians can gain experience include medical staff officer jobs. It's unpaid, but if you work as a chairman of a department, president of the medical staff, or chair of the quality improvement committee, you'll learn  leadership and communication skills.

5 Universal Strategies

In a previous solo episode, I mentioned five universal strategies:

1. Find a mentor
2. Build your network
3. Join physician organizations, including American Association for Physician Leadership (AAPL) and American College of Healthcare Executives (ACHE)
4. Use LinkedIn
5. Create a resume

These strategies will definitely be applied in this situation.

Will I Need an MBA?

Should physicians pursue a business degree such as an MBA, a Master's in Medical Management (MMM), or a Master's of Healthcare Administration (MHA)? There's also the MPH (Master's in Public Health) , which is not strictly a business degree. Some organizations offer a Master of Science in Management.

I don't think you need the management degree. If you have the management degree, I think it's more helpful on paper to demonstrate a commitment to leading and managing. I know many physicians with an MBA who have never applied it. To the extent that you can apply what you learned, it is helpful. An MBA teaches you how to read a P&L and balance sheet, and to understand a budget.

Also, AAPL’s Certified Physician Executive (CPE) designation adds a bit more credence than an MBA or MHA, in terms of experience. The CPE requires an advanced degree or extensive number of hours in leadership and financial management, plus a demonstration of experience.

Even if you have an MBA, but never chaired a committee or worked in an environment where you had exposure to talent and data management, then you’re not eligible for the CPE designation. Recruiters often include CPE as a “like to have,” although not necessarily a “must have.”

How Do I Find Jobs?

The best way to find and get your dream job is through networking. LinkedIn is a good place to network, find a mentor, post your resume, and work with recruiters. There are several large physician executive recruiting firms, such as Cejka, and B.E. Smith. Most of the top 25 executive search firms recruit physicians.

Also, LinkedIn  and AAPL have their own job boards. Check out Indeed and other online job boards.

Preparing for Interviews

Take courses offered by AAPL. Or, start on an MBA, but you don't have to complete it before beginning your job search. Ask if an employer is willing to pay for the majority of your education, such as for an MBA or MHA, or CPE coursework. Start or enroll in courses for an MBA now because many programs take two years to complete. An exception is the University of Tennessee Physician Executive MBA only requires one year.

Even after you enroll, or before you start classes, start looking for your dream job because those efforts indicate to potential employers that you're serious about what you're doing.

The other part of preparation is being intentional  by including specific keywords and appropriately designing your resume. Before you submit your resume and a cover letter, research the companies that you're applying with, so you can customize it for each potential employer.

Then, customize your cover letter. Find a specific person to send it to, instead of uploading it to a generic spot on a web site.

Rehearse for Interviews

If you’re fortunate enough to get an interview after applying, rehearse for it. Practice with another person, who should ask you questions that will most likely be posed to you during your interview with the company.

To some extent, you can't be prepared 100%, but you become better the more you practice. You're not going to get every job that you apply for, and when you move from clinical to non-clinical, there is more competition. Other physicians are wanting these jobs. Employers always interview several candidates. They're going to be very picky about who they hire.

Be Persistent

So, if you’re not offered the job, don't consider that a failure. Each interview is a learning process. Believe me, if you do three, four, five, six interviews, by the time you do that fifth or sixth one, you're really coming across clearly. You've got your message well rehearsed, but you want to make it all sound very spontaneous.

In a nutshell, that’s my overview of the approach to becoming a hospital executive, or to work in hospital management. It's very challenging and rewarding, plus it pays well. I hope that you take what I've said to heart and start working toward it, if you have any interest at all. It's a great career to pursue, if you're ambitious. After all, more physician leaders like you are needed in health care.

Our Sponsor

This podcast is made possible by the University of Tennessee Physician Executive MBA Program offered by the Haslam College of Business.

The UT PEMBA is the longest running, and most highly respected physician-only MBA in the country, with over 650 graduates. It only takes a year to complete.

University of Tennessee PEMBA students bring exceptional value to their organizations. The curriculum includes a number of major assignments and a company project.

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.

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.

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The post How to Pursue a Nonclinical Career in Hospital Management – 080 appeared first on NonClinical Physicians.

This is in follow-up to Episode #52, in which I talked about the skills and experiences needed to become a physician executive. You’ll recall that there were five major domains, beyond character and medical knowledge, that recruiters and CEOs consider when filling an executive position:

• Data Management
• Financial Management
• Business Practices
• Leadership Skills, and
• Talent Management

Powerful Tool

Today I want to describe a powerful tool that managers and leaders use to set goals. The ability to properly identify, describe and measure goals is important to all managers, directors, executives, and leaders in any organization.

Photo by rawpixel on Unsplash

Writing proper goals falls into the Business Practices domain of my model. And, I’ll talk about that briefly today. Sometimes goals are self-evident, driven by universal business needs, such as growing volumes or improving profits.

But sometimes a good leader needs a tool to help her team surface new initiatives, based on a more thoughtful consideration of internal and external factors. That’s where the SWOT Analysis can be an extremely powerful tool. In my model, a SWOT Analysis falls under the Leadership Domain.

For those of you who haven’t heard that term before, I didn’t say “swat” analysis, like swatting flies. No, SWOT is an acronym that stands for Strengths, Weaknesses, Opportunities and Threats.

The  development of the SWOT Analysis (or Matrix) has been attributed to Albert S. Humphrey, although he disavowed having invented it. Countless business leaders have used this tool to assist in planning. As a physician manager, director, or leader, you should become very comfortable using it.

What Are the Components?

The strengths and weaknesses generally refer to internal characteristics of an organization. This includes financial resources and performance, human resources, branding, and customer loyalty. It also might include cultural issues, such as whether your organization is nimble or slow-moving.

