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

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

Our Sponsor

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

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

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

For Podcast Listeners

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

Demystifying Life Insurance Medicine

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

The post Have Faith in Your New Life Insurance Medicine Career appeared first on NonClinical Physicians.

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

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

Early Clinical Career Opportunities

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

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

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

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

Our Sponsor

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

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

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

For Podcast Listeners

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

Private Practice

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

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

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

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

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

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

Our Sponsor

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

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

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

For Podcast Listeners

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

The Art of Total Immersion in Healthcare Leadership

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

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

Building the Bridge from Clinical Excellence to Organizational Impact

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

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

Core Attributes to Be a Better Physician Leader

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

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

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

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

Summary

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

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

Links for today's episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

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

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

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 381

To Be a Better Physician Leader

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Our Sponsor

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

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

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

For Podcast Listeners

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

Inside the Role: What a Health Insurance Medical Director Does

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

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

Creating Your Unique Path: Blending Tradition and Innovation

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

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

Summary

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

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

Links for today's episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

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

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

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 379

Health Insurance Medical Director Is Still A Popular Job

- Interview with Dr. Neetu Sharma

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Neetu Sharma: Yes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

John: Okay, bye-bye.

Dr. Neetu Sharma: Bye-bye.

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

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

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

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

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

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

Our Sponsor

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

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

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

For Podcast Listeners

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

The Daily Life of a CDI Specialist

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

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

Growing Opportunities in the CDI Field

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

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

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

Summary

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

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

Links for today's episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

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

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

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 378

Become a CDI Expert

- A PNC Classic from 2019 with Dr. Christian Zouain

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Christian Zouain: Thank you.

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

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

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

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

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

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

Dr. Christian Zouain: Yes.

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

Dr. Christian Zouain: On LinkedIn.

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Christian Zouain: That's correct.

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

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

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

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

Dr. Christian Zouain: Correct.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

John: Right.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Christian Zouain: Definitely.

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

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

John: Yeah, I think that's great.

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

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

Dr. Christian Zouain: Yeah, sure. Definitely.

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

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

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

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

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

Dr. Christian Zouain: I'm sorry?

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

Dr. Christian Zouain: Yeah.

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

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

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

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

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

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

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

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

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This week John spends a few minutes sharing his thoughts on one of three popular full-time careers when preparing to “level up.”

Today John delves into the idea of “leveling up”- a journey of self-improvement that can lead you to a more satisfying and financially rewarding career. Drawing inspiration from professional athletes and attorneys he shares how to take stock of your strengths, identify areas for growth, and set new goals to help you become the best version of yourself.

Our Sponsor

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

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

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

For Podcast Listeners

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

Three Most Popular Full-time Careers for Physicians Seeking a Change

Suppose you’re a physician considering a career shift. In that case, John highlights three nonclinical roles that might be perfect for you: hospital Chief Medical Officer (CMO), pharma Medical Science Liaison (MSL), and insurance company Utilization Management (UM) Medical Director. These roles offer improved work-life balance, competitive pay, and full-time opportunities with major organizations. John describes each popular full-time career and how you can smoothly transition.

Your Network is Your Net Worth: Resources to Help You Succeed

Transitioning to a new career isn’t just about what you know, it’s also about who you know. In this section, Dr. John reminds us of the importance of building a strong professional network and leveraging resources like LinkedIn, the American Association for Physician Leadership (AAPL), and the MSL Society. He also recommends joining online communities like the Remote Careers for Physicians Facebook group, where you can connect with others who’ve made similar transitions and get advice on your next steps.

Summary

Sometimes it makes sense to level up your career to one that offers better pay and work-life balance. The three options described today have demonstrated that they generally meet those goals. If you're looking for full-time employment in a well-established industry John advises you to consider one of these popular options. 

Links for Today's Episode:

• How to Become CMO in a Year – 052
• 4 Things the CMO Should Never Say to the CEO – 251
• Hospital Management Career Bundle Tactics to Quickly Prepare for a Hospital Management Job
• Find Your Great First Nonclinical MSL Job
• Complete the Journey to Your First Fabulous MSL Job – 277
• Build a Rewarding Career as an MSL – Use Coupon Code HALFOFF to purchase for only $198
• How To Secure Your First Utilization Management Job
• The Truth About Medical Specialists and UM Jobs
• American Association for Physician Leadership (AAPL)
• Remote Careers for Physicians Facebook Group
• MSL Society
• Check out the 2024 Nonclinical Career Summit to learn about MORE career options.

Download This Episode:

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

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 368

First Consider the Most Popular Full-Time Careers

John: Okay, nonclinical nation, many of you are ready to make a change in your professional life. It may be because you're frustrated and your work-life balance is shot, or maybe it's just because you're ready to level up.

What do I mean by leveling up? Well, leveling up can be described as a process of self-development or to become a better version of yourself. This can include identifying weaknesses and strengths, setting goals, replacing old habits with new habits, focus on success, and possibly moving to a career that's more satisfying and financially rewarding.

As I was thinking about this concept, I was trying to get examples, and I have two examples that really come to mind.

The first one is professional athletes. Some professional athletes are forced to retire. Some just reach their peak and decide after they've done everything they want to do, they just retire, but they have a lot of notoriety and they have hopefully saved up some money. And again, it's kind of parallel to what physicians can do.

I think of examples like those of Magic Johnson's business ventures in broadcasting, music, film, and finance, or John Elway's investments in dealerships in the Denver area that he said later sold off, and then him investing in the Colorado Crush of the Arena Football League in 2002. And of course, many successful athletes have finished their careers as athletes, and then leveled up to do something else very powerful.

Now, those might seem like outliers. Maybe those are just a select few, but I also think of attorneys. There are many attorneys who never practice, or let's say they finish law school, they pass their bar, and they do work for a while in the industry, in law, doing something, but then they find that they can take everything they've learned in law school and with their early experiences as an attorney and segue into another career, which they level up.

You can look around and see a lot of attorneys working in C suite of various companies, not actually practicing law, but applying what they learned as leaders, as researchers, as presenters, and they apply to the new job. You're an attorney and you have a background in healthcare law, well, you can do that with a big firm, or you can actually go and become part of a team to run a healthcare organization, and obviously all those skills will come in handy.

I interviewed somebody who was trained as an attorney. He, for a little while, was helping physicians with their contract negotiations as an attorney. What he did was leverage that to become more of an agent. He helps physicians negotiate better contracts as an agent, but not as an attorney. In fact, he still has attorneys review the contracts. That's a way to level up.

I think the physicians can do the same thing. Healthcare is the largest industry in the United States, and there are positions for physicians in every major aspect of healthcare. Maybe it's natural to think after a few years of being in the trenches and seeing patients, at some point it gets old, and now you look for the next challenge, and that's what we call leveling up.

And so, I want to talk about three of the positions that you should consider, particularly if you're in a big hurry. Now, you can spend six, 12, 18 months researching all of the possible nonclinical careers out there, but if you're looking for a particular type of career that I'll mention in a minute, then maybe you should select from one of the three most commonly pursued careers and go from there, and that's what I'm going to talk about today, the pros, the cons, some of the tactics for doing this, and so forth. They definitely provide a better lifestyle, and they pay well, and so I thought I would focus on those today.

Those careers are those of a chief medical officer at a hospital or health system, medical science liaison, or UM medical director. Now, they're all full-time jobs. We're not going to mess around with starting a new business or getting a part-time job and then segwaying to maybe looking for two or three different part-time jobs that you can patch together like I've talked about before, but these are full-time jobs. They involve employment with a large organization. They have a lot of the usual benefits that only large organizations provide, and they're really seen by physicians as very, very viable options. And so, I thought, "Well, if I can provide examples of these three and tell you a little bit about each of them, maybe that can kind of jumpstart your process of leveling up."

