nonclinical Archives - NonClinical Physicians

Exploit Your Medical Knowledge In New Ways

John Jurica — Tue, 18 Feb 2025 13:26:49 +0000

Interview with Dr. Robert Cooper – Part 2 – 392

On this week's episode, John posts Part 2 of his interview with Dr. Robert Cooper who explains how to exploit your medical knowledge in new and profitable ways.

Picking up from Episode 391, Dr. Cooper dives deeper into nonclinical consulting opportunities, including disability file reviews, expert witness work, and medical necessity reviews. He shares key insights on how physicians from all backgrounds, including primary care, can enter these fields, optimize earnings, and avoid common pitfalls.

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The Medical Legal Consulting Coaching Program will teach you to build a nonclinical consulting business. Open to physicians in ANY specialty, completing Dr. Armin Feldman’s Program will teach you how to become a valued consultant to attorneys without doing med mal cases or expert witness work.

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John hosts a short weekly Q&A session on topics related to physicians' careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 monthly.
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.

Navigating Disability File Reviews

Dr. Cooper provides an insider's view of disability file review work, emphasizing the importance of choosing ethical companies and maintaining professional standards. He discusses how to identify legitimate opportunities, appropriate compensation rates, and ways to avoid common pitfalls in this field.

Most importantly, he stresses that specialists and primary care physicians can succeed in this area, making it an accessible option for many doctors.

Exploit Your Medical Knowledge with Multiple Revenue Streams

From expert witness consulting to continuing medical education teaching, Dr. Cooper demonstrates how physicians can create diverse income streams while maintaining professional integrity.

He emphasizes the importance of delivering quality work, understanding market rates, and being selective about opportunities. His experience shows how combining various consulting roles can provide financial rewards and professional satisfaction.

Summary

Physicians interested in exploring consulting opportunities can learn more through Dr. Cooper's Website or by connecting with him on LinkedIn. His approach to combining clinical practice with strategic consulting work demonstrates how to maintain independence and avoid burnout while maximizing earning potential through ethical and professional side gigs.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 392

Exploit Your Medical Knowledge In New Ways

- Interview with Dr. Robert Cooper - Part 2

John: Well, let's go back to another one then. I think that's one that you've been doing for the most amount of time and have spent the most cumulative hours on, and that's the disability file reviews. So how did you find that? Did someone point you to it? Were you just searching around the internet? I mean, how did you find that? What should we do if we're interested in it? Because I have looked into this a little bit myself. And I'll just say, as a family physician, they're usually looking for a specialist. I mean, there's a lot for neuro and physiatrists and that, but I know they're out there for primary care at times when they just need the general. So any tips on that? What's it like? How long does it take? We'll kind of do that first, and then we'll move on to the next one.

Dr. Robert Cooper: Sure. The first gig, I think, was through the New England Journal of Medicine. Like I said, I answered that in the New England Journal of Medicine. Small company, I went out and learned how to do it, and they trained you to some degree—not terrific. And I started doing it. I like it because it's almost like taking raw materials, right? Looking through a file like a detective and trying to figure out what's going on. What you're trying to do is determine the level of impairment of a claimant—we call them claimants. There's terminology involved, but you have to know what you're doing when you're going through this. It's a method for actually sorting out the file, figuring out where it is, where the pieces are, how to put it together, and the different components.

I have not found really good training in this, honestly speaking. I took a course in it, but it didn't help me—I had done it before. So I think really providing nuts and bolts is important. I worked for three companies, but there is another way to find it. I'm not gonna mention the specific companies, but I will say that NAIRO—N-A-I-R-O, the National Association of Independent Review Organizations—has companies on there. Now, here's the important thing. Here's the important point for viewers: don't be undersold, okay? A lot of these companies are paying rates that are ridiculous.

What's happened in the disability world, unfortunately, is that they're moving a lot of stuff in-house to do full-time physicians come on board, and they're taking it away from some of that. I found that that's happened over the last five years. I told you before, I worked 10 hours a week for a major insurance company as an independent contractor. So I was doing that in addition to the other vendor companies. It was just a lot of work—10 hours a weekend. But I learned a lot from doing it. Then they stopped that and moved it in-house. So you have to be careful.

There are companies out there who ghostwrite reports. I'll just tell you that what they do basically is—they write the whole report up, and you just sign it. And they pay you very little money to do it. They're trying to save money. That is something you want to avoid. Okay, I won't mention any specific companies except to say that you don't want to do that. You want to really be legitimate about this. This is important. If you're doing this kind of work, it's important to be fair and impartial and to look at the work and come up with a conclusion that's reasonable. And that's what they want, actually—insurance companies want. Unfortunately, they're constrained like everybody else financially, so they're looking to cut corners. Unfortunately, that doesn't work too well when it happens.

So you have to be careful what you're getting yourself into. It's very important to pick and choose who you're working for carefully—not just in terms of what they're paying but also if they're ethical and so forth.

John: So does it seem like that's one of the things that's sort of changed since you've been doing this, right? I mean, heck, you started probably doing this before the pandemic, and then the pandemic hit, and everything's going online. Any other observations about what we should look for or not look for when looking for disability evaluation file reviews?

Dr. Robert Cooper: I mean, a reasonable rate is reasonable. I mean, I don't want to go into exactly what I mean. The ranges generally are, just to give you a range, I mean, $150 to $200 an hour is reasonable or over that. Some companies—I mean, I've not settled for $50 an hour or $25—I mean, it's ridiculous. Some companies that are actually coming into play, I would just walk away from them. Again, walk away. Instead of walking away, they get in trouble with that.

I will make a comment about something you said, John. There are a lot of family physicians doing this—general physicians. It's not actually—it’s just as much general physicians as there are actually specialists doing this because you need to have a holistic point of view of some of these patients. They look for this, and they want somebody to go through everything, all the problems, and come up with a conclusion. So, it's very much driven by primary care, family medicine, and internal medicine. In fact, the whole segment of that, in the company I worked in, was for that. So, you could do that.

You could also use this, by the way, any of these things, as a segue. I mean, mine is the expert network consultant, but a segue to get into full-time work. If it is what you choose to do and say, "Listen, I just don't wanna do clinical medicine anymore. I have to determine this is not for me." I mean, unfortunately, that's what happens sometimes. It's nothing—somebody's choice.

You could use this because many of these companies will ask you, "Have you had any work before? Have you done this before? Have you done disability file review? Have you done medical assessment review before?" Yes, I have. I've done, you know, X, Y, and Z, and this is what I've done. "Okay, great." And they'll interview you. This is why people have a problem getting in at the ground floor if they want to convert to full-time. If that's what they choose to do, it's because they don't have the experience. This is a way to get experience.

John: One of the things in my little research I've done on this topic is looking at Social Security disability file reviews. And that one seems to be a unique animal. Have you ever done those for Social Security? I think they have different companies specifically that only do SSDI-type reviews.

Dr. Robert Cooper: I have a friend that does that for endocrinology. But the problem is they don’t pay well. Private insurances, the vendors, the ones that deal with private insurance, pay much more. So it's not uncommon to get about a third or a half. She actually looks at me and says, "Oh my God, you're getting that kind of thing for doing it for the vendors? That's ridiculous, I'm getting nothing." And so I don’t, and I get those rates back, and they come back to me. And then, you know, people come to me and they'll approach me all the time. Today I had three of them approach me. "Would you like to do some work for us?" And I just look at it and say, "It's not worth it for me to do what I make." It’s not gonna do it. And I think once you get to the point where you're comfortable doing this, you’re gonna realize that and say, "You know, I’ve just not." It’s better to walk away.

John: Well, that’s good to know. I’ll just stop even trying because it’s been difficult to get any information on the SSDI ones, but they don’t pay well. What’s the point? Are there other types of chart reviews? This one, I get this question all the time. I know, for example, that state medical societies, you know, they have quality reviews. Those are pretty few and far between. But any other types of, you know, more or less paperwork, file review, based on your clinical knowledge that you've done or that you know of?

Dr. Robert Cooper: The medical necessity ones are good ones actually too, because they could be quick sometimes. Unfortunately, they don’t pay as much as the disability ones. But some of the private vendors will pay fairly well for a medical necessity review. The big thing about— I didn’t talk about this—but the peer-to-peer phone calls, those can be challenging. So you have to have a thick neck about you, particularly when you're doing a peer-to-peer for a medical necessity review. But I worked full-time for the insurance company. Every day was filled with these peer-to-peers. And eventually, after about two or three months, I said, "Uh-uh, no more." I went back to clinical medicine because I just didn’t want to. I was just... But doing it on a part-time basis, you know, and calling up, you can conduct these, and it's an act of doing this. You have to have a knack for doing this and calling up, but it’s a challenge sometimes. Because physicians are generally, you know, not going to be amenable. You know, they’re frustrated and upset. You’re calling them up and telling them that you're going to deny something or you don’t have the adequate information, and they're gonna come back at you. But there’s a way to handle yourself in both these things. And that includes disability file reviews too, because there’s peer-to-peer for that as well when you're calling up the attorney position. So you get that a lot too. So you have to be willing to do that. Some people are, some people aren’t. And just handle that. I mean, everything has its pros and cons. Every one of these things, okay? So you have to kind of take the good with the bad when you're doing it.

John: Well, yeah, I guess, you know, each person has to sort of assess what they’re good at, what they’re interested in. You know, I’m a meticulous person. Maybe that helps in certain situations. Maybe it doesn’t help in others. I was going to also ask your opinion, switching gears here, on some follow-up on—you've been, in the past, an expert witness, which, you know, as you mentioned earlier, in the field of endocrinology. But what advice would you have for physicians who maybe are still working, you know, part-time, thinking about entering that field?

Dr. Robert Cooper: It’s a good field. It’s very lucrative. I mean, it’s not uncommon for somebody to charge upwards of up to a thousand dollars an hour in some cases for some specialties. I mean, it sounds great, but it has its problems too. I mean, you have to have a thick neck. I mean, just sitting in the seat I'm in right now—I told you last week, I had a deposition. I was deposed actually on a case. I have another case that’s going on that I’m getting subpoenaed in. I might have to travel to a different state—it’s a criminal case that spun out of a civil case. I mean, I’ve never had that happen before in the years I’ve been doing it, but I mean, these things happen, and they can be disruptive to practice. They can be disruptive to doing it. You have to have a contract in place. I mean, all these things are important. They're not something that you just kind of throw yourself into. And you have to be able to carry yourself well to be able to do that.

I mean, writing an expert report is very important. I mean, SEEK has some courses on this, how to do it. There's a great book on that too, but I think also being coached—like, how do I write a report? How do I put one together that's going to make sense, that's going to flow? Because the better your report is, the less chance you're going to be deposed or put to court because it's going to settle most of these cases. So you have to learn that. It's the kind of thing that you learn as you go along.

So again, you need to enact this—kind of figuring out what is the best way to put a good report together, different stages, learning a little bit about law and how it works, and the evolution of a case. How do you get deposed? When you get deposed, how do you handle yourself during a deposition? How do you handle yourself during a trial? These are all things to consider because if you screw up a couple of times, you're not going to get asked again to do any cases.

So it's all about putting your hands into one thing. You know, I always step back and say, "You know what, I want to do a good job. I really do, as an expert witness." But if, for some reason, something out of my control happens—and it does sometimes—that I get looked upon or frowned upon negatively for whatever reason, I have something else to fall back on. I can do other work. I don't have to throw myself into one particular thing. That's how I always look at it. I still want to do a good job.

John: Let me ask you this, because this comes up, I think, in others I’ve spoken with who are looking to get more and more into expert witness consulting. I guess, marketing themselves—how do they find clients or attorneys? Do they just come to you when you've done this just because of your local notoriety? Or do you have a process for trying to get visibility for some of these attorneys who are looking for help?

Dr. Robert Cooper: First off, you have to be careful with that. If you start listing yourself all over the place, that's going to come up during deposition. It came up last week. "How many directories are you in, Dr. Cooper? How many times do you do this? What are you doing?" Because they're looking for people that are hired guns and trying to nail them on that. So actually, I don’t list myself in anything except SEEK. SEEK is the only directory I list. I’ll make a little plug because they’re a good company.

I just had somebody call me right before I got on the phone with you, saying, "You know, the spam call—it wasn't a spam call—it was somebody trying to get me into a directory." I just quickly got them out of there. "How much money is it going to cost me? What is it going to do?" I really don't have a need to list myself in 16 different directories. I've never really found it to be helpful.

I think the best thing is word of mouth. When you do a good job, the next thing that happens is the next attorney tells somebody else about it. Then they call you and say, "You know, you worked with my friend on a case, and I want to work with you too as well. I've heard that you are pretty good. You're responsive, you get back to me, and you're available."

I think calling people—like if an expert, if an attorney calls you—you need to get on the phone with that attorney the same day, within an hour or two. Get on the phone and respond to that attorney, saying, "What's the deal?" And also, you're interviewing them too. You don’t want to get involved with any type of attorney who’s not doing anything ethical. Everything has got to be ethical. It’s got to be impartial. You don’t want to come across as somebody who’s biased during a case.

These are all things you learn as you do it. There’s a way to conduct yourself. It’s very, very important. You don’t just jump into these things—you have to know what to do to provide a good product.

John: I think that particular one—the expert witness—it’s a good combination because you're acting as a physician, as an expert, as a professional, but at the same time, it’s a business if you decide to continue doing it on a regular basis. So you have to know about those resources, like the SEEK list of available consultants.

And again, there are places where you can learn—SEEK included—that, you know, maybe give you a little advice on how to prepare for these things. And if you're doing your first deposition, that kind of thing. So that's always been interesting to me.

Dr. Robert Cooper: Yeah, oh, sure. It's a very interesting thing. I mean, I've done probably over 100 cases in expert witness work over the last 10 years. And I would say that I've had everything from somebody having a terrorist attack and blowing up the pituitary gland in our country and having me testify in that to, you know, hypoglycemic episodes in jail and things like that. I've had cases like that. I mean, it's so fascinating. It really is. You find yourself like a detective. Many times, I've come back to an attorney and said, "You know what, you don't have a case here." They don't want to hear that, but you don't have a case. You have to be honest, very honest with your attorneys that are coming to you. Very ethical and very honest. This is very important, any of the work you do.

John: Well, they might not like to hear that, but better that than they waste tens of thousands of dollars and find out at the end that they don't have a worthwhile case at that point.

Dr. Robert Cooper: That's right.

John: All right, well, have there been any of these other side gigs, consulting types of things, and reviews that we haven't learned yet from you, any others, examples, or have we kind of covered the majority today?

Dr. Robert Cooper: Well, there is another thing I do—I love actually too. I teach actually, I teach at a, there's a company called MCE—I'll just be specific I guess about that. Cause I teach that once a year or twice a year, they have me fly out somewhere and teach primary care and I love it actually. I really enjoy it. We have about 150 people there sometimes and it's on it, usually it's on endocrinology review for primary care. And I've enjoyed that. I've had two stints in Disney world already.

John: Oh yeah?

Dr. Robert Cooper: Where I've gone out there and done that. And I love having people respond back and ask questions.

John: So that's just like a continuing education for physicians?

Dr. Robert Cooper: Yeah, that's right. That's right.