The opportunities and threats describe external considerations. How is the local economy doing? Is the market growing or shrinking? What are the demographics of your clients or patients? Is your competition strong or weak? What is the regulatory environment like? Are there major hurdles to entering a new market?

Click here to download your TRANSCRIPT

From SWOT Analysis to Goal Setting

To use a SWOT Analysis, goals can be developed from the intersection of Strengths and Weaknesses with Opportunities and Threats from the SWOT Analysis. The following table shows this:

During this episode, I go into great detail on how to use the information in the table to create SMART goals, using examples from an imaginary team considering the opening of an urgent care center.

If you’d like more help in pursuing a CMO job or any other executive healthcare position, I’ve developed a new mentoring program for you that I rolled out in Episode 52.

It’s called Become CMO in a Year.

It’s designed for board certified physicians who work at least part-time in a hospital setting, who want to move into hospital or medical group management. Through the mentoring program, you will identify and fill the gaps in your resume that you need to be irresistible to recruiters and CEOs.

You can learn more by heading over to vitalpe.net/cmomentor

Thanks again for listening today.

Please join me again next week for an exciting interview with a previous guest on the podcast who has a fantastic new program that I'm sure you'll want to hear about.

As always, I welcome your comments and feedback.

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

Disclaimer:

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

The opinions are my own, and my guest's, and not those of any organization(s) that I'm a member of, or affiliated with. The information presented is for entertainment and/or informational purposes only. It should not be construed as advice, such a medical, legal, tax, emotional or other types of advice.

If you take action on any information provided on the blog or podcast, it is at your own risk. Always consult a professional, e.g., attorney, accountant, career counsellor, etc., before making any major decisions related to the subject matter of the blog and podcast.

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

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

The post How to Deploy a Powerful Tool to Identify Goals – 054 appeared first on NonClinical Physicians.

Granted, this is a pretty tall order. It’s certainly easier if the organization you’re working for is looking for a CMO, or if you’re in a large city with multiple hospitals, MCOs and large medical groups.

But what do you need to do to get that chief medical officer job as soon as possible, even if you have limited management and leadership experience? Well, let me be your mentor and show you how it might be done.

Let’s start with the end in mind. What skill sets will a CMO candidate need to demonstrate so that an employer will…

1. read a cover letter and resume,
2. set up a series of interviews and,
3. select you as the new CMO?

If you’ve graduated medical school, completed a residency and worked clinically for a few years, you already have many of the necessary leadership skills.

Photo by Adam Smotkin on Unsplash

But you’ll need to work on those additional business and management skills that will enable you to work in a corporate environment.

I break down those skills into five general areas that a health care organization will generally be looking for:

1. Data Management
2. Financial Management
3. Business Practices
4. Leadership Skills
5. Talent Management

In this solo episode, I describe the specific skills needed in each area. I also provide examples of how you can develop those skills, if you don't already have them. Then, you can dream about becoming CMO in a year!

Click here to download a TRANSCRIPT of today's episode.

So… Is it possible to Become CMO in a Year?

It’s a stretch, but here's one plan for doing so, based on what I outlined in today's episode:

1. Join the AAPL and sign-up for one or two management courses. This demonstrates commitment.
2. If you’re a member of a committee or team, volunteer to be chair as soon as the opportunity presents itself. Let everyone know NOW that you’re willing to do so.
3. Find a local nonprofit that needs a board member and join ASAP. Volunteer for the Finance and Quality Committees and attend every board and committee meeting. Volunteer to chair at least one of the committees as soon as you can.
4. Try to get certified in QI, Lean Process Improvement or Six Sigma in the next 6 months.
5. Keep track of your positions, AND of the measurable accomplishments the organizations or committees have achieved with your help.
6. Leverage any current part-time management positions to include direct reports that you can manage.
7. Take one of the teams or boards that you chair through a SWOT analysis and mini-strategic plan, and set measurable goals for the coming year.

If you can complete those steps in the next 12 months, you’re ready to prepare an awesome resume, and begin your search for that CMO job.

New Paid Mentoring Program

I described a very special offer at the end of this episode. It's for a new paid Mentoring Program called Become CMO in a Year.

It’s designed for board certified physicians who work at least part-time in a hospital setting, who want to move into hospital or medical group management.

Through this mentoring program, I’ll obtain a detailed summary of your business and management experience, training and skills. I’ll identify the gaps in your skill sets, and then outline a plan for you to address gaps as efficiently as possible, using methods I’ve used myself, and have seen others use to great success.

The mentoring will occur through detailed audio advice and coaching that you can review as often as you like, and written transcripts, all designed to address your specific needs. It is completed with a live one-on-one call to answer specific questions and provide additional insights and advice to launch your new career.

If you'd like to read more about this program and launch your fulfilling, high-paying career as a physician executive, you'll definitely want to check out Become CMO in a Year.

There is no obligation. So, go check out Become CMO in One Year, because this could be the turning point in your nonclinical job search!

Please join me again next week for an exciting interview with a physician expert witness. I hope to see you then.

As always, I welcome your comments and feedback.

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

Disclaimer:

The opinions expressed herein are those of me, and my guest where applicable. While the information published in written and audio form on the podcast are true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed herein will lead to success in your career, life or business.

The opinions are my own, and my guest's, and not those of any organization(s) that I'm a member of, or affiliated with. The information presented on this blog and related podcast is for entertainment and/or informational purposes only. They should not be construed as advice, such a medical, legal, tax, emotional or other types of advice.

If you take action on any information provided on the blog or podcast, it is at your own risk. Always consult a professional, e.g., attorney, accountant, career counsellor, etc., before making any major decisions related to the subject matter of the blog and podcast.

