nonclinical jobs Archives - NonClinical Physicians

How to Set Up Your Medical Writing Business

John Jurica — Fri, 21 Jun 2024 10:45:58 +0000

How to Start Your Own Medical Writing Business: A Practical Guide

Starting your own medical writing business can be both exciting and challenging. Whether you're an experienced medical writer or a healthcare professional looking to transition into writing, setting up your business involves several important steps. Here’s a straightforward guide to help you get started.

Identify Your Niche
First, define the kind of medical writing you want to specialize in. The field includes technical writing for pharmaceutical companies, journalistic writing for physicians and patients, and writing continuing medical education (CME) manuscripts. Knowing your niche will help you target clients and tailor your marketing efforts.
Create a Business Plan
A business plan is your roadmap to success. Outline your goals, target audience, pricing strategy, and marketing plan. Here’s what to include:
- Mission Statement: Define why the organization exists, what its overall goal is, the kind of product or service it provides, and its primary customers or market.
- Market Analysis: Research your target market and competitors.
- Services Offered: List the types of writing you plan to provide.
- Pricing Strategy: Set your rates based on industry standards and your experience.
- Marketing Plan: Plan how you will reach potential clients, including creating a website, leveraging social media, and networking.
Choose Your Business Structure
Decide on the legal structure for your business—sole proprietorship, LLC, or corporation. Each has its own legal and tax implications. It might be worth consulting a business attorney or accountant. Also, don't forget to register your business name and get any necessary licenses or permits.
Build an Online Presence
In today's world, having a professional online presence is crucial. Create a website that showcases your services, portfolio, and contact information. Consider including:
- About: Share your background and qualifications.
- Services: Detail the writing services you offer.
- Portfolio: Provide samples of your work.
- Testimonials: Include feedback from past clients.
- Blog: Post industry insights and writing tips to demonstrate your expertise.
Network and Market Yourself
Networking is key in the medical writing industry. Join professional organizations like the American Medical Writers Association (AMWA) or the International Society for Medical Publication Professionals (ISMPP). Attend conferences, webinars, and workshops to connect with potential clients and stay updated on industry trends. Use social media, especially LinkedIn, to build your professional network and highlight your expertise.
Get Your First Clients
Getting your first clients can be tough but rewarding. Start by reaching out to your existing network and offering your services. You might consider doing some work for free or at a discount to build your portfolio and get testimonials. Freelance platforms like Upwork, Freelancer, and specialized medical writing job boards can also help you find opportunities.
Manage Your Business Operations
Effective business management is crucial for long-term success. Set up systems for tracking income and expenses, invoicing clients, and managing deadlines. Tools like QuickBooks for accounting and Trello or Asana for project management can help keep you organized.

Summary

Starting a medical writing business requires careful planning, networking, and dedication. By following these steps, you can build a successful business that leverages your expertise and meets your clients' needs. Stay adaptable and continuously look for opportunities to grow and develop professionally.

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Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

Some of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. I only promote products and services that I believe are of high quality and will be useful to you. As an Amazon Associate, I earn from qualifying purchases.

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

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

The post How to Set Up Your Medical Writing Business appeared first on NonClinical Physicians.

How to Exploit the Surprising Nonclinical Career Academy

John Jurica — Tue, 18 Jun 2024 13:37:10 +0000

Presentation by John Jurica – 357

In today's show, John introduces and describes the Nonclinical Career Academy and MemberClub, emphasizing their extensive resources for physicians seeking nonclinical careers.

He explains the various courses and bundles available, including options for monthly or lifetime memberships. John also mentions a special discount code, RELAUNCH2024, for a significant reduction on lifetime membership during the relaunch week.

Our Show Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast. The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

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.

Discovering Nonclinical Career Options for Physicians

In this segment, John discusses the genesis of his podcast and the pressing need for resources to assist clinicians in exploring nontraditional career paths. The podcast initially served as a platform for John to delve into the world of unconventional careers for physicians. That enabled him to learn while sharing insights and learnings from his guests.

Over time, the podcast evolved into a vital resource for clinicians seeking to leverage their medical training and experience in new and innovative ways, helping them regain autonomy, reduce overwhelm, and achieve a stable income.

The Evolution of the Nonclinical Career Academy

John explains how his journey led to the creation of the Nonclinical Career Academy, an educational platform designed to support physicians in transitioning to nonclinical roles. Initially starting with a few courses, the academy has grown to include a variety of resources. These include detailed lectures on becoming a Chief Medical Officer (CMO), transitioning into medical science liaison (MSL) roles, and exploring dozens of other nontraditional careers.

The Academy now offers a comprehensive membership model, providing unlimited access to 28 courses and ongoing updates. It has become a valuable tool for those committed to long-term career development.

Exclusive Benefits of Joining the NonClinical Career Academy

John highlights the benefits of joining the Nonclinical Career Academy, especially during the relaunch period. Members who join this week receive exclusive bonuses and a discounted rate, which will not be available after Saturday, June 22, 2024. The academy offers flexible membership options, including monthly subscriptions and a one-time fee for lifetime access so members can choose a plan that best fits their needs. The platform is continuously updated with new content including regular Q&A sessions, providing a rich and evolving resource for physicians exploring nonclinical careers.

Summary

John highlights the Nonclinical Career Academy this week. As part of this week's relaunch physicians can receive a sizeable discount for the lifetime membership, by using the code RELAUNCH2024 when registering for the membership HERE.

You can get a one-month MemberClub TRIAL for only $1.00 by choosing the monthly subscription and entering the Coupon Code TRIAL at checkout. After the first month, the $57 monthly membership fee will apply until you withdraw from the MemberClub.

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

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

Links for Today's Episode:

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 357

How to Exploit the Surprising Nonclinical Career Academy

John: Okay folks, today it's just me. I decided to take one show to tell you all about one of the projects I've been working on for several years. When I started in the world of nonclinical and non-traditional careers, it was pretty much a hobby. I had worked several nonclinical careers during my career and I wanted to learn more about what was available. So 70 years ago, I started the podcast and the reason I did that was I could learn more about unconventional careers for physicians from my guests.

And as I was doing that, I recognized that there is really a huge demand for services to help clinicians to figure out how to leverage their training and experience in unconventional ways to regain their autonomy, reduce overwhelm, and make a decent income. Early on, there weren't that many resources and there were a few coaches that I met early on like Heather Fork and Michelle Modriely and Starla Fitch and others. And over time, they started producing other products as well. Some of them started doing group coaching, some went into speaking and lecturing on the topic.

And then there were a couple of podcasts at the time. Then people began to create online courses. And even some people started writing books. For example, I have 50 NonClinical Careers by Sylvie Stacey and my friend wrote a book about locum tenens that was Andrew Willner. And there've been other books along the way, which I often refer to.

Now, I never became a coach per se, but I've done other things to try and help my colleagues. I've had at least two or three mastermind groups and I've helped produce and host two live online summits so far. And about four or five years ago, I started something I called the NonClinical Career Academy. And I have promoted that off and on over the years and I've started to accumulate some students in the academy, but I've never spent an entire show telling you what it is, how it's morphed over the years and what it can do for you. So I thought that I would do that today.

Now, before I get started, let me ask you to do something for me and for your colleagues. Some of you have been with me for years and years, and you've already heard about the NonClinical Career Academy. Some of you may even be members of it as I'm speaking. I assume that maybe you'll drop off today's show, but if you have a colleague who is fed up and burned out or just becoming curious about alternative, nonclinical careers, unconventional careers for physicians or even PAs and NPs, and they don't know where to find good information about it, then you should definitely refer this podcast episode and this show to them today.

And the reason I say today is because on the day that this is being released, which usually is on a Tuesday, I suppose I could release it maybe a day early just to get a little more exposure, but I'm in the middle of a relaunch of the NonClinical Career Academy and its associated member club, and there are definitely some benefits to joining this week.

And I'll give you more information at the end of today's episode, but definitely if you join this week, you're going to have some benefits that will expire on Saturday. You'll still be able to get in after Saturday, but you'll end up paying more and not getting some additional bonuses. So before I get any further, let me share a couple of important messages.

First, I want to remind you that this podcast is sponsored by the Physician Executive MBA Program at the University of Tennessee, Knoxville's Haslam College of Business. In less than one calendar year, this program will equip you with the valuable business acumen and leadership development not found in the traditional medical school curriculum. Are you ready to join the longest running physician-only MBA program in the country and a network of nearly a thousand PEMBA graduates? Contact Dr. Kate Atchley's office at 865-974-6526 to do that, or go to nonclinicalphysicians.com/physicianmba.

They've been a long sponsor. I just talked to Kate Atchley about a week or so ago, and they've definitely had some of you inquire and actually join their program. I've heard nothing but good things about the PEMBA. And like I mentioned in the past, joining one of the benefits is really to become part of that large group of graduates who then you can network with for jobs and projects. So I really encourage you to go to nonclinical physicians.com/physicianmba and check it out.

The next sponsorship is for myself in a way, and it's about sponsoring this show, the Physician Nonclinical Careers podcast. Why would you want to do that? Well, because as a sponsor, you'll reach thousands of physicians. So you can sell your products and services or build your following. Your message will be heard on the podcast, seen on our website, in our newsletters and emails and in social media posts. So if you want to learn more about being a sponsor, then go to nonclinicalphysicians.com/sponsorships.

All right, now let me move into today's important topic. And I'm calling it how to exploit the surprising nonclinical career academy. So this is a somewhat spontaneous and informal episode, and I'm kind of winging it here today. But I get a lot of questions. As I've been doing a weekly Q&A. I think I'm up to about the 35th or 36th iteration of that. And it's just common questions I get over and over again. How do I get started? How do I get into telehealth? How do I get into AI? How do I become a physician advisor? How do I become a physician leader or executive?

And so in addition to producing the podcast about five years ago, I started working on the nonclinical career academy. And basically, I created courses. Some of those are courses with multiple lectures that you can do over a period of weeks, really. Some of them are individual lectures that I've given elsewhere, or that I've created specifically for the academy. And at the beginning, I think I loaded initial six or eight courses. And this is hosted on Teachable.

Teachable is a platform that allows me to go in there, edit things, update things, and add new courses all the time. And so I've been doing that over the last four or five years. And what I did was I just started compiling these courses, tried to cover everything that I felt I was well versed enough and expert enough in talking about.

So there's multiple courses on becoming a hospital CMO. And there's courses on things like work, other work in the hospital as a medical director, work as a physician advisor, or what they call, they do call it a medical director when you're doing, let's say, insurance company, benefits management, and utilization management on the hospital side, they call you a physician advisor. So because of that, I started creating those courses.

I also have posted two or three interviews to help expand what I can cover using the expertise of others. And basically, I'm up to now 28 individual courses. And I'm going to show you this for those that are going to be looking at the video. I'm going to switch over to a video of the actual academy in a moment. So I have a bundle on hospital management, which means I have 11 courses put together as one entity that you can purchase it separately. I've got eight courses into an overview of nonclinical careers. Again, in Teachable, they call that a bundle. So you can purchase those eight.

And then about three years ago, I decided to add a membership version of this. The membership is different in the sense that instead of paying for each individual lecture or course, you can just become a member. And you can come and stay as long as you like. And as long as you're a member, you can access everything that's in there, which now includes the 28 individual courses plus the 30-some Q&A episodes that I've already recorded and anything new that comes in the future. And I even expanded the membership to be either an ongoing membership that you can purchase and then drop off. If you think you're only going to be in there for a few months, it's a less costly option.

The other thing is I made available an option to get a lifetime membership. For one fee, you can be in there forever. And as new things are added, you continue to have access to those. So if this for you is more of a long-term commitment that you know is going to take more than a year, year and a half, two years, whatever, you can pay one price and get lifetime access. And then you can even interact with me and ask me for additional resources. And then I can actually work on those. I created it because I knew there was a demand and it was a way to, rather than do one-on-one coaching, share this with a lot of people.

The member club is a part that I call the membership. So I'll talk a little bit as I present this final 10 or 15 minutes of the presentation today. And I think it can be very helpful to you and others who might be looking for a quick way to learn as much and be as selective in what you want to learn, go right to the things that are most interesting to you without searching over the entire internet, buying a bunch of books and so forth.

I put together as much information and inspiration as I can for beginners and for those who are early in their journey. Like I said, I've condensed thousands of hours of research into a fraction of that. I cover things like how to overcome limiting beliefs and common myths about job transition.

I've included almost every type of common job in the major industries that hire physicians, including biopharma, hospital management, home-based jobs, locum tenants, medical writing, consulting, and even more talk. I've got information there about how to convert your CV to a resume, how to prepare for your interviews, common mistakes to avoid, which, many of us have coaches and consultants have recognized and a lot of specific details about landing a job as a hospital CMO and as a medical science liaison. And new content is being added all the time.

So let's see. I think I'll walk you through this next part by going live into the site. Let me share my screen and we're going to go right from the very beginning about how to sign up here or how to find it. I'm going to go into the site as though I'm not a member yet, just to show you what that looks like. I'm going to go nonclinicalcareeracademy.com. So if you've never been on this site and you're not a member, this is what comes up when you go to nonclinicalcareeracademy.com.

And you'll see that there's all these images for either courses, bundles of courses, lectures, and so forth. Let me then kind of go through, I guess I don't really need to show you how to sign in at this point, but let me just talk about what's in there. And I'll try to explain everything for those that are listening to the podcast.

Well, at the top are something that are not individual courses. At the top left is something called Nonclinical Career Academy Member Club. I call it a member club because it's a membership, it's ongoing, and it's almost like being part of, let's say, a club, a business club, a golf club, something like that.

And you join based on a monthly fee or a one-time fee for lifetime access, and you get access to everything that's in here. Now, what I did too is as I was making courses, the first major course that I put together, some of these are lectures, but there's something called Build a Rewarding, Lucrative Career as a Medical Science Liaison. That's been in there for a long time.

It's six lectures plus an introduction and a summary that walks you through all the steps you need to go through to become a medical science liaison. I've interviewed at least, eight MSLs. I know other MSLs who I've not interviewed. And so I have a lot of information on that. So that was one of my first ones, and it's listed separately. You can purchase that separately because I have a background as a physician executive in the hospital setting as a CMO for 15 years.

I have a lot of individual courses in here that pertain to becoming a CMO. So let's see, Essential Skills and the Chief Medical Officer. And there is one in whether you need a business degree to land a NonClinical Career. And then there's also one on a Quick Guide to a Hospital Executive that gives you the 12-month roadmap.

Anyway, at the top is where you find these bundles, these so-called bundles. So it says Hospital Management Career Bundle. There are 11 courses in there, and those are all available for access at any time on your own schedule for one fee. Then the Introduction to the World of Nonclinical careers is also up here. And it has eight courses that have mostly introductory courses that cover a wide variety of home-based jobs, options for NonClinical Career, so forth and so on.

And then there's the Member Club, which is really the most comprehensive and really the best value because you get access to everything forever for one lifetime membership. So now if you do want to do the membership, then you click on the top left here, and that will bring you to some information about the Member Club itself, which does go in a lot more detail about everything that is included. And so there's a lot of scrolling here.

I'm sorry, I'm going through this, but it gives you the information. And now at the bottom, it does again go through all of those courses that are included in the Member Club. And again, it shows that when you go to enroll, you have an option of the monthly membership.

And this price is currently accurate at $57 per month, but it does change from time to time. And then the one-time purchase price up here. If I log in here real quickly, I'll just show you what a course looks like inside. So when you go in, now it'll say here that the Academy, the Member Club has four courses. These are not actually courses. These are designed to help you navigate through the Member Club, which has the 28 courses and lectures I mentioned earlier.

And so what that does is it kind of gives you some introduction, and then it gets into what to expect. And then there's also a suggested learning path. And I go through that actually in a video. And then when we're done with that, we can get a disclaimer and continue back. And then you will see that on the left-hand side here that the bundle, the included courses are on the left panel. And if you click that, it brings you to that entire list of available resources.

And then you pick and choose. Although again, depending on what your interests are, then you can go and they're all accessible. It will keep track of your progress. So let's say I wanted to look at the best resources for finding a NonClinical Career. I might click on that. You'll see that there's an introduction, kind of gets you oriented to this course. Again, most of these are me on video. And then on this one, we go through an actual presentation. And it keeps track on what you've done so that you can always come and go.

A lot of the courses do have additional resources, things you can download, sometimes podcast episodes. In this particular one, because we're talking about a lot of resources that it actually lists the resources that I talk about, and then you can link to each of those. So there's thousands and thousands of hours worth of information here. I'm not saying there's thousands and thousands of hours of video, but there are hundreds of hours of video, plus all the information that I add to each resource that also includes additional resources that you can access if it's of value to you. I think I will close at that point and stop sharing my screen. As I mentioned earlier, new content is added fairly frequently.

And I'm doing the weekly Q&A, which adds more content every week. Sometimes I skip a week if I'm off out of town or something. Again, if this interests you, you want to learn more about it, go to nonclinicalcareeracademy.com. Look at the complete list of options. Try a single course if you like. Try a bundle for a broad overview of nonclinical careers or a deep dive in the hospital CMO courses.

There's a complete six-course or six-lecture course on becoming an MSL. And the best value is to either get the monthly membership or the lifetime membership, and you can access everything for as long as you would like. If you do the lifetime and use RELAUNCH2024, you'll have lifetime access and you'll get a significant discount. That's RELAUNCH2024 as the coupon code.

That's it for today's presentation. Everything I've created over the years has been designed the best way that I can to help you find fulfillment in your career as a physician. The podcast, the academy, the summits, the website are all designed to meet your needs. Much of it is free and some requires payment to help keep me doing what I'm doing. But it's still small enough that you can always contact me directly if you have a question or you notice a mistake or you'd like to request a particular topic or guest or course you'd like created.

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Disclaimers:

Many of the links that I refer you to are affiliate links. That means I receive a payment from the seller if you purchase the affiliate item using my link. Doing so does not affect the price you are charged. I only promote high-quality products and services that I believe will be useful to you. As an Amazon Associate, I earn from qualifying purchases.

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

The post How to Exploit the Surprising Nonclinical Career Academy appeared first on NonClinical Physicians.

The Essential Guidebook to Being An Outstanding CMO

John Jurica — Tue, 11 Jun 2024 11:56:48 +0000

Interview with Dr. Mark Olsyzk – 356

In today's interview, outstanding CMO Dr. Mark Olszyk provides his advice and that of his co-authors from The Chief Medical Officer's Essential Guidebook.

He discusses the critical skills required for effective medical leadership and practical tips for navigating complex healthcare challenges. And he emphasizes the importance of continuous learning and collaboration among healthcare professionals to be successful.

Our Show Sponsor

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 Journey to Becoming an Outstanding CMO: Insights and Experiences

John leveraged resources from the American Association for Physician Leadership (AAPL), including its Certified Physician Executive (CPE) program, to enhance his leadership skills. That is where he met Dr. Mark Olszyk, a seasoned physician leader with a rich background in military service and medical administration.

Dr. Olszyk, co-author and editor of “The Chief Medical Officer's Essential Guidebook,” shares his extensive experience in medical leadership. From his early days in the Navy to his decade-long tenure as a Chief Medical Officer (CMO), he highlights the importance of learning from successes and mistakes. The book serves as a comprehensive guide for aspiring CMOs, offering practical advice and lessons distilled from the experiences of various medical leaders.

The Role of a Chief Medical Officer: Responsibilities and Challenges

Dr. Olszyk outlines the multifaceted role of a Chief Medical Officer, emphasizing the importance of building bridges between various stakeholders in a hospital. He describes the evolution of the CMO role from the Vice President of Medical Affairs, focusing on credentialing, privileging, quality reviews, and regulatory compliance.

A CMO is a liaison between the medical staff, hospital administration, and the board of directors, ensuring effective collaboration. Dr. Olszyk also discusses his journey in medical leadership and the fulfillment he has experienced during his career.

Advice for Aspiring Medical Leaders: Steps to Take and Skills to Develop

Mark offers practical advice and steps to gain relevant experience for those considering a career in medical leadership. He encourages involvement in leadership roles within hospitals and joining professional organizations like the AAPL and the American College of Healthcare Executives (ACHE).

He also emphasizes the value of networking, seeking mentorship from current medical leaders, and continuously developing leadership skills through education and practical experience. By engaging in paid and volunteer leadership opportunities, physicians can significantly influence the future of healthcare while developing new skills, on their journeys to outstanding CMO.

Summary

In this interview, Dr. Mark Olszyk shares his extensive experience as an outstanding CMO and co-author of “The Chief Medical Officer's Essential Guidebook.” For those interested in purchasing the book, it is available on Amazon or through the American Association for Physician Leadership (AAPL) website, where volume discounts are also offered. You can reach Mark directly via LinkedIn.

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

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

Links for Today's Episode:

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 356

The Essential Guidebook to Being An Outstanding CMO

- Interview with Dr. Mark Olszyk

John: During my efforts to improve my skills as a physician leader, I naturally took advantage of the AAPL, the American Association for Physician Leadership, including its CPE program. And it was during the final week of that CPE program that I met today's guest. He's a consummate physician leader, starting with way back when he was in the military. He may still be in the military, I'll ask him about that. But anyway, he's held numerous leadership and executive positions, and he's also the co-author and editor of a new book, well, it came out last year, The Chief Medical Officer's Essential Guidebook. Let's welcome Dr. Mark Olszyk to the show. Good to see you again, Mark.

Dr. Mark Olszyk: Good to see you, John. It's been too long, but thanks for having me and inviting me to your podcast. I'm really excited to be here.