John: Okay.

Dr. Robert Cooper: Another part of this that we didn't talk about actually, too. Maybe we should at some point. Maybe we've done now. Locums. Locums are a way to freedom, actually, too. And I think I've done that. I've done a lot of locums work in the past. I don't now. I'm permanent. But it's some of the best freedom you can get. And if you're like in this position right now where you're kind of considering, like, I think I would just say to your viewers, if you're in a position where you say, "Oh my God, I can't go back to work," and you have that feeling in your stomach on Sunday night, like I've had a couple of times, think back for a second and say to yourself, "Hey, why do I feel that way?" That's the first thing—introspection. Why do I feel that way? Is it something that I could change in the environment I'm in first that could actually make things better? Or, if it's not, is it a different environment clinically that I could be in? Or do I need to figure out a way to integrate this other stuff maybe into place that I could do it so I could cut back on that? Because I don't think it's all or nothing.

I see people at SEEK when I taught this year. They come up to me at lunch and say to me, they sit down—we have like a group of, like, I have 50 people sitting next to me—and they say, "How do you kind of get away from this?" One physician came to me and said to me, "When I was pregnant, I was sitting on my bed. They were giving me an epidural, and the administrators were coming over to me, saying, 'Look at the computer at the CMR, at the letter on medical records, and go back to the records.'" And I said, "I can't believe that." She said to me, "How do you function in that environment? This is what I'm going through," she said. "I have to find some relief," she said, "because I don't have a break ever." I find that so difficult to deal with. I mean, you have to be able to practice. Medicine is a great field to be in. It's a great thing to be a physician, regardless of what specialty you're in. But I think you have to do it on your own terms. You can't have that plugging and deal dread and stuff. So that's the important point, actually, too.

John: Yeah, absolutely. And... You shouldn't put up with being burnt out and frustrated and unfulfilled for too long. You can do it for a little while, but you don't need to put up with that. Because really, as you said earlier, physicians, they have a lot of information, a lot of knowledge, skills, and it's all very valuable if you can leverage it to your advantage.

Dr. Robert Cooper: I think the thing about locums, I was going to say before, just to get back to that for a second, we used to think of locums as being outsiders. But the truth of the matter is that locums are actually becoming sort of the norm, almost.

John: Right.

Dr. Robert Cooper: That's not a great... I mean, it's getting competitive, actually, to get a locum position or something like that. Because there's a shortage of positions, people are looking. But there are some great companies out there that do locums kinds of activity, a call, and they can really provide you with some great experiences to do it, too. I mean, it may not be for everybody, but it's a way to sort of break away.

John: Yeah, I think if you're feeling desperate, you might as well consider everything and narrow it down, maybe, to what fits best. But locums and part-time work and consulting and telemedicine, you know, is another option.

Dr. Robert Cooper: Yeah, right.

John: So, let's see. So, you told me that you like to help other physicians learn this stuff. You're teaching at SEEK and other places. So, let's see if someone would want to get a hold of you, learn more about what you've been doing, and get some help. I think you are on LinkedIn, is that correct?

Dr. Robert Cooper: That's right. I have a website. You have it there. RJCmedicalconsulting.com.

John: Okay. RJCmedicalconsulting.com. Okay, go ahead.

Dr. Robert Cooper: Correct, correct. I'm looking at some point maybe in... I actually developed a course already for leveraging medical. I haven't done it yet. I'm looking to see if there's any traction, if people want to take it. And when I get a critical volume of people together, I might do that, actually, too—online or in person at some point. And I, you know, all these topics, I think, as I mentioned before, preparation and learning how to do it is very important. So, you know, you could direct them there to that website, and certainly, they can.

John: Yep, I will put those links in the show notes, along with a transcript of our whole conversation. And yeah, maybe they should reach out and at least maybe follow you or connect with you on LinkedIn and then look at the website for more information.

Dr. Robert Cooper: The other thing I haven't done, but if anybody is interested, if they want me to come out and give a lecture at one of the meetings, either a keynote or something else on this particular topic, I'm happy to come out there too. So I'll just ask you that.

John: Yeah, absolutely. In fact, I'll mention this. I haven't talked about this in the podcast much, but when you talk about these opportunities and sort of the non-clinical side of things, most of the time, it still qualifies as CME. So, some of these organizations can actually give you CME credit for it because it's something that supplements your practice. And, as I think you have said in the past, you know, like when you're doing expert witness work, you actually become a better physician. To prepare for that, you have to. So, that's all good stuff for CME.

Dr. Robert Cooper: Absolutely right, absolutely right. And even expert network consulting stuff—you learn things. And things that you wouldn’t know are coming—ARE coming and are the wave of the future. And it really keeps you up to date on what’s happening. It makes it diversified. So it gives a different meaning to going in every day and seeing patients.

John: Exactly.

Dr. Robert Cooper: When you're doing it.

John: Exactly. All right, well, I think we're pretty much at our time now. So I want to say thank you very much for joining me today, Robert. This has been great. And I think the listeners will really appreciate all the wisdom you've shared with us today.

Dr. Robert Cooper: Thank you for having me on. I hope that reaches people and hopefully, we can help them.

John: I'm sure it will. All right. Bye now.

Dr. Robert Cooper: Thanks, John.

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How To Be A Stunning Success Doing Part Time Consulting

John Jurica — Tue, 11 Feb 2025 11:51:46 +0000

Interview with Dr. Robert Cooper – Part 1 – 391

On this week's episode of the PNC podcast, John interviews Dr. Robert Cooper, an expert at part time consulting. Robert is an endocrinologist who has mastered the art of combining clinical practice with lucrative side gigs.

He shares how he doubled his clinical salary by dedicating just one day a week to nonclinical work while maintaining his medical practice. His experience demonstrates how physicians can maintain independence through strategic part-time consulting opportunities.

Our Sponsor

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

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

For Podcast Listeners

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

Building a Diversified Medical Career with Part Time Consulting

Creating a balanced portfolio of clinical and nonclinical work requires strategic planning and a willingness to explore various opportunities. Robert advises against putting “all your eggs in one basket” and encourages physicians to maintain independence through multiple revenue streams.

This approach includes carefully selecting opportunities that value physician expertise appropriately and being willing to walk away from undervalued propositions. This strategy provides financial benefits that help prevent burnout and maintain professional satisfaction.

Maximizing Value in Consulting Opportunities

Expert network consulting offers physicians unique opportunities to leverage their clinical knowledge for substantial compensation, often matching expert witness fees. The key to success lies in providing quality insights while maintaining professional boundaries and understanding market value.

Robert emphasizes the importance of proper preparation, effective communication skills, and setting appropriate fee structures that reflect a physician's expertise. Working with multiple platforms and maintaining strong professional boundaries helps create a sustainable consulting practice.

Summary

For physicians interested in exploring consulting opportunities while maintaining clinical practice, Dr. Cooper's experience provides a practical roadmap through his work with expert networks, disability reviews, and medical necessity reviews. By delivering quality and demanding appropriate compensation, physicians can create rewarding side gigs that complement their clinical practice.

Dr. Cooper actively shares his expertise by teaching at SEAK and he welcomes connections through LinkedIn for those interested in learning more about these opportunities.

Links for today's episode:

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

Email Download New Tab

Transcription PNC Podcast Episode 391

How To Be A Stunning Success Doing Part-Time Consulting

- Interview with Dr. Robert Cooper - Part 1

John: Today's guest is a specialist as a practicing physician, but I bring that up because in the world of physician non-clinical careers, I consider him sort of a generalist because he's done different side gigs and actually some things that are clinical and unconventional clinical. And so he's worked so many numerous side jobs that they're very interesting. And I thought, well, this is going to be really good because doing this kind of helps you avoid burnout. It's interesting, keeps things interesting. You make a little extra income and there's lots of opportunities for physicians. With that, welcome to the podcast, Dr. Robert Cooper.

Dr. Robert Cooper: Thank you very much for having me. It's a pleasure being here, both an honor and a pleasure. I can tell you, I listen to your podcast all the time and it's my favorite thing to do on the treadmill when I'm listening. I've got some great segments there that I've listened to and learned from too as well. So I'm happy to be here contributing. Thank you so much for having me.

John: I love that. I love that. But I think you have a ton to share and maybe some of the things I don't know if you found all these things yourself, or maybe there was something mentioned by one of my guests. It doesn't really matter. This is all going to be helpful. And I'm really happy to have you here to tell us about some of these things. So let's start by just introduce yourself in terms of who you are, what you do, mainly your clinical background, maybe, and clinical work that you've done through your career.

Dr. Robert Cooper: I'm a regular doc. I'm an endocrinologist. I started my training in New York. I trained at Albert Einstein in the Bronx, went on to do a residency at Long Island Jewish, then went on to do a fellowship at Long Island. And I have an entrepreneur spirit about me. So when I finished my training, I was the first endocrinologist out in the Hamptons.

And I enjoyed that, but having your own practice is very difficult these days, even then. When I first started medical school, I had no idea of managed care. I came in because I wanted to be, I actually wanted to be a family doc and I wanted to have people come to my house and set up a shingle.

I went to a very expensive medical school as I said, and I am still paying back my loans, but anyway, but I enjoyed, I enjoyed medicine to this day. I know my son is a medical student. He's a fourth year medical student now, finishing up his rotations and actually going for the match. And he's asked me many times would you go into medicine again? I said, absolutely. I think this is a great time to be in medicine. I actually despite what people say and the naysayers, I love what I do. I love practicing. I love seeing patients, but I like doing it on my terms.

That's the key thing here, John. When I was out in practice, I then got recruited to Western Massachusetts to a place over in Western Massachusetts to run the fellowship there. And I did it the traditional way. And I was in academic medicine and so forth. And there was issues and things like that. And I've been in different places in Western Massachusetts. About 10 or 15 years ago, I looked at, well, I'm not going to go any further. I want you to ask some questions.

John: No, tell me what happened then. Something changed at that point. Practice was okay. It was good. It was fun, but what happened?

Dr. Robert Cooper: It's always been good. But I think I answered an ad actually to do disability file reviews in the New England Journal of Medicine for a company, a small company at that point, so small that my son actually went out to Maine actually. And we went to dinner with the CEO of the company actually. And he still remembers that this day he's 24 years old now. And I started doing disability file reviews at that point. I learned how to do it. You have to learn how to do this stuff. It's very important to learn and to produce a good product. You can't just get thrown in there.

I think there's something I had to learn on my own over years. And that was my first real stint towards nonclinical medicine. And then I learned other companies and I learned how to do it well. And at points in time, I've taken other nonclinical responsibilities as well. That was my first break in to nonclinical. But what I like about it is that I could do things, as you said, in combination. The key to this whole thing, I think, and this is a little words of wisdom if you're going for practicing 30 years, is not to put your hand into one thing. I always say, I taught at SEAK as you mentioned before at SEAK. And when I put my hand, you put your hand into one thing, I tell the audience, it gets chopped off your hand.

And that's true of clinical medicine. That's true of being all in full time sometimes. That's true of being an all in employed as an insurance person. That's true as being all in you do it in little bits of pieces of each thing, actually, too. It makes the best thing because nobody has complete control of you. You have control of yourself. It's on your own terms. We as physicians are very independent people. That's why we went into medicine to begin with. And then now what happens is that all of a sudden we're being controlled. And we don't like that. I don't blame anybody for doing that.

And the problem is as you pointed out, I said before about burnout. And I hate to see physicians burn out. We have a shortage of physicians right now, a shortage of primary care, a shortage of specialists. I would like to see people remain in medicine, quite frankly, but to a certain degree. it's not for everybody.

But I think at some point also in time, if somebody could combine the nonclinical and leverage that as well and stay in clinical medicine, we'd be all better off as well as the person, maybe if they wanted to be and the population at large.

John: Absolutely. That's actually one of the reasons why I wanted you to come on, because I've seen this before where still being in clinical, but maybe cutting back a little bit, doing other things to give you that feeling of autonomy, give you that sense that, okay, you're not if this company goes out of business, if this hospital closes, I'm not going to have a job. And it also helps prevent burnout because it's just the variety and the interest. And I think there's a lot of advantages to it. I'm interested in hearing more. Why don't you run down a list, maybe without going into any depth, just in some of the things you've done over the years, even some of those things, maybe that you're not doing any longer.

Dr. Robert Cooper: Yeah. I'll outline the four things I think I do the most of, and some of it fades in and out. It depends. The thing I do, I mentioned before, disability-followed consulting. I've done that both with the vendors, part-time basis. I've also worked as an independent contracting physician for a major insurance company, 10 hours a week. And that required a little stress. You have to understand something else. I just want to step back for a stressful situations because it can be just as stressful as clinical medicine.

You want to step back and look at this and how much you could take on and so forth. And so I did that, that medical necessity reviews is also part of file review. And that's also something that I've enjoyed doing through vendors. I also worked full-time for a short period of time for an insurance company doing that as well. I didn't care for it too much. I can tell you, it's my own personal thing, but I just say, it's not peaches and cream that people would say, come on sometimes.

That's another end of it, the whole thing. I've done all, the thing I really like doing, and I've done more recently is expert network consulting. That is a wonderful way to do it. People don't know about this. I've gotten into in terms of providing expertise to nonclinical people, Wall Street people, in a way that provides just public information to platforms, but not getting specific about the platforms, but I it is something that is very lucrative. It pays almost as much or as much as expert witness consulting, which I've done also, another one of my things.

I find it to be very fascinating and I love teaching. To me, teaching is teaching fellows and residents in the past. Here, I'm actually teaching people that are brokers or people that are actually doing, or they're sometimes scientific people trying to develop a drug and diabetes or something. I'm an endocrinologist, so I'm doing that. And you could teach people how to, but basically any specialty can do this really, as long as you're doing a little bit of practice most of the time, I think, and you could combine this.

And I can tell you, I will say to you this, that with the nonclinical stuff I did, I told you before, I have a son in medical school who has a huge tuition in Boston and a very good school. I doubled my salary clinically as an endocrinologist last year, last two years doing this, working four days a week, full time. And one day a week doing the nonclinical stuff. If that's your avenue is to get in and make more money and you don't necessarily want to cut back your clinical stuff, that's okay too so you can do that. And it's been really great that way too.

You have to know how to do these things. It doesn't come just with sitting down. We didn't go, we didn't just get put into an exam room and have to examine patients. We went through years of training and residency and so forth, the same thing here. You'd have to know how to do it. You have to know how to be coached, what to do, and kind of how to come up with a good product.

People want a good product like anything else. And when you have to produce that good product, they keep coming back over and over and over again, and they'll pay you what you want, quite frankly.

I think having that, I tell my son who's graduating. I said he's going to go on and do a residency. And I said even if you didn't have that residency, you should have, I'll finish it and do it. But just having that degree, the fact that we went through what we did is, you mentioned this many times on the podcast I've listened to before, being a physician and having that amount of knowledge and be able to pick up on things, we're in a perfect position to do all this type of consulting.

And so, the thing is that doctors don't realize is they're in demand, not just clinically, but nonclinically. They're in huge demand, but they undervalue themselves. This is an important point. And this is another Cooper point.