All right, I have definitely interviewed multiple physicians doing all of these jobs. I personally have been a chief medical officer, know many other chief medical officers and other senior executives in hospitals that are physicians. I've interviewed many medical science liaisons, which represents the pharma industry. And then the third is, again, one of the most common, and maybe somewhat underappreciated, and that's being a medical director for a health insurance company, or you might call them a healthcare payer, one of the big ones. That's what I want to talk about today.

Let's talk about the chief medical officer first. What about that? How do we do that? And one of the things that comes up, because maybe I'm comparing these three directly, and it's a little bit, I wouldn't say disingenuous, but it's not correct to, let's say, talk about a new MSL and someone who's becoming a new CMO. CMO is a pretty high-level position. Now, I was going to talk about medical directors in the hospital setting, and it is the stepping stone to becoming a CMO. Both those jobs pay well, they have great benefits, and the lifestyle is much better than, let's say, a practicing physician as an anesthesiologist or an ER doctor in the hospital.

But most medical directors that work in the hospital setting are medical directors for a service line, which means they're usually practicing at least half-time as well. I wouldn't want to call that medical director position as a full-time position. Now, there are some full-time medical director positions. If you're in a large enough hospital and you can be a medical director for quality improvement or for informatics or for utilization management or, let's say, even coding and documentation, those can all be full-time jobs. They can pay well. You can replace your clinical salary for sure. And they do serve as a stepping stone, though, to the ultimate hospital environment job, which would be that of a chief medical officer or one of the other senior positions like chief medical information officer or chief quality officer, something like that.

Now, as far as getting from your medical director role up to the CMO role, which is that last step before, but you could eventually become a COO or even a CEO of a hospital. But in focusing on the CMO role, you're going to do some of these things that we will talk about with all three positions, really.

Maybe a little different here. You might want to get an executive coach or mentor. You definitely want to join LinkedIn because you're going to do a lot of your networking and looking for jobs on LinkedIn if you don't have a way to segue up to the current institution where you're already working.

One of the resources is the AAPL, which is the American Association for Physician Leadership, which is at physicianleaders.org. They have a bunch of books. There's a bunch of other books you can look at for healthcare finances and leadership and so forth.

And the question with that job is, "Does it require relocation?" If you're in a large metropolitan area, there's probably multiple systems where you could look for a job, but it's not uncommon to be able to work your way up an institution's hierarchy, work as a medical director, take on more responsibility over time while you gradually decrease your practice. And ultimately, while you might keep your license, you reach a point where you really don't need a license.

I would maintain it only because sometimes when you're looking to change to a CMO role at another organization, they want you to have the license. I think sometimes that's because they might be using your license for some things, having to do with the pharmacy or covering for ordering drugs for different units. But ultimately, you won't really need to have that license because you're no longer seeing patients. Although as a CMO, you can continue to see patients once a week or every other week or so if you want to continue to do that.

But it's one of those jobs that you should think of right off the bat if you're in a position that enables you to pursue that kind of job. It's not right for everybody. If you're a dermatologist working in an outpatient setting or if you've never had privileges at a hospital, it makes it difficult to start that job search from nothing as opposed to being one of these people in the hospital that are there all the time, the emergency physicians, anesthesiologists and various surgeons and so forth. Geriatricians and hospitalists are typical, very common to move up that path. So that's the first one.

With that, I think I'll move on to the next one, which is medical science liaison. We've talked about this before. It's a very common and attractive position. It really doesn't require any special background. I think it's helpful if you have experience in working with particular drugs or drug classes. It's kind of whatever's popular at the time. Oncologists typically can get into pharma very easily. They'll often go into more of the clinical research side of things, but as an oncologist, it would be very easy to become an MSL, but also pretty much anyone who's using certain drugs and classes of drugs, whether it's cardiology, even gynecologists and family physicians, internists for sure. There's a big push in GI drugs lately. So if you were doing GI work and wanted to transition to this role, it'd probably be fairly easily.

And there are even positions for people that don't have a residency and haven't been in practice, but we're really focusing on those who have been in practice and want to level up to something new with a better lifestyle, but actually paying equal to or more in the long run than what you're doing now. And as I said, we're going to focus on some of those drugs to help convince our new employer.

As far as resources to try and move into this role, you want to commiserate with others that are doing it, you want to go on LinkedIn, you want to have a great profile. This applies to all three. Great LinkedIn profile, networking on LinkedIn, engage with peers. You can join the MSL Society, which the link there is themsls.org. They have a lot in there for people who are already medical science liaisons, but you can imagine just taking a few entry-level courses and reading about becoming an MSL and being an MSL and exceeding and excelling as an MSL would be very helpful. And in addition, you'll learn the language that they speak.

And when you're doing interviews and submitting your resume, you want to sprinkle those and your LinkedIn profile with the vernacular that's not used outside of the pharma industry. And some of it's not even used by anyone other than medical science liaisons. I do also mention the Contract Research Organization, CRO, because you can work directly for a pharmaceutical company as an MSL, but a lot of MSLs work for contract research organizations.

A CRO has different names, it could be the Contract Research Organization, it could be Contract Resource Organization, but they provide resources to pharma companies for those things that they don't want to keep hiring for. And sometimes it's MSLs, it can be other things, it could be the components that actually provide the studies, that monitor the studies and so forth.

You oftentimes will find that CROs are hiring medical science liaisons a little quicker than the pharmaceutical companies go. And all of these things are dependent on what is going on in the industry, how much demand there is based on what new drugs are being released by various companies. And it's at that point of release that MSLs get heavily involved. It's an educational role, it's not a marketing or sales role.

I remember once talking to a guest who's a pediatrician and she didn't think there was any way she could be employed by a pharma company, but because of all the experience she had with vaccines, they happened to be looking for somebody that had that experience and she was able to get a job. And I think initially she was employed by a CRO and then later moved up to a full-time position either with the CRO or with the pharma company itself. That's the second one I wanted to mention today. Don't forget to look at the MSL Society to get some ideas on how to approach that goal.

The last one I want to talk about today, again, one of the big three, is working as a medical director for a utilization management company, working for a large payer. Again, that doesn't require any special background. If you've done chart reviews before in the hospital setting, particularly maybe you've been a physician advisor for UM in the hospital, that might help. All the big insurance companies hire these people, but they also sometimes farm this out to something called an IRO, which is an independent review organization.

And so, many people when they're starting out and becoming a UM or a benefits management medical director, they'll apply at an IRO first and they'll find a job part-time. This is the one that's a little easier to do, kind of the pilots where you're still doing your old job. You're doing some part-time chart reviews for an IRO and then some IROs will hire you full-time.

One of my colleagues really, he hasn't been a guest on the podcast yet. I'm probably going to have him on someday, but he was a surgeon and he just wanted to spend more time with his kids. And he thought, "Well, I don't know. I make a fair amount of money as a surgeon but I'm not having any time with my kids. I'm not spending enough time with my kids. They're growing up, I'm missing on that." And he said, "I'm going to level up to one of these different careers." And so, he did start working as a medical director for an independent review organization and he actually really enjoys it. In addition to doing general sort of chart review work, he's also serving as a resource for those surgical cases. So you can always get that. Even if you're a specialist, sometimes they have special roles for you. One of my other guests or the other one that was a guest as opposed to this first example, he was an invasive cardiologist for pediatrics.

And yeah, he's been working at a health system or a health insurer rather for gosh, at least five or six years now since I interviewed him. And he's very happy and he actually helps other people do that. The resources for that, besides looking around for IROs, if you want a list of some of the IROs, they're basically the ones that are certified. You can go to NAIRO, which is the National Association of IROs at nairo.org/members. You'll get a list of all the NAIRO members and you can go look at their websites to see if they're hiring the type of medical director that you might be looking at. And again, these can be for part-time positions to get you started, to get you exposed.