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

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

The post How to Become CMO in a Year – 052 appeared first on NonClinical Physicians.

But first, a story…

Ten years into my career as a full-time family physician, I began to consider moving in another direction. For the most part, I enjoyed my practice, and my patients liked me. My two partners and I had busy schedules and a waiting list for appointments.

And we had a good reputation in the community.

But I wanted something more. I enjoyed working on hospital committees. I relished collaborating with nurses, pharmacists and other professionals, to create new protocols that improved patient care. And I enjoyed assessing learning needs and planning CME activities for my colleagues.

When the first wave of managed care plans began to show up in our community, I found it invigorating to work with eleven of my colleagues to help develop an independent physician association. The goal of the IPA was to contract with insurers, develop our own patient panels, and manage our utilization.

Photo by Samuel Zeller on Unsplash

I began to think that I might pursue a career in hospital management.

Self-Limiting Fears

But I had so many fears and insecurities that surfaced with each small step I took in that direction:

How would I explain this to my partners? We shared everything equally in the practice. How could I find time to still cover all of the call responsibilities and ease into a management position?

I’m a family physician. Sure, it’s a noble calling. But surgeons, cardiologists, gynecologists, and other specialists really don’t respect our opinions. We’re treated like the proverbial “red-headed stepchild.” And our hospital had never had a physician executive, so I was sure my peers would be very skeptical of the idea.

I thought, if I move into management, I’ll need to interact with other physicians, and even lead them. What makes me think I can be a leader? I’m not charismatic. I’m an introvert. I don’t have a booming voice or any “gravitas.” For goodness sake, I’m only 5 feet 3 inches tall!

And, I could hear my brothers and sisters, maybe even my parents, saying: “What do you mean, you won’t be seeing patients any more? Why would you give up being a doctor? Why waste your medical education?”

This is just a sampling of the self-limiting beliefs I had to overcome. And with the encouragement of my close friends, and wonderful mentors and supporters, including the CEO that first hired me as VP for Medical Affairs, I slowly faced those fears.

Fears Unfounded

And I discovered that those fears were unfounded. I learned that having a good reputation in the community was important. Being meticulous in my work and committed to improving patient outcomes was appreciated. And serving my colleagues by facilitating a dialogue between hospital executives or board members and the medical staff was what mattered.

As I present a plan today for you to follow, I want to acknowledge that you’ll likely face similar self-doubts and limiting beliefs. But don’t let those stop you.

Your clinical experience is the platform upon which you can build a rewarding career. You just need to add a bit of additional expertise and nonclinical experience.

You’ll likely be helping more patients in your new career. And you’ll be supporting your community and advancing your profession.

Three Awesome Nonclinical Careers

I’m going to briefly outline the steps that will take you from practicing physician to Physician Advisor for Utilization Review, Medical Informaticist, or Physician Advisor for Clinical Documentation Improvement.

Click above to download free guide.

These awesome nonclinical careers are ideal for many hospital-based physicians, including hospitalists, anesthesiologists, infectious disease specialists, and pulmonologists.

Each of these can be started part-time, if you like. But they will readily become a full-time career. They can also serve as a stepping stone to more highly paid positions as medical director, CMIO, or CMO.

Much of the information I’m going to share can be found in a free guide titled 5 Nonclinical Careers You Can Pursue Today. This guide can be downloaded for free by going to vitalpe.net/freeguide and signing up for my newsletter.

For the rest of this episode, you might want to have pen and paper handy. I’m going to provide many resources for you to access.

Utilization Management

This field is also sometimes called case management or care management. A physician advisor for UM will help determine the appropriate care status (outpatient vs. inpatient) in the hospital. As a PA for UM, you may be asked to determine appropriateness for observation care. You will work with other team members to determine if continued stay is warranted.

You’ll also help physicians understand CMS and other payer rules with respect to appropriateness of testing and performing invasive procedures. As a UM advisor, you’ll help your colleagues appropriately document their thought processes so that their patients can get the care that they need.

Finally, your work will be critical to the financial viability and the reported quality outcomes of your organization, by helping to reduce risk adjusted length of stay and unnecessary readmissions.

To begin to seek this career, you generally must be residency trained, and board certified, with 3 or more years of clinical experience. It is easiest to begin this transition if you’re currently a medical staff member at a medium to large hospital with an existing Utilization Management Department.

Typical Job Listing Looks Like This

“Candidate will have a strong clinical background with excellent communication skills and leadership abilities. The role of the Physician Advisor of Case Management Services requires the review of other physicians' cases, their plan of care and resource utilization. Case study can be necessary for various reasons including patient outliers (extended stays), utilization review issues, reimbursement issues or quality concerns. The Physician Advisor will work with hospital administration and clinical committees as requested to develop processes and guidelines to improve quality of care and value.”

Get Started

Here are some actions you can take to begin this career journey. They don’t necessarily need to be taken in the following order.

• Purchase and read: The Hospital Guide to Contemporary Utilization Review, by Stefani Daniels and Ronald Hirsch, and Physician Advisor Handbook, by Pooja Nagpal and Ven Mothkur.
• Meet with the Director for Utilization (or Case) Management and identify the most active physicians and the committees where the work is generally done.
• Then join your hospital utilization or case management committee. Get involved with denials management, including appeals.
• Identify a mentor that is currently working in utilization review, possibly the current Medical Director or a Physician Advisor for UM or case management. Establish a relationship and a dialogue about pursuing a similar career.
• Create a complete LinkedIn profile with a focus on experience in quality and length of stay, and on clinical experiences with hospital care.
• Consider joining the American College of Physician Advisors (acpadvisors.org) or the National Association of Physician Advisors (physicianadvisors.org). Check out their websites and see which one resonates most with you.
• You might consider attending the Annual SEAK Nonclinical Careers Conference held in Chicago, Illinois each October. There is usually at least one presentation devoted to this role.
• You should look into the costs and time commitment needed to achieve certification in Health Care Quality and Management by the American Board of Quality Assurance and Utilization Review Physicians, the ABQAURP (abqaurp.org)
• Finally, to learn more, listen to my interview with Dr. Timothy Owolabi in Episode # 12 of this podcast by going to My Interview with Dr. Timothy Owolabi.