Number two, I'll just say, it's this, walk away from an opportunity that doesn't pay, that undervalues you. People gravitate to these opportunities that I find disgraceful, actually, in terms of what they do. And that can be any breadth of thing, of the things I'm talking about. Walk away. It's more important to walk away, actually, and not get the opportunity, but to take the opportunity and undersell yourself. Very important point that I've learned.

John: Yeah, I think there's nothing wrong with trying different things. But as you said, if it's not really going to be worth the time, because our time is probably our most valuable asset other than our medical knowledge, then you just should move on or take the time back and spend it with your family.

Dr. Robert Cooper: Exactly right.

John: So let's see, why don't you pick one of those? I'm interested in everything you've said so far, but the expert network consulting, how did you personally find this? Is there any ideas you can give us in terms of how to locate some of those? And then what is it you need to know to be able to do? What are they actually looking for based on what you've done so far with that?

Dr. Robert Cooper: They're looking for people who practice, who have some sort of basis, but actually could even do it without practicing. They had knowledge of the scientific basis behind it, some consults. You get these surveys sometimes that come to you through, I guess, a company called Sago or Schlesinger or other companies like that.

I don't want to go into specific companies, as I said before, but I could certainly talk about that individually with the guests that want to do that. But I think that you get these companies that will approach you sometimes and ask you for your expertise, spend an hour or so. In fact, before I got on the line with you today, I spent three hours downstairs working on three different consultations, three different ones today, because I'm "off" on Fridays.

I was working on that, but really, it's just phenomenal in terms of that. So how did I come into this? All of this is really, things just come to me, I think, somehow. When you put yourself out there, that's the key. I have a LinkedIn page and I'd like myself open to opportunities. People will come to you and they see your profile, but the most important thing is when they come to you is being receptive, A. B, providing a good product. When you're on the phone with an hour with somebody coming on that's asking you about a diabetic product or something, or asking you about the sensors or something for how you feel about this different sensors, you want to provide insight into what you do.

We all know this already. I don't have anything non-public. The key thing you have to worry about with this is that you don't want to provide anything that's non-public. That could be construed as you get arrested for doing something like that or have really a problem. So you want to provide all public information that you're not from clinical trials or anything, but I don't know anything non-public. Most of us don't. We're not involved in clinical trials. We just do what we do each day, but that's what they want to know about.

These platforms, expert network platforms are looking for people. They keep asking me, can you refer somebody an endocrinologist, another endocrinologist? I get things that sometimes are outside my field of expertise. I never take anything that's outside my field of expertise. I will not feel uncomfortable with that. I will not do it. I will pass up on it. That's important actually not to do that, but I will go on and I will refer people sometimes to it. I've never actually gotten a commission for doing it.

If you refer people and they actually do consults, you can actually get a commission for it, but I've never actually seen anything like that, but that's okay. But anyway, I think you could get, there's multiple different platforms that are out there that you could look up and research, expert network platforms and do it. It's not perfect.

There are downsides to it. I taught a course at SEAK last year on this, and I think they're making that, they're a good organization, SEAK, and they're making it available too. I think they recorded me part of it, but I think they're making it available as well. But I also have my own course that I've taught already at SEAK.

John: Well, let me ask you this thing just to dig into it a little bit. When I'm online, I've had a LinkedIn profile for a while. And then again, the email addresses get out there, but are you saying that of the expert network consulting platforms, most of those coming through LinkedIn? Do you ever get just blind emails coming in?

Dr. Robert Cooper: Yeah, I do get blind emails coming in from different companies I even heard about before asking me, I've heard that you do this kind of work. Are you interested in joining our platform? Are you interested in doing a one-off consult? The nice things about these one-off is that you don't have to really, but I do prepare for it. There is a way to prepare for it. I wouldn't say I didn't prepare for it. And I could certainly go into elaboration about that in terms of looking at investor conferences. I find myself sometimes looking at that more than I do scientific conferences on different drugs and things like that. So I do prepare for it.

I want to provide a good product when I get online for an hour. Because if you spend an hour and you don't provide anything, I don't think anybody's going to want to come back to you again. It's like anything else. Even the expert witness work, you want to provide a good product when you're going through that. Disability file reviews, anything.

I think that it's important to prepare and to be ready for it. You also have to have a certain mindset when you do these consults. You have to be relaxed. I think the best investment you can make is to buy a headphone, a head jack, just to put it on because it frees you up and you can look at the computer at the same time. You want to get information. That sounds like a simple thing. I think it was a few dollars to buy the headphone investment for me.

But that was a very important thing. I'm not fumbling with the phone when I'm doing it. These are little tricks that you learn as you go along that you wouldn't know about. How do you conduct yourself? How do you continue to keep the conversation flowing? That's an important asset to have that. If you just stay still and don't elaborate or know something and don't talk about it, you're not going to get that across and you're not going to get the best outcome. So I think that there's a way to train people how to do this, I think, to some extent, to make them more effective.

John: Let me ask one more question about this and then we'll move on. I've never participated in that kind of thing, but I always kind of get the sense that from the invitation, sometimes it sounds like it's a one-on-one conversation. Other times it sounds like it's kind of a panel. For the ones that you've experienced, what is it like? Is it just getting on a Zoom call with somebody? Is it more of a multi-person call?

Dr. Robert Cooper: It's all the above. The ones that are multiple ones. Sometimes I'm actually listed as, I do a lecture actually, where I'm lecturing to a group of investors actually. For that, I charge more money for that. I actually have rates that I charge. And that's another thing. I'm not going to go into that now, but I would tell you that I do that and I charge more and I charge a minimum of 60 minutes. That's another important point. I don't prorate it because I don't want to be on a line for 15 minutes and waste my time when it's an hour I could be getting from somebody.

There's a whole series of things I've learned, how to maximize your time and your profitability when you're doing this. But it can be, I actually had times when I've actually had to travel New York City or Boston, I live in Western Massachusetts, to do something.

I always tell the story at SEAK when I'm there, that they had me, it's a funny story actually. They had me actually go to Boston to do, I think it was Sago or one of those companies, to go to Boston to insert into a dummy, a device for diabetes. They had me come there and they were actually paying $1,500 to do this plus travel for an hour's worth of work. Think about that for a second. That's not uncommon, by the way, to have that happen. I got this thing and I went and traveled into Boston. I'm sitting there, there's a one-way mirror actually on this place that I'm working on. I'm trying to put this thing and I was a cardiology fellow before I became an endocrine fellow for a couple of months. A little bit manual, not that disastrous. I'm trying to put this device into the dummy and I can't do it. I'm putting it in the wrong place. They must've been laughing at me behind the mirror. I can guarantee you.

And then they came out and I said, oh my God, they're not going to pay me because I didn't do anything right. They came back and they handed me a check and they said to me, that's exactly what we wanted to know, Dr. Cooper. We wanted to know how to put it in. We wanted to figure out whether endocrinologists were capable of doing this. That was the whole point of this. Thank you so much for your help. And they handed me a check.

John: Interesting. They learned they have to change it if they're going to involve an endocrinologists I guess.

Dr. Robert Cooper: That's right. But they're looking to learn. Exactly.

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The Secret Power of the Subconscious Mind

John Jurica — Tue, 04 Feb 2025 13:56:26 +0000

Interview with Dr. Sanj Katyal – 390

In this podcast episode, John interviews Dr. Sanj Katyal, a radiologist turned mental health expert focused on the power of the subconscious mind. Dr. Katyal describes the use of rapid transformational therapy (RTT) to address modern mental health challenges, particularly in children.

As a physician and certified therapist, he shares insights on accessing the subconscious mind to create lasting positive changes, drawing from his experience helping physicians and families navigate mental health challenges in today's digital age.

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Understanding the Subconscious Mind

Sanj explains how 95% of our thoughts and behaviors originate from the subconscious mind, shaped by early life experiences. This understanding is crucial for addressing deep-rooted issues through RTT, which can achieve significant results in just 1-3 sessions by accessing and restructuring subconscious beliefs.

Studies demonstrate that RTT can reduce anxiety by 62% after six months, offering a promising complement to traditional therapeutic approaches.

Protecting Youth Mental Health

The discussion focuses on the critical intersection of social media and youth mental health, with Dr. Katyal providing practical strategies for parents. He recommends delaying social media exposure until age 16, implementing screen time limits, and creating phone-free zones to sustain meaningful family interactions.

These guidelines stem from extensive research showing the causal relationship between social media use and increased rates of anxiety and depression among youth.

Summary

For parents and professionals interested in learning more about rapid transformational therapy and strategies for protecting youth mental health, visit sanjkatyal.com. Dr. Katyal offers remote sessions focusing on anxiety, screen addictions, sports performance, and career development, helping clients unlock their full potential by addressing limiting beliefs at the level of the subconscious mind.

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Transcription PNC Podcast Episode 390

The Secret Power of the Subconscious Mind

- Interview with Dr. Sanj Katyal

John: We're going to deviate slightly from our usual topics today, and there's a good reason. One of the consequences of working long hours under stressful situations is that invariably it affects our families, it affects our children, and with children facing a lot of mental health issues in recent years, including things like the pandemic and all social media, I thought I would get Sanj back here on the podcast and just get his thoughts on these problems. with that, welcome back to the podcast, Dr. Sanj Katyal.

Dr. Sanj Katyal: Thanks, John. Happy to be here. It's great to see you again.

John: Yeah, it was basically about four years ago that you were here. I think it was April, let's have it written down, 6th of 21. And, we talked a lot about what you were doing at the time. I think a good place to start today is to kind of update us on what you were doing then and what you've maybe, what's changed and what else you're doing now, which in four years, I'm sure there's some new things.

Dr. Sanj Katyal: I'm a radiologist. I ran a large private startup radiology group for about 10 years, managing a group of about 100 radiologists. And probably back in 2012 or 2013, I, and I visited a lot of hospitals, talked to a lot of C-suite CMOs, and I began noticing back then a really growing discontent among physicians. Didn't really matter what specialty they were, or even really what stage of career they were. There just seemed to be a growing unhappiness.

I remember thinking back from one of these drives about my own life, wondering why I wasn't happier than I was back then. It's not like I was unhappy. I had pretty much achieved everything I set out to achieve. And, and I didn't really find myself bursting with joy or fulfillment. And I really sought out to figure out why. And that search led me to become certified in positive psychology, which is, some people call the positive, the science of happiness.

And I did that for a while. I taught university classes to college students in positive psychology and lectured nationally to various groups, a lot of physician groups. And I started working with physicians for, for several years. And I think that's probably around the last time I came on the podcast.

And that's been very fulfilling, but I always seem to hit some sort of limitation when I worked with physicians and even kind of in my own life and my own personal development. And I didn't really understand why until I came across a book called Tell Yourself a Better Lie by Marissa Peer. And she's a world-famous therapist out of London.

My wife actually gave me that book. She's a therapist and she's like, oh, you love studying about the mind. You're going to like this book. And I really did. It basically shed light on why the physicians that I worked with and even myself kind of kept coming up against blocks and seemed to default back to kind of our default state. And that journey has led me to, to really study and become certified in therapy called rapid transformational therapy.

John: Okay. A couple of things that I would comment on. One is that, it's interesting because to me, I talk to a lot of people that want to change careers, have changed careers. And a lot of them say, well, I went into medicine and I pretty much didn't like it from the very beginning, but I did it because it was, I was smart and I was expected to, and I do all these things.

But then I think there's another group like you who had a vision. It was awesome. They love doing it, but I can see how something gets old after 5, 10, 15, 20 years, particularly if it's very stressful because to me, at least personally, I started just experiencing just the emotional and intellectual strain of just having to focus and concentrate much for long every day, not, trying to hurt a patient or something. Yeah, just there's different things that lead us to that point where, well, it's time for a change.

Dr. Sanj Katyal: Yeah, absolutely. I'm definitely in the second camp. I enjoyed it for a while, but things get, you don't want to spend your life on autopilot. Just going through the motions. And I think part of staying healthy and fulfilled is continuously learning and challenging yourself and kind of figuring out what your next passion may lead you to.

John: I did want to mention at this point, because you talked about the positive psychology, you wrote a book called Positive Philosophy: Ancient and Modern Wisdom to Create a Flourishing Life. Just our listeners know that if they want to really learn more about what you've done and written in the past, they can get that at Amazon or wherever. Things have changed. And now you were telling me before we got on the call that there's some recent revelations that you've experienced, you talked about, you mentioned right now, I guess, the rapid transformational therapy. tell us more about that and why that is interesting and exciting for you now.

Dr. Sanj Katyal: Yeah. The thing that's interesting about rapid transformational therapy is it can access the subconscious mind, which is where 95% of our thoughts and behaviors come from. Most of us use our conscious mind, our willpower, our quote, thinking mind to try to make changes in our life, self-improvement, new morning routines, new exercise regimens, diets, whatever it is. But really, it's our subconscious mind.

And what's kind of deeply ingrained at that level, that determines the vast majority of our thoughts and our behaviors. And this is why we always seem to default, and we default to the state of our subconscious mind. And this is the roadblock that I kept hitting up against using positive psychology and our quote, thinking mind to change habits and forth.

John: Okay. This is where some of us concrete thinkers are like, okay, this is going to be confusing. I'm going to have to have you to try and sort this out for me. If I think about my subconscious and accessing it or changing it, I'm pretty much at a brick wall. The closest I can come to is I could say, well, sometimes I have certain dreams, and I have to assume that maybe some of that is triggered by my subconscious. But why don't you explain a little more about how we can even access the subconscious and how can we change what's going on subconsciously? I guess that's what we're going to talk about for the next 10 minutes or so. That'll be very interesting to hear.

Dr. Sanj Katyal: Yeah. So, it's all part of the same mind, but you can think of it in simplistic terms as two different minds, the conscious thinking mind and the feeling subconscious mind. And feeling always wins over logic. Most of us know exactly what we should do, but the vast majority of us don't do everything we're supposed to do or, know that we should do at a conscious level. If we take a step back, as children, we've all had experiences that were unpleasant. It could be minor things like friends not being nice or excluding us from a group to more significant challenges like bullying or abuse.

These experiences left their mark on us and our minds, in an effort to protect us and try to make sense of the situation, came in and formed some beliefs about the situation. The three most common beliefs are, number one is I'm not enough. So, my parents yelled at me because I'm not good enough. My friends didn't include me because I'm not funny enough. I'm not smart enough, thin enough, pretty enough, whatever it is.

The second major belief, and this is a big one for physicians, particularly physicians that may be listening to this podcast, is what I want isn't available. As children, our basic need is love and acceptance. And those experiences where those needs are unmet lead us to form beliefs like what I want, which is basically love and acceptance as a child, isn't available.

The third main limiting belief is I'm different and can't connect with others. And this one was a big one for me, being the only Indian child in an all-white school with a funny name and parents with accents and stuff like that. But we carry these beliefs, these beliefs become deeply ingrained below the level of our awareness, in our subconscious mind. And we carry them basically like baggage or heavy anchors with us throughout our adult life. And they really distort how we see ourselves and how we see others in the world around us. Those are big, big burdens to kind of unshackle ourselves from.

John: I think what you were saying was that the approaches to addressing that is not the same as approaches to what, in the previous, the more superficial kinds of issues. You mentioned that rapid transformational therapy. What is that and how is that different?