You can also go to Facebook and look for the Remote Careers for Physicians Facebook group. It's got at least 10,000 members now. It's pretty big group. And everybody in there is kind of talking about working as a payer or a health insurer UM medical director and other associated types of positions.

All the big insurance companies definitely will hire these people as well. Whether we're talking about Cigna or Centene or several others, any of the big ones, they all have them. But they also outsource some of the work to the IROs. Again, I will remind you that for all these positions, it's important to be on LinkedIn. It's important to have a complete profile. It's important to use LinkedIn and sometimes Doximity to locate your colleagues and network with them. See if some of them are already doing one of these jobs.

Like I said, maybe it's time to level up and this is how you can get started. And if one of these three positions sounds right for you, then you can just jump in now and start working on it and see what you think.

The other thing I would say is besides what I've already mentioned in terms of the benefits is they have great benefit packages in most of these places. You've got health insurance, disability insurance, retirement plans, four to six weeks of paid time off. And some of them will even give physicians deferred compensation benefits. So that can be nice for your retirement planning.

Well, I guess that's it for today's discussion. Thousands of physicians literally just in the last few years have found happiness in each of these three careers. They all offer full-time salaries, generally good benefits, and there are resources that can help you get started. Just check out those resources and get going. And if you have any questions, you can always contact me.

If you want to access everything that I've talked about today easily, you can go to the show notes. You'll also get a link to the podcast episode. You'll get related links, several related links actually and the transcript. And you can find all that at nonclinicalphysicians.com/popular-full-time-careers.

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Disclaimers:

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

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

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. 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 First Consider The Most Popular Full-Time Careers appeared first on NonClinical Physicians.

The post The Amazing Field of Life Insurance Medicine – A PNC Classic from 2018 appeared first on NonClinical Physicians.

This week you will hear priceless advice from an expert in biopharma, Dr. Michelle Mudge-Riley. She also brings her experience as a physician career coach and mentor to bear during our conversation.

Over the past five years, Michelle has made significant strides in her biotech career. And she offers valuable insights and advice for physicians looking to transition into the industry.

Our Sponsor

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

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

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

For Podcast Listeners

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

The Power of Relationships in Career Transitions

Michelle highlights the critical role of networking in securing nonclinical roles. “These jobs are all about relationships. Often, you end up getting a job not because you’re the best fit, but because you know someone,” she explains.

She recommends using platforms like LinkedIn and Doximity to connect with industry professionals and seek advice and opportunities.

Priceless Advice from an Expert

When pursuing a job in the biopharma sector, Michelle advises against additional certifications or degrees as the first step. Instead, she suggests focusing on building transferable skills and relationships within the industry. “You shouldn’t have to jump through hoops to get a job. You likely already have the knowledge and skills needed,” she assures.

She also advises us to explore the Medical Affairs Professional Society for useful advice and information.

Encouragement for Aspiring Biopharma Professionals

Don’t lose confidence in yourself. We all face rejection and setbacks, but remember, you are good enough for these roles. Keep believing in yourself and stay persistent. – Michelle Mudge-Riley

Summary

To connect with Dr. Mudge-Riley and learn from her experiences, you can find her on LinkedIn, another resource for priceless advice from an expert. She also recommends checking out the Medical Affairs Professional Society (MAPS) as a fantastic resource for networking and professional growth in the medical affairs field.

Links for Today's Episode:

• Dr. Michelle Mudge-Riley's LinkedIn
• Medical Affairs Professional Society (MAPS) 
• The Best Biopharma Positions For Motivated Practicing Physicians
• Find Your Great First Nonclinical MSL Job
• Land a Pharma Clinical Development Job: A PNC Classic from 2021
• Landing Your First Pharma Industry Job May Be Easier Than You Think – 311
• Research and Development in Nonclinical Pharma Careers
• The Wonderful World of Nonclinical Pharma Careers

Podcast Editing & Production Services are provided by Oscar Hamilton

Download This Episode:

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

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 364

Priceless Advice From An Expert In The BioPharma Industry

- Interview with Dr. Michelle Mudge-Riley

John: I'm so happy to welcome today's guest back to the podcast. She's been on the podcast before, but it has been quite a while. She's known as an expert in career transition through coaching and live events, but really she has become an expert in biopharma because she's been working in biopharma and doing some pretty interesting things. I'm really happy to welcome Michelle Mudge-Riley here to the podcast. Hi, Michelle.

Dr. Michelle Mudge-Riley: Hi, John. So nice to be back with you again.

John: It's great to see you. We were just reminiscing before we started our interview here, but why don't you fill us in a little bit with the highlights of what has transpired in the last five years, let's say, because that's almost as long as it's been since we spoke on the podcast.

Dr. Michelle Mudge-Riley: Sure. Sounds good. And it really is unbelievable that it's been five years. I know it seems a long time when you're looking at it day to day, but there's so many things you look back and you think, wow, it's been five years or it's been 10 years or it's been years. And yeah, this is a perfect example of that. Yeah, I was the doctor's doctor known as that probably 10, 8 years ago, as I had a thriving business as a career transition coach for physicians. I ran an online and in-person conference. And I also worked for a small boutique consulting company at the time, which enabled me to do a lot of these extra things on the side.

And in my role in that consulting company, I was the medical director for small, medium and large biotech companies. I really enjoyed doing that as well as my side gigs. When COVID hit, that changed everything for everyone. And I won't get into the things that I did with my side gig at that point, but I made some personal decisions that I wanted to look back at my career and have something a little bit different than what I was currently doing. It was like a lot of people, a good time for a change. And that biggest change was that I really wanted to go to the client side, work for a biotech company and experience what it was like on that side versus the consulting side. That's where we were back in 2020.

John: Yeah. Yeah. Now that's a big commitment to make, because you had been doing different things. And of course, even way back before all that, you had a master's degree and did other things as a physician, but that's a big commitment. And as I saw what you were doing, because I could always look on LinkedIn and hopefully you were keeping that up to date. I could see that you were getting involved in more and more different things. I thought you'd be perfect to give us another perspective. I've interviewed a few people working in pharma, but it's usually a specific position we focus on, but I think you can give me a little more of a better perspective, because knowing how physicians are searching for jobs that are more fulfilling and satisfying, and a lot have thought about how can I get into biopharma? So that's why I thought I'd have you come back and enlighten us a little bit today. What is it that interested you about biotech and pharma personally?

Dr. Michelle Mudge-Riley: Yeah, great, great question here. When I started to make my transition over 20 years ago from clinical practice, I considered biotech and pharma and device, and actually did not consider it as seriously as I should have. I thought it was the dark side. I thought it's an easy choice. If you don't want to be a practicing physician, you think about insurance, or you think about pharma. And I didn't want to be such a clich�.

I dabbled a little, but ended up, you're right, getting a master's degree, getting a nutrition, additional training there. I worked for a number of different firms, an employee benefits firm, and then multiple consulting firms. I started some other businesses. And I slowly was always seeing this common thread of being involved with biotech in some way. And I can tell you that what I have done for the past five years has been so fulfilling and so much fun. It's completely changed my life being working directly for a biotech company. And I will most likely finish out my career doing this.

I still have some side gigs. I think that's important. I've always talked about multiple irons in the fire, because it's really easy to get so caught up in the day to day. And you never really know what's going to happen. COVID's another great example, never saw that coming. So making sure that you're diversifying yourself and your career, I still maintain that that's really, really important within compliance, of course, if you're working for a company, that's going to be an issue, which we won't go into today. But it's really fascinating how much fun it is working for biotech. And I know we're going to talk a little bit about that today.

John: Yeah. Well, what's so fun about it? What is it that you personally find to be the fun parts? Because something that's fun for you might not be fun for somebody else. But for you personally, what is it that you like about being involved with the type of company that you are?