John: Excellent. I have brought up the issue of physician leadership, and especially in the hospital setting, many times over the years on the podcast. And as far as I know, there are books written about the job and different aspects. But really, when I saw this book, with excellent collaboration with the AAPL and yourself with all your experience, this is just perfect for those in my audience who are thinking about moving along those lines, and actually a "how to" to get there. I really appreciate you putting this book out there.

Dr. Mark Olszyk: Oh, well, thanks. To answer your previous question, I'm not still in the military. I got out in 2003, kind of hard to believe, but I'm a proud Navy veteran, and my son is an Army ROTC. So, get that out of the way.

John: Nice.

Dr. Mark Olszyk: Yeah, yeah. The book, I think everybody at some point in their lives, reflecting on their experiences, and their travels and their journey, say, "Yeah, I should write a book about that." And I'm no different. But I've been a CMO, chief medical officer for about 10 and a half years. But I've been in medical leadership since the first year after finishing residency, I went into the US Navy. And the military, unlike almost any other sector, will put you in to leadership positions as soon as possible. And you find a way to get the skills and find the maturity and the leadership is thrust upon you and you have to rise to the occasion. I've always been grateful for that.

But I had gone to conferences at AAPL, others where I met other chief medical officers, and we would share stories. And I thought, boy, it'd be great to write this stuff down and distill this because these are some really valuable lessons, not just the things that we had done correctly, but all of the mistakes that we had made. And wouldn't it be better for other people to learn from our mistakes rather than repeat them themselves.

I guess it came to a head in our system. Physician was made chief medical officer of another hospital. And I just kind of casually passed along here's 10 things to do, like the 10 commandments, but not nearly as inspired, but just 10 things. And about six to eight months later, I guess he lost it. It was that impactful. But he lost it and said, hey, can you send it to me again? I just didn't have it. And I thought, "You know what? If I'm going to write some stuff down, let me make it into something." And it just kind of grew. And I talked to some of my colleagues and contacts. And I said, would you guys be interested in collaborating on a book? Because I think it'll be enormously boring if it's just me telling the stories. But if we have a whole chorus of voices, I think that might really strike a note.

I just had no idea how to publish a book. I just didn't want to do it on my own. I approached AAPL. And Nancy Collins was very gracious. We actually met in a Starbucks in Maryland. And she showed me some of her other publications that came out recently, one of which was a collaborative effort. And it just kind of grew from there.

I reached out to everybody I knew in my life who was a CMO or medical leader. And there was a lot of enthusiasm. I learned a lot in trying to shepherd people together for a collective effort where I was not their boss. They were not getting paid. And there was no way I could really enforce any sort of deadlines or standards. That in itself could be a book, a book about how to write a book. But it was a fun journey. I'm glad it's out there and I've received some excellent feedback.

John: Yeah, when I look through it, of course, most physicians, actually, most clinicians, of course, they like teaching, like helping their peers and so forth. And I think many, if not all, not all of the section writers or physicians, of course, you tapped into other expertise, which I like. There's a lot covered there.

And when I think about the CMO role, it's in my mind is like this iconic what does a CMO do? But everyone does it differently. Everyone does different aspects, more depending on each job. It's unique. But yet, I think you covered everything that I could think of in terms of what questions would I have if I was thinking about being a CMO or I was and I was missing something. So tell me a little bit more about the process. How did you herd all these cats and get this thing done? How long did it take you to do?

Dr. Mark Olszyk: From start to finish, it took about a year. Some of the author contributors returned their submissions in two weeks. Others took about eight months. Some needed multiple revisions, some needed none. I did recruit two co-editors, Aaron Dupree and Rex Hoffman. They helped out a lot.

I learned a lot about copy editing and all of the back office productions and placing it and formatting it. From what had existed only as a series of, I'll say, not too well organized Word documents on my desktop, to see that transform into an actual written book was pretty fascinating and eye-opening. But originally I had an idea for a structure and like all initial ideas, it went away pretty quickly.

And so I just asked people to write about what they felt that they were knowledgeable about or passionate. And the outlines of a puzzle began to come together. And then after about 75% of the submissions were in, at least an outline form, then I could actually target what was missing.

As a frustrated or wannabe classicist, I used the model of the medieval concept of the human being. The first set of chapters, the first section is about the anatomy of the CMO, the basics, the blocking and tackling, metrics and patient experience and all the quotidian day-to-day activities that were going to be the guts and the sinews and the bones.

And then we would move on to the heart, which is all about relationships and how the CMO relates to the chief nursing officer, the chief executive officer, to the board of directors, to departmental chiefs or chairs, and also their perspectives, what they think a CMO should be, or how a CMO should act to be successful in their eyes.

And then we moved on to the brain, the strategic thinking, extra hospital relationships, like how do you deal with third-party rating agencies and auditors and joint commission and dealing with the media, especially when the memories refresh from the pandemic, what if you're asked to appear on TV, on live TV, on the radio and newspaper articles how do you prepare for that?

And then finally, the soul or the spirit, which would be the transformational values and ethics and diversity, inclusion, aspirational type things. It was kind of a journey from the very basic things that a CMO would do day-to-day to the more long-range aspirational goals or values. And I think the way it's written, you can skip around. You can say, gee, I want to learn more about how to prepare for a media interview or how to relate to the board of directors. And you can go right to that section. So it doesn't have to be read in order. It can be used as a reference or it could be read as a story in itself.

John: I think it's pretty comprehensive. And probably in anyone who serves as CMO may not even be exposed to all the things that are covered. There's so much and again, because each role is slightly different. So it's awesome. One of the things I like to do when I'm bringing on an editor and author is pick their brain. So I have an ulterior motive for having you here other than just to talk about the book, although again, it's fairly comprehensive.

But just to keep what our audience's appetite here for this job because some are a little reluctant maybe they have a negative feeling about working in hospitals being abused by somebody or another, but there are good systems out there. And the other thing is being the CMO, you can make a big difference in how that organization is run. Tell me what you would say, if you were to boil it down, what are the most common areas that a chief medical officer is sort of responsible for? Maybe another way to look at it is like who reports to them, because it kind of makes me think about, okay, well, I do this because this person reports me. So however you want to answer that question in terms of the core roles of a CMO.

Dr. Mark Olszyk: I think the CMO role evolved from what was previously and still exists, usually in a hyphenated title, Vice President of Medical Affairs. That being the mechanics and the support staff for the organized medical staff. And every hospital per joint commission guidelines and through history, has had an independent organized medical staff who are largely responsible to establish their own standards for credentialing and privileging. And that was made ever more important back in the 1960s, when there were landmark cases, lawsuits, where patients began to sue hospitals. And the hospital said, hey, we have to really have some quality standards, and we're going to ask the medical staff, almost as a guild to police itself. But the medical staff have full-time jobs taking care of patients, and it's hard for them to keep the files and the minutes and the records and organize the meetings and stay abreast of all of the regulatory changes.

There is an Office of Medical Affairs in every hospital. And the Vice President of Medical Affairs, now the CMO, is largely responsible for ensuring the quality of the medical staff, making sure the medical staff leaders understand what they're supposed to do, making sure that they do it. And it's challenging in that the medical staff can be employees of the hospital or healthcare system. They can be contractors or vendors, or they can be completely independent. And when I started out at this hospital, it was about one-third of each.

To get all those different folks with their different interests aligned in a common effort proved to be a challenge, but one I thought was very fun because I had to look at their world through their eyes and also convince them that what we were doing was necessary and important and create a team not of rivals or competitors, but of people who didn't necessarily all fall into the same silo.

We're largely responsible for the credentialing, privileging, presenting those applications to the medical executive committee and to the governing body, which is usually the board of directors, making sure everyone is completing their FPPEs, their OPPEs, the ongoing professional performance assessments, making sure they're up to standards with joint commission, reviewing and knowing the bylaws. I probably know the bylaws better than anybody in the hospital. We've rewritten them 10 times since I've been here. Quality review, and then making sure that the medical staff were involved in all of the various intra-hospital, extra-hospital committees radiation safety, prescribing, that sort of thing.

What I'd like to say is that the chief medical officer is a bridge builder between the hospital administration and the medical staff, but also between the medical staff and the board of directors, between the hospital and the community. Sometimes the CMO, I found myself as the spokesperson during the pandemic especially. It was on local radio, on TV trying to break down in very understandable terms what was happening, but also bring back to the hospital and tell them, hey, this is what the community is concerned about. Here are the questions they have.

We have to be mindful of that, responsible for that. Also within the hospital, being a bridge builder between the various departments translating the needs of the hospitalist team to nursing or between medicine and surgery and sometimes refereeing, sometimes being just the host getting folks together.

But I always come back to bridge building. And again, if you look through history, through cinema, through literature, bridges always figure prominently in history, battles of the Milvian Bridge with Constantine changing the nature of the Roman Empire, Stamford Bridge, which ended the Viking Age in England. All these great events happen on bridges. Even if you've seen Saving Private Ryan, which came out, in 1998. The last ultimate scene, Tom Hanks losing his life is actually on a bridge. And if you're a fan of The Lord of the Rings, that's where Gandalf the Grey transforms into Gandalf the White. And again, Jimmy Stewart, It's a Wonderful Life. The transformational scenes occur on a bridge.

I was a scoutmaster. When the Cub Scouts become Boy Scouts, they cross over this bridge and they don't really pay much attention to it. But I gave a little speech to the parents, like, look, this is a special time, you're going from one part of your life to another. And this is punctuated by going over a bridge. Bridges represent liminal spaces, liminal time, when you're not here, or there. Bridges are a great metaphor, because they're very narrow. And they're very risky, because if you fall off one way or another, if you don't keep a straight path, if you don't keep your eyes on the goal, tragedy can ensue. And sometimes it's foggy, sometimes it's slippery. So, it takes somebody who's been back and forth a few times, who's surefooted, who is focused to to cross that bridge.

And bringing together all those communities, translating their needs and their goals and their concerns from one party to another, can be very risky. If you don't do it correctly, it can really backfire. That's why I consider the role as bridge builder. The Pope himself is the official title is Pontifex Maximus. The greatest bridge builder. I don't think the CMO is the Maximus, but I think it's a very important bridge builder, we can all build bridges. And hopefully, the CMO can exemplify that.

John: The ironic thing is that if you go back the last 20-30 years, for a while there, there weren't that many physicians in leadership positions, at least on the community hospital side you always had academic hierarchies. But I think in the 50s, up to half of hospitals might have been owned by physicians, and then over time, it just everything got split. And so I think what you just said, it's important that physicians be in those roles. So I'm glad that there are more physicians and when I started as VPMA, our hospital had never had a VPMA or a CMO. So many hospitals now do.

Building on that, tell me in your opinion, the pros and cons of being a CMO. Like I say, I have many people that are a little reluctant to make that commitment. But to me, it was a natural thing to pursue. So, what are your feelings and some of the challenges and also just what you love about it?

Dr. Mark Olszyk: Yeah, for me,this can sound a little pollyannish or saccharine, but for me, there's no downside. I guess it just fits my personality. When I was a brand new attending physician, I would see these larger forces at work in a hospital, budget, staffing challenges. And I'm like, man, I just want to be able to fix that I want to get involved in that. So it was kind of a natural course. I got my MBA so I could talk the talk and understand some of the discussions a little bit better, and then got more and more involved.

And it's just hard for me to resist trying to represent my fellow medical staff members, physicians, but pretty much trying to weigh in. If we're planning an expansion to the hospital or adding a new service line, or how do we go about on some major quality initiative, I really want to have a seat at the table and have a voice. So the best way to do that is to get into the C-suite, you get into medical leadership, develop those relationships and connections.

What I love most about the job is probably as a CMO, I'm an ambassador, plenty potentiary, I can go to any clinical department, I can go right down to pathology right now, talk to my chief pathologist. And he's got a two sided microscope, and he'll show me some slides which look like pink and purple squares. And he'll say, what is this, and I'll get it wrong every single time. Then we talk about his family. I get to know him as a person. And that builds a bond of trust, it furthers our relationship. I can walk out of there and I can go up to radiology and look at some of the images with the radiologists. And then I can walk in to the surgical suite and get gowned up and just see what the surgeons are going through, see what their day is like. Yeah, I can do the same thing for the hospitalists, for pediatrics.

I actually like being a medical student in my third and fourth years because you have a different rotation every month. It was always fresh, it was always interesting. And that's why I went into emergency medicine where you're expected to be somewhat proficient in almost anything because you don't know what's going to walk through the door. So, you have to know about pediatric medication doses, you have to know how to treat people struck by lightning or bitten by rattlesnakes or CHF in a hundred-year-old.

So, you have to know everything you have to know enough about every specialty. And then you wind up calling every specialty, sometimes in the middle of the night, but often during the course of your shift, either for follow-up or for intervention. And so, you have to learn how to speak their languages. And I just never really wanted to give that up. I didn't want to find myself just in one specialty and not continuing to learn and stay abreast of all the others.

So, I think that's the most fascinating aspect of being a CMO is, I'm pretty much given a hall pass to go wherever I want in the hospital and no one questions that. In fact, they kind of expect that. And that carries over. I get to go to the board meetings, to the finance meetings.

I can drop in on the chief nursing officer, chief quality officer. So for a person who's emergency medicine docs tend to be a little bit restless and always looking for some new stimulus, that was just a perfect job for me. So, that's my favorite aspect and one I would not ever want to give up.

John: Excellent. Now, it's interesting. We all have our own particular things that we like. I loved interacting with the board. I was on the every board meeting. I had an official presentation and I actually love spending an hour or two preparing that. I like being alone in my office and doing things to prepare for that. Whereas other people are like I want to be out there in the public. There's so many different things that one can do.

So, if there's someone in the audience who's either thinking about, well, would I like this or should I do this? Or I'm about 50% sure that I want to do this. What advice would you have for that person early in the thought process of pursuing a leadership position, let's say, rather than and it may be eventually CMO?

Dr. Mark Olszyk: Yeah, I'll approach that a little bit obliquely. So, I've given a number of leadership talks over the years and folks are always asking, well, how do I get experience being a leader? I'm like, there's no end of opportunities. Having been in the Boy Scouts, I have three sons, and they're all Eagle Scouts now. But people are always looking for leaders. And it might not be the thing you want to do forever.

But whether it's your church or civic group, the schools, they're always looking for someone to step up. And I said, boy, if you can be a Scout leader, and hold the attention of 60, 10 and 11 year olds for 90 minutes, you can do anything. First of all, brush up your leadership skills wherever you can find the opportunity doesn't have to be in the hospital.

Secondly, the hospitals are always looking for medical leaders. I've seen a ocean sea change in the last 10 years. It used to be that our medical staff meetings, our quarterly medical staff meetings, were raucous affairs, we would have 60 or 70 people there.

As our models have become more contracted or employed physicians, I guess they don't have the same feeling of being community stakeholders as when it was mostly independent physicians in the community who had been there for decades. Now the days are long. And I think after a 12 hour shift, the hospitalists want to go home. And there's also the opportunity to Zoom into a meeting. So we don't see as many people attend in person. And it's getting harder and harder to get people to volunteer to spend an hour or two, even if it's once a month, in a peer review committee, because it does take some commitment to read over the cases and then show up for the committee. And we don't stipend or remunerate anyone except for the chair or the chief.

So it's volunteer work. We're always hungry for that. I'm sure every hospital has opportunities. If you want to get involved in peer review or bylaws or credentialing, or on the pharmacy and therapeutics committee, there's definitely opportunities there. Or the foundation or fundraising, or there's lots of opportunities.

And then you begin to network. I guess the next opportunity would be just to ask your chief medical officer. You could probably shadow him or her for the day. We all like to talk about ourselves. I'm doing it right now. If someone came to my office and said, hey, I'm interested in one day being a CMO or an assistant or vice, what's the path? And it depends on the person, on their personality, what they would like to do. Everyone does it differently. Every hospital has a different set of requirements or needs. So it's dependent, but I would be very willing to talk to them. I think anybody would.

Next you could buy the book and look through that. A little selfish promotion, or you could join one of the organizations, AAPL, ACHE. States have their own chapters. Every specialty has its own chapter as well. I think there's lots and lots of opportunities. You can write articles. Journals are always looking for articles. So there's a lot of ways to just get more involved. I don't think anybody in a medical leadership position would be reluctant or hesitant just to make the time for someone who expressed an interest and wanted to learn more.

John: The other thing I found useful, I don't know if it's still the same, but talking to the CEO, hey, what's your perspective on physician leaders and what should I do if I want to get up and be part of the senior executive team? So there's tons of opportunities.

Dr. Mark Olszyk: Absolutely.

John: But we are going to run out of time. So let's talk about the book again. Let's start with what do you think is the best way to get the book? Should we go to the AAPL? Should we go to Amazon? Are there other ways of finding the book?

Dr. Mark Olszyk: Either one of those is fantastic. If you go through AAPL and you want to order a lot, there are volume discounts or you can go to Amazon, it's easy. You can type in chief medical officer or even my last name, which is not too common, Olszyk book, and it'll pop up. You'll see a couple of Amazon reviews. Unfortunately, some were written by my children. Ignore those. And if your listeners or podcast watchers do get a copy, please do leave a review. It's important. But yeah, either way, you go through AAPL. I think there are some other platforms out there, but those are probably the two most common and easiest to go through.

John: That makes sense. What if they have a question for you? Can they reach out to you?

Dr. Mark Olszyk: They can reach out to me. Yeah, I'm on LinkedIn, as you know so you can direct message me. People have done that and I've responded quickly.

John: Okay, good. Excellent. It's good sometimes just really to talk to the editor or author. Of course, you wrote several of the sections of the book in addition to being the chief editor and you said you had some help with that. But okay, well, any last bit of advice before I do let you go in terms of the future of medicine and physician leadership therein? Any other words of wisdom before I release you from this torture?

Dr. Mark Olszyk: No, it wasn't torture at all. I really enjoyed it. It's good seeing you again. And again, thank you for the opportunity. Clearly, like everything else, medicine is going to change more in the next 10 years than it has in the last two generations. So if you want to be part of that change, get into a leadership position, let your voice be heard. I think a pessimist is someone who takes no joy in being proven right. And an optimist is someone who thinks the future is yet uncertain. So if you want to help craft the future, get involved.

John: That's awesome advice again. And I think physicians do resonate with that for the most part. I want to thank you again for being my guest. I might have to have you come back and dig into one of these topics that's in the book, maybe in more detail at some point, but it's been great talking to you again. We appreciate you sharing your expertise with us today.

Dr. Mark Olszyk: Cool. Thanks, John.

John: You're welcome.

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The post The Essential Guidebook to Being An Outstanding CMO appeared first on NonClinical Physicians.

How to Become a Consultant to Venture Capital Firms

John Jurica — Tue, 04 Jun 2024 11:59:53 +0000

Presentation by Dr. Tom Davis – 355

Today's show presents Dr. Tom Davis' lecture on becoming a consultant to venture capital firms from the 2023 Nonclinical Career Summit.

This serves as a motivational guide for those looking to navigate the consulting landscape successfully. Tom also shares his advice on using the consulting relationship to become a shareholder in selected start-ups.

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Overcoming “The Dip”

Dr. Tom Davis, a board-certified family physician, shares his journey into healthcare consulting. Despite initial struggles and feeling stuck in what Seth Godin calls “The Dip,” Tom persevered. His breakthrough came unexpectedly with a lucrative offer from a venture capital firm, which marked his transformation into a successful professional consultant.

Types of Consulting

Dr. Davis outlines the three primary types of consulting:

Skills-Based Consulting: Utilizing specific skills clients lack, like creating a motivational video.
Credibility Consulting: Lending credibility to client decisions, often based on reputation and Google rankings.
Advisory Services: Providing strategic advice, often under retainer agreements, to venture capitalist firms and other entities.

Building Trust and Value

Dr. Davis emphasizes the importance of consistency and value in establishing trust with clients. Drawing from Seth Godin’s analogy, he highlights the need to offer valuable insights consistently, akin to placing a crisp $10 bill in a neighbor's mailbox daily, to build credibility and eventually secure larger client commitments.

Summary

For more information or to connect with Dr. Tom Davis, visit his website at tomdavisconsulting.com. He also shares valuable insights on LinkedIn, where you can follow his professional updates and articles. Tom is also a professional speaker and podcast guest, sharing his expertise in value-based care and telemedicine.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 355

How to Become a Consultant to Venture Capital Firms

- Presentation by Dr. Tom Davis

Dr. Tom Davis: My first love was really consulting and value-based care. That was my goal as I started to pivot, but I was very discouraged at that time because I really wasn't getting the traction I wanted. I was getting clients, but I wasn't succeeding as well as I had thought.

I was in a period that the marketer named Seth Godin called "The Dip." After you've gotten started and you're very excited, then suddenly things just don't move as fast as you want, and you're kind of in the doldrums, and it's important to work through it.

Well, I remember this day. I was just laying on a couch, and it was my day off from my employee position as an FP, and the phone rang. Normally, the phone rings. It's probably another kind of basic engagement, or it's a telemedicine clinician looking for some help. I had been working very hard and diligently trying to engage potential clients in my practice. I had a website up that I blogged on a regular basis. I had a couple books out.

I did some professional speaking. I really was doing everything that I should, but your clients really don't care about that. They only care if you can solve their problems, so when the phone rang, I answered it without a lot of anticipation, and it was this gentleman from a venture capital firm looking for my assistance in helping them place evaluation on an acquisition that they were looking for, and we talked.