Dr. Sanj Katyal: Yeah, behavior change is really the last, it's far downstream of the thing. We're talking about negative experiences leading to limiting beliefs and faulty programming that lead to kind of distortions and behaviors that don't serve us. And most of us try to focus on the very last part and change our behavior, maybe act a little different, do some things that may mitigate symptoms, symptom relief of anxiety, of depression, discontent.

But it's really going back upstream and uncovering the root cause of where and why and when these limiting beliefs formed. And it's really just understanding where they formed, how they formed, that you become free of them. You don't really even need to do anything except gain an awareness of them.

And then you can install more effective beliefs that serve us better, align with our highest aspirations and true selves. And that's what rapid transformational therapy does. Typically, very common things like anxiety, phobias, fear of heights, fear of needles, agoraphobia, depression, these are all, could be handled very effectively in one to three sessions.

This is not long-term weekly therapy for years going back. And the reason that can be done that effectively and quickly is because it's done under a guided simple hypnosis that allows us to bypass the critical thinking mind, goes to the subconscious level where these childhood experiences took place. And then once we're aware of them, it's easy to dismantle those beliefs that form from those experiences.

John: Is there much research or follow up either you personally or in the literature with the ability for that kind of shift to maintain itself for more than three months, six months a year? I don't know that there would be any difference, but I'm thinking for people who are attached to, well, five years of one-on-one weekly therapy for an hour versus what you're talking about, they're going to probably have a little skepticism. Where do you stand on that?

Dr. Sanj Katyal: Yeah. And I want to be clear also, this is not like, I think as physicians, when we look at new things or things are maybe are unfamiliar to us, we're looking at everything as an either or thing. And this is not an either or thing. This can very easily be a supplemental add on to counseling, therapy, medication, if that's appropriate.

I'm not here to say this is going to replace everything in the field of psychiatry. What I am saying is that this is very effective, quickly bypassing and uncovering blockages that have been, that have kept us stuck for many, many years, often unknowingly because of that subconscious access. There are studies also, because there's a large number of growing physicians trained in RTT, MDs. And I'm actually with another physician in Asia forming a group of physicians trained in RTT. There are several studies. The latest one I saw was six months out, 62% reduction in anxiety. So, these are obviously ongoing and stuff, but that's, those are, and from my experience and anecdotally from all the people that I've interacted with, that's a pretty significant and realistic number to achieve.

John: That's pretty interesting to hear because, today, if you're a family physician, you're treating somebody for a medical problem and there's always some kind of psychological component, or it is a completely different DSM-3 diagnosis, but it's like, you have to refer them. Sometimes you can't get them in for months and months. You are, as a family physician, kind of committed to treating, more than just, 2% of their illnesses. It sounds like something that maybe in the future, pediatricians, family physicians, others could learn this and just incorporate it into their approach to patient care.

Dr. Sanj Katyal: Oh yeah, no doubt. There was a journal article, which I can send you any of these, in the Annals of Internal Medicine that showed RTT is the most effective treatment you have yet to prescribe. That's the title of the article. And it kind of goes through that.

John: All right. But we were going to talk about a specific topic that you're very interested in and that many of us are. And I mentioned in the intro is that the rate of mental illness in children is just skyrocketing, really. I'm not going to go into the details, but it's just been something that's been talked about and written about for years now. Seemed to be the tipping point was the pandemic, but I'm really interested in hearing about that. And the issue with social media, it just seems like it's obvious there are issues and maybe you can expound on what social media, the impacts have been negative impacts primarily. We kind of know the positive and then how this might fit into therapy or coaching or a different approach.

Dr. Sanj Katyal: Sure. Yeah. The mental health crisis really started back in 2010. If you look at it, it's basically a hockey stick graph. It goes like that. And in 2010, a couple of things happened. The social media companies introduced forward-facing cameras. They introduced third-party apps that had intentionally addictive principles by behavioral psychologists embedded into these apps. number of likes streaks. Those are all the infinite scroll.

The goal was always singular. And that was to keep as many eyeballs on the screens for as long as possible. They didn't care at all about the consequences. And consequently the rates of anxiety and depression and suicidal ideations and suicide itself, successful suicide have skyrocketed. And people, skeptics have said, well, that's correlational, that's not causation, but there have been now hundreds of causation studies.

If you take teens and you remove Facebook or Instagram for one week or three weeks or a month, and you measure pre and post metrics using well-established statistically significant life satisfaction skills, anxiety surveys, all of that, there is no doubt that it's a causation in addition to a correlation. And what's interesting to me, because I give a lot of lectures to schools and to parents around screen addiction and youth mental health is the tech company founders, the people that got really rich off of social media, they are very stringent with their own families on when they get social media and how much they use, because they know that they know the dose dependent relationship.

There was a big article in wall street journal a few years ago on Facebook files where it all came out of all the data they had on Instagram and causing anxiety and depression and suicidal ideation in young teenage girls, and they covered it up for years. It's a huge problem, but I think it's related specifically to social media itself, as opposed to just banning phones.

John: Do you have guidelines that some of us could just take, easy guidelines in terms of limiting exposure and how to even do that? Is there some way to logically have a conversation with your kid?

Dr. Sanj Katyal: Yeah, there is, because I think you can show them now graphs and I can send you a graph. I have a graph on my Facebook profile. It's pinned up there. And it basically shows the rates of anxiety, depression in adolescence and undergraduates, I believe since 2010. I've shared all this with my kids and say, what do you think about this? Have you experienced this? Have your friends experienced this? It's not a secret to any of them. They know that the levels of stress and anxiety are rampant among them and their friends.

Probably the number one thing is I would delay social media as long as possible. Definitely till age 16 at the earliest, if you can, many people need to give people kids phones for convenience, say contact, picking up for sports and stuff like that. That's fine. But if you can delay, especially Instagram, TikTok, Facebook, good 14 year olds aren't on Facebook, but Instagram and TikTok are the big ones. And as long as possible, if you can delay that, there are a few other very simple guidelines.

If you'd like me to share them now, let's do that. One is I would turn off all notifications except text messages. Steve Jobs, the way he intended the iPhone to work was talk, text and music. That's what that was his great dream. It was not infinite scroll or constant interruptions while you're trying to study or in school or having dinner with your family or whatever. I would remove notifications. And what that tells them is you want to teach your kids to use their phone on their own terms with intention. I'm going to go in and I'm going to check my email. I'm going to check social media. I'm going to check this. I'm not going to be a passive person sitting here with a barrage of stimuli coming at me that I can't control all done on other people's timelines. That's no way to live life.

John: Absolutely. I would say, and it's probably easier for us old people. I'm a few years older than you. I'm sure to me, none of those should be synchronous. They're not synchronous. The only thing that synchronous is when I pick up the phone to call somebody, I don't even consider texting synchronous. People ask, well, you didn't answer your text. So, what it was 15 minutes ago. A text can be answered whenever I feel like it.

Dr. Sanj Katyal: Yeah. See the difference between the younger generation and us is their preferred means of communication is text. That is to them, that's a synchronous conversation, which is why I say, okay, texts are fine. If you cause your friend is that's all they do is text. That's how they communicate with each other. But you're right. Everything else is totally asynchronous. But there's a lot people around me, adults, physicians that I work with they're addicted to checking their emails. They're addicted to social media. It's a habit that's very easy to fall into because it's a dopamine hit intentionally designed to be that way.

John: Oh boy. All right. What else should we know about this other tips or other things to watch for and where can we get help?

Dr. Sanj Katyal: Yeah. I think delay social media, turn off notifications. Apple screen time is a great tool. I limit the number of minutes that they can go on different apps, and then they have to request permission for additional time to do that. My son, when he was an undergrad, he told me, he's like, you need to just remove my Twitter at all, because I have finals coming up and I don't want to spend, I don't want to waste any time on that. They know that it's a waste of time. Once they learned to live with limits. Limiting with screen time is a big deal. I would say no phones and at the dinner tables and restaurants and in car rides, car rides, especially for people that have kids at home, they're not going to be at home forever.

And those car rides are going to become very precious memories to you, or they should be from very precious memories to you. And they won't be if your child is just on the phone the whole time. Those might be the only time you have alone with that child uninterrupted for that whole day. I would protect dinners, restaurants, and car rides from phones.

John: Now, this shows you how far out of the loop I am now. All my kids are in their 30s. Are you saying that basically the parent maintains control over the phone? They have set the access to certain things with their password, the adult's password that the kids can't fiddle with that and change those settings?

Dr. Sanj Katyal: Yeah, it's a screen time password that only you would know. And it sounds big brother-ish or draconian, but it's really not because these apps are addictive that unless you teach this generation how to limit themselves and find ways to occupy themselves without just going to the phone as a default, they're not going to do it.

John: Yeah. It makes perfect sense. Obviously. You have to think in terms of, well, let's see, am I giving my kid beer to drink at night? While he's watching TV? Am I giving him, handing him the car keys when he's 10 years old? These are just basic things. It's gotten to the point where you got to do that, even for social media, obviously, because it's just as important, just as dangerous.

Dr. Sanj Katyal: Yeah, exactly.

John: All right. Now you're doing some of this right with your clients/patients, whatever. Tell us how that works for you. And then you can actually give us your website for anyone that might want to pursue your help.

Dr. Sanj Katyal: Sure. Yeah. I think that the reason that kids, the default to screens all the time is that they're really living far below their potential and they're not engaged in life. And this all goes back to what we talked about at the beginning, the parents limiting beliefs and conditioning is being passed on to their children in the form, and they're now becoming indoctrinated with the same limiting beliefs, forget about what I really want to do. I better get a high paying job where I can make a lot of money and then retire one day and be happy.

Well, we all know that that just doesn't work. There's thousands of very wealthy, successful people that are miserable. And rather than pursuing what they're really interested in doing and having their parents facilitate that and support that most of the people that I see and work with, their kids are being inadvertently, and it's not malicious. That's just the way we think we're doing something good for them. We're teaching them how to succeed in the world.

But these limiting beliefs that are being passed on to our kids essentially limit their potential. And by limiting the potential limits, their ultimate happiness and fulfillment. And that's why a lot of kids are wasting time scrolling because they're not engaged. And that's quite frankly, why a lot of adults are right.

You think about the Gallup surveys about workplace engagement and stuff, and it's less than 40%. And that's why, because people are in jobs that they have no business being in. And I think that's something that you help facilitate physicians by giving them options to explore nonclinical careers that they can use their training, but perhaps in different, more fulfilling ways. And I think that's part of dismantling these kinds of beliefs. The life I want isn't available to me. The career I want isn't available to me. I'm stuck. I'm trapped. I'm just going to suck it up for the next five years until I can retire.

John: Yeah. Are you serving an audience or a clientele that's physically located near you? Are you doing a lot of remote work? How does it work? And tell us if we want to reach you, how would we do that? And for what kind of issues?

Dr. Sanj Katyal: Yeah, it's all on Zoom. I use Google Meet. it's very convenient. I work with people all around the world. I work primarily in four main domains. One is anxiety. The other is screen addictions and other kinds of addictions because addiction is basically a self-soothing behavior. And you got to figure out what you're trying to soothe yourself from, where the underlying pain is. Third is sports performance, really among kids and young adults. And then I work with a lot of adults that are trying to figure out where to go next in life, what to really uncover their own, their full potential and decide what to do. That's more of a career coaching stuff.

John: Got it. they can find you, tell us your website.

Dr. Sanj Katyal: It's sanjkatyal.com.

John: Okay, that will go in the show notes along with some of the other things, the book and so forth, and some of those other resources that you mentioned earlier. I don't know, any last words of advice or cautions for our listeners? Let's say our physician parents out there with their kids?

Dr. Sanj Katyal: Yeah, I would encourage everybody to kind of look at their own belief system, conditioning, and what they're passing on to their kids, and try to see where that came from, and whether it serves them or their children, because most of the time, at least in my experience, it doesn't.

John: Yeah, I think back to my childhood and my parents. My dad didn't finish high school. I don't think they ever thought about reading a book on parenting. And so all those things, residual things, you just don't have access to solutions to problems that they never solved, or never even dealt with. And it happens within every generation. We're learning new things, we're facing new challenges, and we may not have all the answers. Would you say to just observe your kids and don't assume, well, they're just going through some stage if they're unhappy, depressed, anxious?

Dr. Sanj Katyal: Yeah, I would try to find out what your kids really want to do in life, free of your own inputs, and what parenting advice or suggestions, what did they love to do? What do they naturally do, without being asked to do? What did they do when they were really young on their own, try to find out what really makes them tick, and then do everything you can to facilitate them doing that, because they will be able to make a career out of it. And they will be far happier than if they're pushed into some of the things that we've all been pushed into.

John: What happens if you have that conversation, and either one, they say, I just want to hang out with my friends, or B, I don't know. I don't know what I like to do. I don't know what I want to do.

Dr. Sanj Katyal: Yeah, I think not knowing is a good thing. We shouldn't expect an 18 year old to make a life sentence decision. Not knowing and taking a few years now, if they're sitting on the couch and playing video games, you have to have some kind of guidelines around what they can do. But taking a gap year or two and exploring different things, gaining awareness of themselves, and their underlying aspirations. There's nothing wrong with that. There's no race there. I tell my kids and other parents' kids, there's no race to the job market. The job market is going to be there. You're going to be working there for the next 30 years. There's no race to ever leave college early unless it's a tuition thing.

John: Yeah. Right. So long as they're not spending their time in college drinking and partying. Let's see some decent grades. All right. We'll go off on tangents on this all day long, I think. All right. Well, I want to thank you for coming to talk to me today about these topics. And it's pretty thought provoking. And I know there's a lot of anxiety around our kids and social media, and can we just cut them off and how to handle this. I think just what you've mentioned today is very helpful. I think they can do their research and if they feel like there's a problem, they should maybe look at your website, get some ideas and possibly even contact you in terms of helping one of their kids.

Dr. Sanj Katyal: Yeah, I'm happy to help. Thanks a lot for having me back. It's good to talk to you.

John: I'd love to do this a little more often.

Dr. Sanj Katyal: Yeah, it sounds good.

John: All right, Sanj, thanks a lot. I'm glad you could make it today. I really appreciate it.

Dr. Sanj Katyal: Thank you, John.

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Have Faith in Your New Life Insurance Medicine Career

John Jurica — Tue, 28 Jan 2025 12:04:27 +0000

Interview with Dr. Megan Leivant – 389

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

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

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Demystifying Life Insurance Medicine

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

Building a Career Path in Insurance Medicine

The transition into life insurance medicine involves specific strategies and resources for success. Dr. Leivant discusses professional organizations, networking opportunities, and industry certifications that can help physicians enter and advance in the field.

She emphasizes how full-time and part-time opportunities exist, making it an attractive option for physicians seeking career alternatives.

Beyond Patients, Still Doctoring

Dr. Megan Leivant shares how her medical skills and ability to build relationships remain central to her new role.