Dr. Michelle Mudge-Riley: Yes, there are two big things that I love about my job. And one is the actual work. And that was something that I've always talked about as being really important, but really hard to find with a career, because you may be influenced by your boss or your colleagues or the autonomy or lack thereof, or all of these other little things, which are also important, by the way. But if you don't like the work, that will drive you to burnout and to just being not your best self.

And so, for me, the work is something I love. I love being able to be able to understand the scientific articles and explain them to others, talk amongst my colleagues about the science and the medicine aspects, learn the new things that we don't learn in medical school about clinical trials and all the aspects. Working with the FDA, looking at the different clinical endpoints, inclusion criteria, talking about the criticisms of different trials and how they compare or don't, and working with other physicians who are experts in the field.

We should get into that too, because that's really interesting working with other physicians, because most people in my position at a pharmaceutical company or device company, they are physicians or their PhDs. And so, how does that differ from the physicians that I work with that are still in practice? But that's an aspect I really, really like as well.

The last part about what I really like about my job is working with very smart and really quirky colleagues. Anyone who's really smart, I feel like has some unique aspect about them that kind of makes them quirky. And I love that about people, just finding out what their unique characteristics are and being able to talk with them about science and just really high level complex stuff, but also get to know them as people and what their hobbies are, what they like to do. They like to go axe throwing or something else that you wouldn't think about. And most people would never think about doing either. Typically people in these companies, they have these really cool hobbies that you then get to learn about.

John: It reminds me about some of the things when I was chief medical officer and thinking back, what did I really like? I really liked the science behind the quality improvement. I would sit in my office by myself creating reports for the board and that. And so, I'm more of an introvert, but that's what I liked. And I had no trouble spending two or three hours doing this report and then explaining it to, let's say, the board or somebody else.

The other thing you mentioned, like the quirky people, our CMO was a nurse. CMO, he was a nurse of course. And he raised chickens. I'm like, okay, there's a weird quirky thing to do. And he'd go to not conferences, but they'd have these shows where he could find the best new chicken breed out there. It's like, you got to be kidding me. But yeah, it's good. It's different than being face-to-face with patients all day. And you do get to interact with physicians in other realms clinically. And the thing again about the pharma and the biotech, it's so scientific. If you have a scientific mind, I think you really fit in well there.

Dr. Michelle Mudge-Riley: Yes. Yes. I completely agree. I have a colleague who likes to fix coffee makers. How interesting is that? And how different? I would not really thought about doing that, but yeah, just buying coffee makers that may have a small problem and fixing them, making them look really good and selling them. It's interesting.

John: That's interesting. And if yours breaks down, well, you know where to go.

Dr. Michelle Mudge-Riley: Right. Exactly.

John: To be an entrepreneur and to have to build something yourself is one thing, but tell me, there was something very comforting about being part of a large corporation and probably most pharma companies are massively larger than let's say a hospital that I worked for, but there was just a consistency and the hours were regular and there was a nice IRA or whatever, but that wasn't a pension anymore. But yeah, they had that all worked out. So you find some of that helpful and beneficial as well?

Dr. Michelle Mudge-Riley: Yes. I think the constant struggle of an entrepreneur is can get old and that grind can get to be something that I've spoken with other physicians who have started companies, sold companies, and then moved into more of a corporate job or just a job where they receive a regular paycheck. It's part of that. Yes. But I will say that in biotech, it's not a massive company all the time that there are really small biotech pharma device companies and they have a different culture than the larger companies. So if someone has tried this before and they haven't really flourished in the way that they want, maybe it's just a matter of a small company versus a large company.

John: How do you prepare for that? What advice do you have? Is there something I can do ahead of time that gives me just a little bit of exposure, maybe a little certain skills that would be good for biotech versus a large pharma company, something like that. Any thoughts on that?Dr.

Michelle Mudge-Riley: It's really hard because you'll hear about physicians and others who have tried for years to get into a biotech company or an insurance company or just to get into this nonclinical career space and have had a lot of difficulty. And so that's a common question. What sort of certifications do you need? What sort of degree? Should I go get an MBA? What have you done to make you successful? And I think the number one thing is that this is really not what people want to hear, but this is what I see over and over and I experienced myself. It's talking to others. It's getting out to people that you don't know that are working in the space and talking to them about what they do.

All of these things are relationship driven type jobs. And often you end up getting your job, maybe not because you're the best fit, but because you knew someone. I don't know, for better for worse, that's how it goes. Because with all of these applicant tracking systems and people not knowing others, you may be the perfect fit for a job or multiple jobs, and you won't even get an interview and that gets people really down. I get it. It's so humbling, but it's not you. It's the system and the system is not perfect. And so, the more people you can talk to and find out about keywords to use, what the industry is actually like, what sort of transferable skills you have. I know you talk about transferable skills on your podcast a lot, and who's there at the company that maybe went to your universe. It could be as simple as that to get that interview. And then everyone likes you when they're talking to you because physicians are typically likable people and we all have the ability to go work at a biotech company if we wanted to.

John: Yeah, I think that's really good advice. Between LinkedIn and Doximity, you can probably locate most of your former med school cohorts, your residency, your fellowship, whatever it might be. And chances are someone out of all those hundreds of people that you know, is doing something kind of maybe what you're thinking about. So I've heard that before. And I'm being an introvert. I don't like to really necessarily reach out to people, cold call them, but an email or call they really, they always respond positively in my experience and what I've talked to people about.

I was going to ask you another thing, and it's maybe more about pharma than biotech. See what you think about this. But I imagine if I go on to Pfizer's website and try and apply for a job, I've got about a one in a million chance. But I know pharmaceutical companies use something called the CRO, which we've talked about here before, contract research organization is one definition. But in your experience, whether yourself or with others in businesses you've been involved with, is that something that it can be a bit of a shortcut, or a little easier to get hired than to go directly for one big company?

Dr. Michelle Mudge-Riley: Yeah, I think it's all about timing. There's some good TED talks that really speak to this. It's all about timing. There are some people who apply to jobs at Pfizer, J&J, or some of these massive companies that you might think of off the top of your head that are pharmaceutical companies when you're starting to think about it. And they're applying, they get the job. But yeah, you're right. In general, these positions, there are hundreds, maybe thousands of people applying. And so, it's a numbers game in a lot of aspects. And if you're finding a CRO, or maybe a smaller biotech company that people haven't heard of before, it's numbers game, it's just going to be less applicants. And maybe your application, your resume will catch someone's eye. A lot of this, again, is luck, timing, and you can increase your chances by talking to people in those relationships.

John: It's always better to have someone you can actually send your resume to, even if you go through the electronic version of that, it's still nice to have a human that might be able to sit through them and find yours. See, with the pandemic, it really kind of blew things up a bit. But there used to be some large national meetings that would occur every once in a while. And you could just show up or maybe attend the meeting, maybe it was on some topic related to a diagnostic class or something. And then you could run into people and meet them, take their cards. Does that still happen, do you think?

Dr. Michelle Mudge-Riley: Yes, yes. I think that still happens a lot. The Medical Affairs Professional Society, or MAPS, is a great example. They have an annual meeting every year in the US. They also have one in the EU every year. That's a great place to maybe start that networking or go to the meeting. It's not a guarantee. So just knowing that ahead of time is important.

John: Let me ask you a definition issue. Because one thing you can do is you can maybe look up people on LinkedIn, again, see if it cross paths with something else you've done in life. But the thing is, what are you looking for? Like medical director, it's a common term in pharma, biotech, medical devices, it doesn't mean that much per se, because it's such a general term. Would that be something you would shoot for right away? Or are there other entry level positions one might usually go to?