He's a very engaging guy, and eventually, he got the fees. He asked me what I would charge for advising them for a period of three months, and I told him I had to find out exactly how much value I could generate, and I didn't like hourly wages. I really liked retainer arrangements, and he responded, "Well, we can't pay you more than $50,000."

Well, I give myself great credit that I didn't choke or sputter because that was 10 times what I had earned in any other previous engagement, and normally you would take that as a starting point and begin to negotiate, but I took that money and ran because it was the very first time I really felt like a professional consultant.

Now, as John said, my name is Tom Davis. I'm a board-certified family physician. I came out of residency, and with my new partners in rural Missouri, we founded Patients First Healthcare, which was the first value-based care health system in the country. Lots of firsts there that I'll spare you from, but in 2012, we were acquired for more money than anybody should ever be paid, and with that acquisition, I decided that I needed to spread the love because practicing as a value-based care physician was just like walking on air. It was wonderful, so I still had three years on a personal service agreement with the folks who acquired us, so I started opening up my consultancy.

I stumbled into telemedicine. I did that on the side just for my own edification and as a service to my fellow clinicians, but that was the course that led me to that afternoon in 2015 when I became a real consultant, and after all, all consulting is, is helping someone, just helping someone fill a need, whatever that particular need is, and there's three basic types of consulting.

There's skilled-based consulting. When you have a skill, you're a web developer or a marketer that the potential client doesn't have, and they need to hire someone outside. For example, last year, I got an engagement to create a three-minute video to kind of rally the troops in this given organization to help them with their value-based care initiative. They paid me $3,000. Actually, they paid me $5,000. I spent three hours going on and creating the video for them, and that was it. So that was a skill I offered. They didn't have it internally.

Boom, it was done. I'm creating my own web, a new web presence for my consulting firm right now. I don't have the expertise in WordPress. I'm hiring somebody to create it. That's skills-based consulting, and that is certainly something that clinicians can do.

The second type of consulting is credibility consulting, and your goal there is really to your client's ass because they have either made a decision or they're about to make a decision, and they need somebody with some credibility that can help justify their decision, and this is something that I have some experience with.

Charissa told the story that back in 2020, when the whole health system went online, she was suddenly very busy with her telemedicine practice. Well, I was in the same place. That first weekend, I took 250 calls in my practice. It was quite hectic, but at the same time, if you Googled telemedicine, telemedicinemastery.com with my name right behind it and the MD there was the fifth non-boosted result that you would get.

Suddenly my phone was ringing off the hook as a telemedicine consultant, and because I was organically that high in Google's rankings, I had credibility, and what I discovered being a credibility consultant is they're really not interested in your expertise. What they're interested in is getting your credibility so that they can justify the decisions that have already been made.

I had engagements with several dozen folks over the first six weeks. Some of them were paid. Many of them were not once I figured out what was going on, but in almost every case, not every case, but almost every case, the client had been given a load of money, and they had already decided how to apportion it, and they simply needed somebody with credibility in order to rubber stamp that decision.

Now, these clients have bosses. Everybody has a boss. Sometimes it was the CEO of an organization had to answer to his board. Sometimes it was someone a little lower on the food chain that had to answer to their boss. Once you get that high up in the corporate structure, it's much less hierarchical than you think. It's very much a group, a collaborative practice where everybody's covering for everybody else. But as a credibility consultant, they wanted somebody that they could say, hey, this guy was high on Google. When we searched, nobody else knows anything about this. This guy is going to support what we want to do.

Now, occasionally, when you're a credibility consultant, there are folks who actually have plans for their money or for their processes, but they still bring you in to rubber stamp them. Then when you try to share your expertise with them, they get angry. That was a lesson I learned too back in 2020, having never been a credibility consultant before and not understanding what these folks want to buy. They simply wanted to buy your credibility. After about six months, my Google searches got suppressed because other folks were boosting theirs, as you can with SEO. My days as a credibility consultant were blessedly limited.

During that time, it was extremely instructive. One of the things I learned was that I didn't want to be a credibility consultant. That doesn't mean that it's not a reasonable path for a clinician, especially when coming out of school and not wanting or able to go into residency. You have to remember, these folks are selling credibility. The folks that they put out in the field are generally young. They're selling things that give them credibility, but they're not selling their expertise.

You don't have to be an expert to be a credibility consultant. You just have to be willing to put in the hours and be good at getting new business. That's the coin of the realm with these credibility consultants. They want you to generate billable hours and they want you to generate new business. It really is the Thunderdome to determine who's going to move up the ranks and be offered a partnership. If that's you, having an MDDO is the equivalent of having a business degree from a branded business school.

A final word on credibility consultants is that I have worked with a significant number of female folks in that industry. They are universal about the amount of misogyny and sexual harassment that goes on from their point of view. Never had a man tell me about that, but had virtually every woman tell me about some pretty significant exploitation.

If you're female and you're thinking about doing that, I felt a word to the wise was indicated. Surprisingly, credibility consulting is not what we're talking about today. It's not venture capital consulting.

Consulting with venture capital folks falls under the third type of consulting and that is advisory services. But advisory services is exactly what it sounds like. People pay you to give them advice. They might take it, they might not, but that's what they're paying you for. Typically, an advisory consultant works under a retainer arrangement, meaning that you get paid a certain amount of money to provide advisory services for a certain period of time. I have an advisory arrangement with a venture capital firm right now.

They paid me back in July for one year. We worked together for about 20 hours and then I haven't heard from them again until this very morning where they wanted to talk to me again. That's fine. We had an arrangement for an entire year. That is usually how they're structured. You can charge for that based on the value that you think that you are providing them because what they want is your expertise.

Now, I didn't start out providing advisory services of venture capital folks. I started to do it to payers, to health systems, to individual clinicians and then I started attracting some vendors, people who are selling technologies to support value-based care billing systems. All this time, I was learning the craft until that fateful day in 2015 that I told you about.

When you're a consultant, any of these three types of consultants, but especially advisory consultants, you are telling your client a story. That's what you want them to buy. You want them to buy the story that you can fill their needs.

For a skills-based consultant, you have the skills and you're going to complete things on time. That's the story that you're selling to them. If they hire you, they bought it.

For credibility consultants, it's, "You know what? We'll keep you safe. We're the safe choice. We'll cover you. We'll endorse whatever you want." That's the credibility consultant. For the advisory consultant, it's "I have expertise. I have something that I have knowledge that you need that can get you to a better place."

Now, when we talk about folks in the VC world, I like to ask audiences what they think that the VC, the people that work in these venture capital and other investing groups want to achieve from their business plan. What is their goal as doing what they're doing? And most folks will say, well, they want to make money. And that's only partially correct. These folks want to make more money than other people. So they're intensely competitive, just as competitive as anybody that we knew in medical school. They don't just don't want to make money. The absolute amount of money is nice, but it matters more that they beat their compatriots. They want an edge. They want to know something that somebody else doesn't know.

Because in the investing world, asymmetrical information is how you make your game. So the story that you're selling them is that you are the diamond in the rough. You're the one that everybody else has missed that has what they need to give you that edge. That's the story that you're selling these folks. And if you sell them that story, if you put that out there, it's just like a lure. Eventually, somebody will bite.

Now, how do you put out that story? Well, it's pretty straightforward. Again, Seth Godin is one of the folks that I read heavily as I was learning how to do this. He gave a great allegory about a next door neighbor that just moved in. And he doesn't know you from Adam. And if you were to go over there the first day that he moved in and ask him to cash a $500 check for you, he would think you are nuts.

He certainly wouldn't take a check from you. But if for 90 days, every morning at 8am as he's pulling out for work, he sees you walk over and put a crisp $10 bill in his mailbox. Then on the 91st day, he will cash that check.

So what you're doing is giving him a small amount of value on a consistent basis in a way that he recognizes in a way that he is easily absorbable. So that when you do make the ask, that he's much more likely to take you up on it. Imagine if instead of a $500 check on that 90th day, 91st day, you just did $100 check. Well, he's much more likely to do that. Then you keep on giving him the 10 bucks. A couple months later, you ask for a $500 check. He'll do that. Then you do for a couple months, you ask for a $750 check. So he's learned to trust you.

He's learned to understand that you are providing value. So he's willing to give you something that he values in return. And that is how you reach out to folks to tell them your story, to get them to give you something that they value, which is their time, their money, the engagement. And how you do that depends on who your customer is.

Now for venture capital, the platform of choice is LinkedIn. LinkedIn is a B2B or a business-to-business platform. And although I'm in the middle of renovating my LinkedIn platform as part of my new updated internet presence, you can still see that I regularly release information on a regular basis that's free. It's high value. And it encourages folks to tell themselves a story that I'm their edge. I'm their angle. And I blogged almost every day for five years. You can still see a portion of that blog on tomdavisconsulting.com. And it's no great shakes. It didn't get millions of hits. In fact, some days it only got one or two.

But the people that saw that are the people who I wanted to tell themselves a story. It's all about releasing information freely on a regular basis, day in and day out. I did professional speaking. I wrote books. I did podcast after podcast after podcast. And just by throwing that hook out every day in the still waters, regardless of what the weather was like, eventually somebody bit. And since that time, the venture capital folks have been my most enjoyable and fulfilling clients. And it's not because they do what I suggest. I usually don't have any idea what they decide based on the information that I ask. But they reach out to me for specific needs. I answer their questions, do the analyses that they ask for. And in return, they're very grateful.

Now, you have to compare and contrast this to doing the same thing with other potential clients like payers or health systems. Those folks, their check's clear. There's no question about that.

But there is a lot more institutional inertia about the types of advice that they'll accept. And sat around the table more than once to get verbally abused by folks that didn't like what I had to say. And again, that's OK. There's no more engaging those folks. And again, their check is cleared. But you did their best for them. That never happens with venture capital. I'm always treated with respect and always treated with professional courtesy. And that is not something that I can say dealing with my fellow clinicians, not by a long shot.

Now, one of the benefits that everybody thinks comes with consulting in venture capital is that you get in on the ground floor. Sometimes you can get a piece of the company early on in exchange for giving advice and instead of getting a fee. And you don't know you'll get a piece of the next eBay or Amazon or something like that.

And there's actually some truth to that, but only if you approach the situation in the right way. So there are companies, usually tech firms, that offer supportive technologies for folks in value-based care. And oftentimes, after an initial engagement of consulting with them, we'll talk about further engagements.

And I'll offer to do that in exchange for a piece of the action. And here's a first technical tip if you ever do get in this position is only ask for a teeny tiny little small slice. And the reason for that is twofold.

One is that the more that you ask, the more they can demand of you. So that puts you in a situation of being a stock picker, of trying to pick and choose the winners in an environment where very, very, very, very few organizations actually reach the finish line and either get acquired or go public. Your best bet, your best strategy, is to take a little, when the opportunity comes, is take a little bit of a whole lot of companies.

And when one converts, then you call that a win. None of those things are going to put you in the cent-a-millionaire club, but when they do convert, it's very, very nice. So there are opportunities to do that, but the wise way to approach that is to simply take small pieces of a number of different companies.

And usually, those opportunities don't present themselves until you've had a successful collaboration with them first. And I've had collaborations with companies that either I didn't do a good job on or they didn't like what I had to say, and so no further offers were forthcoming. And that's okay.

That's just part of life. But when you do get those opportunities, use the technique that I discussed and you will be in a much better position. Now, to reach out to these firms, some of these social media platforms offer opportunities to boost or to do direct mailings.

I don't do any of that stuff. I don't want to annoy or bother any potential clients, just like you don't move the hook around when you're trying to fish. You just offer them something of value. If they want it, they want it. If they don't, they don't. The key is consistency and high value and doing it every day. And you realize over time that what you're doing as a consultant is basically what you're doing as a doctor.

What are we but advisory consultants? We have expertise. The patients come in. We advise them. A lot of times they don't do what we say. Sometimes they do. If we're specialists, we have primary care doctors that send their patients to us for a consultation. In the old days, that's exactly what it was. You send them to another doctor for their opinion. The doctor sent them back to you with recommendations on how to treat them. That's exactly what we do now.

And so when you enter consulting with that mindset, it actually makes things a lot more comfortable. And then as you are more successful consulting in the venture capital space, you will start to realize that it is different than being successful in another space. So when I help a clinician generally, he will refer me to his friends.

When I help a health system, generally, I get referrals for their colleagues who work in other health systems, not ones that are directly competing from them, but other health systems. When I work for vendors, these folks, these technology firms, they collapse all the time and talent gets redistributed. And then I get word of mouth referrals in that fashion.

That's very common. But you have to understand that the story that you're selling in venture capital is that you are the edge that they need. And so they're not going to tell other folks that they're competing with that they need to talk to you. So you're not going to get any word of mouth. And it took me a little while to understand that. Really, you have to rely on them passively coming to you after you have set the hook.

Now, again, this is we've talked again about nine years before you're successful overnight. Being a consultant is very much that path. It was years of blog posting and learning how to be a professional speaker and working on all of my skills before I got that big bite.

I also had a number of consulting engagements where I didn't know what I was doing. And some of those did a bad job. And you just have to learn from your mistakes and move on. The nice part about it in consulting, nobody dies when you make a mistake. I've been fortunate not to have that. But you have to understand it's a learning process.

It is a journey. But if you stick with it, then good things can happen. So it's not something that you want to do right off the gate and say, I'm going to quit my job. And tomorrow, I'm going to earn the same amount of money being consulted. It doesn't work that way. Fortunately, it is a job that you can usually do on the side outside of your non-compete.

You got to always have your lawyer check on that. But non-competes are usually pretty restrictive. And for them to cover something non-clinical like consulting, that's a pretty restrictive non-compete and may be hard to enforce.

It is something that you can start doing right now just by putting yourself out there. Every one of us that are looking at this has expertise that venture capital firms are looking for, because they're always looking to invest in something new, something novel, something that nobody else is investing in.

Now, everything has a fashion. When there's one superhero movie, everybody makes superhero movies. When there's one successful type of tech firm, everybody tries to invest in those tech firms, those similar tech firms. And there's some truth to that. But that's only part of what goes on in the angel investor venture capital world. There are always folks looking for the next thing. There's always folks who have budgeted a certain amount of money to invest in speculative endeavors.

EBay is a great example of something that was totally speculative when it came down. Bidding on the internet, who the heck knows? Nobody knows that. And it subsequently sold for several billion dollars. So there are always people that set aside a little bit of their pile of money to invest in speculative investments. And these are things that you have expertise in.

For me, it's value-based care. For Narissa, it could be working with a person that has developed a new medication or new drug that she has special knowledge about. For sports medicine folks, it could be somebody that's looking at investing a new business-to-consumer rehab platform. You just never know until you put it out there. Because these people are either running their own money or they're running somebody else's money who has aligned incentives with them. And they are looking, looking, looking, looking for that edge that will help them to succeed.

And the internet has lowered the barriers of connectivity to essentially zero. There's really no expense other than your time to put into it. And that's one of the reasons why I really like consulting, because after paying hundreds of thousands of dollars for my medical education, I wasn't ready to lay out any more money, any more capital to invest in a new career.

Consulting is completely unlicensed. It's unregulated, and it's not going to be regulated. Anybody can hang up the shingles and call themselves a consultant. You don't need any credentials. You don't need anything but a story, a story that someone else will accept that you will get them to a better place.

And for my money, the apex is working with these folks who run money. They are very serious. They're very talented. It's very intellectually stimulating and challenging, and you can really make a difference. Also, there's just a teeny, teeny, teeny, tiny little chance that you could, while you're helping other people, while you're still scratching that itch, you could hit it big. And when you do, when that happens, it feels all those failures fall away, and you feel wonderful.

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The post How to Become a Consultant to Venture Capital Firms appeared first on NonClinical Physicians.

How to Recognize and Overcome Moral Injury in Healthcare

John Jurica — Tue, 28 May 2024 10:34:07 +0000

Interview with Dr. Jennie Byrne – 354

Today's episode features my interview with the author of Moral Injury: Healing the Healers.

We explore the concepts of burnout and moral injury within the healthcare profession through a detailed discussion with Dr. Jennie Byrne. Dr. Byrne shares her insights and experiences, highlighting the evolution of these issues, their impacts on healthcare professionals, and potential solutions.

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The Evolution from Burnout to Moral Injury

Burnout has long been recognized as a significant issue in healthcare, intensifying in discussions since the 70s and 80s. However, Dr. Jennie Byrne and others have shifted the focus to “moral injury” as a more accurate description of what healthcare professionals experience.

Moral injury involves:

participating in or witnessing events that conflict with one's personal or professional values,
under directives from superiors,
in which high stakes are involved.

This concept, originating from military contexts, provides a deeper understanding of the profound, soul-wounding experiences of many in the healthcare field.

Personal Stories and Systemic Issues

Dr. Byrne shares her journey and experiences in healthcare, from her varied educational background to her work in psychiatry and healthcare consulting. She highlights the systemic issues that contribute to moral injury, including the intense pressures and emotional challenges faced by medical professionals.

Personal anecdotes, such as her experience with a medical board investigation, illustrate how non-workplace-related events can also inflict significant wounds. These stories underscore the complexity of moral injury, extending beyond workplace stress.

Healing Strategies and Systemic Changes

Addressing moral injury requires both personal and systemic approaches. Dr. Byrne emphasizes the importance of open conversations and peer support as initial steps toward healing. Creating safe spaces for healthcare professionals to share their experiences and feel seen and heard is crucial.

On a systemic level, having dedicated resources such as a Chief Wellness Officer and structured support systems can provide lasting solutions. Additionally, small acts of kindness and advocacy work play a significant role in the healing process, fostering a culture of empathy and support within the medical community.

Summary

Dr. Jennie Byrne can be contacted and found through her professional website DrJennieByrne.com, where you can learn more about her background, services, and resources. Additionally, she shares insights and updates on her LinkedIn profile, where you can connect with her professionally and stay updated on her latest activities and contributions. Dr. Byrne's blog, also accessible through her website, offers information on various topics related to her fields of expertise.

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

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Links for Today's Episode:

Dr. Jennie Byrne's LinkedIn Profile
Dr. Byrne's Website
Dr. Byrne's Private Psychiatry Practice
Moral Injury: Healing the Healers, by Dr. Jennie Byrne (This is an Amazon affiliate link).
Dr. Warren Kinghorns's LinkedIn Profile
Amy Story's LinkedIn Profile
Humans in Healthcare
Monica Bean, BSN's LinkedIn Page
Dr. Tammie Chang's Website
Dr. Paul Dechant's Website
Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine (This is an Amazon affiliate link.)
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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 354

How to Recognize and Overcome Moral Injury in Healthcare

- Interview with Dr. Jennie Byrne

John: The concept of burnout's been around for a long time, I don't know, maybe decades if not centuries, but it seems like in the 70s and 80s, it started to be applied to healthcare just because of the intensity and the long periods of education and so forth. And I remember talking about it with colleagues, early in my career in the mid 80s. And then at some point, it started to evolve into this concept of moral injury as a better descriptor of what's actually happening. And so I thought it was about time that we just address that issue here on the podcast. So to that end, I'm very happy to have Dr. Jenny Byrne here on the show today. Welcome, Dr. Byrne.

Dr. Jennie Byrne: Hey, great to be here.

John: I'm really looking forward to picking your brain. You know, you've got the book and I was able to go through the book, but it definitely hits all the points that I'm interested in hearing about. So I'm glad to have you here and have you talk us through this. But I always wanna give my guests a chance to talk about themselves for a few minutes. I've had a very long and illustrious career, but talk about your medical training, what you do, what you do now for the most part, and then we'll get going into the topic of the day.

Dr. Jennie Byrne: Great, so I'm originally from Pennsylvania, and I don't know, I know you have a lot of physicians listening. I did not know I wanted to be a doctor when I grew up. I was a music performance major. Going into college, became a French major so I could live overseas. And it really wasn't until I came back, took a class in brain and behavior and fell in love with it. So pretty much my whole career circles around brain and behavior in some form or fashion. So I did an MD PhD. I don't know if you have any MD PhD listeners. Mudfud's out there, but I did an MD PhD in neurophysiology. Again, love the intersection of human brain and behavior. So I trained as a psychiatrist. I did my MD PhD at NYU, and then I did psychiatry at Mount Sinai. So I lived in New York City for a very long time, which was very exciting. And then I did a leap of faith down here at North Carolina, which is where I live now and I love it here. And I've done a whole bunch of different stuff. I'm always curious, I'm always learning, and I'm always saying yes to things and that's led me in a bunch of different directions. I've had a outpatient practice that I sold a couple of years ago. I grew that out over about nine year period. So I've practiced psychiatry for over 20 years. I got involved in Medicaid in North Carolina, helping design programs for integrated care, worked a lot with primary care docs, real fondness for primary care. Then I went to work as a national executive for a company called CareMore out of California. ran all of behavioral health and specialty for them nationally. So I saw what like a fully scaled healthcare organization looks like and kind of behind the curtain of what it's like to be an executive at some of these companies. But I love early stage. So that's what I do now. I advise early stage healthcare companies, a lot of which are mental health, but also value-based care and really just human behavior because that's pretty much everywhere in health, including physician behavior. You know, we're, human too, even though we don't like to admit it and we do dumb human stuff like everybody else. So that's what I focus on now. I do see patients a little bit and I have a practice that is not publicized, but for you all listening may be interesting, I take care of other physicians. So I have a really cool AI hybrid infused practice where I can care for other physicians as a psychiatrist, a therapist, or a coach.