I miss seeing patients, but I'm still able to create relationships. It's just done in a different way now… It's critical thinking, it's teaching, it's teamwork and collaboration. So, I'm getting to still use a lot of those skills that I used when I was a practicing physician. – Dr. Megan Leivant

Summary

For physicians interested in exploring life insurance medicine, connections can be made through the American Academy of Insurance Medicine (AAIM) and LinkedIn. Dr. Leivant welcomes connection requests from interested physicians on LinkedIn to learn more about this rewarding career path.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 389

Have Faith in Your New Life Insurance Medicine Career

- Interview with Dr. Megan Leivant

John: Over the years, I've had the occasion to meet physicians who work in the life insurance industry, not health insurance not doing UM, but actual life insurance. And I've been sort of very interested in that topic. Those that I have spoken with informally, not necessarily on the podcast have said they really like those jobs. I've been interested in finding someone who's doing life insurance medicine. And so that is today's guest. I'm very happy to have the opportunity to talk to her. Hello, and welcome to the podcast, Dr. Megan Leivant.

Dr. Megan Leivant: Thank you so much for having me.

John: I think this is going to be fun. I wanted to learn more about this for years. And it's not as common a full time or even part time position as let's say, someone working in health insurance. I don't know about disability. Anyway, tell us a little bit about yourself, your mainly your education and clinical background that will get into what you do professionally now.

Dr. Megan Leivant: Sure. Well, thank you so much for having me on the podcast today. I'm really excited to be able to talk about life insurance medicine. It all started for me. I went to DePaul University for my undergrad, and I majored in biology and did a minor in French and then went to IU School of Medicine, Indiana University School of Medicine, and followed that up with my residency in internal medicine at Northwestern in Chicago. And then actually practiced outpatient internal medicine for 10 years.

And I did that in a variety of settings. I started out in a traditional private practice, and then I moved to the VA, and I worked at the VA for about five years. And then I was in more of a hospital based community practice before I made my transition. And then I did have a lot of teaching appointments throughout that period of time as well. And that was something that was really important to me.

John: Very nice. Well, then the obvious question that comes up is when a physician transitions from clinical to nonclinical, what led to that decision?

Dr. Megan Leivant: I would say several years before I transitioned out of clinical practice I realized that I was having an increasingly difficult time coping with the demands of outpatient clinical practice, which I know that many people are feeling that way. And present day. And so I actually started working with a physician career coach, Dr. Heather Fork, through Doctors Crossing, just to see what I could do to help my situation. Because at that point, I wasn't sure if I wanted to leave clinical medicine. I just wanted to try to figure out could I could I do better? Were there changes that I could make to try to make the day to day a little bit more manageable?

And we worked together for a good while. And I ultimately realized that transitioning to a nonclinical career was the path that I needed and wanted to follow. So through coaching, I learned a lot about my interests and my dislikes. We did the Enneagram and talked about marketable skills and personality traits. And it was really just a great growth experience to learn all that stuff and then help leverage those findings to apply them to different nonclinical career options. So part of that process, I attended the SEEK nonclinical careers conference to help jumpstart my research and look into other career options and reached out to former colleagues to kind of explore what they've done in the nonclinical realm.

I made new contacts on LinkedIn. it was a very kind of vulnerable, exposed experience putting myself out there to try to just figure out what was next. And I even tried some telemedicine during that transition. I did a little utilization management just to see what else is out there. But I kept hearing about this life insurance medicine career. And the more I heard about it, the more I thought it would be a really good fit. And so that's ultimately how I got from point A to point B.

John: Well, what you described is really, it could be considered like a model in some ways. These are things we always talk about in the podcast. Okay, getting a coach, using a coach. Heather Fork's been a guest here at least three or four times, and I've been on her podcast several times as well. And so she's kind of an icon from the standpoint of coaching physicians. There's many out there now. But while you've hit on a lot of the points we've talked about Seek here before. Many of the people I've interviewed have actually been alumni from Seek as speakers. So you can add your name to that list now. I guess you've been a mentor there, I believe?

Dr. Megan Leivant: Heather. Yes, I was actually a mentor just this past October, and that was a great experience.

John: I guess I'll go off a little longer on Seek. It's only like 45 minutes from where I live. It's held near Chicago, and I live south of Chicago. I've driven up there and attended a couple of times to meet some of the mentors and the speakers. So that is good. I mean, I think that'll inspire some people to get off the dime because I get asked a lot about what about coaching. And in the old days, Heather and a couple others were like the only ones. I don't know when you started.

Dr. Megan Leivant: Yes, yes, there are a lot of physician coaches out there.

John: It's always something to say, oh to try if that's if you're kind of stuck. All right. You kind of looked at your skills and your interests and what's out there. And then the lifestyle, I think, is always part of that decision. So why don't you start by next telling us what are the duties of a medical director? That's the really the entry point for most if they're going to do life insurance medicine. What does that look like?

Dr. Megan Leivant: Exactly. Yeah. And it is a bit of a of a frame shift, but at the core, I like to think of the primary duties of a life insurance medical director as three pillars. Case consultations are definitely the biggest pillar. And I'll talk about that a little bit more. Teaching is certainly part of that.

And then research. At a very basic level, you're assessing the morbidity and mortality risk of insurance applicants. And so they can be applying for many different types of life insurance products, but really at the core it's mortality and morbidity. And as a physician, really, that responsibility lies in understanding disease processes, their associated risk factors, and how that's going to impact morbidity and mortality. So that's where that frame shift comes in a little bit. as physicians, we are thinking certainly more in the moment, treating what is in front of us.

I think that's probably one of the biggest pivots that has to happen. But there's a number of areas of risk selection. So there's that life mortality risk, there's disability, there's critical illness, and then there's long term care, which is more that morbidity component.

Really a day in the life, the bulk of it is those case consultations. So an underwriter will send over a consultation. And I almost liken that to presentations on rounds. They ideally are sending over, this is a 58 year old male with X, Y, and Z medical conditions. Here's my question. And so, as a medical director, you were there as a consultant to give your opinion. And you provide your opinion back to the underwriter. You're also fielding messages from them and calls and that kind of stuff. But that's, that's, I'd say the bulk of the day to day.

But then you're teaching the underwriters are there to learn from you as well. So that's what I really enjoy about this career is I still get to teach. And it's formal, it's informal you could be giving an external presentation to a room of underwriters, or you're just teaching over over the phone or through one of your consults.

I like that piece of it as well. And then research we're always needing to research these medical conditions that we're encountering. I feel like I've learned so much more in this career, I could probably go back and be a much better clinician. I think from my experiences, but you're doing projects, you're helping update the manual, the manual is what you use to help rate the impairments that the applicants have. That's at the core, I think what the primary duties look like for a medical director.

John: The scary part of that might be if I'm imagining that I'm thinking about taking a job like this, it's well, how I have an understanding of how different illnesses impact one another and why having hypertension might be a risk factor for something involving cardiac problems and so on and so forth. But I'm thinking that people might be like, but I don't know how to quantify that. Where does the quantification come in? Does that come from the underwriter or is that working together or is there a book that has numbers in it? There's some training involved on the job, right?

Dr. Megan Leivant: Oh, yes, absolutely. And I would say it probably takes a good six to 12 months just to really feel comfortable with that. So yes, to your point, when an applicant comes in and presents with, let's say diabetes or heart disease we all have 100% mortality that's a given, right? We all know that. But in the life insurance industry, we use what are called table ratings. And so they go up by 25 increments. 125%, 150%. And that corresponds to a person's mortality. So the higher that number gets the more medical impairments they have.

And every company uses a manual. And that manual includes those conditions like diabetes, heart disease, cancer and there's ratings that are associated with those disease processes. And that can vary. And it does vary per company. But that is where that risk is then assigned to the condition. And then as a medical director, where we come in is, well, what if you've got someone who's had diabetes and heart disease and prostate cancer? Is that a risk that we can consider that the company wants to consider? And from a medical standpoint, can we put all that together to determine if that applicant is suitable for a policy? Jennifer That's a great question.

John: Dr. Justin Marchegiani. But just like anything that you're doing, when you're going from clinical to non-clinical, there's obviously something you're doing in that new job that, well, it uses those skills and that background. It's different because it's a different industry. And I think that's what stops some people. And the thing is, all of these things have been figured out. whether you're going to health insurance or life insurance or pharma, these are not mysteries to the people that are on the other side. And usually they are well-prepared to train you. Now, there isn't really any certification that a physician would typically pursue or do other education before maybe applying for their first job as a medical director in the insurance industry.

Dr. Megan Leivant: That's correct. there are definitely a number of things a person can do to build their knowledge base. But there are a number of directors, myself included, where I walked into this industry very green. I'd had no experience in life insurance medicine, and I was trained on the job. And I've done a lot of those additional classes and certifications now as a director within the industry.

John: I want to hear more about what your career has done since you've been there. But why don't we go first into the obvious question? Maybe they've talked to people that have started doing this, they really love their job, their lifestyle is good. How would I start to look for those jobs and or prepare for the job?

Dr. Megan Leivant: Yeah, that's a great question. So I think there's a number of ways to start looking into this career. And I think there's not just one pathway, probably one of the most useful tools would be to consider joining AIM.

And through that organization, this is kind of like our governing body, if you will, of within insurance medicine. So it's a group of insurance medicine directors, but there are also underwriters and that are members as well. And when you become a member of AIM, you actually can get paired up with a mentor. And the mentor is usually a director who is already in the industry. And I have really found that that's been a great way for individuals who are interested in getting into the industry. they now have a point of contact.

And that really can be a great nurturing relationship to help jumpstart that interest within insurance medicine. But then I think it's a lot of the other things that individuals do to look for new jobs, right? Look for job postings on LinkedIn, get your LinkedIn profile spruced up, try to reach out to if you happen to know anybody that's in the life insurance industry, certainly that's always really, really helpful.

Let others know that you are looking for a new career or that you're interested in this. Connect with an industry recruiter. they are definitely out there. Depending on where you live most of our positions are remote. There are some that are hybrid, but research life insurance companies that are in your hometown that could always potentially provide an opportunity, whether it's a bigger name or a smaller name. And attending a meeting.

That's an absolutely wonderful way to get to network and meet other industry directors, industry professionals. And there's a number of those. So, AIM has its own meeting every fall. And then there are several others that also could provide really good opportunities to try to help kind of jumpstart that career.

John: That sounds logical. Yeah. And I, one thing that I ask about, because we, for some of the big industries, there are these things like LinkedIn groups and Facebook groups. Do are there any such entities that you're aware of for life insurance medicine?

Dr. Megan Leivant: AIM does have a presence on LinkedIn, and I would say that would be a great place to start. I am not aware of any specific life insurance medicine, Facebook groups or anything, but, but AIM again has so many great resources. And so, that's where we end up directing a lot of our individuals that are interested.

John: Okay. So, I'll be sure to put a link to AIM in the show notes.

Dr. Megan Leivant: Yes.

John: So, now let's talk more about you. A couple of things. Maybe you can tell us a little bit about what you like about it and, and, and then what you've done because you're, I think you're no longer an entry-level medical director. We'll just kind of talk about both of those issues.

Dr. Megan Leivant: Sure. I'd say what, what keeps me coming back every day is that this is a really mentally stimulating job. I've really enjoyed, and I continue to enjoy the, the challenge that comes from reviewing these cases that come through every day. This is why I went into internal medicine. I love to solve problems. So, it really gives me the chance to still continue to do that on a day-to-day basis.

There's a ton of variety. I'm seeing diseases that to this day, I still had never seen before. So, I'm still getting to use my medical, medical degree. I'm growing my knowledge base, and, and that was really important to me as I was considering the, the pivot. But it's also a small industry, so there's a lot of great networking opportunities. I've really been able to kind of expand a different part of my marketable skills, if you will.

I miss seeing patients, but I'm still able to create relationships. It's just done in a different way now. And so I'd say that those are probably the big things that kind of keep me coming back every day. It's critical thinking, it's teaching, it's teamwork and collaboration. So, I'm getting to still use a lot of those skills that I used when I was a practicing physician. Yeah, as far as my kind of course throughout my career so far, I've been in the industry over six years, and I started out at what's called a direct life insurance company.

So, a direct life insurance company would be the company where you apply for your life insurance policy. So, they directly, they do that underwriting, and I worked there as a medical director for just under two years, and I got that experience. And then I've, since then, have been working for reinsurance companies.

There are a lot more direct life insurance companies than there are reinsurance companies. So, reinsurance companies help to insure the direct insurance companies. That's probably a very high-level way to kind of describe it, but, but so our clients are the direct insurance companies.

We still, as a medical director, are doing very much the same thing on a day-to-day basis, whether you're at a reinsurance company or a direct insurance company. But in a reinsurance company, we're probably seeing cases that might be a little bit more medically complex. There are certainly some differences there. But at the core, like I said, this is ultimately, it's still the case consults, but there's more teaching, there's more research, and that's kind of helps keep it really interesting and a lot of variety.

John: I wonder I was a CMO for a hospital for a while, and our hospital insured itself from liability. We're talking a little different than life insurance. But they had a consortium, they were so, quote, self-insured. But they did have a reinsurance company, I think, on top of that. Like, there's things that happen that they can't really predict or plan for. So, it's kind of the same idea.

Dr. Megan Leivant: Exactly. if I had a whiteboard, I could draw a diagram the direct companies would be in the middle, and then the reinsurance would kind of be a bubble around it. So, here's an extra layer of protection. We might take on the full risk that a direct company doesn't want to take, or maybe we share that risk because it's a really high net worth case. There's just so many different permutations. But that is a great way to describe it.

John: All right. Now, let me ask you this. Do most of medical directors for a reinsurance company come from a direct insurance company, or are they just out there trying to grab anybody that comes along?

Dr. Megan Leivant: No, that is a really, really great question. I would say, on the majority, physicians that are within reinsurance companies usually are coming to those companies with some direct experience. Now, I'm going to say that's not an absolute, because I do know of some directors that started out in reinsurance. And you're going to get that on-the-job training, no matter where you are. But I would say, on the majority, that's probably the path that you normally see is a direct to a reinsurer.

John: Now, in other industries that are similar, in my mind, to this, they have this whole hierarchy of medical directors and senior medical directors and executive medical directors, and then they get into the VP level. And again, kind of mirrors even the hospital setting. medical director is still involved in the clinical stuff a lot.

The VP or the chief medical officer is really an executive position. So how does that work? The physicians, because I did know one VP of a life insurance company. I haven't talked to him in many years, but I didn't know exactly what he did as a VP, which was different from what he maybe had done prior in previous roles.

Dr. Megan Leivant: Yeah, that's a great question. I think it really, at least what I've seen, is that it really varies per company. I know a number of medical directors, whether they're in a direct company or a reinsurance company in that core role, they have a VP title associated with what they're doing. And I can't speak to the full industry as far as how many are VPs, but I think generally you're going to see that title or you will have that title as a medical director coming into a role, but it's very company specific.

The step up after that, though, is that, yes, depending on how big the company is, then some of them do have a chief medical director, and that's where you start to see some of that delineation as far as the administrative duties etc. Usually the chiefs are probably doing less casework and they're more involved with maybe research or product development or kind of higher level higher level concepts.

John: Yeah, that makes sense. And we see that in a lot of other industries where they just they just have a cascade of titles just to recognize the skill, the experience, and so forth. And then in some cases, it really means you're part of the senior executive team, which does a lot of the strategic planning and creating new service lines and things like that. So each industry, I think, has its own specific ways of doing things.