Dr. Michelle Mudge-Riley: Yeah, that's a tough one. Because you're right, medical director is such an ambiguous term. And it can mean something different in a lot different industries and at a lot of different companies. It's a good term, but it's going to be tough to use to search and find what you need there.

Medical Science Liaison is more of an entry level sometimes type job into these companies. The thing about an MSL is it's quite different from a medical director. And working as an MSL means you are working within medical affairs, whereas maybe some physicians will be a better fit to work for clinical development, or maybe even clinical operations. Or they may feel like the MSL role is a little bit of a demotion. So, you really have to balance all of those things.

If you're looking to find people in a medical director role, which I think is a really doable and achievable entry level role for most physicians, because we have the degree, we have the background, we have the clinical knowledge, and that's really looked at in a positive way, is to search by different companies. Maybe make a list of companies and then do that cross check and cross reference on LinkedIn. And then you can find people maybe a little bit easier within these different departments at that company.

John: Now, here's the question I've never asked anyone. But again, I'm always noticing these terms and trying to keep them all straight. But I've seen a number of people that the word global is in part, like global medical director, global this, global that. I assume that means because it's international. But what the heck does that really mean? Does it mean you're traveling the globe to do your work? Or what's your experience with that?

Dr. Michelle Mudge-Riley: You mean something different at every company. It most likely means that you are on the global team, which means you'll interact with colleagues in the EU or Asia, just somewhere other than the United States. But doesn't necessarily mean that you're traveling there. But it may, it may mean you're traveling there a lot. So it's very different depending on the company.

John: See, I talked to somebody about medical device, he teaches people how to do the MDR stuff in Great Britain. And his comment was though, let's say you're on that side of the pond, and you're looking for a job like this, because we get people that go back and forth. And he said, whatever you're doing there in Europe usually is going to apply in the United States, because all the companies in Europe that make drugs and biotech, they want to also sell in the United States. That can be a good thing to know that there's options on both sides of the Atlantic.

Dr. Michelle Mudge-Riley: Absolutely, yes, there is a lot of money in drugs in the US for better for worse. We could have a whole conversation about the ethics behind that. And is this the right thing? And how does this work needed for R&D? Let's not go down any of those routes. But you're right. Yes.

John: But I think they're big businesses. And so, they either hire a lot of people directly or indirectly. So that's good. It's a good option for physicians, we're scientists, and we most of us use drugs and medical devices so that kind of makes for a natural transition.

I think you alluded to this next question, but I have it on my list. I'm going to double check. That has to do with how to prepare or to increase your chances. I know we both don't tell people to go out and spend $60,000 or $100,000 on MBA just to get a job in a pharma company. But is there anything out there in terms of maybe a certificate exposure to research? I don't know, ways to get a little bit on your resume that might be might demonstrate some knowledge?

Dr. Michelle Mudge-Riley: Yeah. I wish but not really. It really comes down to all the things that I talked about before. The timing, the knowing people the right place, right time, you can get certifications just to make sure that you know about these different topics, or you're well educated, you can do a good job in the interviews. And that's great. And maybe that will help you a bit. But it's nothing is a slam dunk guarantee. That's the really hard part about all of this. I wish there was. But if there was, we would already know about it now, I guess, right?

John: Yeah, I think it gets back to what you said earlier, if you can have a connection and find out, narrow your search down based on talking to people, you may find in that particular job that this particular certification might help you get that job, but it's not going to apply across the board.

Dr. Michelle Mudge-Riley: Yes, yes. And if you're truly interested in that topic, getting that certification is only going to help you. And that's good, you should never just be doing things to get the job. In two years, you're going to be tired of it, you're going to be moving on anyway. So, try to also check your own self and make sure that you're doing these things, because you want this information. And would you do it anyway? Maybe if it's a little bit? Well, no, probably not, a little bit it's okay. But if it's you're just doing this to get the job, that may be also a little bit of a signal that this isn't the right field, or maybe looking at an easier way to do it, because you shouldn't be killing yourself to try to get that job.

John: Yeah, you should have the knowledge and a lot of the skills that already that would apply in that job.

Dr. Michelle Mudge-Riley: Yes.

John: Because like you said, so many of them are filled by physicians. So there is a demand there. And it's just a matter of getting that communicated across to the company in the HR department that you're applying to. Okay, Michelle, well, I think I've bent your ear for long enough here. So why don't you close by giving our listeners here some any last minute advice or positive words of encouragement for those that are thinking "I do want to try something different. And I do think it's in the biotech or biopharma area."

Dr. Michelle Mudge-Riley: Yeah, I think the biggest thing is something that I usually mentioned, so people have heard me speak before they've heard this, and they'll be like, yeah, yeah, yeah. But it's lose confidence in yourself. And I'm just as guilty of it as others. We go through these phases where we're so beaten down by rejection, and things not working out, it's really easy to start thinking that you're not good enough, you don't know enough, you're not smart enough, not good looking enough, not tall enough, you're never going to make it. I hate those periods, but we all go through them. And that's what's going to just bring you down even more. Because when you're when you're in that place, you can't be the person that you are. And I think all of us as physicians, we got into med school, we got through at least a year, most of us all the years and all the residency, but whether you cut it short or not, you still were able to get there. And you are good enough to be in one of these jobs.

So don't lose confidence in yourself, do whatever it takes, have your support system, find a therapist, find a coach, find whatever it takes to just kind of get yourself to the point where you're able to talk about your strengths and your weaknesses, but be able to articulate what you want to do, and why you want to do it and why you're a good fit. And then it's a numbers game. It's annoying like that, but it is.

John: Yeah, and I know that you and I both could give dozens, if not hundreds of examples of physicians who have done that, and they thought it was kind of impossible at first, and then they realized "No, it's not." And now they're having great careers and loving it. So that's excellent reminder.

All right, Michelle, with that, I think it's time to say goodbye. I will tell people, I have links in the show notes, just reminding them that they can find you at LinkedIn. And that'd probably be the best way to reach out to you if they have any questions or things they want to double check. Maybe they went to school with you, and they've lost touch. Maybe you can help them get a job in pharma. But anyway, with that, I'll say goodbye.

Dr. Michelle Mudge-Riley: That sounds great. Thanks, John. Thanks for your time. Thanks for having me.

John: You're welcome.

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The post Priceless Advice From an Expert in The BioPharma Industry appeared first on NonClinical Physicians.

In this week's show, an interview from the archives with Dr.Laura McKain explains how to land a pharma clinical development job.

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From Clinical Medicine to Clinical Development

Laura received her medical degree from Georgetown University in Washington, DC, and completed her training in obstetrics and gynecology at Virginia Commonwealth University in Richmond, Virginia. She was in private practice for twelve years where her clinical interests included well-women care, contraception, HPV, menopause management, as well as general and high-risk obstetrics.

Anybody that feels miserable and trapped… You may feel like you have no options but, I promise you, you have a thousand different options. – Dr. Laura McKain

Subsequently, Laura transitioned her career to the pharmaceutical industry. There she was involved in clinical development projects encompassing various therapeutic areas. During her tenure, she brought two new therapeutics to market.

Land a Pharma Clinical Development Job

She recently retired from full-time work. That allowed her to focus on helping other physicians find new nonclinical careers. She does that in several ways. And she is very confident that almost any physician in practice can make a move to a pharmaceutical job.

She is a career coach and resumé expert at mckainconsulting.com. And, she founded the Physician Nonclinical Career Hunters Facebook Group. Opened 8 years ago, it now serves 30,000+ members. It is the premier group to connect with other physicians, find job openings, and obtain valuable advice and mentorship about nonclinical careers.

During our interview, she described the tactics she recommends to find a clinical development job. She also defines job descriptions used in the pharma industry, and which jobs are the easiest to secure.