John: That's all very interesting. And you talked about the healthcare advising that you do, I think, and there's probably at least five or 10 different things we could talk about on another podcast episode. But so I'm really glad you took the time to join us though to talk about this topic, moral injury. You know, I just, you know, like the book is what attracted me and because I had this question, a lot of bunch of questions about moral injury and what it means. And so let me, let's go to why did you write the book?

Dr. Jennie Byrne: While I was thinking about it, and I have to say, writing my second book in under a year wasn't really on the top of my list for this year. Um, but the reason I wrote it was because I, I feel passionate and I felt there was a real urgency to talk about this, now this year. And it really started where I was just having conversations with folks like your listeners or you, or, you know, colleagues, physicians, other clinicians. And maybe because I'm a shrink, people just tell me stuff, but What I heard really upset me and worried me. It's really bad. It's really bad out there Medical students are ready to leave the profession before they even get started Residents are ready to leave. People who are amazing clinicians are ready to leave people retiring early. I mean There's a reason for all of this and my kids Pediatrician left and it really threw me for a loop. I was like this was someone who was I don't know maybe late forties, early fifties, seemed to love her job and, and she just kind of disappeared and that really, you know, struck a chord with me. Like what is going on? And of course, in my private practice, I've taken care of physicians and I know that, you know, sometimes we look at our peers and they seem like they have everything together, but behind closed doors to their psychiatrist, you know, they'll tell me they're thinking about suicide or they're, they're paranoid or not to go off on a negative tangent, but you know, it's really bad. So I really wanted to figure this out and I wanted to know what was going on. So I started just doing some research, talking to people and came across the idea of moral injury from a colleague in North Carolina, whose name is Dr. Warren Kinghorn. He is a psychiatrist, but he also works with the veterans of the VA. And he also has a divinity degree. So he's got this really interesting intersection of faith, military and psychiatry. And he told me about moral injury. It's a concept that comes from the military.

John: You know, I have to admit too, that I've heard the same thing, because I'm talking to people looking about getting out of medicine. And what I've heard is that, you know, the med students will say, oh, I got to tough it out. You can't get any worse. And then they get in the residency and the burnout, whatever you want to call it, seems to be worse. And each year it gets worse, you know, depending on the residency. And it's just not very hopeful at this point, if that's kind of the way our system is built.

Dr. Jennie Byrne: So, so the definition of moral injury. So this is where kind of this topic about burnout versus moral injury. I think that words matter. I'm a psychiatrist. I think words matter. I think it's important for us as physicians and others to articulate what we feel inside. And that's particularly hard for us because our culture is one of, you know, repression and denial and all those coping skills we got to get through school. So we feel bad inside and we don't know why. So moral injury, the definition is threefold. The first is that you are part of something, do something, witness something that goes against your values, whether that's personal values or professional values. Second, that it is ordered or condoned by somebody superior to you. And third, that the stakes are high. So you can imagine all these military folks coming back from maybe combat zones where they weren't really in the line of fire, but they just really struggled to reintegrate into their lives and it wasn't PTSD and it wasn't depression. And it was really this like, I think about it as like a wound on your soul. And that's different than burnout. Burnout is more of this industrial energy concept that we're tired and fatigued and burned out and we just need to go recharge our batteries or take a vacation, do some yoga and come back and we'll be just fine. But I think it's like this wound, this metaphor of a wound really resonated with me. And so that's why I really liked this concept.

John: So that kind of gets to the root causes, I guess, is what's behind it. I mean, we have, like you said, what we're doing generally, depending on the circumstances, they're high stakes and yet we don't feel supported, we're being told what to do that may be against even what we think we should do. I know, did you get the sense during the pandemic that this was just like an overdrive?

Dr. Jennie Byrne: The problem predated, clearly the pandemic, right? Clearly, but the pandemic just put it into stark relief. And then post pandemic, there wasn't a period of healing. So the wound, if you think of, I talk in the book about staging it like a wound, the wounds were bigger, right? The pandemic really, really made those wounds gaping. And then we didn't have any opportunity to heal post-pandemic. So those wounds are still there and they're for most people still pretty gaping wounds.

John: Yeah, I think that was one of the notes to myself was to ask you to expound on that issue of like sort of using the pressure ulcer as, as you mentioned in the book, and I thought it was a pretty good analogy.

Dr. Jennie Byrne: I love the good visual, right? So I told a story in the book about one of my worst rotations in med school. I was at Bellevue training and I had to do vascular surgery because I couldn't get my top elective choice. For some reason, they put me in vascular surgery. I don't know why. And it was awful. And I got to know wounds really, really well during that rotation. And some of them were just horrific. And so this idea of what it really means to heal wounds. I think that's a great metaphor for a moral entry because you can look at a pressure, we stage pressure wounds in particular. So you kind of say, okay, stage one, there's redness, maybe a little tenderness. You can tell something's brewing in there, but if you just let it be, it'll probably be okay. To me, that's kind of the burnout, like take a vacation, change jobs. you know, something like that, that'll heal on its own. Then you break the surface, you know, the stage two, the surface is breached. Okay, well now the burnout's worse, and I don't think it's just gonna heal on its own. It needs something, maybe your own psychotherapy or coaching or adding consulting, doing something different, you know, maybe that will heal it, maybe that gives you enough to heal. And then you get to stage three where it's pretty messy. It's a pretty messy wound and there's really, you need systemic healing to be in place. You need the system, the environment around the wound to be properly maintained. It has to be clean, it has to be dry. Maybe it needs antibiotics. You know, you gotta do some stuff for that to heal. And then you get to stage four where you're, you know, you're in there looking at the bone. And that's what I remember from my vascular surgery days. You know, there were days where I was packing things where I could see the bone. And that is a whole other ball game. And some folks are at that place. And that's where, unfortunately, physicians in particular can internalize and go to really dark places. Or they can externalize and get really angry and hostile, which can lead to other problems. So I like this idea of a wound, because we can all kind of imagine that and understand healing, not fixing. I don't like the fix. I don't like burnout that we're gonna fix it. I think these are wounds, and wounds require healing, not fixing.

John: Now, the other thing that has occurred to me thinking about this topic is, and you mentioned the military, and we're talking about medicine. It's basically a workplace-related situation, is it not? I mean, I guess there might be other circumstances, but in most cases, the things that you've described are happening in a workplace of some sort. So it would seem to be something that OSHA or some other organization besides just the maybe the physician or the others affected by this, the military and so forth would have to address. What do you think about that?

Dr. Jennie Byrne: I think yes and no. I think sometimes that wound is the workplace. You know, the death by a thousand cuts, the EMR clicking and the, you know, 10 patients an hour and the blah, like, yes, yes. But there's more to it than that. And I think this is where the conversation gets interesting for me. So in addition to the workplace kind of injurious things, you know, I opened the book with a very personal, vulnerable story about an incident that somebody reported me to the medical board. That had nothing to do with the workplace. That was purely about me having to deal with someone questioning my values and my skills as a clinician, even though I was not in the wrong. And at the end of the day, it didn't really matter. But I had to go through this huge process where other physicians on the medical board had a process which wounded me. And I had to go take a class on controlled, on opioid prescribing, which was ironic because I wasn't even prescribing opioids. And when I went to that class, they flashed slides of jails where they send doctors who prescribe opioids. That was what I sat through, you know, and that wounded me at such a deep level. I can't tell you, even writing about it for the book really was painful. And my hope is that by writing and sharing the story, it heals me as well as maybe healing others who have had similar things. So Sometimes the injuries don't come from the workplace. Sometimes they come from a lack of respect in the community, the way we're treated. Sometimes it comes from our peers who injure us, whether intentionally or not. Sometimes it comes from just the difficulty of managing chronic illness with so much information that we can't possibly keep up. Our human brains can't possibly keep up. Sometimes it comes from trying to manage this increasing intersection of things like gender and politics and sexuality and like culture and like, you know, and it's really hard. It's not like it used to be. I have a grandfather that was a doc in the 40s, you know, and I have his little black bag sitting over here. You can't see it. Things were a lot different back then and it's just not that way anymore. So I guess the answer is yes to the workplace but also other things which we don't talk about as much.

John: Well, that in my mind also kind of points to, let's say being sued, a lawsuit, I would think. That adds like a whole another layer of pressure.

Dr. Jennie Byrne: And I'm sure you have people listening who probably have had these things happen and they've never told anyone. I didn't tell anyone about my medical, I was so embarrassed, ashamed, you know, pained by it. I didn't even tell anybody. So I'm sure there are folks listening who've had, like you said, a malpractice suit, a patient complaint, a medical board issue. You know, people don't talk about these things. I'm sure that people out there have had this happen and I'm sure that it was wounding to them the same way that it was wounding to me.

John: This is a little bit of a left turn just for a moment, but one of the things that you just mentioned is I did an interview some time back about sham peer review, where the peer review process was actually being sort of misused to get someone off staff, destroying their career and so forth. I don't know if you've experienced, if you've coached, if you've treated people under that, that could be almost unbearable kind of pressure.

Dr. Jennie Byrne: I have. And it's something that unfortunately that's kind of part of our culture, you know, the old school medical culture, right, of being a resident and being shamed, publicly shamed in front of others as the way to learn. That's just kind of part of our culture and it doesn't make it right. But we still do that to each other. And it's not, I don't blame, I don't blame the other physician doing it because when you're in a negative, stressed burned out, time crunched, injured mindset, is very easy to injure somebody else, whether intentionally or not. So I don't blame them. I have deep empathy for them as well, because I know that under other circumstances, they probably wouldn't do that to their colleague.

John: Well, I think we should shift gears and talk about what are the solutions or what can we do to at least ameliorate, if not eliminate this problem eventually. What thoughts do you have on that?

Dr. Jennie Byrne: Well, one of the best news is, I know this is kind of a serious topic, but one of the best news is that just talking about it is part of the solution. So we know this from the military. Just talking about it, being able to identify that feeling that's inside of you, being able to share your story in a safe place, not that the other person can change what happened to you, but feeling seen and heard by a peer is incredibly healing. So, talking about it, having the words to describe what's going on, and having others in our ecosystem listen to us and giving them the language to talk to us about what's going on. Because I can tell you, I work with a lot of administrators, executives, tech people. They're not greedy, evil people. I know that's the narrative that's convenient. No, it's a convenient narrative. And sometimes it's true, but mostly they're trying to do the right thing and they could make money more money doing something else too. So they lack the understanding of what it's like and we don't help them. We don't give them the language to talk to us and we act like we're perfect. So I think just talking about it and giving others the tools to have real conversations is something which actually doesn't cost any money and is incredibly healing. So that's the first thing. Yes to the system change. Yes to the like designing clinical products for clinicians, understanding the psychology of clinicians. Yes to all of those things too. And then I think, you know, I write about in the book, I do believe in butterfly effects, especially from one clinician to another. Or as a patient, like I'm a patient, we're all patients too, right? It's not just us as clinicians, we're all patients too. And I always tell someone, you know, when you see your clinician, tell them thank you for all you do. Just do that. Like small acts of kindness, they don't fix the wound, but they can really help. So the more small acts of kindness and empathy that you can show others or call your peer. I had a psychiatrist that was a mentor of mine send me an email today. He said, I read your story in the book and I can't believe I was so upset by what you wrote. And he said, I had something happen to me like that. And I never told anyone. And I was like, I can't believe, you know, and just so that sharing and that kindness, especially from one peer to the other. So taking that five minutes to write that email to your peer, like, you know, I was in a really tough spot the other day and you came and you told me this, that really helped me. Or if you see your colleague who's struggling, say, I don't know what's going on. It seems like something's gone on and I'm here if you want to chat with me or what, you know, like these small things I believe really matter. So in addition to the bigger systemic change, I do think there are things that we can do right now that actually don't cost any money.

John: You know, as you were talking, it occurred to me something else that I've experienced for times in my life where there were issues. One was a support group for divorced men and I for a reason that I won't disclose now, but I mean, I attended Al-Anon and you know, those are supposed to be private and not anonymous per se, but they're not discussed outside and it's supposed to be supportive and all that. Have you ever seen that ever used with physicians?

Dr. Jennie Byrne: Yeah, so for example, some resources to check out for your audience, so Amy's story, She is a PA by training. She has a company called Humans in Healthcare, and that's exactly what they do. It's clinician groups where they share stories. Sometimes they grieve together for patients that have died or their own losses. She's doing amazing work. There are a ton of coaches out there. So if you're a nurse, probably don't have nurses listening, but. There's a woman, a nurse, Monica Bean, who does this for nurses. She's a nurse by training. Trying to think of some others. I could, you know, have people reach out to me. I can share some of these resources, but there are lots of groups of physicians coming together. There's one woman that focuses on moms, physician moms. And I did forget to mention one thing that's important for your audience to know that. One of the ways you can heal that I've heard from my interviewer interviewees is through advocacy and through feeling like you're part of the solution. So if folks are thinking about advising other companies, taking a leadership mentorship roles or being an advocate for even if it's just a single patient or another physician or that really can help you heal too. So If you find a way to have an impact that's not just your day-to-day with patients, often that's quite healing.

John: Well, I just took a quick peek back at the index of the book, Moral Injury, and I think a lot of these things are really addressed there in much more detail, so I would encourage everyone to get the book. So let's talk about that. How do we get the book, and where do we find it, and so forth? And how do we find you?

Dr. Jennie Byrne: So if anyone else has written a book, you'll know that Amazon is where all the books are. So the book is on Amazon as well as my first book which is called Work Smart. And if anybody is interested in a book club or sometimes we'll go do a talk where we get a whole bunch of books, just reach out to me if you're interested in anything like that. In terms of getting a hold of me for questions about advisory work, again, LinkedIn is a great place to just send me a message. I do have a website, drjennieburn.com, which is kind of a list of some of the stuff I've done. And then I'm gonna share with this group. I don't share this with all the people I do podcasts with. I have a small private practice that is not advertised where I care for other physicians, whether that be coaching, psychotherapy, or I think 12 states I can do medications as well. And that is called constellationpllc.com So you can also just reach out if you need help. If I can't help you, I'll do my best to find somebody else in your state or wherever you need help.

John: I'm gonna put a dig in here against the industry right now just for a second, only because I think I read in the book that the number one cure for moral injury is not resilience training. Is that my off base there? But because I get offended when they tell me that, that's the solution.

Dr. Jennie Byrne: I think that's happily falling out of favor this year. My statement in the book is I believe clinicians are inherently resilient. I don't know how on earth anyone gets through all that training without being resilient. I mean, seriously. So that doesn't mean we're not human and we need help. But I think if my point is if a clinician of peers, they're not resilient, you should be asking what's going on.

John: Hmm, because they've reached -they've gone way beyond the point where it's not dangerous, you know. Have you seen any big organizations? This is what I keep looking for because I know of physicians who have addressed burnout, moral injury, you know as a coach or something and they'll spend a lot of time with an organization But have you seen any put into place something that is lasting and is effective over time?

Dr. Jennie Byrne: So I think the most effective long-term solutions come from leadership when they put, when they basically put money into it. So when a leader, a CEO or something, you know, creates a wellness group, like a chief wellness officer, and really devotes significant resources to it, that's probably the best long-term solution is to actually have people internal to the organization who are driving it forward. So I, one of the people I talked to was Dr. Tammy Chang. So she's been doing this for a long time. She's a great resource to reach out to. She's at a health system as their chief wellness officer and she's just a wealth of information. And then there's some others who do like private interventions, but company solutions. So Dr. Paul Duchant does that. So he's a good resource. He and Diane Shannon wrote a really good book on physician burnout, which I recommend as well. So there are folks who do it. Now, he leans a little heavy on the operational end of things, and I'm more the shrink. I really think that the healing has a lot to do with our hearts, not just operations. So we, I don't wanna say we disagree. We don't disagree. I just, I think we undervalue the emotional component of change. And I think it's, it's actually easier than we think it is sometimes to connect with someone at that like heartfelt level, and make a real difference in their life. I don't think it always has to be fixed the EMR fixed. I mean, yes, do those things, but and have that human connection that heart part because I think that's how we heal. It's not just our bodies, right? Like our hearts have to heal.

John: Very good. But I appreciate you taking the time and sharing all this with us, giving me a little more clarity on exactly what it is. And like you said, the metaphor, the pressure ulcer, trying to explain it to people. And you gave me a little hope there at the end that there are people that are making a difference in this area. So I'm going to have to let you go soon. We're pretty much out of time. But I guess, do you have any last words of advice for, let's say, the listeners who might feel... I mean, one of the reasons they're looking sometimes to change their career or their life is because they're having this particular problem. Any other advice for them individually to how to find a solution for themselves?

Dr. Jennie Byrne: Yeah, the main thing is really you're not alone. There are a lot of us out there, we're feeling the same way, we may not be talking about it, and you're not helpless. A lot of us, we get in that negative mindset, we feel very helpless, you're not helpless. You have tremendous skills, you're in tremendous demand, you've come a long way, right? Like you have more control than you think you do, and there are people out there who will help you. So I guess my only precautionary thing would be, leaving the practice of clinical medicine altogether may not heal all those wounds. So I still see patients, it's important to me and I do advising for a living. So just a little like, you know, it may not heal everything just to leave. So if you are interested in doing clinical practice and doing something else, you can do both. You don't have to give up one for the other. It may not fix all your wounds just to leave clinical medicine because it's probably, there was a reason you went through medicine in the first place. And that part of you is important.

John: I used to focus almost entirely on like, what are the options for just getting out? But I'm convinced now that there's so many options for staying in. If you can kind of carve out the things that are making your life miserable or that you're just reacting to in whatever way you're reacting to, get rid of the bad parts, keep the good parts. And there are more and more ways of doing that, even though the employment has been going up, I think we're reaching a point where you can do DPC and whatever, other forms of practice and just set boundaries and write your list of your must haves and really start to take control. But what you said earlier, people don't even realize that they're in the midst of burnout or moral injury. So they don't really look at it that way and take a step.

Dr. Jennie Byrne: And one final thing would be too for those who are a little later in their career, a little older like me, sometimes being a mentor, being a support for younger early stage folks, that's really rewarding too. So if you decide I just can't go back to clinical practice and maybe you wanna do advisor or other work, but you can still find ways to support those who are coming up who maybe have a little more energy. And maybe you can prevent them from feeling so wounded so they can go and do that good work. That can be a really wonderful way to stay connected with clinical medicine in a way that maybe supports you in whatever stage of your career that you're in.

John: Awesome. Thanks for that. Thanks for taking the time to talk to us today. I really appreciate it. I advise everyone get the book, go to Amazon, Moral Injury. Let's see, what's the byline? Moral injury?

Dr. Jennie Byrne: Healing the healers.

John: Healing the healers, okay. I had that written down here somewhere, but it's really good and it's pretty comprehensive. I mean, there's a lot in there starting from recognizing it to even potential solutions. So it's a great resource. Okay, thanks Jenny, I really appreciate it. And hopefully maybe we can have you come back and talk about some of the other things you're up to at some point.

Dr. Jennie Byrne: Thank you for having me and to everyone out there listening, be well, please take care of yourselves, please. Please get help if you need it.

John: All right, bye now.

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The post How to Recognize and Overcome Moral Injury in Healthcare appeared first on NonClinical Physicians.

New Unconventional Clinical Careers Will Set You Free

John Jurica — Tue, 21 May 2024 11:30:08 +0000

Interview with Dr. Sylvie Stacy – 353

Today's episode features my interview with the author of 50 Unconventional Clinical Careers for Physicians.

Dr. Sylvie Stacy discusses her journey from writing and blogging to full-time clinical practice. Despite many physicians moving towards nonclinical roles, she became increasingly involved in unconventional clinical work. This inspired her to write a book dedicated to unconventional clinical careers.

This book highlights lesser-known clinical opportunities, providing physicians with alternatives to traditional medical roles.

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Addiction Medicine: A Case Study in Unconventional Clinical Work

Dr. Stacy's experience in addiction medicine is a prime example of an unconventional clinical career. Initially working as a corporate medical director in correctional healthcare, she was exposed to addiction medicine out of necessity. Over time, she grew passionate about this field. It is a good fit for her due to its unique challenges and the positive impact on patients' lives.

Addiction medicine offers a flexible schedule, especially in settings like methadone clinics, which operate early hours to accommodate patients' needs. This flexibility allows physicians to balance multiple roles and gain diverse experiences. Dr. Stacy emphasizes the rewarding nature of addiction medicine, where visible, positive changes in patient's lives provide professional fulfillment.

Remote Monitoring and Other Unconventional Clinical Careers

Remote monitoring, telemedicine, and teleconsulting (e-consulting) present growing opportunities for physicians seeking flexibility and work-life balance. Dr. Stacy highlights various roles, including tele-ICU, intraoperative monitoring, and e-consults. E-consults enable physicians to practice clinically from home. These roles offer part-time and full-time opportunities, making them suitable for physicians looking to diversify their work settings.

Physicians can engage in remote monitoring by reviewing clinical data and providing critical support without being physically present with patients. This not only offers flexibility but also expands the scope of telemedicine beyond traditional patient consultations. Platforms like AristaMD and RubiconMD facilitate these roles, providing physicians with additional income and professional satisfaction while working from home.

Dr. Sylvie Stacy's Advice on Side Gig Compensation

Dr. Sylvie advises not to directly compare the compensation for unconventional side gigs to the salary from a regular clinical position, as they are fundamentally different. For consulting or “1099” positions, compensation should be higher than an equivalent hourly rate from a full-time salary due to differences in tax responsibilities. Physicians should account for self-employment taxes, including Social Security and Medicare, when evaluating these positions.