Dr. Megan Leivant: Definitely.

John: All right. Well, have I forgotten any important questions to ask you? I'm going to let you go in a minute. I definitely shed a lot of light. So any last comments or other things maybe that we've missed in this last 20 minutes or so?

Dr. Megan Leivant: Sure. Well, I think one thing you asked earlier was about prerequisites in a way of getting into the industry. And while there isn't anything that you need to specifically do to get into the industry, there are definitely once you are in, like, we actually, insurance medicine is a boarded specialty.

After you've been in the industry for several years, and there are definitely other courses you have to take and criteria you have to meet, but you can be boarded in insurance medicine. I'm actually working towards that myself. So I did want to kind of add that. And we do what's called a basic morbidity and mortality course that is part of that board preparation. So there are definitely all these opportunities to get that teaching that is needed as just part of the core function of our roles as medical directors.

John: Yeah, I would bet 99.9% of physicians coming out of the training would have no idea that there's such a thing as board certification in life insurance medicine.

Dr. Megan Leivant: Oh, sure. And it's both a written exam and an oral exam. So it's a process that can take up to a year really to kind of go through both of those.

John: And I saw that there's some certifications. Again, I'm assuming that those kind of things are sought after you're in the industry, but I noticed that there are certain things maybe you can explain a little bit about that.

Dr. Megan Leivant: Absolutely. There's a lot of, like I said, a lot of different initials, you can get after your name, a lot of certifications. And these are the courses that the underwriters take. There's LOMA courses, which is Life Office Management Association. And then there's ALU, which is the Association of Life Underwriting. And there are a myriad of different courses within each of those groups.

And those you take those and they're great courses. They really help teach you about the life insurance industry, especially the LOMA courses. Those are definitely more geared towards life insurance, just basic knowledge financial underwriting, risk management all of that. So yes, you can take a number of those courses and then ultimately get different designations depending on what combination of those courses you've taken.

John: Very good. Appreciate that. Yeah, I don't know. I'm a little too old to apply for a life insurance medicine job, but it sounds like the course might just be interesting.

Dr. Megan Leivant: Maybe not. And it depends on the company not everybody needs to be boarded. I think that's very company specific. There are definitely companies that might lay that down as an expectation. But I know there are directors out there that might do this part time and that's not an ask for them. So it's not I think there's definitely a spectrum.

John: Okay. Well, that's really good to know. Maybe they could create a career where they're doing half clinical and half something like this whether it's in this industry or even UM, whatever, that sometimes can be very positive from a lifestyle standpoint.

Dr. Megan Leivant: Sure. And I know of directors that are still doing that very thing. I do know of some that are still practicing clinical medicine, and then they do their life insurance job as well.

John: Excellent. Well, you did mention earlier, this whole thing about networking, tracking down your colleagues and former co-residents and so forth. But one of the things that I'm sure that our listeners might want to do is reach out to you. Hopefully that would be okay to do on LinkedIn. At least you can control that somewhat.

Dr. Megan Leivant: Yes, I'm happy to certainly connect with anybody that would like to do that through LinkedIn.

John: Okay. I'll put your LinkedIn, a link to your LinkedIn profile in the show notes as well, although if they just input your name, they're going to find you. So, all right, Megan, I think we've learned a lot today. I know I have, and I've appreciated this. I really encourage people who are listening to consider this because again, it's a small number, but the people I've talked to, some of them, they just love their jobs, you know? And so there's just something about applying your medical knowledge in this way that just so lines up so well with a lot of our intellectual stimulation, what we love and challenges. And so, I really appreciate you for describing all this and sharing this with us today.

Dr. Megan Leivant: Thank you so much for having me. Yes. Medical directors in this industry are very happy.

John: Nice. All right, Megan, you take care.

Dr. Megan Leivant: Thanks, John. Appreciate it. Bye.

John: Bye-bye.

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How To Make Meaningful Changes In Your Life Immediately

John Jurica — Tue, 21 Jan 2025 13:59:37 +0000

Interview with Dr. Michelle Bailey – 388

In this podcast episode, John's guest shares how to make meaningful changes in your life and career. Dr. Michelle Bailey is an accomplished academic pediatrician, medical director, and physician coach who first visited the podcast in Episode 124.

Helping physicians navigate career transitions since 2012, Dr. Bailey combines personal experience with expertise to guide others through transformative career decisions. Her approach emphasizes the importance of thoughtful reflection and strategic planning in making successful life changes.

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Dr. Armin Feldman's Prelitigation Pre-trial Medical Legal Consulting Coaching Program

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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.

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

Make Meaningful Changes Using the Power of Strategic Pausing

Drawing from years of coaching experience, Dr. Bailey introduces her concept of the power of the pause – a transformative approach to career decision-making. She explains how taking intentional time to reflect and assess can lead to more fulfilling career choices, rather than making decisions from a place of burnout or fear. This methodical approach has helped numerous physicians discover paths they hadn't previously considered.

Her framework helps doctors identify their core values and non-negotiables, essential elements often overlooked in career transitions. The process involves creating space for deep reflection about both professional and personal priorities. Dr. Bailey emphasizes how this pause can be the crucial difference between making a reactive career move and finding a truly fulfilling path.

Transforming Medical Skills into New Opportunities

Michelle shares eye-opening perspectives on how physicians can leverage their existing skills in new ways. Her insights challenge common misconceptions about career transitions, revealing how medical training provides valuable transferable skills that can open doors to diverse opportunities. She offers practical guidance on identifying and articulating these skills effectively to make meaningful changes in your career.

Her approach helps physicians recognize and articulate their unique value proposition in nonclinical roles. She discusses how medical training develops numerous transferable skills that are highly valued across industries.

Summary

Physicians interested in exploring career transitions or seeking clarity in their professional journey can connect with Dr. Michelle Bailey through her website at DrMichelleBailey.com or schedule a complimentary career consultation at callwithmichelle.com. Her approach focuses on helping physicians make thoughtful, strategic career decisions through structured reflection and practical action steps.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 388

How To Make Meaningful Changes In Your Life Immediately

- Interview with Dr. Michelle Bailey

John: I'm really happy to welcome back a guest from about five years ago. Back then, we were talking to her about her work as a senior medical director and some of the coaching she was doing. And I've been looking to get her back for a while, she's back to talk to us today and we're going to discuss mostly what she's learned and what she can teach us about career transition and physicians and so forth. Dr. Michelle Bailey, welcome back to the PNC podcast.

Dr. Michelle Bailey: Hi, John, thank you so much for inviting me back. I'm so happy to be here.

John: Yeah, I've been following you over those last five or six years just to kind of see what you're doing. As far as I know, you still exist. You still have a LinkedIn profile. And I know that you're still doing coaching, physician coaching, it's always good to pick the brain of someone who has interacted with and helped physicians navigate their career, their life, whatever. That's why I really wanted to get you back here. So welcome back.

Dr. Michelle Bailey: Thank you, thank you. Yeah, I've learned quite a few lessons over the last five years since we've had a chance to talk.

John: Yeah, and I think you've been coaching since around 2012. So you've been doing that for a while.

Dr. Michelle Bailey: Yeah, I actually started coaching around self-care and balance between work and home-life before it was a thing. And it was just what I was seeing in my work at Duke with students and residents and fellows and even some faculty. And that sort of blossomed into more coaching work around career satisfaction and career transitions, particularly after I made my own transition back in 2016.

John: Yes, yes, that was a big change. To go from full-time, I think you were doing academic pediatrics at the time.

Dr. Michelle Bailey: That's right.

John: Yeah, and then you flipped into the other thing you're doing, which is the nonclinical work. Tell us just about that for a minute.

Dr. Michelle Bailey: Sure, yeah, I was an academic pediatrician. I was seeing patients full-time in addition to teaching responsibilities at the medical school. And I decided to make the leap and move into a nonclinical career. I went to work as a medical director for a global contract research organization. And for those listeners who haven't heard of that, essentially the company I work for is hired by pharmaceutical or biotech companies to execute the running of their clinical trials. And so I wasn't sure if I was qualified to do that in the beginning, but they were very confident that I was and made an offer for me to join the team.

And essentially I get to leverage my medical education and experience and bring all of that into the world of pediatric clinical trials. And it's just been a wonderful career path for me, surprising in many ways. I still get to learn, which I love, and I still get to advocate for kids and to be a part of helping to bring life-saving and life-changing medicines to them.

John: Okay, we're going to talk mostly about what you've been doing with the coaching, things that maybe are new or just aha moments maybe that you've even had over these, let's say last five years. However, you did mention that issue about going to, I guess some people call it now biopharma, they use this kind of all-encompassing name, but the physicians often just feel like, well, how can I do that? I'm not a researcher. I haven't spent any time writing articles on things like that. But explain what you were kind of alluding to in terms of the fact that you were qualified for what you did then and what you're doing now.

Dr. Michelle Bailey: Yeah, I can certainly say my journey and my experience mirrors a lot of the physicians that I have conversations with and ultimately end up coaching in that in our training and education, we don't really learn about options outside of direct patient care or bench research. And so that's really all I knew. And once I decided that I wanted to do something different, I had no idea what that would be.

And back during that time, there weren't a lot of podcasts like yours or conferences and other things around to kind of help educate you. But what I've learned over my eight plus years of being in this new industry is that we have transferable skills. So these things that we learn and skills we acquire as physicians, like leadership, for example, we have these skills that we bring with us to other industries and we can apply them.

For example, in my case, some of the skills that I get to use are just my general knowledge about children and the fact that they don't come to clinic visits alone, they come with their parents or they come with siblings. And so I'm looking at a study protocol for a research trial. And I see that the assessments for that study are going to keep that family on site in the clinic for like six to eight hours.

In my mind, that's going to be a difficult study to enroll for because as a parent, it means I've got to take time off from work. I've got to get my kids from school. I've got to arrange maybe childcare for the other kids or bring them with me. We got to figure out food while we're there for that period of time. So those are the insights that I can bring to a team that has never worked in a clinic and had these kinds of interactions with a family. And so it's things that are seemingly simple to us.

And I think we don't appreciate how much we know because it's just our world. It's what we do. But also just sort of the leadership that we acquire as a physician, the fact that we are really good at doing hard things, that's a part of our training. And also we're really good at figuring things out. So just because you've never seen something before, you don't know how to do something, you are motivated to figure out a potential solution. So that's another skill that we bring with us into these different roles.

And so I quickly understood how I could add value and contribute in meaningful ways to the team. And that really helped boost my confidence. And so what I talk to physicians about now is understanding their own set of transferable skills.

What are the strengths that they have? What skillset do they already have? And what gaps might they need to fill? But also just really paying attention to what it is they enjoy doing. Because usually there are things that we're really good at that don't feel like work because it comes naturally to us. And those are things that other people struggle with.

For me, what was really helpful was what I call the power of the pause is just stopping long enough to reflect on how I felt about my career at that point in time, what it was I wanted moving forward and getting really clear on that. And that included what I didn't want. So I had to get clear on that as well and then ask myself why I wanted that because that was going to be the motivation to help me push through the difficult moments as I was looking for a new career path. And I helped my clients with that power of the pause as well.

John: Nice. Well, I got to write that down, the power of the pause. I'm going to tell my listeners a secret right now. Actually, I've never discussed how I prepare for an interview before, but I want to discuss it now with you here because I'm going to ask you probably at least a few questions that the audience will be like, well, where did those come from? And so I'm just explaining to my listeners that when I'm preparing, some of my cohorts that do podcasts just wing it. They just know what they want to talk about when the guest comes on and they just do it. I'm so, I don't know what you'd call it, maybe insecure or is it just compulsive, obsessive compulsive?

I have to do a little research and so I'm looking at Michelle's website and I'm looking at Michelle's LinkedIn profile and so then I see these things out there. And so that's why I'm going to ask, for example, the next question. I think you may have already answered this question, but this is, I just want to let the audience know why I'm maybe being a little redundant, but you talk about getting clear on what's working, what's not working and what's missing from our lives.

That's kind of something a coach does, I think it helps their clients. And you're talking about the pause, is that when you're doing that getting some clarity or am I looking at something different there?

Dr. Michelle Bailey: No, I think you're absolutely right, John. So taking the time to pause is what allows you to have the space created to get clear. For many of the physicians that are looking to make a transition from clinical practice, they often are feeling very burned out, they're feeling low energy, exhausted.

And so from that space, if you're really just looking for how do I get out, your search is going to be driven largely by fear. It's like this sort of desperate energy of, I don't know what I'm going to do, but I got to get out of here, I got to do something. And instead, what I'm encouraging is to take that time to pause and give yourself a little breathing space to say, okay, I know I don't want to continue to do this indefinitely, it doesn't feel sustainable for me.

Given that, if I knew everything could work out well, what is it that I would want to do? And why do I want to do that? And taking the time to get clear on those things instead moves you into this energy of sort of positive momentum to move forward. It's a focus on where you're going rather than what you're running away from, you know? And I've seen how that makes a difference because I've had some physicians who've come to me after they've made a transition, but they didn't really think it through. They saw someone that they knew made this move into a different industry.

They thought, "Oh, they look happy, that's what I'm going to pursue." And so they do and they get an offer and they're thrilled about that. Everybody just wants to get their foot in the door, but only to find that this isn't a good fit for them based on the season of life and career that they're in and what it is they want.

For me I'm not afraid to tell my age, but I'm at a different stage of life. I'm 57. And so I have grandkids. I want to be able to travel with my wife. I want to spend time with my grandkids. I want to pick them up from school or go on field trips with them.

It was important to me that whatever I did next allowed me location independent work and also allowed me to be able to have a flexible schedule so that if I needed to go and pick up my grandson from school, I could do that without feeling stressed out about it. So you have to just get clear on what your priorities are and what your values are.

When I work with clients, I have an exercise I do with them to help them get in touch with what their core values are now. Because the person that we are when we embark upon this journey in medicine is not necessarily the same person we are now, depending on how much time has passed. Like most of us are young adults when we're starting out on this medical journey and life happens along the way. And so being clear on where you are and what's important to you and where you want to go will really help direct your path towards something that's going to be a better fit for you.

John: Boy, how long would you say the average client that you've spoken with or even people you've even just mentored, how long does it take to figure that out do you think normally? Because many of us have this sense that we don't know what our passion is. We don't know what our purpose is. We don't really know what we like and we don't like. We just barrel forward and do our job because that's what we'd spent 15 years of our lives learning and it's hard for us to stop and even come up with answers to those questions.

Dr. Michelle Bailey: Yeah, it varies quite a bit. I will say the physicians that have the fastest results in terms of finding that next step career in the nonclinical world are the ones that already come with a degree of clarity. They have made the decision. There's no ambivalence as to whether or not I want to do this. It's like, I've decided I'm going to leave clinical practice. I want to pursue a nonclinical career.

I don't know exactly what, but this is what I'm thinking of because I like X, Y, and Z. And so that the more clarity you have, the more accelerated I would say your journey is in terms of the transition. But for some people who haven't really given it much thought, the questions that we go through are very deep and reflective questions and it can take a good six weeks for them to really figure out, okay, this is what I want and this is why I want it.