Before proceeding, I want to spend a minute talking about the American Association for Physician Leadership. I’m not an affiliate and receive no compensation for this endorsement. But I’ve been a proud member of the AAPL for about 25 years, because it’s an outstanding organization.

It helps to support and promote physicians as managers, executives and leaders. The AAPL provides live conferences, online education, books, coaching, mentoring, career services and nonclinical job postings. It also provides physician executive certification, the CPE, that demonstrates expertise and skills as a physician leader.

I’ve mentioned the AAPL in numerous podcast episodes and interviewed the Director of Career Services, Dian Ginsberg, in Episode 24.

It truly is the world’s leading organization of emerging and established physician leaders. The cost of annual membership is a little less than $300.00 per year, which is a ridiculously low price. I strongly recommend you consider joining. Check It out using this link – vitalpe.net/aapl – to find out more.

Medical Informatics

Physicians in this position will need to learn about information technology and informatics. Medical informatics is the study of the design, development, adoption and application of IT-based innovations in healthcare services delivery, management and planning.

As a physician informaticist, you will be the bridge between information technology and practicing physicians. You will be involved in converting clinical protocols for use in an EHR. And you will develop procedures for effective use of technology in health delivery. This is probably the fastest growing of these awesome nonclinical careers.

To pursue this career, you should generally be residency trained and board certified, with 5 or more years of clinical experience.

Typical Job Listing Looks Like This

“The primary purpose of the Physician Informaticist is to develop EMR application training in one on one and group settings for physicians, based on workflow analysis and evaluation. The Physician Informaticist will develop and deliver learning solutions that improve efficiency and promote business objectives. As a member of the Clinical Informatics team, this person will provide ongoing support of EMR products and will work with the team in the maintenance and enhancement of EMR software. He/she will help implement requests for system changes on all assigned modules and participate in the development of operational workflow.”

Get Started

Here are some steps you can take to begin this career journey.

• Purchase and read: Health Informatics: Practical Guide for Healthcare and Information Technology Professionals by Robert E. Hoyt (Editor).
• Meet with the Director or VP for Informatics and identify the most active physicians and the committees.
• Participate in IT or EHR committees in your hospital.
• Identify a non-physician mentor that’s currently working in the Medical Informatics Department, or a medical informaticist or the Chief Medical Informatics Officer, if one exists. Meet with them and learn more about seeking a career in informatics.
• Create a complete LinkedIn profile with a focus on experience in EMR implementation, application, protocol development, etc.
• You should check out the following organizations: The American Medical Informatics Association is devoted to informatics and has a substantial physician component; The American Health Information Management Association addresses coding, privacy, security, data analytics, and CDI, in addition to informatics. It has a smaller focus on physician members.
• You should subscribe to the Health Data Management Online Journal at healthdatamanagement.com for news related to healthcare information technology.
• Join the Healthcare Information and Management Systems Society or HIMSS. And then check out the Physician Community within HIMSS at himss.org/physician.
• You can learn even more about this career choice by listening to my interview with Brian Young in Episode #14 by going to My Interview with Dr. Brian Young.

Clinical Documentation Improvement

Physicians in this position will need to learn appropriate coding and documentation guidelines and teach other physicians about coding. You will likely need to interact with them on specific cases to make appropriate changes to coding when needed.

As coding guidelines have become more specific, the need for an expert in this field continues to grow. As a CDI expert, you will help to ensure that the severity of illness of hospitalized patients is fully demonstrated.

This is critical to proper risk adjustment and quality outcomes published by CMS and other quality reporting organizations (Truven Top 100 and HealthGrades, for example).

Photo by rawpixel on Unsplash

Like the Physician Advisor for Utilization Management, your work will be critical to the financial viability your organization. You accomplish this by helping to optimize payments, reduce CMS-imposed penalties and demonstrate the quality of care to your stakeholders.

You’ll need to be residency trained, and board certified, with 3 to 5 or more years of clinical experience.

Typical Job Listing Looks Like This

“As the CDI physician advisor, you will act as a liaison between other CDI professionals, the Health Information Management Department, and the hospital’s medical staff. The PA will facilitate accurate and complete documentation for coding and abstracting of clinical data, in order to capture severity, acuity and risk of mortality, in addition to DRG assignment.”

Get Started

Here are some of the steps you can take, not necessarily in this order:

• You can read manuals such as Understanding Hospital Billing and Coding, 3rd Edition or DRG Expert – 2015.
• Better yet, you can go to the CMS page with DRG data at CMS Website and download the most recent DRG dataset in Excel format and sort by volume to see the most common DRGs being used nationally. Then you can look up the definitions of individual high-volume MS-DRGs at this link on the CMS website
• Meet with the Director or VP for Health Information Management and the Director of Clinical Documentation and identify the most active physicians and the committees.
• If possible, join the CDI team and attend CDI committee meetings. Spend time with the coding specialists in the Hospital Information Management Department.
• Identify a mentor that is currently working in hospital clinical documentation improvement.
• Create a complete LinkedIn profile with a focus on documentation and coding experience.
• Consider joining the Association of Clinical Documentation Specialists. It has a significant physician membership.
• The American Academy of Professional Coders may also have some useful educational and networking opportunities.
• The American College of Physician Advisors and the National Association of Physician Advisors might be useful to you. AHIMA may be more helpful for the CDI specialist than for the physician advisor for utilization management.
• And you can learn even more about this career choice by listening to my interview with Cesar Limjoco in Episode #5 by going to My Interview with Dr. Cesar Limjoco.