Summary

Both of Sylvie's books should be part of your library if you're contemplating a career change. They can be bought at any major online bookstore or the American Association for Physicians Leadership's Bookstore. You can connect with Dr. Sylvie Stacy or learn more about her insights, you can connect on LinkedIn, where she shares her expertise on career development and nonclinical opportunities for healthcare professionals.

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

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Dr. Sylvie Stacy's LinkedIn Page
50 Unconventional Clinical Careers for Physicians by Dr. Sylvie Stacy (this is an Amazon affiliate link that pays a small fee for the referral)
50 Nonclinical Careers for Physicians, by Dr. Sylvie Stacy (this is an Amazon affiliate link that pays a small fee for the referral)
AAPL Online Bookstore
Forbes Article About Concierge Medicine
eConsult Company AristaMD
eConsult Company RubiconMD
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Why You Should Look for Zebras with Dr. Sylvie Stacy – 044
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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 353

New Unconventional Clinical Careers Will Set You Free

- Interview with Dr. Sylvie Stacy

John: I'm really happy to have today's guest here with me. I was looking and she was on the podcast actually in 2018 because at the time she had a website that was devoted to non-clinical careers. And so we had her on, but then I don't know if I had her on again later, but she published a book in 2020, which we'll talk briefly about, which is about non-clinical careers. So go figure that's like my main topic here. And she just recently... wrote and had published through the APL another book. So that's the main reason I brought her back today. So welcome back to the podcast, Dr. Sylvie Stacey.

Dr. Sylvie Stacy: Thank you for having me, John. It is great to be back on the show.

John: Yeah, I just, just for the people that eventually will see this on YouTube, I think you're pretty well known for the first book that you wrote and had published called 50 Unconventional Clinical Careers for Physicians. It's one place where you can look in, because I'm always getting questions about that. And it's like, well, just go look at 50 non-clinical careers for physicians and you can get a good start on what to even consider. But we're going to be talking about the follow-up book to that. But before we get into all that, just kind of update us on what you're doing now, other than occasionally writing a book.

Dr. Sylvie Stacy: Yeah, so last time that I was on your podcast, I was writing and speaking pretty heavily about professional topics and career related topics for physicians, including publishing that first book and running a blog about those topics. And I think that you and I started writing and speaking about these topics around the same time, probably around like 2015, 2016. So I did a lot of that for a while. I had to take a step back from writing and blogging several years after that. And since I wrote that first book have still been practicing both non-clinically and clinically, though my work has become more and more clinical over time, which I think is kind of the opposite of what tends to happen with most physicians that do work non-clinically. Many of them transition from clinical to something more non-clinical, but my path has been a little bit backwards, which has been fine. It's been great for me, but that's part of what led me to write this second book about unconventional clinical careers. And actually, after I wrote the first book about non-clinical careers, I had made a comment to my publisher about how I felt that there, I could write another whole book about clinical careers that were just somehow non-traditional or alternative. And a couple of years later, my publisher called me up and said, "Hey, remember this comment that you made about publishing another book? I think that it's time we had a conversation about that." And that's how this second book was born.

John: You know, to me, it's really an important topic. I don't know if it's just out there in the ether or what, but you know, back in the day when you and I were both really focused on these non-clinical careers and learning about those and sharing those with people. You know, there's always been this feeling, I think, that physicians are like, well, why can't I be happy doing what I was trained to do? Why is it so difficult? And actually, I'm going to ask you a question about that later. Now, what are some of these, you know, unconventional clinical careers that really help bring the physician to a point where they have more autonomy and control, but still achieve all those things that they want from a clinical?

The other thing I wanted to mention is that one of the things that you taught me whether you're aware of it or not, is that you kind of taught me about preventive medicine and the whole idea of going to a preventive medicine residency. Because it's one of those things that has a lot more focus on administrative and not necessarily direct clinical. A lot of your colleagues, I think, do a lot of non-clinical or partially clinical things because that one. So I bring that up a lot now to people saying, okay, you want to do a residency in something have options that might be more related to the non-clinical side. I think that's still true, and so I don't know if you agree with that.

Dr. Sylvie Stacy: Oh, definitely. Yeah, I think probably the main reason that physicians are just largely unaware of many of these unconventional options is just because what we're exposed to during medical school and often during residency is just such a limited scope of what we can actually do with our medical degrees. And I think there's good reason for that. There's only so much that you can fit into a medical school or residency curriculum. And medical schools are based in these large academic medical centers where you're seeing patients in a traditional hospital setting or outpatient setting. And so that's where you get all of your exposure and your training. And we just remain pretty much unaware of all of these other settings that physicians are needed and that patients need to be treated sort of off the beaten path things that our degrees and our credentials are needed for.

And so I feel like part of the goal with this new book is to just provide some baseline exposure to what some of those opportunities are and make physicians aware of them and put descriptions of them in a format in which a physician can compare them apples to apples and really think about, is this something that might be a good fit for me if I wanna make a change or do something different?

John: Now we're going to learn more about the book itself and not everything is in it. I have some specific questions for you, but the first question is, tell us exactly what you're doing clinically, because it's a good example of one of those. I think it's one of those unconventional clinical careers.

Dr. Sylvie Stacy: Yes. So I am doing mainly addiction medicine. And the way I got into this is my first job after I completed my preventive medicine residency was working as a corporate medical director for a company that provides healthcare services at prisons and jails. And so in their corporate office, I was working in kind of an oversight position in which I would do a lot of utilization management, policy and procedure development, training of clinical staff, overseeing clinical staff, and a little bit of clinical work myself in the facilities. But in jails and prisons, there's such a high percentage of patients who have addictions that I... began learning about addiction medicine just out of necessity to be able to work in this industry. And I ended up really loving it. And it was the first type of clinical medicine that I truly felt was a good fit for me. I really struggled in medicine to find any setting or specialty that really jived with me. And I finally found that with addiction medicine. And so in addition to that main job with the... jail and prison healthcare provider, I started doing some moonlighting in other settings doing addiction medicine. And that included being the medical director for a methadone clinic and doing some addiction medicine by telemedicine and in a couple of community clinics near where I live. And that really gave me some exposure to the different settings in which addiction treatment is needed.

And also opened my eyes a little bit more to this whole concept of unconventional clinical work. And that is because in addiction medicine, there's so much regulation and rules surrounding when and where and how you can treat patients with things like methadone or suboxone that creates just this very unconventional setting that's really driven by federal regulations and various restrictions that need to be followed, which I found to be really interesting. There definitely are challenges and roadblocks, but very interesting at the same time.

John: How does it stand up in terms of work-life balance or just having a little more autonomy and flexibility? That's what a lot of physicians are looking for.

Dr. Sylvie Stacy: Yeah, with addiction medicine, it's been great for me because the settings that addiction medicine is often practiced in are somewhat atypical that creates an atypical schedule and sometimes more flexibility. So for example, in the methadone clinic that I have worked in, methadone clinics, are unique and that patients need to come to the clinic every day, at least for the first 90 days of their treatment to get their medication. And to accommodate patients who are working and need to go to their jobs or go take care of their kids, the clinics have really early morning hours. Most of them are open around five or 5:30 in the morning. So working at the methadone clinic, I would start my day at five and be done by 10 or 10:30, which allowed me to then have my whole, the rest of my morning and afternoon to do a other work or my regular job, you know, so I could squeeze that in, but still have that exposure to that other clinical setting to still have that additional income, that additional experience. So I loved having that flexibility, even though it required waking up really early, it ended up being a great thing for my career and getting additional exposure in addiction medicine.

John: Yeah, I don't know if this observation is correct or not, but you know how as a family physician, you know, I would, you know, I'd see somebody maybe twice a year, see them for their annual, whatever. I guess if you, and I don't know how much time you're spending with the patients, but if you're seeing someone every day for 90 days, you get a pretty good grasp about what's going on with that person, I assume by about the end of a month.

Dr. Sylvie Stacy: Oh, yeah, definitely. And actually, one of the things that I love about addiction medicine is oftentimes you can see a patient's life turn around so fast once they are stable on treatment. I think there are very few medical conditions in which you can start someone on a medication and suddenly every aspect of their life is changing. Not only are they not having to turn to their drug of abuse, but they can suddenly hold down a job. They can take care of a pet. They can maintain a relationship, whereas in the past they've broken relationships and lost jobs and gotten DOIs. Suddenly, they're headed in the right direction and that's very motivating for them and it's very motivating for the clinician as well.

John: Very nice. All right. I'm going to jump into some other parts of the book and different things. We can go in any direction we want, but these are just things that stood out to me. For example, this whole issue of remote monitoring is another option. I'll give you an example in a minute, but just tell me your perception of that. What are the things that would fall under that category when you wrote the book and that you're seeing as an interesting option within this remote monitoring area?

Dr. Sylvie Stacy: Remote monitoring is kind of a hidden gem, I think, and also an increasingly popular job that physicians can take sometimes full-time or at the part-time side gig. And it- It is just one example of a way that you can practice medicine clinically and do it from home. So as I'm sure all your listeners know, working from home in general has just really taken off in popularity. This happened during the pandemic and now many companies are continuing to allow their employees to work from home due to more better and more efficient technologies that allow us to do that. And some doctors were impacted by that and they were, they either had the opportunity to or were forced to use telemedicine during the pandemic and others not so much they just had to keep seeing patients in person. But regardless, I think we've all, we've all to some extent been exposed to telemedicine, but I've found that many physicians when they think of working from home, they think that their only options are either to do traditional telemedicine or to do something completely non-clinical like medical writing or chart reviews or certain jobs with pharmaceutical companies. But that's actually not true. There are a number of opportunities that allow us to really practice medicine from home that are either a variation on traditional telemedicine or other types of clinical work in which you might not be seeing an individual patient face to face, but you still play an important role in patient care through something like clinical oversight.

So remote monitoring is just one of those things and we can talk more about that and I can delve into one or two others as well.

John: I would say that I had a guest, I think it's been a year now, she's a perinatologist. And now all that she does, I mean, there's probably more to it, but let me boil it down for listeners if they don't remember. She does consults remotely and it basically based on reading the ultrasounds for the, you know, that they get sent from these high risk pregnancies. She said she's got six screens up at any one time. She's coordinating all this stuff and then she talks to the clients or the patients in that case. And it just to me, it kind of blew my mind. Okay, remote perinatal consultations. She's helping the physician, the obstetrician and the patient. So I think that kind of is an example.

Dr. Sylvie Stacy: Yeah, that is a great example. And I would consider that to be under the umbrella of remote monitoring in which you may not be having a live face-to-face video consult with a patient and then putting in orders in the EHR, but you're still looking at test results, you're still interpreting labs and probably reviewing prior medical records or records from other specialists and then putting everything together in the context of your area of expertise or specialty and either making recommendations to another physician like a primary care physician or putting in treatment and order of orders of different types yourself based on the data that you've analyzed. Other types of remote monitoring are things like tele-ICUs or also known as EICUs in which critically ill patients are being remotely monitored using advanced types of software and telecommunication systems and they get real-time support from physicians who are not on site at the actual ICU where the patient is, but they're just looking at the data coming from that ICU from the comfort of their own homes or their office using those six computer screens that you mentioned from the example that you gave. And then similarly intraoperative monitoring is another area in which sometimes physicians are utilized to identify changes in the patient's condition during an operative procedure, but that's done from another location by looking at things like hemodynamics and electrophysiologic monitoring and other data that you don't actually have to be in the OR to see.

John: I think I remember that even in my hospital, they had some monitoring. The neurosurgeons would do a lot of monitoring to sort of... make sure they weren't going where they shouldn't go or they were going where they should. And I think sometimes cases couldn't be done because the monitoring wasn't available. So to have someone that you could just link up remotely that would solve that problem.

Dr. Sylvie Stacy: Yeah, yeah, that's another good example. I feel like there is a lot of opportunity for neurologists in this space, reviewing things like motor evoked potentials and EEGs and somatosensory evoked potentials and other things during procedures. Again, you don't have to be there actually laying eyes on the patient, you really can get all of the data that you need by logging onto a portal that gives you that clinical information. So there are full-time jobs available in remote monitoring and similar types of telemedicine alternatives, but then there's also a lot of part-time opportunities and side gig type work as well. And because you can do it from home, that just, it tends to improve work-life balance when we're able to be in the comfort of our own home and the hours, if they're flexible, that contributes to a good work-life balance as well. So, my hope is that physicians who are wanting to work from home will consider these other options in addition to just traditional telemedicine.

John: Yeah, you just have to get a little bit creative. I mean, particularly if you're someone who does these kind of monitoring services, you but you're doing it in a fixed location, well, maybe you could just think outside the box, say, well, how could I do this? Maybe it already exists, I could help someone else who's already doing this remotely and add some flexibility and extra income and maybe even eventually full time.

Dr. Sylvie Stacy: Yeah, and that reminded me, another good kind of version of telemedicine that's worth mentioning here is e-consults or interprofessional consults. And they're... There are technology that allows physicians who usually are in primary care, sometimes nurse practitioners or PAs as well, when they have a question that requires specialty level input about their patient, they can use an e-consult platform to enter their question along with any relevant patient information, send it to the e-consult portal. From there, it's assigned to a physician within that specialty who can take a look at all of that information, review the medical records. and then answer the primary care doctor's question just online through the portal, which is then sent back to the originating doctor's own portal where they can see your recommendations and decide from there if it's something that they can just implement on their own or if a formal in-person consult is gonna be needed. So a couple of the... The major e-consult platforms that are available right now are Arista MD is one and Rubicon MD is another. And both of those have been around for about a decade now and they have pretty easy and straightforward onboarding processes for any licensed physicians who want to join their specialist panel. And once you go through their credentialing processes and sign up, to be part of their panel, they'll assign you relevant consults based on your own availability and schedule that you send to them. So that can be just a source, again, of additional income and it's work that you can do on your own time from your own home.

John: All right. Well, we'll definitely put the links to those for those that might align with that. I want to switch gears now and just, this is a big area, but I was interested in the... just the different ways of practicing clinically that are more traditional, but opting out of let's say insurance companies. I mean, we've heard of concierge, concierge medicine, things like that, but maybe what, what seemed to be the most popular and are they going to continue to grow, whether it's DPC concierge or some other version that you've come across?

Dr. Sylvie Stacy: Yeah. I, I think that all of those are going to continue to grow at this point. I think that probably many of your listeners are aware. To others, it will come as no surprise that physician practice ownership has been declining in the U.S. So somewhere around the year 2018, I think, we shifted from the majority of practicing physicians being in private practice to the majority of practicing physicians being employed. And that's largely due to competition with large healthcare systems and really all that's involved in managing a practice under insurance constraints. So when you take insurance out of the equation... A medical practice can really become a lot simpler and a lot of the headaches can be removed. So not only do you not have to deal with coding and billing but you don't need to manage claim denials and appeals. You don't need to deal with insurance company credentialing and negotiating your rates with them. You might not have to participate in certain like insurance run quality improvement programs or even stay up to speed on the changes in their policy and medical necessity criteria and coverage guidelines. So these types of alternative practice models that take insurance out of the equation, I think can make it a lot more palatable for many physicians to start thinking about whether it makes sense for them to start their own practice. And so just probably the most basic example of that is a simple cash only model. And with that, the patient... pays directly for the services that you provide them, like just by a credit card or a check at the time of the service. And they don't accept any form of insurance and they don't bill health insurance for any reason. And then as the practice owner, you can establish your own fee schedule and just make that available to your patients. And it can be a flat amount for each service or it can be a bundled, a bundle of certain services together for a flat rate, whatever you want it to be. And I would say a key feature here is that the patient is paying at the time of service. So you're not even billing patients after the fact. You're just requiring them to pay when they get the service. And so then not only are you not dealing with the insurance company, but you also don't need to deal with things like sending invoices to patients and chasing after late payments or non-payments. And again, that just simplifies things and allows you as the doctor to both hire fewer staff to help you and to spend more of your own time just focused on patient care.

John: Yeah, I think people get confused and sometimes they think, well, I can't be like a concierge doctor, my area, they're not gonna pay me at $500 a month or some membership fee, but would they forget that you can just do a fixed schedule for services? So maybe a simple example is doing DOT physicals. Okay, fine. I'm gonna charge you $100 to do it. DOT physical, it's very simple, it's not expensive. You need to have it to drive, and maybe you do other services like that. And so it's not a membership, it's simply cash payment at the time, just like urgent care. A lot of urgent cares get more than half, and you can conceivably do urgent care with only cash paying patients.

Dr. Sylvie Stacy: Yeah, and I think if you stop and really think about what patients are willing to pay cash for, there are really a number of options. Patients want services that simply just aren't covered by their insurance and they're willing to pay out of pocket for that. That tends to be more things that are cosmetic or considered not medically necessary. Things like weight loss clinics are really trendy right now and patients are willing to pay out of pocket for that. Even when insurance will pay for a lot of weight loss related treatments, patients tend to think that, think of weight loss treatment as something that isn't necessarily traditional medical care, but something they're just doing for their health. And so they're willing to go to a practice that will charge them a monthly fee for a certain number of months of getting a medication and maybe some counseling and nutrition plans and meeting with a dietician. They're willing to pay out of pocket for that. And then another example is any medical services that patients sometimes want an additional level of privacy and confidentiality related to what they're getting.

So going back to addiction medicine. addiction treatment is sometimes something that patients are willing to pay out of pocket for because they just wanna keep all of those records off of anything related to their insurance documentation or even the medical records that come from their primary care physician's office. But even thinking about services that are covered by insurance, I have definitely come across examples of cash only practices that have been very successful. A couple more examples for you to potentially put in your show notes are first the surgery center of Oklahoma is a very renowned and very successful surgery center for a wide range of surgeries that was started by a team of two surgeons back in the late 1990s. And it's grown to a team of over 40 surgeons and anesthesiologist. And they have done a great job of just making their services so patient friendly that they get patients coming to them who will just pay out of pocket for their perioperative care and the surgery itself. And they have just completely rid themselves of anything related to insurance billing and reimbursement. And instead they're just very forthcoming with their patients about that fact and what it's going to cost them. And then one other is the Ear and Balance Institute of Louisiana, which similarly, it's an ENT specialty group that just operates on a cash only basis and has just done a really good job of attracting patients despite the fact that the patients need to pay themselves. So those are just two sources of potential inspiration for anybody who's thinking about taking this route.

John: You know, I think too that sometimes it doesn't mean that the person can't get reimbursed from their insurance company after the fact because there's out of network agreements and so forth that'll pay, but then you just have the responsibility of taking those records and getting paid after the fact from your insurance carrier, I would hope in some cases at least.

Dr. Sylvie Stacy: Yeah, definitely. I think one of the most helpful things that a physician in a CASP practice can do for their patients when it comes to the finances is just provide them with some education about how it is that they might first find out if they can get reimbursed, and then also what it is that they need to do to get reimbursed. Because insurance, just as it is confusing for us as clinicians, it is even more confusing for patients. So just helping them navigate how they can make a cash only service work for them.

John: The bottom line is if as a physician side of it, you're not having to pay three or four staff to do the billing and track the billing and go after it and fight denials and all that, you can actually provide your services at a reasonable rate. And I think this patients still come out ahead in many of those situations, not only financially, but with the convenience and the trust that they have in those medical providers.

Dr. Sylvie Stacy: Yeah, for sure. And I also wanna mention that just two days ago, I think there was an article that came out in Forbes that was written by a physician all about concierge practices that goes through several different examples of physicians that have been successful in opening a concierge practice in the past few years. So I'll send you a link to that. It's a good read for anybody interested in this area.

John: Nice. Well, let's pause here for a minute. They can get the book. What's the best way do you think for them to find it and purchase it if they want to get that?

Dr. Sylvie Stacy: Yeah, both books were published by the American Association for Physician Leadership and they have a bookmarked on their website where both books are available. And then if you prefer Amazon, they're also both available on Amazon.

John: And everything we've talked about today is covered in the book. And maybe not exactly as we've discussed, but they're in there. That's why I'm grilling Sylvie so much to kind of learn at least some of what's there. But believe me, there is a lot more than that. All right, let's see. I do have one more question. So what I'm wondering is in the very end of the book, you talk about something about thriving in an unconventional career. So I just wanted you to kind of tell us, what did you mean by that? What were like two or three of the tips for thriving in an unconventional career?

Dr. Sylvie Stacy: Yeah. So I think kind of by definition, when you have an unconventional career, you're going to be stepping out of your comfort zone or you're stepping away from the settings and types of... of work environments that you trained in during medical school or residency. And so you need to kind of have some tools in your toolbox to make sure that you can meet all those new challenges and get over that learning curve that is definitely gonna come with doing something unconventional. So I think one good example that I can delve into a little bit is as it relates to compensation. I do think it's hard for most people to truly feel fulfilled in their work unless they feel fairly compensated. So just some thoughts about that. Given that so many unconventional jobs, especially those that we've talked about right now, they're done as side gigs, as secondary sources of income, whether they're consulting engagements or moonlighting or just a part-time position in something like telemedicine or other types of clinical work. Those are compensated differently than your regular, full-time employed position that has a salary associated with it. And with those diverse work structures, there also comes diverse payment structures. And I think probably my biggest piece of advice is don't try to compare the compensation that you're being offered for an unconventional side gig to the salary that you're earning in your regular conventional clinical position. Those are not comparing apples to apples. So if you're taking a consulting position or a 1099 position, just keep in mind that is taxed very differently than if you're a W-2 employee. You're going to be responsible for your own social security and Medicare tax. And therefore, if you're paid an hourly rate, it needs to be higher than the hourly rate equivalent of a full-time salary that you might be earning in a regular job. I think that's a common misconception is physicians automatically try to convert their full-time salary to an hourly rate when they look at doing some work on the side or in a moonlighting position, but that's often not adequate. You deserve and should get paid more than that if you're going to be responsible for your taxes.