But then there's another step of giving yourself permission to actually go after what you want. There's a lot of guilt and other uncomfortable emotions that can arise in thinking about making the transition. I feel like I'm going to be abandoning my patients. I don't want to abandon my partners. I don't want to leave them in a lurch. My family won't understand.

I may have to change my lifestyle if the salary that I get for nonclinical position is less than what I've had as a clinician. So there are all of these variables that come into play and I do think it's really helpful when you have a coach that can help hold space for you to work through some of that because you don't want that to be the barrier that keeps you stuck for yet another year and you're miserable. Life is just too short and too precious for that.

John: Well, if I was going to engage a coach, that would kind of be the thing. That's why I would do the engagements. Like, okay, I don't like what I'm doing. I'm not satisfied. It doesn't mean I'm burned out or whatever. I'm just it's just no longer what I want to pursue. And I really can't figure out, I would engage a coach to do that. So that makes perfect sense. that's kind of a core addition to the process that you have. So can you give us like just a glimpse as like what you said, you had either like some method or some tool or something to help people tease that out. Just an example would be very helpful.

Dr. Michelle Bailey: Yeah, sure. So one of the things that we do is to explore like what's important to you now so that you can figure out what are some of the non-negotiables that you will need in this next career. So for example, like I have one client that I'm working with now, and it's important to her to be near an aging parent so that she can be a support to them.

And so she is really looking for an opportunity that allows her to stay in her geographic region for work. She knows through this exploration that it's important to her to have social connections around work. So as much as some people think, oh, I would love to just work from home full time, it is not for everyone.

And so if you need that social stimulation and connection on a regular basis through work, then you may need to have an opportunity that is office-based or at least hybrid. Where certain number of days you're going into the office and then a certain number of days you're working from home. So these are the kinds of questions that I will ask a client so that they can get clear on what's really important to them. And that sort of builds the scaffolding so that they know this is the container. Like I have to have this and I have to have that. Those are my non-negotiables.

Now with that in mind, what kinds of opportunities would fit into that? Because often we're doing the opposite. We're looking for an opportunity and then seeing how we can fit into that opportunity instead of the other way around.

John: I'm such a practical person at times. I have to ask this question. So what I would do, it could be a little overwhelming. There's lots of things that I definitely do want and a lot of things that are like absolutely not. And so they develop maybe even a checklist so that when as they're looking at job descriptions or they're talking to recruiters or whatever, it's like, okay, I got to make sure that we got these five are in and these five are definitely out of this job.

Dr. Michelle Bailey: Yes, absolutely. And it kind of helps you create a matrix that you can work from. And even for you, like if you were thinking about doing something different, for example, I would start by saying, well, John, just write down like top of mind, the first 10 things that would be important to you in your next career, in this next opportunity.

And sometimes when people are asked that question, they're not able to write down 10 immediately. So that's not an uncommon thing. But what I would do is continue to ask yourself, it's like, okay, if I'm not so clear yet on what it is that I do want, let me start with what I don't want and write that out.

Let me get clear on that. For me, as an example, I was really clear that I did not want a job with a long commute because that's what I had in my clinical work. My commute was easily 40 to 45 minutes, an hour plus if the weather was inclement.

And so, it's like, well, I need a commute that's 15 minutes or less because I want to be able to maybe even go home for lunch. So starting there can help you gain that clarity that you need for what it is you do want. And thinking about like what would an ideal schedule look like for you? What hours would you be working? Would you be sitting at a desk or would you be doing something that's more interactive with people on a day-to-day basis? So these are the kinds of questions that you can ask. And I've developed some tools that I use with my clients to kind of help guide them through that process.

John: Excellent. I think that gives everyone a pretty good idea how that goes. And I go back probably about the time when I was speaking with you the first time on the podcast, like just have an episode with a coach about why coaching is so beneficial.

And because there's a lot of resistance to coaching. I see it all the time. And people call me or they ask for advice and it's like maybe you just need to sit down with a coach for a few weeks because I don't do coaching. And I'm not going to answer your question in a short email. But they're like very reluctant at times. But so that's a good refresher and a good look into coaching.

Now, I had on my list too, I wanted to ask you about what new revelations have you had about coaching in the last five years? Is there something new about coaching or just have things evolved in terms of where we are as physicians in the whole milieu of the healthcare system itself and different forms of employment?

Dr. Michelle Bailey: Yeah. Let me start off by saying, I believe in the power of coaching. And so I have my own coach. I'm a coach, but still I have my thoughts and beliefs that at times can be limited. And so one of the things that's valuable in working with a coach is having someone to help you see different perspectives. I will say that I have noticed that there seems to be an increase in thinking about working with a coach. Like you, I've been in a lot of Facebook groups and other social media groups where I saw a fair amount of bashing of coaches.

John: Oh, really?

Dr. Michelle Bailey: Yeah. And I think there's some that really feel like there are people who are out there who are presenting themselves as coaches that don't have any training, that don't have any background and are really just looking to take advantage of physician colleagues. So I'm not a proponent of that. However, there are a lot of us physicians who have gone on to do additional training in coaching.

And there are different types of coaching as you probably know, John there's executive coaching for people who are trying to get into executive level positions who want to do hospital administration or maybe go into the C-suite for an organization. There are life coaches, there are career coaches. So there are different sort of specialty areas, if you will.

And for me, career coaching was the likely choice because people started reaching out to me to ask me to help them with their own transition because I was speaking so visibly about my own journey and how I didn't have as much support as I would have liked back then and thought something was wrong with me because I wasn't happy doing what I was doing. And so I do see that more physicians are reaching out for some support, that many of the challenges that I hear when I have conversations with physicians about their career, is they're feeling a bit stuck and unmotivated. They don't know what they would do next if they were to transition.

If they decide that they do want to transition, they don't know where to start or how to sort of get their foot in the door. And it's feeling not as easy to make the transition for a lot of physicians as it was previously. And I can say that certainly there are changes within the industry that are reflective of the economic state of the region that you're living in that can make a difference.

But even at times where we've seen a downturn, where there were fewer jobs available, there's always someone somewhere that is hiring. And so one of the most powerful things that you can do to enhance your own career and raise the likelihood that you can accelerate your transition is networking. And I get a lot of eye rolls when I say that. It's kind of like role plays when we were in medicine and we were learning a new skill and they were like, okay, we're going to do a role play. And everyone's eyes would kind of glaze over because no one enjoys doing it. But it is an activity that helps you develop a skill and get better at it.

And networking is one of those things. And the way I sort of talk about it is if you're looking for an opportunity for yourself, you are one set of eyes, one set of ears. But if you are telling other people what it is you would like to do, then you get more sets of eyes, more sets of ears.

It's kind of like boots on the ground that are going out like little sentinels that are looking on your behalf. So when something comes to their attention, they can think about you and reach out to you. So you want to stay top of mind for people. And that's one of the most important reasons for networking. Plus you learn about other things that people are doing that you otherwise might not be aware of.

John: Yeah, I just have a comment on a couple of things you said just to actually emphasize those and support what you're saying. Number one, most physicians would probably be shocked to know how many hospital CEOs still get coaching. There's so many people in business that get coaching.

They just see it as part of the job because they want to be cutting edge. They want to think strategically and they get a lot from the coaching. So that's one thing I, again, that kind of just because of this resistance that physicians have like, well, I've gone to all this school.

Well, that's not the point. And then the networking that's, there's so many it's not like you're going to a meeting and then having some drinks after the meeting and a conference room and you're networking. Nobody likes that really, at least physicians don't have time for that.

But to connect with people, whether it's through LinkedIn or through word of mouth or whatever, like you said, it just magnifies what you're doing. It just makes it so much more of a reach and exposure. So, yeah, it seems like that's becoming more important since we last spoke.

Dr. Michelle Bailey: Absolutely, yeah. I think, as you mentioned, CEOs and other executives, this is just a part of the job. And often they are provided with a coach at the expense of it's charged to the company. And coaches are really valuable in helping you with a strategic plan so that there's some organization to what you're doing. And you're not just like throwing things at the wall to see what sticks. Because that burns a lot of time and a coach can really help you be more efficient and more organized because you're thinking in a more strategic manner.

John: That is so true. And I love hearing that. Okay, we're going to run out of time pretty soon, actually. I had this long list of questions, but let's try and kind of focus here. What else have you got to tell us that really can be useful? I know we were talking before we got on about making changes and I was thinking, well, that could be useful not only in career transition. I don't know if we've touched on that yet, just how to implement those changes in your life or other career tips or transition tips, anything like that that you think would be helpful.

Dr. Michelle Bailey: Yeah, I think there are a few skills that really lend themselves to making change. One is decision-making. I didn't give this too much thought before I started working with a coach, but then I realized I have an approach to how I make decisions.

And I'm one where I need to have all the information. I want to see it all laid out so that I can weigh all my options before I make the decision. And there's this saying, how you do anything is how you do everything. And I noticed that that wasn't just showing up with big, important decisions. It was little decisions, like what entree I wanted to eat when I went out to a restaurant at dinner.

And my wife is like, pick one. I'm asking all these questions of the server to try and weigh my options. Which am I going to enjoy more? So decision making is a skill and I think it's one that can really lend itself nicely to helping you when you want to make change in your life. I think another skill like that is, well, I call it a skill, but self-confidence.

So belief in yourself. I said earlier during our conversation that physicians can do hard things. It's just part of our training and we're really good at figuring things out. I often remind the physicians that I'm coaching that they can do hard things and that they can figure it out. And it's okay that you haven't done this exact thing before. You have what it takes to be able to do it. And so your own self-confidence plays a big factor in how successful you may or may not be in doing things in your life when you're ready to make a change.

John: Okay. No, that is also, and people, I think if they recognize that maybe they don't feel that they're portraying themselves as not confident, but if they're doing it and not realizing it, then maybe they just need to step back and say, okay, let's stop and think about what I'm doing and saying, and then let's see if I can just portray myself as I really am, which is a confident powerful person that definitely can handle this new job.

Dr. Michelle Bailey: Right. And I'll tell you one way you can know if you're lacking in confidence is the action that you're taking or rather the action you're not taking. So one of the things that I do see is for a lot of physicians, they are doing what they feel is taking steps to transition, but it's honestly a lot of busy work.

That's not really putting themselves out there because they're either afraid of rejection or they're having that self-confidence issue. And so when I ask very concrete questions, like how many applications have you submitted in the last week? And they say, well, none. So being able to really look at some concrete metrics for yourself and focusing on what you have control over. So you don't have control over whether or not someone makes you an offer for a job, but you do have control over how many people you connect with to network, how many applications you're putting out there how many jobs you're exploring, like maybe reaching out to recruiters.

These are things that you have some control over and just take a look at whether or not the actions you're taking are things that will make a meaningful difference in moving your career search forward, or if it's just accumulating more information and more data, which isn't necessarily going to help you in that next step.

John: So true. Again, it's logical. But the thing is, too, if you apply to a lot of places, you're eventually going to get feedback. And then you're going to say, oh, I didn't know that was stupid of me to do that way. And you're telling me because I've now made a contact with this person, a recruiter or the HR department. And there's a lot of information you can get from that. And it doesn't happen unless you start to apply.

Dr. Michelle Bailey: Right. And the caveat is applying strategically.

John: Yeah.

Dr. Michelle Bailey: Right. Just applying for any job and using the exact same resume, the exact same cover letter isn't going to cut it. People are looking at why should we hire you over someone else? And so the purpose of your resume and your LinkedIn profile is to help them understand why they should hire you. Why would you be a good choice as opposed to someone else? And most of the folks within HR who are looking at the initial application to invite folks for a screening interview don't have a medical background.

They don't necessarily understand how you can translate the skills you already have into this new role. And as a result, a lot of physicians, when they look at the job description, feel like they're not qualified for these roles that they're interested in. And so that's where transferable skills come in. And I'm developing a resource that folks can use to help them identify those transferable skills and what positions would be really good, a good fit for those skills.

John: Okay. That's a good segue because this is going to be a chance to learn more about your website and contacting you. But I want to say one other thing, and I've probably forgotten it now. But anyway, I think it's, I had a guest once tell me that she, before she found her first nonclinical job, she literally had sent in a thousand resumes, but she was going to websites and putting it in. She had no contact with any company person. She never called anybody, never talked to anybody.

And so, it was just a black hole. These things were going into. And like you said, the other thing I remember was that the job descriptions are like what they would want in the perfect candidate. Here's everything we want. They never get everything they want. So don't think that that rules you out.

Dr. Michelle Bailey: And to that point, I would say there's a lot of research that's been done on gender bias. And men, when they look at a job description, if they have like a third of the qualifications will apply. Whereas women, if they don't check off all the boxes, are less likely to apply. And that may sound like a generalization, but there's a lot of literature that's been done to kind of back that up. And so I would encourage listeners to not count themselves out. And if you check all the boxes, you're probably overqualified for the position and it's not going to necessarily be a good fit for you. So look for something where you have a lot of the qualifications and you can move into that role and still have room to grow.

John: That sounds good. That's good advice. Okay. So how do we find you and tell us about your website and yeah. And maybe even if you want to do a little pitch to say, what is the kind of client you're looking for that would be ideal for you? We could give you that opportunity too. Just tell us about your website and stuff.

Dr. Michelle Bailey: Sure. Folks can find my website at drmichellebailey.com. You can also sign up for a complimentary career consultation with me. I love having conversations with physicians and hearing about where you are and what you're thinking about if you're considering a transition. And I'm happy to give you just some guidance on what might help. And for that, you can sign up at callwithmichelle.com. And then you can also find me on social media.

I'm on Facebook at Michelle Bailey, and I'm on Instagram at the Dr. Michelle Bailey. And I would say in terms of an ideal client that I enjoy working with and that I think I can help the most, it's someone who has been thinking about leaving medicine for a while, but they're still ambivalent. They're not sure whether or not that's the best course of action for them. And they have no idea where to start or how to figure that out. I think having just that complimentary consultation that I spoke of earlier is an opportunity to create that space where you can pause and reflect on where you are and where you'd like to be.

And I've had conversations with a lot of physicians who haven't gone on to be clients, but had that one consultation and came back to me and said that was so helpful because I got much clearer on what it was I wanted, or I learned that I'm actually not ready to leave clinical practice. I just need a different position within clinical medicine. And so I would encourage you to just think about that. But I'm happy to sit and chat with anyone who wants to have a conversation. I enjoy helping.

John: Very good. Now, I would definitely encourage people if they've been in this mode for the last six or 12 months, thinking about it and maybe even ruminating about it and just can't get it out of their mind, but I have not taken any action, you definitely want to reach out to Michelle and see if you can get off either fix the problem or move forward to the next thing. So that'll be very helpful.

There will be links in the show notes with all those, because it's sometimes hard to write those things down while you're driving. So just go to the website. At the end of the outro of this, then I'll put all that stuff there where you go to find all these links.

All right, Michelle, I will thank you very much for coming here today. But we really covered a lot of stuff that was very dense. Like you could write a book based on that.

Dr. Michelle Bailey: Thank you so much, John, for having me. I really appreciate it. And just wanted to say how much I appreciate all you do to support the physician community.

John: I love doing it. And it gives me a chance to meet people like you, which is really fascinating. And I like to see other people helping us, our colleagues who are suffering.