Closing

Well, there you go. I tried to provide actionable information and inspiration for three very important and popular nonclinical careers.

Let's close with this quote:

If you have any questions about what has been presented, please email me directly at johnjurica@nonclinical.buzzmybrand.net.

You can get the written overview of these three careers and two others by signing up for my newsletter at vitalpe.net/freeguide.

Resources

The resources mentioned in this episode are all linked below.

[table id=25 /]

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

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

If you'd like to listen to the premier episode and show notes, you can find it here: Getting Acquainted with Physician NonClinical Careers Podcast – 001

The post Three Awesome Nonclinical Careers You Can Embark on Today – 034 appeared first on NonClinical Physicians.

• What is the CPE?
• How was it established?
• What are the requirements for completing the CPE?
• How costly is the CPE to obtain?
• Is a management degree required?

Photo by rawpixel.com on Unsplash

Before proceeding, I want to spend a minute talking about the American Association for Physician Leadership. I’m not an affiliate and receive no compensation for this endorsement. But I’ve been a proud member of the AAPL for about 25 years, because it’s an outstanding organization.

It helps to support and promote physicians as managers, executives and leaders. Its members work in government; health, life and disability insurance companies; hospitals and health systems; medical groups; pharmaceutical companies; and anywhere physicians are employed.

The AAPL provides live conferences, online education, books, coaching, mentoring, career services and nonclinical job postings. It also provides physician executive certification, the CPE, that demonstrates expertise and skills as a physician leader.

I’ve mentioned the AAPL in numerous podcast episodes and interviewed the Director of Career Services, Dian Ginsberg, in Episode 24.

It truly is the world’s leading organization of emerging and established physician leaders. The cost of annual membership is a little less than $300.00 per year, which is a ridiculously low price. I strongly recommend you consider joining. Check It out using this link – vitalpe.net/aapl – to find out more.

Now, let’s get to today’s presentation.

Speaking of the AAPL, I'm often asked by physicians considering a management career about the CPE program. Is it worth the effort to complete? Is it better to get a business degree or the CPE?

Most of the information that follows is from the web sites of the American Association for Physician Leadership (or AAPL) and the Certifying Commission on Medical Management (or CCMM). I’ll provide my personal comments about the CPE at the end of this discussion. I’ll summarize the three reasons to pursue the qualification.

But these comments are my own. I do not represent, nor speak for, the CCMM or the AAPL.

What Is The CPE?

First, let me answer this question: What exactly is the CPE?

It’s both a program and a certification that physician leaders can obtain through a formal educational and experiential process.

According to comments I’ve heard from AAPL leaders, there was a desire 25 or 30 years ago at the AAPL (which was then called the American College of Physician Executives), to create some type of certification that would demonstrate the expertise in management and leadership.

There were efforts to create a board certification, possibly under the auspices of the American Board of Medical Specialties. When it became clear that such a certification in these nonclinical skills would not fit into the ABMS model, the AAPL leadership ultimately created the CCMM as a semi-independent entity to develop and administer certification as a physician executive, and the CPE program was born.

The AAPL is now celebrating the 20th anniversary of the CPE this year. To date, about 3,000 physicians have completed all of the requirements, and successfully attained the CPE designation.

Let's look at the requirements in more detail.

Professional Status

The first major requirement has to do with professional status. This means that you must have completed medical school training, be licensed to practice medicine, have at least three years of practice experience, and are board certified. That’s the basic starting point.

Education

The second major component are the educational requirements. This can be met by completing a management degree, such as an MBA, MMM, MHA, or MS in management. The alternative to a master's degree, is to complete the educational the required courses of the core curriculum through the AAPL.

Let me list some of the coursework that would be required if you don’t have a master's degree. The CCMM requires education in the following FOUR broad categories:

• Fundamental
• Developmental
• Experiential, and
• Transformational

The Fundamental Category includes courses addressing communication, finance, Influence, quality and negotiation.

The Developmental Category includes Managing Physician Performance and 2 electives running about 4 hours each.

The Experiential Category includes additional education in quality, accounting and high reliability, along with another 2 electives.

The final Educational Category, Transformational, consists of courses addressing financial decision-making, health law, conflict resolution and change management.

Leadership Experience

The next major requirement is one year of leadership experience. Each applicant must detail their leadership experience in a one-page narrative that is submitted to the CCMM for review. According to the website, the following are the areas that they ask the applicant to specifically address to demonstrate leadership experience.

• Talent management such as performance evaluations, determining salaries, hiring and firing of immediate staff, direct oversight over other physicians
• Data management (what data do you gather and how do you use it?)
• Fiscal responsibilities (managing your budget)
• Organizational impact (project implementation, managing up the chain, deal with stakeholders, etc.)

Capstone

The final component to the CPE completion is what has been called the CPE Capstone. This is a three-and-a-half-day program designed to provide additional education and to hone and assess your skills. It culminates in the presentation of a CPE leadership summary presentation. This presentation allows you to briefly and succinctly communicate how you have demonstrated your ability as a physician leader according to the CCMM website.

During the capstone, you'll be working with a cohort of other physicians and that large cohort will be broken down into teams. You will work with your teammates and often develop long-term relationships that persist beyond the completion of the capstone event.

So, what does that mean?