Then on a similar note, when you're working for yourself, if you're doing consulting work or 1099 work, you're going to be paid more than that. you're essentially running your own business. You might be doing it as a sole proprietorship. You might not have a formal LLC in place and that's fine. But either way, you're working for yourself on your terms. And the more that you consider that work to be a small business rather than just a job, the better off you can do for yourself financially. So that means like keeping track of any expenses that might be associated with the work that you're doing. So, and then being able to use those as tax write-offs. when tax season comes, and also thinking about maybe putting some resources into marketing your services. Even though that's an additional expense, oftentimes putting in a little bit of money to marketing will pay back in spades with the additional work that you have coming in as a consultant. So think of yourself as your own small company, and you'll be better off financially in the end.

John: Those are important points. And I can't tell you how many people I've known, not necessarily physicians, but people who have started small businesses and didn't realize until they got a notice from the IRS that they hadn't paid any taxes on the income they had generated from their new business. It wasn't built in. Again, because they're the sole proprietor and just don't think about that. But those are great points. And I think physicians probably at least have some knowledge of business and have worked in as employees at least and should be able to make that transition very readily with a little bit of education.

Dr. Sylvie Stacy: Oh, definitely. Yeah, it's not a ton of new stuff to learn, but it is a difference from what most of us have been doing. So it's worth taking some time to really like learn about the tax laws, learn what legal risks might be involved. And then if you do find that you're in over your head in any of those areas, hire a professional, even if just on an hourly basis for a few hours to get you up to speed with what you want to know.

John: Absolutely. I've never been disappointed when I've hired an attorney or an accountant to help me figure something out because it's just way over my head. So that's great advice. All right, we need to know how to get a hold of you. I think we mentioned before we got on here. You and I were talking about LinkedIn. They can find you on LinkedIn if they have follow up questions or concerns.

Dr. Sylvie Stacy: Yeah. Or if they just want to connect with me, that's the best place online to find me. And I'm the only Sylvie Stacey that I'm aware of that's out there. So you should be able to search for me and I'd love to connect.

John: Excellent. So I will put that link in too and make it easy for people. So that's, I really appreciate you coming back on and talking about some of the things in the book. There's a ton more in there. So I really physicians, if you were looking for non-clinical or clinical jobs that are different. You can get both books really, and that should be part of your library. Thanks a lot and congratulations for two really awesome pieces of work that will probably stand out there for years and years as this go-to resources for physicians.

Dr. Sylvie Stacy: Thanks so much, John. It's been great to have this talk.

John: All right. Well, I hope to talk to you again sometime down the road.

Dr. Sylvie Stacy: You too.

John: So with that, I will say goodbye.

Dr. Sylvie Stacy: Take care.

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The post New Unconventional Clinical Careers Will Set You Free appeared first on NonClinical Physicians.

Find Your Great First Nonclinical MSL Job

John Jurica — Tue, 14 May 2024 11:57:14 +0000

Presentation by Dr. Maria Abunto – 352

Today's episode presents an excerpt from Dr. Maria Abunto's masterclass on securing your first nonclinical MSL job from the 2023 Nonclinical Career Summit.

Dr. Maria Abunto, a senior manager of medical science liaisons (MSLs) at Exact Sciences, shares her journey and insights into the MSL role. Dr. Abunto's insights focus on relationship-building, continuous learning, and strategic networking. Whether you are considering a career change or seeking to understand the MSL role better, this post offers valuable guidance and inspiration.

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From Academia to Industry: Dr. Maria Abunto's Journey

Dr. Maria Abunto transitioned from academia to industry, bringing experience from the NIH, Stryker, and now Exact Sciences. Her journey began with a master's degree in public health, where she developed a passion for public service. Driven to make a broader impact, she ventured into the world of medical science liaisons (MSLs).

Dr. Abunto shares her personal story, highlighting the importance of investing in oneself and continuously seeking opportunities to learn and grow. Her transition underscores the value of networking and finding mentors who can guide and support one's career path.

The MSL Role: Responsibilities and Rewards

The MSL role established over 50 years ago is vital in the biopharma industry. MSLs are responsible for building relationships with key opinion leaders (KOLs) and educating them on the science and advancements in treatment related to a company's product. This communication-focused role requires a strong scientific background, typically a doctorate, and excellent interpersonal skills.

Dr. Abunto explains that MSLs work remotely, managing their schedules and traveling to meet with KOLs. The role offers significant rewards, including high compensation, flexible work arrangements, and the opportunity to make a meaningful impact in healthcare.

Finding Your First Nonclinical MSL Job: Tips and Strategies

Breaking into the MSL role can be challenging but achievable with the right preparation and strategy. Dr. Abunto advises aspiring MSLs to focus on matching their skills and experiences with specific therapeutic areas and companies.

Networking is crucial. Attending industry conferences, joining professional organizations like the MSL Society, and connecting with key MSL leaders can open doors to opportunities. Additionally, enrolling in relevant training programs can enhance one's qualifications. Dr. Abunto also emphasizes the importance of building quality professional contacts and researching target companies to stand out in the competitive MSL job market.

Summary

To learn more you should explore the MSL Society website, which offers information and training opportunities for aspiring Medical Science Liaisons. To connect with Maria check out her profile on LinkedIn, where she is likely active and engaging with the medical and scientific community. For detailed presentations and insights from the 2023 Nonclinical Careers Summit, including Dr. Abunto's complete talk, visit the 2023 Summit’s Official Page.

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

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Transcription PNC Podcast Episode 352

Find Your Great First Nonclinical MSL Job

- Interview with Dr. Maria Abunto

John: Dr. Maria Abunto is the senior manager of medical science liaisons at ExactSciences, a molecular diagnostics company specializing in the detection of early-stage cancers. Before she worked there, she was global medical science liaison for Stryker. And she previously worked as an epidemiologist and investigator for the NIH and as a medical scientific expert on the IRB at a large children's hospital. She holds a master's degree in public health from the University of Pittsburgh and she completed a medical degree at the University of the East in Manila, Philippines. All right.

Today's podcast episode is the first half of her presentation from the 2023 Non-Clinical Career Summit in which she describes the MSL biopharma role, why it is a popular non-clinical career, and how to land your first MSL job. So let's jump in as she describes how she landed her first role as an MSL.

Dr. Maria Bunto: I'm Maria Bunto and I'll give a talk about coming from academia to industry or going from the ivory tower to the dark side. So the purpose of my presentation is to educate you on what is a medical science liaison or MSL. And if there's one thing I'd like for you to remember about being an MSL, it's not really bad at all. In fact, it's quite the opposite. It's one of the best jobs in the world and I'm fortunate to have transitioned to a non-clinical career that I love. And hopefully my talk will resonate with some of you.

So this is my disclaimer and the views and opinions are my own and do not reflect that of exact sciences, my employer, and I have no financial relationships to disclose.

So here's an outline of what I'll be talking about today. I'll start with a background about myself and my journey of how I transitioned. Then I'll talk about the MSL role, who MSLs are, and what compensation looks like, and then highlight the pros and cons of being an MSL. Then I'll take a deeper dive into how to become an MSL and briefly talk about the different career paths. I'll provide some information about the MSL society, their training and other resources.

So I'm just gonna go ahead and go into my why. This is my story and I'd like to spend just a few minutes and take you through my journey. Everyone has their unique experiences. So I think it's really important to connect with all of you, the audience out there who's interested and just figuring out what your why is. and why you want to transition. So as a physician, I have had previous experiences as a medical director, supervising operations for a busy family medicine practice. And during that time, I saw countless health disparities and underserved populations without any support or insurance. And so chronic disease is being passed down from generation to generation. And it's just one day that I just had an epiphany at a health fair and we were conducting where I realized I didn't wanna do this anymore, but rather just really focusing on understanding really what's going on here and what's happening upstream in a lot of these marginalized populations and how can we prevent that domino effect downstream?

So I always knew that I wanted to be more than just a medical director. I really wanted to affect populations on a greater level and really make that difference on even a more broader impact. while continuing to develop myself professionally. So identified public health problems, but I also realized the solution really starts with me. So the decision, this became my why. But how I was going to do this was the big question is how was I going to reinvent myself? So I knew my strengths were in public service and building connections and relationships. But I also realized during the soul searching that in order to do this, I needed to up my game and invest in myself. So my journey really begins in 2016 when I went back to graduate school and obtained my master in public health at the University of Pittsburgh. So this was a really great decision and wise investment because I needed to focus and reinvent myself. So I really worked hard to increase my knowledge and skillset, and I discovered that I absolutely loved learning as an adult student, but I didn't know what I would be doing after graduation, but I kept going and I didn't stop and I kept looking for opportunities.

It's in academia where I found an opportunity to expand my network. build my meaningful connections and relationships. So at the bottom right of the corner of the screen here, I'm pictured at graduation with my program director and long time mentor, Dr. David Feingold and the former Dean of Public Health, Dr. Donald Burke. And like I mentioned, I knew my strengths were not only in relationship building, but in public service. So at the top right is where I immersed myself in the Center for Health Equity Initiatives, such as Take the Health Professional to the People Day. So that's where I would conduct blood pressure screenings at barbershops and salons and inner cities around Pittsburgh. And you see, after all these years, I'm still volunteering in a community and giving back. It's been about a decade now. And these are opportunities like creating these long-term relationships with mentors. I also had an awesome mentor during grad school, who after graduation, I joined him at his lab at the National Institutes of Health and Population Sciences is at the NIH. And that's me pictured there on the left-hand corner. at the NIH Clinical Center in Bethesda, Maryland. That's really how I got into research because not only my connections, but my public health experience.

So it was at the NIH where I said, I mentioned that I conducted colorectal cancer research and that I became an epidemiologist there, attended all conferences and network like crazy. And I think that's where in 2017, I joined the MSL Society and became really active. And I attended the three-day live MSL communication and presentation skills training. There I learned as much as I could about being an MSL because I didn't really know I've heard about it, but it was really when I learned more about it that it appealed to me. And it was at the MSL Society Women's Conference in 2018 where I met a physician MSL. She introduced me to her career coach. And I immediately consulted that coach. So I wanted to realize that coach was also a physician. I wanted to really understand, is this a good fit for me? How hard is it to break into the role? She really helped me after 10 months. I landed my first job in industry. It was because of a connection she had, another physician who was hiring at a medical device company. And I know that after working there my first week, I just knew that I loved it and it was such a good fit. So in a nutshell, That was my career path and I'd have to say, I continue to solidify these relationships in the roles with MSLs and MSL leaders who continuously inspire me.

So now let's talk about the MSL role. The MSL was first established in 1967 by the Upjohn company and has existed for more than 50 years. And it continues to evolve in line with the changing diseases, treatment landscapes and healthcare trends. So MSLs were created in response to the need for a professionally trained staff to build rapport with influential physicians known in the pharma industry as key opinion leaders or KOLs and then thought leaders in various therapeutic areas of research. So MSLs became a part of medical affairs department where their activities revolve around building relationships with KOLs, but it's important to note that in the US the MSL is not a commercial role. or a promotional one. It's also not a science role, but rather a communication role through science, where discussions revolve around the research and the data behind the drug or product. So in the past, an advanced clinical degree was not required. However, in the late 1980s and 90s, a number of companies began to require MSLs to hold a doctorate degree, such as an MD, PharmD, or PhD, and now even Doctorate of Nursing, or DNP. As the MSL role grew over the years, the doctorate degrees became the new standard. Many companies require these credentials because MSLs are often viewed as more credible and it helps really establish those peer-to-peer relationships with doctors who you will be working with. And it's a growing field, which is a good sign. It's growing at a rate of about 10% a year with at least one out of four MSLs being hired without previous MSL experience. So over the years, companies have used various titles for the role and Medical Science Liaison or MSL is not the only name, it is called, for example, Pfizer calls MSL's field medical directors or FMDs and Amgen refers to them as regional leaders. So I'd also like to point out that obtaining a master degree may not likely make you a better applicant unless that degree really strengthens your match to the specific MSL role. But we have seen, and also on our team, we've had people that had master degrees and go on to also get a PhD while they're working for an industry company. So what is the purpose of the MSO role? The primary purpose is to be a scientific or disease state expert in the therapeutic area of the company product or pipeline.

So what is an MSL? Well, an MSL is one who holds a clinical degree in the life sciences with extensive experience in clinical medicine and or research. A doctor degree is preferred, but I've seen, as I mentioned, MSLs with master degree break into the role. There are more PhDs and PharmDs or MDs. And lately we've seen a lot of DERS practitioners and also physician assistants transitioning to become MSLs. So an MSL is employed by a pharma, biotech or medical device company. And He or she is a subject matter expert in a particular therapeutic area, such as oncology, hematology, and immunology. Now oncology and immunology, they lead the way with growth rates of about 31% and 28% respectively. And MSL's primary function is to educate on the science and advances in the treatment of the drug or product in a fair and balanced manner.

So it's a remote job where one works from home, one has a home office, and arranges meetings with KOLs or healthcare providers, either in person or virtually. So this diagram is event diagram and really illustrates what the role of the MSL encompasses. So the circle on the left contains all of the people with the science degrees, which is the PharmD, MD, PhDs. And these are people like yourself who have the proven science skills and have spent hours and hours conducting research or practicing science. Now the circle on the right This contains the people with communication relationship driven skills. So these are the soft skills. And that includes emotional intelligence and self-awareness. The circle on the left is necessary but not sufficient to land an MSL role. However, the circle on the right is full of people you want to be with, but is no good without the technical science skills found on the left. The silver middle, the sliver in the middle is where the two circles intersect and that's why the MSL talent is so hard to come by. However, as mastering the science and having degree is found in every candidate, what's often overlooked are the soft skills and the communication skills, as I mentioned, which actually may even be more important here. So MSLs are excellent communicators and this quality is really what is what makes one stand out. It's one thing to know the science and it's quite another to communicate the science. And if you think of the communication rolled through science, that's what makes an awesome MSL.

What are some of the responsibilities of an MSL? The primary responsibility is to establish and maintain relationships with KOLs who are influential doctors or healthcare providers. So since MSLs are subject matter experts of the science behind the products, engagements with KOLs involve discussions about the disease state and can involve education through presentations. An MSL first starts by KOL mapping in their territory and identifying who the key influencers are. and who are important players to get in front of as they begin strategizing and building relationships. A typical day involves proactively reaching out to a list of KOLs, and the MSL will introduce himself or herself through an email or a phone call. And then introductions can also happen at conferences or through your commercial sales force. The goal is to be able to schedule a one-on-one meeting, engage in conversation, and begin to build those relationships. And then from these conversations, may find that the KOL is interested in conducting a clinical trial that aligns with the pharma company or the KOL may request more education on the pivotal study about a company product recently launched. And whatever the outcome, collecting insights are important information to bring back to the company because insights are considered currency to the overall business, especially competitive intelligence insights. And sometimes these meetings are in-person and require travel. And so travel days are an average about two to three days per week. and are structured around the KOL schedule. But you can also modify your schedule, really makes sense to you. If you think according to the metrics of the company or of your team, if you can actually meet those metrics in two to three meetings, half virtual, half in person, minimal travel, that can be accomplished too. So it's really about you being the CEO or you managing and being the manager of your territory.

So here's a survey that was conducted by the MSL Society in 2020 and showing the many different activities that MSLs participate in and can be found on the website, which is free for all members. And also, I think there's also free resources for non-members. And as you can see, majority of the MSLs, over 98%, they manage KOL relationships. And approximately 90% of MSL surveyed said that they attend medical conferences and also provide education through scientific presentations. MSLs focus on meetings with those who are experts and thought leaders because they are influencing how others practice or conduct research using the product or the drug treatment. And an MSL would do that through a peer-to-peer scientific exchange. And the scientific exchange has two aspects to it. The first aspect of the role is a therapeutic area subject matter expert. So disease state awareness and the knowledge of the competitive landscape and the company specific products and pipeline. The second aspect is bringing value that the KOL wants. And sometimes they don't need the MSL scientific acumen. So sometimes what they want are opportunities. For instance, opportunities like a grant for an investigator led study or clinical trial. And sometimes KOLs are not looking for that scientific information, but looking to the MSL to be that conduit to the company's resources to help their career or institutions like being on an advisory board or speaker on podium or an author of a publication. So as an MSL, you will have to know the KOL very well to find out what it is that you can bring value to them. Is it the scientific presentations or is it the career opportunities? And the key is to meet the KOLs where they're at. So now let's shift a little bit and talk about who MSLs are and what compensation looks like. I think this is a really nice set of slides from the MSL Society data that shows an infograph of the makeup of the MSL surveyed by the MSL Society in 2020. 2023 results are very similar. So they surveyed over 2000 MSL professionals and the results in the US showed there was an overwhelming number of women MSLs compared to men, more than half were women and about 41% were men. 31% of MSLs work in the oncology space while 15% of MSLs work in Majority of MSL surveyed were white who had a PhD degree at 39%, followed by 27% for PharmDs. So only 8% of MSLs had a medical degree. The top three places where MSLs work are in large, medium, and small pharma or biotech companies. And then the survey also breaks it down by years of experience.

So MSL-based salaries can vary significantly depending on the therapeutic area, geographic region, years of experience. educational background, and then size of the company, as well as a company's product and pipeline life cycle. So this is a comparison of the average base salary of MSLs from around the globe. The MSL Society hired an external research firm to collect and analyze the data from over 2000 participants from 60 countries around the world. So this is 2022 data. And keep in mind that the MSL role may be defined differently around the world. They may take on other responsibilities similar to commercial sales or marketing. So from those that participated in the 2021 salary survey, the majority of managers or directors of MSLs based in the US use the report as their primary salary benchmark data. I know we use this for our, not only just the MSL society data, but other data that we use as benchmark for our hire for this year. And so as you can see, there is a wide range of salaries and the MSL pay trends on the higher side in the US and then it increases annually, about 3%.

This is a snapshot of the 2022 average base salary of MSLs in the US according to years of experience. And as you can see on the left, the average starting salary is about 160,000. That's not including benefits, which makes it a very attractive compensation, even with less than one year of experience. The salary increases about 3% every year, as I mentioned. However, this is underestimating how much MSLs make because it doesn't include the long-term benefits which could be another 30 to $50,000. For example, some of those benefits are health insurance, 401k, stock options, a company car, and an expense account, which are added on top of your base salary. Now on the right is the average starting salary for an MSL manager or director. It usually starts above $200,000, but varies according to the years of experience. So if you see though that the difference here from managers compared to the MSL's salary is that it varies and it doesn't necessarily mean a trend up as one gains more experience. The years of experience of being a manager or director doesn't always translate to higher pay. And sometimes they do take a pay cut to move up into a company.

So when I was doing my research and deciding on whether the MSL job was right for me, I thought it was important to write down the pros and cons of being an MSL. And I... And I suggest you do the same transitioning, if you're transitioning from clinical to non-clinical. So please note that this is not a comprehensive list and it's very subjective. So for the pros, I showed on the previous slide that MSLs in the US are well compensated with a high base salary. Remote work is a plus, especially during the pandemic when I started. But working from home may not be suitable for some people. Having a flexible schedule includes making your own work schedule, arranging your own meetings and then. healthcare providers, meetings, as well as booking work travel. And there is at least 50% within your region or territory. And travel may be a deal breaker for some, but for me, it suits my lifestyle. And also there are great benefits that I explained. Some of the cons. So for industry is highly regulated and there is a lot of compliance and rules to follow. There is some loss of autonomy there. It's a transition from being a discoverer, for instance, like in academia, to being a knower. You know, you will not have a lot of patient interaction if you were a clinician and moving into becoming an MSL. And will certainly not be a scientist, but rather more of a communicator of science. And then you're going to be part of a larger team that is metrics driven and performance driven. So for example, you're measured on the number of healthcare provider. Outreach and interactions, insights and presentations, those are part of your metrics. Access to healthcare providers and scheduling face-to-face meetings. They were very difficult during the pandemic. But then we made it work through a hybrid kind of meetings where we had virtual and also in-person once they started opening up to vendors and to industry. So it's about really finding creative ways of gaining access.

The MSL role is very competitive. You will be competing against experienced MSLs for every single role you apply for. Breaking in is not easy, but it's not impossible. And most companies will require having MSL experience. It does take a lot of hard work and the right match to find that ideal job. And now I just, I'm going to pause here for a minute and just talk about one thing that I did not touch on. And that is that negative impression or that bias about working in industry. And you know, I came from academia came from practice as well. And I specifically titled my talk, going from academia to the dark side to illustrate this bias. But as someone who has worked on both sides, I believe education and having an open mind are key in tackling these biases and assumptions when considering transitioning to industry. And this section is going to be talking about how to become an MSL. I can be whole another presentation and discussion, but I'll just take a few minutes to talk about some steps and strategies that has worked for me and others. And the bottom line is preparation is key.