Summary

Dr. McKain provides lots of actionable advice in today's interview. She is a great resource for information and coaching about nonclinical careers. And she continues to grow her popular Facebook Group where you can learn more about how to land a pharma clinical development job.

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

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Links for Today's Episode:

• Dr. Laura McKain's Website
• Physician Nonclinical Career Hunters Facebook Group
• The Best Biopharma Positions For Motivated Practicing Physicians
• Landing Your First Pharma Industry Job May Be Easier Than You Think – 311
• Research and Development in Nonclinical Pharma Careers
• Medical Science Liaison Is Still a Fantastic Pharma Job – 261
• Highlight These 5 Experiences to Land Your First Pharma Job – 242
• Use These Simple Tactics to Land a Fantastic First Pharma Job – 209
• How to Find a Job in Pharma That You Love – 184
• How to Claim Your First Job in Industry – 168
• Nonclinical Physicians YouTube Channel
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 214

How Does a Physician Land a Pharma Clinical Development Job?

John: Today on the podcast I really hope to bring more clarity to the issue of jobs and pharma, particularly those in clinical development. My guest today is definitely an expert in this topic. She's a physician coach. She's a resume consultant or expert, whatever you want to call it. And she's also the founder of The Physician Nonclinical Career Hunters Facebook group, which I think most of you know about. Dr. Laura McKain, hello, and welcome to the podcast.

Dr. Laura McKain: Hi John. What a great pleasure to finally be here with you today.

John: I know. We've known each other for quite a while and it's like, why have we not been able to get together on this thing? But it just happens that way sometimes. Yeah, I've been really looking forward to talking to you, and my listeners probably know this, but you have so many areas of expertise and you've been doing this for so long. It's not just the pharma part, but the helping physician's part that I'm already going to put a bug in your ear about coming back on the podcast to cover another topic sometime in the future.

But we're going to really pick your brain today. First thing we need to do is just learn a little bit more about you. I have a separate intro that I did, but give us high points of your background and your career and what you're doing now.

Dr. Laura McKain: Absolutely. I'm a board-certified obstetrician gynecologist. I practiced in private practice for 12 years before transitioning over to pharma more than 13 years ago actually. I worked first in a couple of contract research organizations. And then I took a big leap and moved over to a startup biotech company on the west coast. Actually, I just recently retired from that company, after my drug got approved. I'm just tremendously passionate about my own career. Actually, I think I've had two careers, as well as my career transition from clinical medicine. And I am just incredibly passionate about assisting other physicians to make sure that they're really satisfied in their professional life.

John: That's fantastic. There has been such a demand over the last few years. And I don't know about you, I assume you've seen the same thing, but it was sort of something that people didn't ever talk about or didn't know about until now there are just physicians all over the place, including in the Facebook group looking for help and making the transition. That maybe doesn't bode well for the practice of medicine and all the hardships that are driving that, but it's definitely something that's growing.

Dr. Laura McKain: I absolutely agree. And I'm hoping that physicians can find perhaps other ways to find work-life balance without necessarily completely leaving clinical medicine.

John: Yeah. I think we talked a lot about making a transition, but always building it on that background in medicine, the knowledge of healthcare. Pharma is an awesome place to do that in my opinion. I've never worked in pharma, but we've interviewed MSLs and medical monitors and others, but really have had minimal exposure to the topic I hope to talk to you about today, which is clinical development or drug development. Tell me a little bit about what is that? I think we have our own understanding about it. It has to do with bringing drugs to market, but tell us what clinical development is as a division in pharma and what it does.

Dr. Laura McKain: Absolutely. Clinical development truly it's a blanket term that is used to define the entire process of bringing a new drug or a device to the market. It includes everything from the folks in the lab that are doing drug discovery, actually looking for molecules that might work, to the folks that are in product development, including the preclinical research, that may be done in microorganisms or in animals to early-stage clinical development where people are doing first in human studies to the later phases of clinical development, which involved the large clinical trials on humans that lead more directly to approval of a new drug. It's a broad range and there are actually a lot of different roles for physicians across clinical development.

John: Now, when I think about physicians in clinical development, I think about those maybe who went directly into academics, or they were doing research as part of their training. But what I think you and I tend to run into are physicians who have already been in practice for a while, they're thinking of leaving and now they want to transition back into some aspects. Maybe give us a little bit more of an idea of what jobs are in there that would be the most appropriate for physicians looking to go from clinical into that division of work.

Dr. Laura McKain: I think there are a lot of options and some of them may actually be things that physicians haven't even really thought about, particularly ones that still actually rely upon a lot of physician's clinical skills. One of them to start out with, and I'm going to start before a physician actually becomes employed by either a contract research organization or actual pharma company is to be a principal investigator in clinical trials. While you're still interacting with patients, it's very different than having a sick patient come to you for an answer.

When you're a clinical investigator, you're actually conducting industry sponsored clinical trials that are aimed toward getting a drug approved. And it is a fabulous role for somebody who feels like they have no experience in pharma or they feel like they don't have anything that they could put on a resume to get them their foot in the door with pharma. It's a great way for physicians to work on building that book of experience to make that transition.

And there are a lot of different settings for principal investigators that they can use their skills and to build this experience. For instance, they could work for actually large phase one units, which there are many across the country, where you're actually a full-time employee and you are enrolling patients, oftentimes, folks who are participating first in man trials, or they are doing studies like pharmacokinetic studies, to understand how new drugs are metabolized. Many of these types of facilities are actually inpatient facilities because they sometimes need to keep the patients for days in order to do the needed studies on them. They love employing emergency medicine physicians in this role, because again, it's a first demand drug. So, it's a great use of skills.

But there are also a lot of freestanding dedicated research sites that are either privately held or that a lot of physicians develop on their own to do later phase clinical trials. Think about like "Where did all of our trials that got us COVID 19 vaccines come from?" They were not done at academic institutions. Some of them definitely were done at academic institutions, but a lot of them were done in freestanding clinical research sites with principal investigators that were family practice docs or internists or from other specialties.

John: Okay. I'm going to dig into this a little bit, just to clarify for me and the listeners. Let me just give an example. I'm at a hospital where I was a CMO and we had an IRB and I sat on the IRB and we had these protocols come through. Most of those were external. And then we had people that were on staff at the hospital as part of that study, but would they be called a principal investigator or they would be an actual site from a study that was being produced either by the company directly or a CRO? How does that work?

Dr. Laura McKain: It really kind of depends upon how things are contracted, but you're right. Some physicians who are acting as a principal investigator, they may use their local institutional review board, the IRB, the committee that's required to review protocols to ensure that they are appropriate for patients. They may use a local IRB to conduct this research, but something that you may not know is that there are a lot of what we call central institutional review boards. IRB is that free standing units, not associated in any way with a hospital or an academic institution will use as their approval body for conducting this research.

Again, it really varies. There are some physicians that even act as a principal investigator within their own practice. They use a central IRB to get that approved. And they do it just part time. I've conducted many studies with lots of investigators who have that sort of setup. And then some of them love it so much they transitioned more and more away from actually seeing regular care patients and move toward doing clinical research on a full-time basis.

So, there are a lot of different settings where clinical research gets done. Academic institutions, hospitals, privately held investigational sites and then mom and pop organizations that physicians have started on their own.

John: All right. I hope I wasn't confusing anyone that's listening about the IRB. I think our IRB when we were involved with, let's say a national study and we happened to be at site, we were more just monitoring it. And there was a central IRB that approved the overall protocol, but we might have an oncologist on staff who was just enrolling patients into a study or urologist. I think he was more involved with procedures or in ortho doing certain implants. So, that did give them an exposure. And I didn't personally know anyone that used that and went into more of a full-time, but you're saying that's definitely a segue where you can say, "Look, I've been doing these studies, I've been monitoring patients. And so, why not do that full-time or something like that?"