According to the AAPL, this certification has become the benchmark for CEOs and recruiters seeking the most accomplished and influential healthcare leaders.

As I look at job postings on LinkedIn and other job sites, I'm starting to see the CPE mentioned on an increasingly regular basis. Recruiters and hospital medical group leaders understand that if a physician has the CPE designation, then he or she has experience as a leader, has completed foundational education in management and business concepts, and has demonstrated a commitment to continuous learning in healthcare management.

Costs

Let’s talk about the cost.

The cost for the AAPL educational components basically run about $100 per hour of study. For the 150 hours of coursework, it's going to run about $15,000. Most physicians complete the coursework over a period of three to five years or more.

That's quite a bit less than the cost of an MBA, which would generally cost from $30,000 to $80,000, as was discussed in Episode #25. The capstone runs $3,650, which includes the $150 application fee.

You can learn more out the specifics by going to vitalpe.net/aapl or to ccmm.org.

3 Reasons to Pursue the CPE Qualification

Here are the three major reasons to complete the CPE:

Reason #1

If you wish to pursue a management or administrative career, this structured program will ensure that you'll have the basic attitudes, education, experience and communication skills to succeed in almost any such role.

Reason #2

The CPE credential demonstrates to employers that you have attained a high level of management education and experience with core competencies in key leadership areas, and superior communication skills.

I've noticed lately that many job postings for a hospital or medical group executive list the CPE designation as something that they're interested in seeing. And I believe that it provides a competitive advantage when seeking a high-level leadership position in any healthcare organization.

Reason #3

You will develop lifelong relationships with your CPE instructors and cohort members, that may well become useful later in your career.

I completed the CPE in 2012, and I think that I benefited primarily through the coursework that I completed, although I already had the master's in public health. It's hard to separate the networking and other support of the AAPL membership from the work done to complete the CPE. But, in general, it was a very positive experience and it ensured that I had the requisite background in finance, communication, negotiation, and so forth that I drew upon as CMO for my health system.

I found the capstone to be a very worthwhile experience. It may have changed since I completed it six years ago. A team of eight of us worked together, after some introductory lectures to the larger group.

We had homework to complete each night of the course, and several group activities. Then, we role-played interviews and difficult conversations with a disruptive colleague. Finally, we were videotaped and received feedback, both from our partners, and from the facilitator for our small group.

So, it is something that I would definitely recommend for anyone thinking about pursuing a career in leadership, whether it's with a medical group, an insurance company, a hospital, or any other large organization.

CPE vs. MBA?

The question about whether to get an MBA or complete a CPE is not really the right question. The real question is whether to obtain the business degree, or rely on the AAPL course work.

I believe that is a personal choice. It depends on financial considerations, your access to an appropriate degree program, the urgency of your desire to complete the CPE, and perhaps your learning style.

In my opinion, the required AAPL course work is basically equivalent to an MBA. So, either choice will work.

Thoughts on Leadership Experience

When I'm coaching physicians who are thinking about moving into an executive career, I use the CPE as a model for the physicians looking to make the transition, because if you think about it, the CPE does indicate the basic requirements for an effective physician leader.

To me the leadership experience component is probably the most variable and potentially confusing part of the journey.
Such leadership can be formal or informal, in a volunteer or paid position. It can be part-time, or full-time. And it might be independent or supervised.

Let me provide some examples.

Serving as a member of a nonprofit board can be useful leadership experience. But serving as the chair of that board will provide much more meaningful leadership experience.

Working on a hospital quality committee can be instructive. But chairing the committee provides deeper leadership experience.
Running a small practice or working in an entrepreneurial role provides some degree of leadership experience. But it is unsupervised and lacks direct feedback.

Working as a medical director within a larger organization, with an annual budget and formal reporting relationships, is more likely to provide real world leadership experience than the unmanaged experiences of the solo practitioner.

In summary, I think applying for and completing the CPE is a very worthwhile plan. Whether you obtain a formal management degree or obtain the business and management education through AAPL courses, the CPE program formalizes the process needed to obtain all the necessary education and experience to effectively function in a leadership position in most organizations. And there’s evidence that prospective employers recognize the value of the CPE when comparing applicants.

I hope you enjoyed today’s episode. If so, open your podcast app or go to iTunes and leave a review.

Join me next week for another episode of Physician Nonclinical Careers.

Resources

The resources mentioned in this episode are linked above.

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

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

If you'd like to listen to the premier episode and show notes, you can find it here: Getting Acquainted with Physician NonClinical Careers Podcast – 001

The post 3 Reasons to Pursue the CPE Qualification – 033 appeared first on NonClinical Physicians.

Free Career Transition Guide

Before I jump into today’s content, I need to tell you about a new “how-to-guide” I’ve written. It’s a 24-page manual, complete with checklists for 5 nonclinical careers. It outlines the steps you can take to pursue a career in utilization management, clinical documentation improvement, informatics, medical writing, and hospital management as VP for Medical Affairs.

I wrote it based on my personal experiences, and what I’ve learned doing interviews for this podcast. I was thinking of selling it on Amazon as a Kindle Book. But for now, it’s completely FREE for listeners to this podcast. To download your copy, just go to Free Career Guide.

A Listener's Question

I was on a phone call the other day, talking with a physician listener interested in exploring a new career. She was working as a gastroenterologist in a fairly large medical group and had become involved in quality initiatives at her local hospital.

Let’s call her Nina.

She didn’t have a formal leadership role in the hospital or medical group, but she really enjoyed working on quality improvement projects. And she wanted to explore a career in quality improvement.

She was thinking that she might ultimately want to work as chief quality officer at a hospital or a large group. And, she asked me how to best pursue such a career.