So remember that there are no general MSL roles. There are all disease state or therapeutic area focus. The first step is to really identify your therapeutic area or TA. For example, you could be conducting research in Alzheimer's and your disease state focuses neurology or neuroscience. or if you are conducting sickle cell anemia research, your TA will be hematology. If you want to exponentially increase your chances of breaking into your first MSL role, I'd say the three most important things are really to match, match. Match and find those target companies, target roles, and only apply to those once you have done your research and preparation. Next, research the role in the company you'd like to work for. I'd say do that now, follow the company on social media or even on Twitter, on LinkedIn, know everything you can about the company because when it does come time to interview, what I did is I told the company, I said, I've been following you for years, which is, it's a good sign that you actually are very knowledgeable about them. It also allows you more opportunities that help you get in front of people as you network and then get your foot in the door. There are also, for example, internships or fellowships offered because these can count as experience. translatable experience. And so too, you wanna look at and see if there's companies that have internships and apply for those opportunities. Attend industry-wide conferences and events and really build your network. Let them know you, your face and really introduce yourself and be proactive. A focus on quality professional contacts that are directly related to the MSL community. and identify key MSL leaders in medical affairs at companies that are of interest to you. So this is the most effective and easiest way to connect with a hiring manager and other key decision-makers. So the more relevant connections you make, the greater chance you will be successful in breaking in. So become an active member of MSL relevant groups, like the MSL Society, and there's others out there, cheeky scientists. This will allow you to really increase the network your circle of influence with those MSLs in industry, but also in the companies that you are interested in. It's really challenging to achieve on your own your circle of influence without the help of your network. So I highly encourage you to expand your reach and get out of your comfort zone and connect with others.

It's also really challenging to achieve becoming an MSL on your own without proper preparation and guidance. You will need to really stand apart from the competition. So there's also MSL trainings offered for aspiring MSLs, especially if you have no MSL experience. That's a great way to upscale, build your skills. If you lack industry experience or research experience, you know, we wanna keep pace with the changing demands of the profession. And if you need to enroll in online courses to learn about clinical trials or regulatory compliance, I'll provide a list of resources too with websites at the end of this talk.

John: Physicians are uniquely positioned to enter the biopharma industry. They obviously use the products produced by biopharma and are very comfortable discussing the research, development, and deployment of new pharmaceuticals, diagnostic tests, and medical devices. In today's presentation, Maria provided a nice review of the pros and cons of the MSL job, the likely salary to expect, and sound advice to help you transition into the role. If you'd like to hear the rest of our presentation and the other 11 topics presented at the 2023 Non-Clinical Careers Summit, you can check that out at nonc forward slash two zero two three summit. That's nonc forward slash twenty three summit. That's all one word, no hyphens.

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Explore What Matters Most and Design Your Professional Career

John Jurica — Tue, 07 May 2024 11:30:43 +0000

Interview with Dr. Sharon Hull – 351

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

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

Our Show Sponsor

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

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

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

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

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

Navigating Leadership in Medicine

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

Professional Careers by Design

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

Dr. Sharon Hull's Mantra

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

Summary

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

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 351

Explore What Matters Most and Design Your Professional Career

- Interview with Dr. Sharon Hull

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Sharon Hull: Top ten list.

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

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

John: Thanks again for coming. Bye-bye.

Dr. Sharon Hull: Bye-bye.

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How to Apply the Visibility Formula to Become Known

John Jurica — Tue, 30 Apr 2024 11:45:14 +0000

Interview with Dr. Nneka Unachukwu – 350

In today's episode, Dr. Una returns to the podcast to teach us how to use her visibility formula and to tell us about her new book.

Two years ago, Dr. Una introduced us to the transformative power of entrepreneurship for physicians. Now, she shares the strategies that have propelled her clients to success, with practical advice for physicians ready to embark on their entrepreneurial journey.

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The Visibility Formula: Unlocking Business Success for Physicians

Dr. Una explains the core principles of her latest book, The Visibility Formula. The book aims to empower physicians to overcome challenges in marketing and branding their businesses. From redefining introversion in entrepreneurship to practical strategies for increasing visibility, she offers valuable insights into building a thriving medical practice.

Practical Strategies for Physician Entrepreneurs

Dr. Una shares actionable tips and strategies for physicians venturing into entrepreneurship. She provides concrete steps for building a sustainable and successful medical practice or business, from identifying target audiences to leveraging social media. Drawing from her own experiences and those of her clients, Dr. Una offers valuable insights into overcoming common challenges and achieving long-term business success.

Summary

From homeschooling her children to leading The EntreMD Business School, Dr. Una's journey is filled with insights for physicians seeking to navigate the entrepreneurial world.

In her latest book, “The Visibility Formula,” Dr. Una unlocks the secrets to business success for physicians, offering practical strategies to overcome introversion, master visibility, and build thriving practices.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 350

How to Apply the Visibility Formula to Become Known

- Interview with Dr. Nneka Unachukwu

John: I found that one of the best ways for physicians to thrive in today's healthcare environment is to opt out of the traditional corporate employment. That just doesn't do it for most of us. And as an alternative, build your own practice or a healthcare-related business. And to do that, of course, you need business knowledge and marketing knowledge. And that's why I brought on today's guest because she is an expert in both. Maybe we'll get she's taught so many people how to start a business, run a business, optimize a business, market a business. And so, I want to welcome back to the podcast, Dr. Nneka Unuchukwu.

Dr. Nneka Unachukwu: Hi, John. Thank you so much for having me back. This is a treat.

John: Yeah. And of course, you are being a presenter at the summit, which starts a week from now, but it's actually in the past by the time this is posted. I do want to mention it though, because people can still buy the videos after the fact. You are our kickoff speaker next Tuesday. I'm very thankful that you're going to be doing that for us.

Dr. Nneka Unachukwu: Yeah. And I think it's a gift to the physician community really, because we really do need all hands on deck and for people to see examples of what is possible. And you really gathered a really great group of speakers who are speaking on so many different things and everybody should be able to find something that resonates with them. And then hopefully just change the trajectory of their lives really.

John: Yeah. And not the least of which is just get to know some of these speakers who maybe they've never met before or seen and just say, "Wow, I didn't know there was someone doing that, that I could emulate or I could reach out to." Because pretty much all of us, if we're doing this for mentors or coaches or something along those lines too.

All right. Let's see, you were last here about two years ago. Of course, I can never go back and remember where things were two years ago, but just give us an update on maybe how your life has changed and some of the newer things you've been doing since we last spoke back in, I think 2022.

Dr. Nneka Unachukwu: Yeah. A lot has changed since then, but on a personal note, I started homeschooling my older two kids, which has been so good because they get a full education. They get the academic piece. I'm teaching them business, leadership, real estate, character development, and they get a lot of hands-on because I have them hands-on in the business. They're 16 and 14. It's been so rewarding. And some of the things we're going to talk about today are the things that made that possible because I was able to create that space so I could do that. That's been really good.

From a business perspective, I've done a lot, but really focused. As you know we have The EntreMD Business School, which is really about helping doctors build six, seven, multiple seven figure businesses. And for the last two years, I could have started many, many other programs, but I really poured a lot of energy into that. How can I help the doctors get bigger results? How can I help them get results faster? How can I help them see as many examples as possible of what is possible?

And really over the last two years watching them, we're talking docs, building multiple seven figure businesses, taking vacations once a quarter. Their marriages are better. Their relationships with their kids are better. Their health is better. Everything is better because they're back in control. They're back in control. And so just watching that has been so great. I'm really glad. The school is almost four years old now. Just the sheer amount of focus that I've put on that.

And then I really took to writing. I figured we didn't get a business education and everybody's not going to come into the business school, but I did really want physicians to have all these blueprints of how they can change their businesses, how they can grow really great brands and things like that.

This year I was like, "I'm going to do a book a quarter and we see how that goes." For the last two years, I've done a book a year. But then this year I was like, "I'll do one a quarter." That's my tall order for my own self.

John: That sounds like a challenge. It's hard. The way through that and with everything else you're doing, but it's a good challenge.

Dr. Nneka Unachukwu: Yeah, I'm up for it. I committed for a year, so we see what happens after that.

John: Yeah. Well, maybe by then you'll have written everything that needs to be known by anybody. So that'll be good. But that's why we're here. We want to talk about your latest book. You wrote The Visibility Formula recently, and published it. I've had a chance to look through it, but why did you write that and what aspect is it focused on?

Dr. Nneka Unachukwu: Yeah. I started off in entrepreneurship as a socially awkward, super shy introverted introvert. And I think many physicians are introverts and all of that. The problem with that is if we adopt the traditional sense of an introvert, it's almost impossible to make a business work because then the introvert will say, "Well, I can't go out and ask for referrals because I'm shy and I can't speak on stages because I'm shy. I can't ask for reviews because I'm shy." And it goes on and on and on. And I had treated that like a handicap, but being able to show up and promote your business and promote your brand and all of that, it's not really a personality type. It's like a skillset. It's a skillset. And I found so many physician owned businesses struggling, not because they don't have a great service because we lead with service. We have amazing services, but the thing is nobody knows about them. Obscurity is the big problem.

And so, I wanted to create one book where you can go end to end and discover how to build a business that is like a household name where people start saying you're everywhere, where all the people you want to serve can find you because there are so many people who have the problems that our businesses fix, but again, they don't know we exist and if they don't know we exist, they can't say yes to working with us. And so I wanted every doctor to be able to lay their hands on something that they can follow, their team can follow, and it will take them over the course of time from obscure to household name.

And then once we get to that place, we're in a position where we can help the people we're called to serve and we can create financial freedom at the same time. So that's kind of what drove me to write the book.

John: Oh yeah, I think most physicians, it's not something they're aware of or exposed to the idea of marketing or sales or, I don't know, branding even, that kind of thing. Maybe you can walk us through the components of the book or of the visibility formula. Obviously we should all go by the book if we want the details, but you can at least give us a high level overview of at least two or three, or maybe all.

Dr. Nneka Unachukwu: Yeah. The starting point of all things visibility is really recognizing how powerful it is. And when I talk to people about them, if your brand is visible, you get to attract more people that you can work with, which is what you want to do. You get to attract more people who refer people to you, because again, there are people looking to refer to people just like you. They just don't know you exist. You'll get to attract people who will come work for you.

I have so many doctors in The EntreMD Business School who now have one of them over the last three months has had six doctors from different states reach out and say, "You're the person I want to work with. I will move my family cross country to come work with you." Visibility does that.

And then one of my favorite things is that the visibility formula will do for you is it sets the stage for what I call the unknown. There's so many opportunities that can fall in our lap. That could be investments, that could be partnerships, that could be so many things, but they're not things that are on a vision boards and not things that are goals, but they can fall in our lap if people can find us. And so, if we understand how valuable visibility is, we'll be willing to embrace some of our discomfort to be visible. And so, that's the starting point.

Then the second thing, especially for physicians, because when I started out as an entrepreneur, I thought sales marketing, all those things are sleazy things, that used car salesmen did, not professionals like me. But redefining what that is. For instance, I could see selling as something you do to manipulate people to take their money, which is not what selling is. Selling or even being visible is really putting yourself out there loud enough and long enough so the people who have a pain that your business solves can find you. And so, the truth of the matter is putting ourselves out there is sometimes some of the best service we'll do to the people we're called to serve, because they have real problems.

Dr. John, if you think about it, there are problems in maybe your life, your business and things that you're thinking, "If I could just find somebody who does this, I'm willing to pay them whatever. Whatever they want, I'm willing to pay them. I just need the person." But there's somebody else who has a business who solves that. The reason why you're not working with them is because you don't know they exist. And it's the same thing for us.

If that person were to come to you and the person tells you, this is what I do, you're not going to say, "Oh my goodness, this person is sleazy and manipulative." You can even almost hug them and say "I've been looking for somebody like you." And so, being visible is not a slimy thing at all. It's a good thing. It's you serving your people. And if we can just reframe the way we think about it, everything becomes better. These are almost like prerequisites. Once these two are here, it makes embracing the formula, it makes it much easier.

As far as the actual formula, the starting point is who do I serve? Who do I serve? Who is the person? And a lot of times people will tell me, "Well, I can't choose. What I do will help everybody." And I'm like, "They're 8 billion people. You're not going to help everybody." And they're like, "No, but I really can't choose." I'm like, "Yeah, but you're an OB-GYN. You're not a pediatrician, you're not a dermatologist, you're not a heart surgeon. You chose a specialty so you can choose."

Really identifying who is the person my business serves, because when we talk to everybody, we're talking to nobody. And that's the rule of the game. You want it so that this way, everything you're doing is strategic. You're talking to your person at all times. That's the first part of the formula.

The second part of the formula is the person you serve already exists. They're not going to be born. This is someone who's going to swipe a credit card or swipe a card to work with you. They already exist. And so, they're out there in communities and groups and tribes where they've been gathered.

The second part of the formula is identifying where they are already gathered and going to them. For instance, Dr. John, I'm on your podcast and there are people who are listening now who have never heard of me, but they hear of me because I'm here. And the same thing, if you go on somebody else's podcast, there are people who've never heard of you, but they're gathered and you show up there and they're like, "Oh, now I've met Dr. John. Let me go find his podcast. Let me go attend his conference."

And so, we go show up where our audience already is. Because a lot of times what people do, they start a business, they open a social media account and they're talking there all day, every day, but nobody knows them. You have to go find the people. The second stage is going to find the people.

The third stage is then creating what we call a headquarters where people can come and binge on your stuff. Think about Netflix for business. If we use this example, Dr. John, I'm here on your podcast. Some may listen to this and be like "I find what she's saying is really fascinating." They could come to my podcast. My podcast has 414 episodes at this point. So they can binge away. They can see, "Oh, this is what it's like when people work with her." They can see, "Oh, this is what she's about." These are the principles to stand for. "Oh, she showed me this. I can go apply it in my business now and get wins and all that." Everybody kind of wants to own that so people can come home, if you will. They come to the headquarters and really experience you.

And done right, your podcast, YouTube, blog, those are the three main types of headquarters. They really can be a full-time employee in your business because while you're asleep, Dr. John, someone just listened to you talk about the conference. So someone's like, "Yeah, I heard you say the conference has passed, but I'm going to buy the replays and stuff like that." This could be happening at 02:00 A.M. You're asleep where your podcast is working like a full-time employee. Identify who you want to serve, go out there, go find them, build an HQ for them.

And then the fourth stage is really around "How do I set this up in a way that it doesn't take over my life?" I don't want to spend all day every day doing the podcast, creating, pitching where I'm going to go, all of that. Because sometimes people hear about this, they're like, "It's too much. It's a lot of stuff." And that's why we talk about things like repurposing, batching, getting a team, delegation, all of those things.

You can do it because I've had a whole month period where I didn't record a single podcast episode because I wanted to take a break. But I batched and I created six episodes, which is for six weeks. So of course I can take a break. My podcast didn't take a break, but I took a break. So there are ways to do all of these things and it will look like you're everywhere doing all the things at all times, but not really. That's not what's really happening because you've learned to leverage all these other things.

And the truth of the matter is we put ourselves out there long enough, loud enough, and we're strategic with inviting people to work with us and all of that. We will just build a brand. We will build a business where we can serve all the people we want to serve and really create massive change, which is what we really want to do. That's a long answer to your question, but that's kind of the formula.

John: That's a good overview of the formula. Now I'm going to get into the specifics of a couple of questions. One of the things I've become more interested in is instead of pulling people into just these nonclinical jobs, working for UM or an insurance company or something, but going back and saying, "Look, just start your own practice. Maybe do a cash only business of some sort or concierge or whatever you want to call it."

I just want to know when your experience, when you're working with those people, are there certain techniques that they use? Looking for patients geographically around them, do they go out on LinkedIn on social media or do they just do ads in newspapers or what?

Dr. Nneka Unachukwu: That's a great question. There's a lot of things they can do, but I'll tell you almost in order of importance, if you will. I'll give you some. When you have a brick and mortar and you're going to be serving people locally. When we talk about going out to where the people are, a lot of times they're local referral sources.

I'll give you an example. I'm a pediatrician and a great referral source for me would be an OB-GYN because we serve the same person in different ways. The OB-GYN will take care of the mom. I will take care of the mom's kid. And so, there's no competition there because we do completely different things.

Now, if I were to have build a relationship with six OB-GYNs and they're all preferentially referring to me, I'm busy, the end. The end. Because their moms are going to keep having babies and they're going to keep sending them to me. So I just have this constant stream of new people who are coming in.

I will give you an example of one of the docs in The EntreMD Business School, she does weight loss, brick and mortar, and she had been courting this orthopedic surgery group. Because they would need for their patients to have some weight loss to qualify for certain surgeries and stuff like that. And it took her a minute, it took her about 11 months of following up with them and all of that, but it's a big group. And so, the day they said, "Oh, come do a lunch and learn from us. We want to learn more about what you do." She ended up with 42 new referral sources, 42. If they sent you one patient a month, that is 42 new patients a month from one referral source. You see what I mean? And so for brick and mortar, that right there, it's so powerful, it's super powerful. That's number one.

Number two, because private practices tend to be high volume for the most part, except they're concierge like DPC, they tend to be larger volume than say a coach would have. Unleashing your current patients is so powerful. Many of them will refer, but they don't refer because they don't know you're accepting new referrals. Case in point, I was taking care of a patient one day and she said, Dr. Una, are you accepting new patients? Because I had this friend, she has three kids. She asked me who my doctor was and I was like telling her how you were amazing and all of that, but you're busy, I'm sure you don't take new patients. Here she is thinking she's doing me a favor by not referring patients. Meanwhile, I'm actively recruiting and accepting new patients. If we don't tell them, they won't refer. Now sometimes they will, but we won't experience the real magic of it if we're not telling them.

It's as simple as maybe I see 12 patients a day and I decide every day I'm going to ask four people to refer people to me. Especially when they're like, "You're the best thing since sliced bread." What they're literally telling you is ask me for something. Ask me for something. When they tell you that, oh, that's so amazing, that we're looking to build this practice up with patients just like you. Do you have any friends or family who you think deserve to be in a practice like this? And then they're like, of course, yes. And there they go. Because again, one person may give you five people. One person may be someone who's very influential, leads an organization, may give you 20 people. But if we don't ask, that's not happening.

Now people can do ads, but for me, I usually say ads is like gasoline on the fire. You want to make sure there's a fire. You want to make sure there's something already happening and you're doing the ads. I usually put that as last. And social media is also really powerful. Even if you're not getting a whole lot of engagement, do not be confused by it. People are watching, people are referring, people are sharing the video because they're like, oh yeah, this is my doctor and stuff like that. It's so powerful.

I've had clients who they're like, "I'm not getting a whole lot of engagement", but they keep hearing their patients say, "Oh, I see you. I see you online all the time and I shared your video with somebody else." They've gotten paid speaking gigs from that. They've had speaking gigs where they were in front of their ideal audience. They went to speak somewhere and got 20 new patients from one Facebook video that 25 people watched. It's really powerful. If they do the referrals, internal and external, and they do the social media, it's amazing what can happen.

John: All right. Well, let me shift gears to another. As you were talking, I thought, "Well, this whole idea of automating is a good one, because otherwise we just get overwhelmed." Do you have like a one or two of the things that you found that really just made a huge difference in any aspect of your business or your practice?

Dr. Nneka Unachukwu: Yeah. For me, delegation is one that's made the biggest difference. And I like to talk about it because I struggled so much. Because I'm good at a lot of things like most physicians are. And so, I'm like, yeah, I can do it. It'd take too much time to train somebody else to do it. But the problem is that one is too small a number for greatness. There's no way to build a great company with one person. And if you do the opportunity cost is pretty high.

And so, if you can always ask yourself this question, "Is this the best use of my time?" Either as a physician working clinically, or if you're working as a CEO in your business, you are the most expensive person on your team. The question is, would I pay somebody else what I will have to pay me to do this task? I had a client who loved to play on Canva. And if she listens to this, she'll laugh, she knows herself. Loves to play on Canva, loves to create graphics and do all this stuff. I'm like, "Look, if your hourly rate is $350 an hour, and you spent two hours creating this graphic, that's a $700 flyer. Would you ever in this lifetime pay somebody $700 to do that?" And she's like, absolutely not. I'm like, "So stop it. Find somebody else who you can pay appropriately to do that. It's too expensive."

Delegation is it, but one of the struggles with delegation is then we don't want to train the person to do it. They should come, they should know what to do, and they should read my mind and all of those things. The rules that make delegation work are really around you have to be very clear on what you want them to do. You have to be very intentional about training them to do it. You have to be willing to do some hand-holding in the beginning so you can set them free. And it's kind of like you're free for a really long time.

I'll give you an example. The last time I onboarded an executive assistant, I knew she was going to have a lot of tasks to do for me and all of that. I did a 30-day bootcamp with her. 30 days. 30 days, I met with her. I'm like, "This is how you do this. This is why we do this. This is my thinking about this." I did that every day for the first 30 days.

Now, after the first 30 days, she has been able to take so much off my plate. I kid you not, I probably have 12 hours a week back. But the cost for her to be able to do that, do it so efficiently, I represent the brand so perfectly, is a 30-day bootcamp.

John: Yeah. I appreciate what you're saying because I hired a podcast coordinator/assistant. And one of the things she said, "Hey, do you want me to do some of those images, those graphics for your social media and for your podcast?" I'm like, sure. Of course, she does them 10 times better than I ever would. And it actually takes her less time than I was spending doing them. And so, yeah, it's just amazing. You can't get away from having that human person that replaces what you do in spite of all the automated tools we have these days. Ciara, if you're listening to this, helping me with my podcast, then I'm giving you a shout out right now.

Dr. Nneka Unachukwu: That's awesome.

John: Okay. I want to hear more about everything that you do, starting with the book, so we know where is the best place to get the book and so forth.