Dr. Laura McKain: Absolutely. I've worked with lots of folks that have been principal investigators for industry sponsored research, and have used that as leverage to get a job with a pharma company. Absolutely. It's a great way because you already know how protocols work. You know so much that you would need to be able to know from the other side to be a medical monitor or what have you.

John: Would those people look at the firms, the companies that they were helping with their own study, or they look somewhere else? They say, "Look, I've got this experience in oncology" as the easiest way to use the company that they're already affiliated with, or could they just go to a CRO or some other company?

Dr. Laura McKain: Oncology is kind of a separate beast in terms of clinical development. Let's kind of just set that aside because a lot of oncologists, as part of their regular practice, do offer their patients the opportunity oftentimes last-ditch effort to enroll in study. So that's a little bit different. Let's talk about developing a new diabetes drug, or as I said, a vaccine. I did women's health studies. Those spokes are how they get their studies, how they find them really varies. Generally, some of them begin because they have relationships with contract research organizations, or they may work through what's called an SMO - Site Management Organization who helps them to find studies. And then there are some people who have just been doing it for so long that the companies come to them when they have a potential study. So, there are a variety of different ways here.

John: Okay. I guess that brings me to the question then, how would a physician other than being involved in something like that position themselves to move into pharma more directly? Are there things they can do beyond that that would help bolster their resume? What kind of suggestions would you have for that?

Dr. Laura McKain: You mean beyond being a principal investigator?

John: Yes. Or instead of if they haven't happened to be a principal investigator.

Dr. Laura McKain: I think there are a number of things that physicians can do to demonstrate that they have an understanding of how clinical trials work and what the work that they may be doing at a contract research organization or a pharma company. It definitely helps if you've got some clinical research experience but it could be something just as simple as being a real supporter of clinical research and being somebody who refers your patients to potential clinical trials. Getting great familiarity with clinical trials through that sort of pathway. So, physicians, let's say gastroenterologist. They have patients who have Crohn's disease which is very difficult to treat and they haven't found the right drug. They may help their patients find clinical trials to enroll in to offer them other potential options for successful treatment. That's definitely one way.

Other ways if you're a physician and you have absolutely no experience, would be to do a lot of reading, quite frankly. Really pay attention when new drugs are getting approved. Really look at sort of what the end product of new drug approvals are. And specifically, that's the prescribing information. Those long little leaflets that come that come with the drug. They're like 27 pages long. That's the end result of a clinical development project and really understanding what's in those documents and studying those sorts of documents and understanding the lingo and how they get to it. Looking at the published trials that come from new drug development, the pivotal phase three trials that are submitted as part of the new drug application.

Just getting that education and being well versed in it, being able to speak about it is great. If you're involved with drug reps at all, getting the word out that you're potentially an early adopter of a particular product and asking to speak with your regional medical science liaison to develop relationships with an MSL, to maybe get on a speaker's bureau for a drug. Actually, that was one of the ways that I got into the industry. I had been part of a number of speakers' bureaus for products that I really, really, really believed in. And that counted for me as being industry experienced, believe it or not.

I think another important thing is to potentially become a key opinion leader in your area. Choose some niche in your practice, something that's really of interest. Particularly, it's kind of nice if it's something where they're doing ongoing research. And become an expert. You should be the person that people refer patients to, have passion for it, really specialize in it.

And then last, but certainly not least what I always say is you should be networking. You should be networking. You should find people in the industry, find out what they do, do informational interviews with them, et cetera, et cetera. And those sorts of experiences can help you get your foot in the door with either a contract research organization or with a pharma company.

John: Does it seem like one works better than the other in terms of a CRO versus directly with a pharma company or does it just depend?

Dr. Laura McKain: I think there are certain specialties that can leap over to pharma much more easily. We already mentioned it, oncologists. If you're an oncologist out there listening, getting a job in pharma, it's as easy as falling off a log. I'm exaggerating, I know I'm exaggerating, but there are some specialties that are in tremendous domains. There are other specialties that I think have a much more difficult time. I've worked with a couple of folks like radiologists. I have really had a hard time trying to find an avenue for radiologists to get in. I'm not saying it's impossible because I know radiologists who've worked in clinical development, but it's probably a little bit more tough. Although even with that, there are angles for their careers.

We're kind of getting off on a tangent here, but there are companies that provide services to clinical trials, where they do very standardized assessments of certain diagnostic studies. A radiologist could go to work for one of these companies that does what we call "centralized readings" to make sure everyone's x-rays or what have you gets read in exactly the same way using exactly the same criteria. And I've worked with many radiologists who've gotten into that business. So, there are a lot of different avenues. There are lots of possibilities depending upon your specialty. Nothing's really off the table.

John: Very interesting. It can be overwhelming in a way. But you mentioned the KOL or key opinion leader and influencers and so forth. I mean, that's kind of the jargon they've heard from MSLs for example, and I'm sure there's a lot of other jargon. So, what about the titles themselves? What would be the jobs that a physician is looking at getting? Is it a medical director position? Is it a clinical scientist? If they're just trying to look around now, maybe look on Indeed or LinkedIn or somewhere just to look at a job description, what should they look up if they're looking for that kind of a job at a CRO or a pharma company?

Dr. Laura McKain: Sure. It does depend upon how much experience you have and where you might need to aim if you're looking to work for a contract research organization or for a pharma company.

I would say that generally speaking, a board-certified licensed physician who's looking to make this transition but maybe you don't have a lot of experience. I think a safe job title to pull up is an associate medical director position. And if you're entering it into LinkedIn, I put "Associate medical director clinical development", very specifically to look for those sorts of jobs. At a contract research organization, you're that type of role. You're really going to be serving as what we call a medical monitor.

It's actually not very common to find jobs titled as medical monitors. You can find them, but they're less common. Typically, the overarching term is an associate medical director or a medical director. But you would be performing that sort of role. You would be monitoring clinical trials, providing medical oversight to clinical trials in an associate medical director role in clinical development.

Going up the food chain from their medical director, senior medical director, executive medical director, some companies do or do not have this would lead them into a VP role. And then ultimately to a chief medical officer role. Obviously, those are all demanding experiences, but associate medical director is a good place to start.

For some people, even that may be kind of too high to aim. And another role that you can look for is a role as what's called a clinical scientist. And you can find those at pharma companies and also some contract research organizations. A clinical scientist is kind of the right hand to the medical monitor on a clinical trial. They still need to have a lot of clinical experience. They need to be very familiar and know a lot clinically to be able to review data.

They will play supportive roles to medical monitors, particularly on really high-volume studies. Again, I keep going back to our recent example of, "How did we get these COVID vaccines?" I guarantee there was like an army of clinical scientists out there that were helping to monitor the data, and to summarize it for the applications which got us emergency use authorization.

But clinical scientist is a great entry role. You'll find some physicians in that role, you'll find potentially foreign ex-US trained physicians in that role, but you'll also find PharmDs and even PhDs in that role. But it can be a potential place to get your foot in the door.

And then let's talk about the person who perhaps graduated medical school, but didn't do a residency or somebody who didn't complete a residency, or again, I'll even go back to somebody who graduated or trained outside of the US who's never been licensed here.

You talk enough about this, or we don't talk enough about that group of people, but there are roles in clinical development for those folks also. And I have worked with many people with the background that I've just described who serve as a role as a clinical research associate. And they often work for contract research organizations and they are fully trained on clinical trial protocols. And they actually go to the sites that are conducting the research. I'm really simplifying this, but they ensure that the data has integrity, that it's not fraudulent data, that it's been entered into the database correctly, that the site has conducted the study according to the protocol, with like I said, great integrity and they reported everything that they need to report.