I thought you’d like to hear the advice I gave her, so I’m presenting that today. But first, let me give you a little more information about this relatively new senior hospital executive position.

A New Position: Chief Quality Officer

As hospitals have begun to shift from volume- to value-based care, someone must be responsible for collecting and submitting data needed to demonstrate the organization's quality. And there are multiple processes, tools, and departments that must coordinate their efforts to make that happen.

Let me point out some of the duties of the CQO:

1. Implementing quality improvement measurement tools that can provide risk-adjusted outcome measures;
2. Implementing a tool that will cull clinical data for the purpose of reporting to CMS;
3. Writing and implementing a quality improvement plan that addresses all QI activities, such as
   • physician peer review,
   • chart reviews for quality monitoring,
   • implementing mandatory quality initiatives, such as those for central line infections and DVT prophylaxis,
   • initiating QI projects using QI models such as PDCA (plan – do – check – act),
   • performing root cause analyses for serious errors or sentinel events;
4. Monitoring public reporting (Hospital Compare, HealthGrades, LeapFrog, Truven Top 100 and others);
5. Hiring, directing and evaluating the director of QI department and often the Patient Safety Department; and,
6. Developing and promoting a culture of safety and quality.

I described my vision of the ideal QI program in Building a Great Hospital Quality Improvement Program.

I’ve seen tremendous growth in this field. This is primarily because CMS is penalizing hospitals financially that don’t meet quality, safety, length of stay and readmissions benchmarks. So, it now makes sense to invest 200- to 300-thousand dollars to avoid paying millions of dollars in penalties. And a CQO will promote quality of care and the hospital’s rankings and reputation.

Suffice it to say that there is a growing demand for physicians who meet the qualifications needed to lead hospital quality efforts.

My Roadmap to Chief Quality Officer

As I thought about her situation, there were several ideas that came to mind, and I shared those with her. Thinking more about the question later, here is what occurs to me:
In general, there is a pretty standard approach to shifting from a strictly clinical career to one in hospital administration, including a role as CQO. It involves these basic steps:

1. Overcome mindset issues
2. Demonstrate commitment
3. Utilize mentors
4. Obtain unpaid real-world experience
5. Get formal education
6. Acquire certifications and degrees
7. Obtain formal or paid experience
8. Actively pursue a CQO position

It’s sometimes possible to skip a step or rearrange the order. Some clinicians are thrust into a formal, paid position out of necessity and have to address multiple steps concurrently. Some physicians may obtain an advanced degree, such as an MPH, while completing medical school, not realizing it will help them in the search for a CQO job later. But most of us need to follow the steps I’ve outlined.

And there are tactics along the way that help accelerate the process, like joining appropriate associations, obtaining coaching, and networking.

1. Mindset

I’ve previously discussed the issue of mindset and self-limiting beliefs with at least two of my guests – (Episodes 10 and 18). Nina had already overcome that barrier. She was really excited about quality improvement and knew it was something she’d be good at.

2. Demonstrate Commitment

In the hospital setting, in order to be involved in formal and informal QI projects or standing committees, those in charge must understand that you have both interest and expertise. In an absurd example, the president of the medical staff is not going to recommend someone in the finance department to work on quality initiatives due to lack of both of these attributes.

Physicians already have the necessary expertise to get started. We know medicine, epidemiology, statistics, and basic infection control and quality improvement principles. But unless someone in a leadership position knows we’re interested, they won’t seek out our help.

Our interest can be demonstrated in only 2 ways: what we say and what we do.

In my conversation with Nina, I started by asking her if she had talked to the director of the Quality Improvement Department at her hospital. She had not. I told her the director would be the person who'd have the most information about the quality improvement enterprise there.

If there was a chief quality officer, she'd know who that person was, and she'd also know which physicians had been most active in the quality initiatives. If there's no chief quality officer, there might be a medical director or two that were involved in certain projects.

Photo by Dan Gold on Unsplash

And during that conversation, of course, Nina would tell the director that she was interested in working on QI projects, even if they did not involve her specialty. She’d also express this interest to the chair of her department and to the chair of the QI Committee and the president of the medical staff.

She’d also have a conversation within her medical group, to the extent there was a formal QI department or team.

Finally, she’d really demonstrate her interest by consistently attending the meetings, and contributing her input and time to the projects she was working on.

3. Mentors

I told her that based on those conversations, it should be possible for her to identify a mentor or two to begin speaking with. The Director of Quality, generally a nurse with special training, could be one of her non-physician mentors.

The best mentor would be a physician already deeply involved in quality, such as the CQO or medical director for quality. Remember, the typical mentor is generally a step or two ahead of you. I described how to identify and engage a mentor in Episode 4 of this podcast.

If there's no mentor readily available in your organization, it’s possible to identify mentors outside the organization. There are associations that physicians like Nina can join. They provide access to education and certification, but a big benefit is the networking and access to mentors.

The National Association for Healthcare Quality is probably the best known. There is also the American College of Medical Quality.

Another way to find a mentor is by using LinkedIn. Membership is free, so there's really no barrier to joining. On LinkedIn search for PEOPLE with the designation of chief quality officer or medical director for quality. You can filter the list by geographic LOCATION. If there are any reasonably close by, you can start by asking to connect on LinkedIn. Later you can speak with them directly, or even meet them face to face.

Then begin a dialogue, ultimately creating a relationship in which you can ask for advice as you pursue a career in quality improvement.

4. Informal or Unpaid Experience

I suggested to Nina that while speaking with the Director for Quality Improvement, she should inquire about ongoing quality projects that she can help with, and committee meetings she can attend.

The committee structure at a hospital is fairly formal. And each committee has assigned members. Nina was concerned that she couldn’t attend a meeting if she was not the appointed committee representative.