Dr. Nneka Unachukwu: Yeah. To get the book, it's really simple. You can go to entremd.com/visibilitybook. And you can get the book there. We have other books that we've written, The EntreMD Method, and then Made for More, which is a compilation book from 40 doctors from the EntreMD Business School came together to tell their stories and stuff like that. So, that would be the place to get the book.

John, the way we like to look at this is we call the EntreMD podcast the free MBA for physicians. We deliver a lot of high value talking about business principles, how to scale, what you need to do to take your practice, for instance, to the seven figure mark, how to build a formidable team, all those kinds of things. We talk about all of that there. And it costs nothing. You're on a podcast platform already, just pop in entremd.com and go there.

The second thing we call our $15 MBA, and that will be our books. The Visibility Formula, Made for More, The EntreMD Method, and all the other ones I'm going to write this year. And then the third thing really is for the doctor who is committed to building a six, seven, multiple seven figure business. They're committed to their goals, but they're like, I need some mentorship. I want to be in a community of people who are doing the same things. I don't feel like I'm a unicorn doing something that nobody else has ever done and I can be inspired by people who are doing that. I need accountability because I'm not always motivated and nobody is.

And so, that would be the EntreMD Business School. That's our year-long program. It is a place where it's an alternate reality in medicine really, because you'll see people from starting up to all the way to eight and a half million in revenue, people who are monetizing their personal brand. So, they're working jobs, but they're building their personal brand as their business to private practice, DPC, DSC, speakers, event hosts, people with products, all kinds of businesses in there. The results that they're going on to create are just unbelievable, because you know what I think. Doctors, we make some of the best entrepreneurs, but all in one community creating those results. And so, all of these you can find on the website entremd.com, but these are the ways we support physicians. Those are the three MBAs.

John: Excellent. I think that's fantastic. We know what we know clinically, we're all well-trained. I think there's a big fear of venturing into the practice environment, but I think that's going to be our only saving really. Yeah, there's some good organizations that treat their physicians well, but you don't have the autonomy. Someone is telling you what to do, and you have this 15-page contract, and it's like, who wants to live like that? I would definitely take advantage of this if I was starting my practice, just to learn those business and marketing and promotional things, and just the common sense things that people that have already run a business know about.

Dr. Nneka Unachukwu: Yeah, you talk about fear, but I think that we should be afraid if we don't evolve. Because with the way it is, the burnout is at an all-time high, loss of autonomy is there, and there's no way to explore your full potential, which is one of the things that entrepreneurship allows you to do. There's no financial stability, let's not fool ourselves, because anybody could be fired any day. And so, yes, there may be a fear to venturing out, but you never know. That could absolutely work, and there's so many evidences of people it's worked for, but this other one is a guaranteed fear. We know this is not working. Choose your heart, choose your fear.

John: Yeah, think of a strategy. Maybe you're coming out of residency or fellowship, and you think, "Okay, let me be employed for a while, but make sure that I can get out of that in two or three years, and in the meantime, learn all these other things I need to know, so I can create the perfect situation for myself." But I tell you, I never thought about things that way back in the day, but maybe it's an option for some of the newer grads to consider.

Dr. Nneka Unachukwu: Yeah, very different times. We've had a lot of new grads in recent times, fresh out of fellowship, fresh out of residency, and watching them thrive in private practice, now that's been something. We have what it takes. I always joke, and I say, if we could learn the Krebs cycle, we can learn business.

John: Exactly. All right. Well, I think we're going to be out of time here momentarily. Any last bit of advice, just because you know my audience, it's a lot of physicians, some of whom are unhappy, some are frustrated, some are just looking for fulfillment. But what's your advice for my audience these days?

Dr. Nneka Unachukwu: Yeah, I think the best thing I could say now is with the way the healthcare space is now, the requirement for our evolution, it's a mandatory requirement. We have to change, and we have the capacity to. We're not fixed, we're not stuck. The way it is, it's not the way it always has to be. We can change. We can learn business skills, we can learn speaking skills, we can learn how to monetize brands. The things we're uncomfortable with, we can become comfortable with them. But I want to invite everybody to embrace becoming different, becoming an upgraded version. If you would like 2.0 because the healthcare space and you having autonomy, living without burnout, having financial freedom, having time, freedom to do what you really want to do requires that you evolve. The old model is not working, it's not going to get better. We have to change.

John: Very good, wise words. All right, Dr. Una, thank you for being here today and we'll get you back on in a couple of years again, if I'm still around. But I'm looking forward to hearing your first presentation at the summit and on a future podcast I will definitely give everybody a review of how things went. So I thank you for being here again today.

Dr. Nneka Unachukwu: Thank you so much for having me. And thank you so much for what you do for physicians everywhere. We appreciate you.

John: Thank you for that. All right, with that I'll say goodbye.

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The Best Biopharma Positions For Motivated Practicing Physicians

John Jurica — Tue, 23 Apr 2024 11:14:09 +0000

Presentation by Dr. Nerissa Kreher – 349

In today's episode, we present an excerpt from Dr. Nerissa Kreher's masterclass on securing the best biopharma positions from the 2023 Nonclinical Career Summit.

Dr. Nerissa Kreher is a pediatric endocrinologist and the Chief Medical Officer at a biotech company. She received her medical degree from East Carolina University. She then completed a pediatric residency and pediatric endocrinology fellowship at Indiana University School of Medicine.

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Unveiling New Horizons: Career Transitions in the Biopharma Industry

Dr. Kreher's journey inspires physicians to contemplate career transitions beyond traditional clinical practice. With over 17 years of experience in the biopharma industry, she offers invaluable insights into the diverse pathways available to medical professionals seeking new challenges and opportunities.

Through her narrative, Dr. Kreher illuminates how to leverage clinical expertise in roles ranging from clinical development to patient safety and medical affairs.

Decoding the Biopharma Realm: Contrasts and Considerations

Nerissa highlights the contrasting dynamics between clinical practice and the biopharma industry. She explores the differing hierarchies, teamwork dynamics, and work flexibility, offering her insights for physicians contemplating a career transition to the pharma industry.

These insights will help listeners prepare for their transition from a frustrated clinician to a fulfilling biopharma career.

Summary

Dr. Nerissa Kreher describes how to navigate from clinical medicine to the biopharma industry effectively. Gain insights into diverse career pathways beyond traditional clinical practice, from clinical development to patient safety and medical affairs. Explore new horizons with invaluable guidance from Dr. Kreher.

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Transcription PNC Podcast Episode 349

The Best Biopharma Positions For Motivated Practicing Physicians

- Lecture by Dr. Nerissa Kreher

Dr. Nerissa Kreher: I'm really excited to be here, John and Tom, thank you so much for this amazing forum. I've enjoyed participating over the last couple of nights and looking forward to tomorrow night as well. Thanks for the opportunity. I'll be speaking today about career opportunities for physicians in the biopharma industry. And I'll get to a little bit of lingo in just a second.

A little bit of background on me. I have a business called The Pharma IndustryMDCoach, and I help physicians explore and ultimately find a fulfilling career in the biopharma industry and use a step-by-step guide of taking you through the process of a resume, LinkedIn, interviewing, negotiating.

But in addition, I'm a certified life coach. And so I also apply the principles of life coaching to help people dispel imposter phenomenon, lack of confidence, self-doubt. And I'll raise some of those things throughout our conversation tonight.

John asked us to start by giving a little bit of our background. I thought it would be fun to share my story because people often ask, "How did I end up transitioning?" And I have to tell you that it was a bit fortuitous actually, but I'm very grateful that it happened. And I'm 17 years now in the biotech industry.

Of course, medical school, residency, fellowship, I'm a pediatric endocrinologist by training. I got married during medical school, had kids during residency and fellowship. And my husband, he was a year behind me, med-peds, and had practiced, but then decided he wanted to go back and do a sports medicine fellowship. We found ourselves in the situation of this is a match for sports medicine, and I was looking for a real job. And so, we ended up looking in three different cities, obviously ones with large academic centers where I could have a pediatric endocrine job.

I was on a clinical research path. I got my master's in clinical research during my fellowship and really enjoyed seeing my clinical research patients, but I never really enjoyed being in clinic day in and day out. I really was on that clinical research track and that's where my passion was.

Through this, I thought I had a job waiting for me at Mass General Hospital in clinical research. When my husband matched in sports medicine there, I called the program director, division director, and the first words out of her mouth were, "Oh no." That obviously was a bit stressful. They offered me a job, ultimately a job seeing patients 80% of the time.

I'm very grateful that I at least knew that's really not what I wanted and didn't just take the job out of feeling helpless and hopeless. I interviewed around the East Coast as far as Rhode Island and Dartmouth, New Hampshire, still didn't find what I was looking for. And a sales representative from Serono asked if I would give her my resume so she could share it at her company. And some of you may know or not, Serono has a recombinant human growth hormone, which obviously is a pedendo I'm very familiar with.

That landed me my first role in the biotech industry as the medical director in medical affairs. And I truly loved it from day one. I think it really pulled from that forever learner phenotype that many physicians have. I was exposed to so many new things, but also I was an expert in pediatric endocrinology. And so I was able to teach people, but I was also learning from others at the same time.

I'm now 17 years in, I've worked at seven different companies, medical affairs, as well as clinical development. I'm in my third chief medical officer role. I've had the opportunity of doing two public offerings, taking private companies public, and I serve on the board of director of a public biotech company as well.

COVID hit us, I felt like very, very dire straits in the early parts of COVID. I couldn't go and do a shift in an ER. And so my way of helping was to try to start helping some of my colleagues that needed to transition. And that's where the IndustryMDCoach was born from. So, that's my story. You can probably tell I have a lot of energy about our industry and really enjoy helping people understand it. I look forward to any questions at the end of the talk.

I like to compare and contrast a little bit between clinical and the biotech and pharma industry. Before I do that, I will use biotech and pharma and biopharma very interchangeably. It used to be that biotech technically meant something that we made in cells. For example, recombinant human growth hormone is manufactured in live cells. And pharma meant things that are synthetically made.

It's a big mishmash now. So many, many companies are biopharma companies because they do both. Some people actually now sort of refer to pharma as bigger companies and biotech as smaller companies. I think biopharma encapsules our whole industry. But if I use one or the other, I probably really mean biopharma.

In the clinical setting, and I fully admit there are some generalities here, but the physician is pretty high on the totem pole from a decision-making standpoint. I recognize insurance, admin, things also have an impact on that decision-making, but they are relatively high on the totem pole.

In the biotech and pharma industry, the physician may not be the ultimate decision-maker. Even as the chief medical officer, meaning I'm like the top medical officer at the company, I'm very rarely making decisions in a vacuum. I have my CEO, I have my chief operating officer, my chief financial officer. And so, decisions are being made in cross-functional teams all the time. That's one big difference that I think a physician really has to think about as they consider, "Is biotech and pharma the right thing for me?"

Obviously, clinical individual patient care, biopharma, we're caring for groups of patients. Now I actually don't even have an active medical license anymore. So I'm not caring for them, meaning making medical decisions for them, but I'm doing things that impact their medical journey overall. And I work in the rare disease space and I'm also understanding that medical journey and learning from patients. I do have the opportunity to be at patient meetings, have patients come to our office and speak to us, but I'm not doing that day-to-day medical care.

I mentioned cross-functional teamwork. Clearly physicians are working cross-functionally every day, with nurses, with physical therapists, with occupational therapists, we can name lots of them, pharmacists. But they all are generally healthcare providers, or at least in that healthcare provider universe. Whereas the cross-functional teamwork we do in the biopharma industry is much more highly varied. And so, for example, a program team might have a person from manufacturing, a person from regulatory, a person from clinical, an operations person, a program lead who's in charge of timelines, deliverables, a finance person.

And so, we're really working with people who speak very different languages than us. And one of the things you have to learn when you come into the industry are some of these languages so that you can actually communicate effectively with one another. But again, as I said, that was one of the things that I found to be really fun because I wanted to learn new things.

In clinical, the day can be very highly structured. As many of you know, there may be a patient waiting for you tomorrow at 08:30 and you know that they're supposed to be in the room. For those of us in the biopharma industry, I don't have a patient waiting for me. I may very well have an 08:30 in the morning meeting, but if my child is sick and vomiting, that meeting is a very different pressure than the patient waiting in the room. And so, there is more flexibility overall in the biopharma industry.

Now, lots of caveats. You could have a manager that was a dictator-style manager and your flexibility is out the window. But just in generalities, not having sort of that scheduled patient waiting for you makes that very different.

We have key indicators of success. Obviously, we're trying to make bonuses. We're trying to hit our timelines and our goals. Our key indicators of success vary with the function and with seniority. And so typically, the company sets their goals and they filter down through the organization. Whereas in clinical, maybe if you're in academics, it's related to grants or publications, then obviously RVUs are a major measure as well.

Funding pressures might be high. That, of course, might apply more towards the academic group. But in biopharma, we don't have funding pressures. I don't need to get a grant to do the research. The company has a budget to support that.

Those are some compare and contrasts. One, not better than the other, but I like to share them with people so that if they're thinking about a transition, they can start to think about, "Would I like that? Would that be concerning to me? Does that sound really exciting to me?"

I mentioned learning a new language. So I'll move past that one. But I really do encourage people to think about what kinds of learners are they? Do they enjoy new challenges? Do they enjoy or maybe even, sometimes I feel like I get bored if I'm doing the same thing day in and day out. And so this ability to interact with different people helps with that issue of not getting bored.

Again, you're typically not going to be the decision maker. And so when I'm working with a physician that wants to transition, there's this balance of humility and confidence that you have to strike during the interview process. People have stereotypes about doctors. And I think many of us would laugh at the stereotype because we know that for most of us it's not true, but people do think that doctors are know-it-alls. And so when you're looking at being on a cross-functional team, people don't want to work with know-it-alls. So you're balancing that in the interview process, but you also have to balance being confident and showing that you can do this job.

I think it's a lot of fun. One of the perks in my mind, I love to travel and I've had the chance to literally see the world. I've been to Japan, to the country of Georgia, Australia, Europe. Now, some people would say I have no interest in travel, and that's fine too, because there are roles in the pharma industry that have very little travel for physicians too. But for me, this opportunity to really see the world has been great.

I have amazing colleagues. I'm still in touch with people from that first Serono job. I was just at a networking event tonight. And the six degrees of separation, it's way less than that. This industry, people move roles, move companies. And so, you really have an opportunity to meet some really cool people.

And it can be really stressful. We still have timelines. We still have expectations. There are weekends that I'm working because I'm at a conference. There are evenings that I'm working because maybe I'm running a clinical trial in Australia and the times are different. I had a boss one time who said, people think we sit around and drink coffee and eat bonbons. It's not drinking coffee and eating bonbons. But the stress is something in my mind, I have more control over when I do the work. I still have to do the work, but the "when" there's not sort of it waiting for me in a patient room.

So, what are the main roles for physicians in the pharma industry? I break it down into three. These are the three entry level roles. Now, once you get in, really the sky's the limit. Physicians can be CEOs. Physicians can lead business development functions. There are all kinds of opportunities, but those are rare until you get your foot in the door, unless you have some kind of other specialty training like if you were maybe went through a MBA program and came right out into pharma, there might be some other opportunities.

But tonight we'll focus on the three main ones, clinical development, patient safety or pharmacovigilance. And at some companies, they call this drug safety. A lot of names for the same thing. And medical affairs.

In clinical development, the main roles that you're thinking about as you're looking for jobs, clinical scientists and clinical development physician, which is the director level or senior director level. And it goes up from there. Most physicians that are entering are entering in the associate director or director level. That's where I'm pointing most people, and then you can rise from there.

Pharmacovigilance, drug safety, patient safety. Same thing. You're sort of director level in pharmacovigilance. And then medical affairs, again, same thing for the physicians, medical affairs director. And then there's also another thing that many of you have heard of called a medical science liaison. I'm not going to spend much time on that tonight because we have another person that's going to spend a whole lecture on MSLs and she's the right person to do it because she's been an MSL. I've never been an MSL. And so I'm really looking forward to her talk as well.

As we move through those, I'll talk about clinical development first. Clinical development involves all aspects of studying an investigational drug product in humans. So we refer to early phase trials as phase one and phase two and late phase trials as phase three and phase four.

So if you think way, way, way back sometime, probably in medical school, you might've learned about this in one of your courses, but phase one trials are the initial safety trials. These are the first time we're putting drugs into humans. It usually in larger drug populations is in healthy volunteers. In the rare disease world in oncology, it's often patients that we're doing these safety studies in.

Phase two is early proof of concept. So you're still looking at safety. We're always looking at safety, but you're starting to look at proof of concept efficacy. Phase three studies typically are the large phase three. They're randomized double-blind placebo controlled studies that we use for registration or approval of a drug with regulatory agencies.

And then phase four typically is post-marketing. After a drug is approved, companies still are running trials to either follow long-term efficacy or follow long-term safety. And we refer to those as phase four.

That gives you a sense of the sort of large bucket of what clinical development is, but that doesn't really answer your questions, I'm guessing. So, let's dive a little deeper. The clinical development physician at the, again, associate director, director level, when they're coming into pharma, they're going to be involved in clinical development strategy and planning.

We're thinking about not just what does one trial look like, but what does it take to develop the drug all the way from putting it into the first human to getting it approved, whether it's with FDA or EMA, which is the European FDA or the Japanese or the Chinese or whatever it might be, whatever regulatory agency. You're thinking about the whole program.

More detailed responsibilities might include protocol design, where we're focused as the physicians on what are the appropriate inclusion, exclusion criteria, endpoints, safety monitoring. Maybe there's been a safety signal in the tox studies, you need to pull that into the protocol so you can monitor it in humans.

Another big regulatory document called the investigator's brochure, the physician's going to have a lot to say about what's in that document. And then of course, as you generate data, you've got data analysis, presenting data at scientific conferences, highly engaged in regulatory conversations. Going and talking to FDA, going and talking to MHRA in the UK.

Engaging with thought leaders or key opinion leaders, KOLs, to get their input. So I'm a pediatric endocrinologist and I work in the area of neuromuscular disease right now. So I don't know everything about neuromuscular. I need to go and ask the people that do. And so those are my thought leaders or KOLs.

And then I'm interacting with people like clinical operations. Those are the people that actually execute the trials. Regulatory, patient safety, patient advocacy. Again, those cross-functional team members.

I mentioned some of the titles already. Some of the transferable skills would be clinical experience, clinical trial experience. But here it doesn't have to be that you were the PI on a phase three pharma-sponsored randomized double-blind placebo-controlled study. It can be that you participated in research and that can be retrospective as well. Data analysis, publications.

Without clinical research experience, I typically would say to people, clinical development will be the hardest place to enter. But if you have research experience, which many of you do, then there are opportunities to come in through clinical development.

Moving to pharmacovigilance, again, drug or patient safety. This involves all things safety data. Those physicians are really not thinking about the efficacy of the drug. They are focused on safety and they have to understand the whole safety package around the drug from when it was first put into cells and into animals all the way through.

They're focusing on understanding all the available data and trying to assign whether or not there's relatability to a side effect to the drug, but maybe it's related just to the disease that we're trying to treat. And that's where the clinical knowledge comes into the patient safety role.

They have significant interactions with clinical development, with regulatory. I think I had no idea coming into the industry how much safety data we have to send to agencies like the FDA every, not even just year, but there are reports that are required by law that go in and these safety physicians are highly involved in those.

Some of the titles, associate medical director, medical director. And transferable skills here, your clinical experience. You're the one that understands pharmacology. You're the one that understands the actual clinical disease and that understanding is what you bring to the table for a safety role.

Clinical trial experience is a plus, but not a necessity. And if you have any experience as a principal investigator, that's PI or sub investigator where you've had to report safety data, again, that's a plus as well, because you understand the reporting process, but that's something that you can learn in the job. It's really that clinical experience that comes as the transferable skill.

And then moving to medical affairs. I actually find medical affairs to be the more difficult of all three to explain to people, because if I talk to you about a clinical trial protocol, most people can get that safety, but medical affairs is a bit nebulous. The definition is the external scientific medical arm that takes clinical or medical information from the company to external stakeholders, such as those key opinion leaders and patient groups, even more importantly these days. They share that information and they bring information back into the company for us to integrate into our development.

Medical affairs is engaged in the scientific exchange of information with external stakeholders. Those stakeholders might be, as I've said, thought leaders, but healthcare providers generally. It doesn't have to be Professor Smith, who's the best neuromuscular doctor in the whole of the United States. Yes, Dr. Smith is probably important, but the doctors who are treating the neuromuscular patients day in and day out are also very important to me. And I'm using neuromuscular as an example, it could be endocrine, it could be cardiovascular. But getting that information, what do they need from drugs? What is an unmet need? What is not being met appropriately? And again, patients and patient family input as well.

They're sharing that scientific and clinical knowledge and they're gathering that scientific and clinical knowledge. They also are very engaged in teaching. Oftentimes, I'm asked to give a lecture to a group of laboratory colleagues who they understand what they're doing at the bench, but they might not understand the disease they're actually working on and helping them understand it and talking to them about what happens to the patient helps them really understand why they come to work every day. So there's a lot of teaching involved in med affairs.

And you're interacting with a lot of people, clinical, but here may be more commercial colleagues and also regulatory because we are a highly regulated industry and anything we take outside, we have to get approval to do so. Regulatory is an important part as well.

Similar titles, again, I'm going to leave medical science liaisons for tomorrow night, but associate medical director, medical director and transferable skills here, again, that clinical experience. And if you have experience with data analysis, with publications, that can be a really nice addition as well, but again, not absolutely necessary.

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