Those clinical research associate roles are extraordinarily important. They definitely require a great medical background. I often see nurses in that role, other paramedical people in that role, but I've also, like I said, I've seen foreign trained MDs in that role. And it can be a foot in the door for pharma.

I built a drug safety team at one of the companies that I worked at. And I actually promoted a couple of people who had served as CRA's clinical research associates to drug safety physicians because they had all the medical know-how and they knew about clinical trials and they were great people to promote up to a more traditional physician role. So, there are lots of opportunities out there.

John: Oh, that's very helpful. I don't want to digress too much, but you mentioned this person, just this last bit here, that they were promoted into a safety role. This is just because in my mind, I'm trying to keep the parts of a pharma in my head and I tend to break them down into sections. So, I kind of think of the safety as standing by itself. It's not really part of clinical development. I don't think it's part of medical affairs. It doesn't kind of straddle all those things because it's maintaining safety.

Dr. Laura McKain: It does. Think about the role that safety plays in clinical development. When a company is developing a drug, there are two things that they are trying to establish. They're trying to establish the efficacy of the drug and also the safety of the drug. If the drug isn't safe, it doesn't matter if it's effective or not. You can't approve it. The pharmacovigilance department, the drug safety folks played an enormous role in clinical development.

And in fact, the clinical development people work very closely with the safety folks. And there is a ton of communication that goes on between the two groups. They review and analyze data together. Although the clinical development people are responsible for collecting the data, the pharmacovigilance people are really important in terms of meeting the regulatory requirements during development, but also, they play a huge role in the development of the actual applications when they go in. There is a ton of overlap.

And I'll tell you, John, that folks who work at contract research organizations, their positions that they get as a medical director are oftentimes really hybrid positions where they are responsible for medical monitoring, but they also can play a huge role in safety and they get very well versed in the regulatory requirements about both of those.

Of course, it's my experience, but I think contract research organizations are an amazing learning field for physicians who want to get into industry because you really get a broad view of things and you get to work with a bunch of different pharma companies to see how things are done differently at different companies. And it makes it much easier I believe to go onto pharma from there.

John: That is very helpful because we need to know how to get our first job. That's the hardest part I think from what I understand. Once you're in, then you can look around, you can continue to grow and learn and maybe shift. I just want to summarize things here though. I want to go back to the beginning. I'm in a position where

I'm thinking about doing something like this, but at the beginning, as you said, do your research, learn as much as you can, network. And I would assume also in some cases like physicians you've helped, get a coach, maybe that can help navigate this with you, if necessary, because it can get very confusing. Are you still doing coaching for physicians at this time?

Dr. Laura McKain: Absolutely, I do. I do work with individual physicians. And I'll be honest, I've really sort of narrowed my focus. I was kind of taking all commerce for a while, but I really have honed in on folks that are more interested in moving into pharma. I work with them to help them really mine their own background, their own experience to find those transferable skills that make them qualified for pharma. But I also can coach them on finding opportunities to build that runway to make the leap over.

John: All right. I do have to put the plug in now. It's at www.mckainconsulting.com.

Dr. Laura McKain: Yes. And check the show notes to make sure you get my last name spelled because it's a tricky one.

John: Right, right. So, that's one way you're helping people. Now, you're also helping them through the Facebook group so we have to spend a few minutes talking about that. Give us the entire history of the Facebook group in two seconds. No, I'm kidding. Just give us an overview of what's going on there.

Dr. Laura McKain: I established it five years ago, really just because of my own passion around this amazing second career that I've had. I really love my clinical career but I just feel like I've had this amazing second career I've gotten to. I've had two drugs that have gotten approved. I've literally traveled the world. I've gone to see how medicine is practiced all over the world. It's really been phenomenal. I just feel really privileged to have been able to do this. And after I got out of clinical medicine, I had lots of physicians, friends, and whatnot coming to me, "How would you do? How would you do it? How would you do it?" And I started the group to try to answer that question. And it has grown extraordinarily organically.

John, you've been an absolutely important administrator for the group for many years that have really helped us to truly grow organically. I mean, the group has sort of grown on its own. I will say. There has not been a lot of effort that's gone towards building it. We're up to almost 17,000 members at this point. We're fortunate that we've got a number of different experts in a variety of nonclinical settings that are really offering expertise to the group.

And then most recently, I made some changes in the group. And now because it's becoming more work to administer the group, we have a number of awesome sponsors for the group. John, you're one of our platinum sponsors for the group because of all of the contributions that you've made. But there have been a couple of individuals and one company that have stepped up to provide a little bit of financial support to kind of keep the thing moving and rolling.

But it's a great place for physicians to come to get exposed to people that are doing a variety of different things, non-clinically, as well as getting advice about navigating a transition. I think more and more our group is also helping to assist physicians who are just really feeling burnt out and maybe transitioning out of medicine isn't the right thing. But I think some of them are all saying they are finding appropriate connections within the group. "Maybe I just need to change my clinical practice and stay". So, I think we're beginning to kind of service that group also.

John: Well, that's good. That's awesome. And you're right. A lot of it is basically just people that are unhappy and they'd need support and they're getting encouragement with all physicians, 100% physicians, obviously. Yeah, I like all the new changes that you've made in the last several months and I think there are more coming. But it's a great place to go if you just don't know where to go, who to ask for advice on how to move into a nonclinical career or something like direct patient primary care or concierge med. All these things that are alternatives to the traditional practice that may be causing your brain to fry physically.

Dr. Laura McKain: A lot of the stressors seem to come from some sort of corporate medicine right now. People really do need to know that there are alternatives there and for anybody out there who's listening that feels miserable and trapped, you have to know that you may feel like you have no options, but I promise you, you have a thousand different options. It just takes some courage to find the thing that'll work for you. It may be something nonclinical, but you know what? I think there is also a great chance that there are answers if you want to stay in clinical medicine. Probably not what you expected me to say today, John.

John: No, no. I have guests on frequently that it's like if you can figure out a way to practice that isn't corporate medicine, because it's just killing you then by all means, do it. I certainly want to have a doctor for myself.

Dr. Laura McKain: Oh, yeah. And there are maybe people that can do things part time. Like I said there are a lot of people who have a clinical practice, but they also act as a principal investigator and that variety in their life makes things more doable for them. There's a lot of different ways to find happiness professionally. And I encourage everyone to do it. Don't wait. This is not a dress rehearsal.

John: Absolutely. I'll put a link to the Facebook group, but if you look up "Physician Nonclinical Careers" or "Nonclinical Careers", you'll find the Facebook group. I would encourage if you're not already a member to join there. There is a little vetting. You have to answer some questions, but if you're a physician, you can join. Is there anything else I'm missing in terms of places we should look for you? I think you're on LinkedIn, for sure.

Dr. Laura McKain: I think that's plenty. I'm in the Facebook group every day, now that I'm retired. Of course, once I've retired, I've got little quotation marks. I'm still doing pharma consulting and some other things, but I'm really doing it on my terms now. But the Facebook group definitely is a place to find me and mckainconsulting.com is another place.

John: All right. Well, it looks like we're about at the end here. Any last bits of advice for the listeners today?

Dr. Laura McKain: The last piece I would say is that if you're really seriously considering transition, I accomplished my transition solo and I don't recommend that. I think that now there are so many more resources and places to go for help. Rather than groping your way in the dark, reach out for help. It's worth it. I swear to you, I'm not trying to sell coaching services. I just hate to see people struggle. There are opportunities for people to get real professional help that can make the process much more efficient.

John: Very good words of wisdom there, reach out for help. And it goes all the way back at the beginning, when you were talking about networking and talking to others and learning. So, that's great. All right, Laura, thank you very much for joining us today. I'm definitely going to hold you to come back again and talk about some other things. So, with that, I'll say goodbye.

Dr. Laura McKain: Bye John. Thank you.

John: You're welcome. Bye-bye.

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