However, I advised her that most medical staff committees can be attended by any medical staff member. Just to avoid potential confusion, it is wise to speak with the chair of the quality committee and the department chair about attending as a nonvoting member because of your interest in quality improvement. You’ll quickly become a regular member.

Doing so demonstrates commitment, offers another opportunity for networking and mentoring, and begins the process of acquiring experience in QI. By observing the chair, you will also learn about planning and running meetings, project planning and working on an interdisciplinary team, all useful leadership skills.

Nina can also volunteer to sit on any formal quality or process improvement teams that her medical group might have. Learning about process improvement is very useful. PI projects are more common in the outpatient office and procedural settings than formal QI projects.

Lean is the term used for process improvement methods originally developed and implemented by Toyota. Lean process improvement uses techniques to reduce waste and improve quality in manufacturing. It’s now been applied to the healthcare setting.

Nina and I talked about learning Lean methods in the office setting, and possibly becoming certified in Lean process improvement. Knowing Lean concepts and procedures is very useful for those interested in quality improvement.

5. Formal Education

This brings us to the next step involving formal education. You can become a green belt or black belt in Six Sigma, another PI methodology designed to reduce variation in care. As noted a minute ago, there are courses in Lean process improvement.

The associations mentioned earlier (NAHQ and ACMQ) provide formal education in quality improvement, as do other organizations:

• Institute for Healthcare Improvement
• American Association for Physician Leadership (see Episode 24)
• Many specialty societies

6. Certification and Advanced Degrees

The NAHQ provides a path to certification in quality improvement through the Healthcare Quality Certification Commission. After obtaining the necessary experience and education, you can take an exam leading to achieve the designation as a Certified Professional in Healthcare Quality. It's a national certificate in quality improvement that demonstrates expertise in the field.

You can take that a step further and complete a master's degree in quality improvement. There are multiple university programs. The AAPL has helped develop a program specifically for physician leaders. It’s called the Master’s in Healthcare Quality and Safety Management (MS-HQSM) offered by Thomas Jefferson University.

I did not discuss this option with Nina during our call. It might be best to wait on pursuing this degree until after working in a formal QI position. That might allow you to get your employer to contribute financially and with time off to pursue the degree.

7. Formal Paid Experience

At some point, you’ll want to get into a formal QI role. If you have enough meaningful experience in quality and safety projects and with the CPHQ certification, you may be able to transition to a full, or near full-time position as CQO or VP for Medical Affairs.

More likely, you’ll split your time between clinical work and quality activities as the Medical Director for Quality in a health plan, medical group or hospital. In the hospital setting, you’ll bridge the gap between clinical and management realms. You’ll be promoting quality initiatives, reviewing quality data, presenting quality reports to medical staff departments, and working with individual physicians to improve their metrics.

During this phase of your career transition, you’ll continue to hone your quality and management skills. You’ll need to focus on leadership skills also, since the Chief Quality Officer serves as a senior level executive.

Therefor, you will need to shift your educational efforts to focus on leadership topics. Organizations such as the AAPL, the American College of Healthcare Executives and the Advisory Board are just a few that offer leadership education that will help you.

Reminder: Think About Your Resume

As Nina pursues her career as a CQO, she should keep in mind that she will be competing with other highly qualified physicians. At some point she’ll be sending resumes to prospective employers.

Those employers will be looking primarily at what this new CQO can do for them. So, they’ll be looking on the resume, and soliciting during the interviews, evidence of what Nina has accomplished.

They won’t put much weight on what committees she’s been part of, or which projects she’s worked on. Instead they’ll be looking for the initiatives she’s led. They’ll be looking for evidence of metrics she’s improved. Did she get length of stay down significantly, or reduce mortality or complications? Has she increased compliance with core measures? Did she help reduce the occurrence of never events?

Keep this in mind as you participate in formal and informal positions. Don’t be a passive participant. Be a leader in these positions. Don’t just remain a committee member. Step up to committee chair when you can. And keep track of the measurable improvements that result when you and your team tackle each quality initiative.

Time to Pursue a Career in Quality Improvement

By following the steps I’ve outlined, you’ll find a CQO position.

It'll be easier if you’re willing to relocate, but if you live in a large metropolitan area, you might not need to.

The job is very rewarding, because you’ll be helping to improve the care of thousands of patients through your efforts. Quality Improvement was always one of my favorite departments when I was CMO.

Quick Review

Let me quickly review the steps I’ve outlined for Nina to follow as she pursues a career in quality improvement.

She should:

1. Overcome mindset issues
2. Demonstrate commitment
3. Find and utilize mentors
4. Obtain unpaid/informal experience
5. Get formal education
6. Acquire certifications and degrees
7. Obtain formal paid experience
8. Actively pursue a CQO position

Along the way she’ll find appropriate associations to join, like the NAHQ and AAPL, she’ll network with colleagues, and she’ll take advantage of educational opportunities as they arise.

I hope you found this information helpful. If you have any questions, post them in the comments section below, or contact me at johnjurica@nonclinical.buzzmybrand.net.

Don't Forget to Download Your Free Guide to 5 Nonclinical Careers

As noted earlier, I’ve completed a Free Guide called 5 Nonclinical Careers You Can Pursue Today that outlines the steps for 5 more highly popular careers. It can be found at vitalpe.net/freeguide

Let’s end with this quote from John Ruskin:

See you next time on Physician NonClinical Careers.

The resources included in the podcast are all linked above.

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

The easiest ways to listen:  vitalpe.net/itunes or vitalpe.net/stitcher

The post Follow These 8 Steps to a Career in Quality Improvement – 027 appeared first on NonClinical Physicians.