Dr. Michelle Bailey: Agreed.

John: Yeah.

Dr. Michelle Bailey: And impact is the most important thing for me.

John: All right. With that, I'll say goodbye.

Dr. Michelle Bailey: Bye, John.

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Be Creative And Flexible And Love Your Career – A PNC Classic from 2019

John Jurica — Tue, 14 Jan 2025 12:39:22 +0000

Interview with Dr. Helen Rhodes – 387

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

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

Early Clinical Career Opportunities

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

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

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

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

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Private Practice

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

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

Supplemental Income

Helen recognized the need to supplement her income in private practice to match her previous salary. After doing file review jobs, sales, and legal testimony, she finally landed on locum tenens work.

You've got to throw a lot of lines in the water. – Dr. Helen Rhodes

Initially, Helen had difficulty finding locum tenens work because she had been out of obstetrics for so long. However, with persistence and lots of time spent browsing recruitment sites and answering emails, she found work that enabled her to do prenatal care.

These unexpected opportunities encouraged Helen to be creative and flexible. And she continued to explore unfamiliar clinical and nonclinical options.

Business School

While managing her private practice, Helen decided to get her MBA with the goal of either entering administration or consulting. There she met several doctors from rural Kansas who offered her a locum tenens opportunity that would allow her to return to obstetrics.

That opened her eyes to the option of working out of state. After finding another opportunity in Kansas, Helen delivered her first baby in 13 years. So she pursued more out-of-state work, getting licensed in New Mexico. She ultimately found a rewarding, semi-permanent position at an underserved rural hospital there.

Be Creative and Flexible and Add Plasmapheresis

Soon, another business school peer introduced Helen to the world of plasmapheresis, where she became a medical director for a facility in Houston. She found the work stimulating and the compensation very reasonable. With a commitment of only 4 hours for any day that she worked, it fit well into her private practice and locum schedules.

Summary

Helen's story is a timeless one. Through her willingness to take risks, explore every opportunity, and work hard, she cultivated a successful, diverse, and rewarding career.

Most importantly, you just have to think outside the box. Look at many many opportunities…. Expect to get a lot of “no”s and don’t get discouraged. – Dr. Helen Rhodes

That's not to say that she hasn't experienced difficult times. She can certainly recognize areas where she would have done things differently. At its core though, her story is one of perseverance and the value of exploring every available option.

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Transcription PNC Podcast Episode 387

Be Creative And Flexible to Love Your Career

- A PNC Classic from 2019

John: Dr. Helen Rhodes, welcome to the PNC podcast. I'm really glad to have you here today. I always like to give my audience a little, let's say, preview as to why we're talking today. We met through a mutual friend and from what I know, you reached a point in your clinical career where you were, just needed to make a change for reasons which I think you'll describe. I thought your story sounds quite interesting and hopefully very inspiring. Why don't you describe a little bit about your background?

Dr. Helen Rhodes: Well, I did all my training in Texas. I grew up in Texas and I finished OB-GYN residency back in the early 90s, so that would be last century, I guess, technically, and was actually recruited by an academic institution here in the Houston area to do GYN only. And it was an academic position without any obstetrics, so I was pretty fortunate and it was very unique to have that opportunity right out of training, but I quickly discovered that I really wasn't ready for academic medicine.

I wasn't even 30 years old yet and so, after a couple years, I left that institution and worked in the Houston community doing full scope obstetrics and gynecology, various practice opportunities, multi-specialty group practice. I worked part-time, I worked full-time, I worked at a managed care group, and then, interestingly enough, about 10 years after doing that, I really was having difficulty with the lifestyle of obstetrics, primarily, and actually went back to the institution that I left 10 years earlier into the same position of GYN only and stayed there for almost another 10 years, but I always wanted to have my own solo practice and after my youngest finished high school, I made this big leap and left academic medicine again and started a GYN only solo private practice in a bedroom community south of Houston.

It was pretty risky to do that because it's really hard to start a private practice, especially mid-career with really no patients to follow you, starting it from the ground up, and not doing obstetrics financially, it was very challenging, so I started looking for ways to supplement my practice income, looked at clinical and non-clinical options, and did medical file review.

I actually, for a little bit of time, sold supplements in my office, did some testifying for legal cases, and got into locum tenens opportunities. Initially, just outpatient locum tenens opportunities because without doing recent labor and delivery work, I couldn't get any jobs in L&D anywhere, and there's really no retraining for obstetricians once you've stepped away from it for a couple of years. There's no way to get back into it. The American Board of OB-GYN doesn't have a formal retraining program. You really have to get lucky.

John: Helen, let me jump in there for a second. You were trying to get locums without the OB, and did you have any success at that, or was it pretty much a wash?

Dr. Helen Rhodes: I did have some success. I was able to do outpatient gen-like physicals for an underserved area in town. They weren't a federally qualified health clinic, but they were state-funded health clinics, so I was able to do that on Saturdays and some Fridays when I was not seeing patients or in the operating room.

I did that for a while, and I just got an hourly rate and saw the patients that they had scheduled. They weren't my own patients. I also was able to get an outpatient job with Texas Children's Health Plan, which is affiliated with Baylor College of Medicine, and did OB and gen, so that was good.

That way, I was starting to at least see obstetrical patients in the outpatient setting and relearn prenatal care, high-risk prenatal care, but at that point, I wasn't able to do anything in labor and delivery. I did have some success.

John: How easy is it to find locums? Is there a clearing house? Is it word of mouth? Do you just go on Google? How do you even start to look for positions like that?

Dr. Helen Rhodes: You have to throw a lot of lines in the water. You get on a lot of the recruiting sites and submit your CV, answer a lot of emails, texts, phone calls. I had a lot of dead ends because of the lack of recent labor and delivery work.

John: Okay, so that was a challenge.

Dr. Helen Rhodes: Yeah, very challenging.

John: Now, as you were going through this too, you started your practice. Was the issue in terms of the gross revenues or what have you, was it the fact that it was a startup or did you look and say, even when I'm busy, this is not going to be something that is meeting the financial levels that I think I need?

Dr. Helen Rhodes: Yeah. I think there's a lot of reasons that the revenues weren't where I wanted them to be. I had come from this academic salary and that was my benchmark. It was a pretty high benchmark because once you're in solo practice, you don't have anyone paying your benefits or contributing to your retirement or paying your liability premiums, etc., etc. That all comes out of your revenue. You can either do a couple of things.

You can see more patients because we are reimbursed per patient in this fee-for-service world of OB-GYN. We're primary care, specialty care, stuck in between. I had already lived that life of seeing lots and lots of patients and not getting to spend time with patients.

When I started my practice, it was very important to me to spend time with my patients. I wasn't seeing the volume that I was seeing before and I didn't want to see the volume I was seeing before. The overhead is higher and because I wasn't increasing my volume and doing tons and tons of surgery, my revenues were less.

John: Okay. You're looking at locums. You're trying some different things out. Take us down the next few steps in this process.

Dr. Helen Rhodes: It's an interesting story. For some reason, I wanted to go back to school and learn business. I did a hybrid program where we spent four residential sessions over an 18-month period and then did online coursework, lectures, projects. I did that between 2015 and 2017 through a business school and connected with some really innovative healthcare leaders in my class and the class ahead of me from rural Kansas. Until I met them, really my search for locums work had been confined to the state of Texas because that's where I had my license. One of the individuals that I met through the business program said, hey, we would love to have you come to Kansas.

Kansas is not that far. It's a couple hours. I ended up getting my medical license in Kansas. Well, that opportunity with my business school colleague fell through for various reasons, but another Kansas opportunity came up through one of the locums recruiters that I had been working with. This time, even though I hadn't delivered a baby in 13 years, the little hospital in the middle of Kansas said yes, and off I went. I did my first delivery in 13 years.

John: Oh, boy. Yeah. What was that like?

Dr. Helen Rhodes: I was very nervous. Very nervous. Of course, it happened at three in the morning, and I didn't have much time to get to the hospital and think about things, but that was the beginning of thinking outside the box in terms of, wow, if I can go to Kansas, I can go to other places too. I eventually got my license in New Mexico, and there's lots and lots of work in underserved rural areas of New Mexico, so one of those opportunities has actually turned into a permanent position.

John: Okay.

Dr. Helen Rhodes: Yeah.

John: So there was a locums opportunity in New Mexico?

Dr. Helen Rhodes: Yes.

John: And was it another sort of a smaller type location or?

Dr. Helen Rhodes: Yeah. It's definitely rural. It's about an hour south of Albuquerque, and the hospital is a critical access hospital, so by definition, it has less than 25 beds, but they have a very unique model for taking care of their OB-GYN patients.

There's a certified nurse midwife who lives in the town and knows all the patients on our service, and then there are four board-certified OB-GYNs. I live in Texas. Two others live in other parts of New Mexico, and the fourth actually lives near Washington, D.C. Yeah. So between the four of us and the nurse midwife, we cover the service. So I go there for just under a week, once a month. This small hospital is actually affiliated with a larger healthcare system in New Mexico, one of the bigger systems, so is able to keep things running because they they're a small hospital within a big system, so they can achieve economies of scale, et cetera, et cetera, from the business perspective.

John: Okay. Now, are you still balancing that with the other clinical activities in your private practice at home?

Dr. Helen Rhodes: I am. Because I don't do OB in my private practice, it's pretty easy for me to leave. As long as I feel like I can get all my patients seen in a timely manner here and get the surgeries done, it's really not a problem to leave and go work in New Mexico once a month. And having an electronic health record that I can take with me, essentially, as long as I have internet access, I can communicate with my patients here, check their lab results, communicate with my staff. I have two employees. Things keep running even when I'm not here. So it's wonderful.

John: That makes me think of, and I don't know if this is even doable, but would it be possible to do some kind of telehealth, telemedicine? Are there certain types of things that you could do? I've never talked to an OB about that.

Dr. Helen Rhodes: Yeah. So I've actually been talking about this with my office manager and my nurse that there are certain types of patient appointments that I think would be very amenable to the telehealth platform. It just became legal in Texas.

We really haven't had a lot going on with telemedicine until very recently. Some of the bigger hospital systems are now doing it and I'm looking to see kind of how they're doing it and to see if I can incorporate that into my practice. But I see a lot of young girls that I start on contraception and then they go off to college.

And I really like to see them two to three months into that rather than waiting for them to come home during the summer, the holidays. And so telehealth would be great because in the evenings or while I'm in New Mexico, or when I'm not seeing patients here, I could have a quick tele-visit with them or telehealth visit with them and see how they're doing. Similarly, my post-op patients, they could take a photograph of their incision and I could look at it and do a telehealth visit. Those are the two types of visits that I'm looking into for telehealth.

John: It wasn't that long ago I talked to an orthopedist and he came to realization because he was off visiting someone else. He happened to have a patient in the town who was a hundred miles away from where he did surgery. And while he was there, he just went to visit the patient to look at his wound.mAnd then when he got back, he said, this would be perfect for telemedicine. That was three or four years ago. So now that's what he does because he has such a large drawing area. He's a pediatric orthopedic surgeon. So he does a lot of his follow-up visits with telemedicine. So that'll be interesting.

I'll have to follow up with you down the road and see how that pans out. But you're doing some other things, right? Aren't you into something that is a non-clinical or it's sort of clinically related, but not patient care? Tell us about that and how that fits in.

Dr. Helen Rhodes: When I was in business school, I really had two main goals. One was to learn more about the business side of medicine and possibly go into administration. And the other was to teach others what I learned or become a consultant regarding healthcare economics, et cetera.

I found out from a friend of mine who actually, she's an OB-GYN that went back to law school about the time I went to business school. And she had told me about the plasmapheresis industry, whereby they hire physicians to be the medical directors for each of the plasma centers. So when I initially heard about that job, which was a couple of years ago, I wasn't very interested. I didn't think it was a good fit. But then after I finished my business school education, I thought, wow, this is, now I understand more about operations management, working in teams. So this might be a good fit. I ended up doing that to help supplement my income. And I really enjoyed it because it's completely different from clinical medicine. You deal with a lot of federal regulations and guidelines for the industry.

And you're dealing with a population of individuals that are extremely impoverished for the most part, don't have access to healthcare. And really your job as medical director is to make sure that the donors are eligible for plasmapheresis, that they're healthy, and also to keep the medical operations team credentialed. There's very specific credentialing that's required by the FDA and industry regulations. And you're responsible for that. And you're also responsible for medical education of the medical operations team. So it's very interesting work. Since I've gotten so busy with the work in New Mexico and other places, I've had to cut back on the medical director work. And I'm now a backup director for a couple of the centers around here.

John: Do you have a sense for how much demand there is for that kind of a position in case someone might be thinking, well, this is interesting?

Dr. Helen Rhodes: There's a lot of demand. There's several companies throughout the United States. It's not just one company. And they pay an hourly rate. The training is paid. They pay for your mileage.

The commitment is four hours a week. I know one person in our group, I believe she was a pediatric emergency room physician. She's given that up. And now she handles five centers in the Houston area. She's a medical director for five centers. But essentially, she's working five, four-hour shifts a week and making good money. And she doesn't have any overhead. She just drives from center to center and takes care of her responsibilities and has a lot of time with her family.

John: Sounds very nice.

Dr. Helen Rhodes: Yeah.

John: For you, how does that compare, let's say, to the various clinical things you're doing? I mean, just from a payment standpoint without giving necessarily an hourly rate. But I mean, when you had the time, it was definitely worthwhile doing.

Dr. Helen Rhodes: Yes. Yes. I actually first took on that position because I had a small business loan for my practice. And I had this goal of paying it back in a certain amount of time. And that's why I originally took the position. Because all the money that I was earning from being medical director went directly to the loan repayment.

But then once I paid it off, it was a nice little extra check every month. But yes, I think the compensation for that work is very fair and very comparable to what you would earn in a clinical job.

John: Without any call?

Dr. Helen Rhodes: No call. And you only work four hours a day. I mean, there's nothing else. There's only so much you can do there. Now, I don't know anyone who's doing more than a four-hour shift. I don't think they allow it. But four hours is plenty. It's a very different kind of work.

John: You have to be very focused, very meticulous in doing that?

Dr. Helen Rhodes: You have to be focused. Yeah. You're basically reporting to the center manager and to the quality department. And it is a very tightly regulated industry. As it should be.

John: Yeah. It falls under the FDA, does it? Basically, the regulations?

Dr. Helen Rhodes: Basically, the plasma that's collected is actually sent over to various centers in Europe. Depends on which company you're working for. At one point, I was working for two different companies.

And one of them had a processing plant in Spain and the other company had a processing plant in Germany. And so in Europe, the plasma is made into pharmaceutical products, which are then sold back to the hospitals here in the United States. They also make a lot of vaccines, as well as fresh frozen plasma and all the clotting factors.

John: Okay. So, it's a pharmaceutical business, definitely. Now you've kind of reached, it sounds like at least for now, a point where you seem to have a balance. You've got some stability. The private practice is pretty stable. You're thinking maybe of adding telemedicine if it works out. And you have this pretty stable situation. It used to be locums, but now you're employed or it's more of a stable situation with the New Mexico practice. And you're working with three other physicians there. So how do you feel?

Dr. Helen Rhodes: I feel great. I feel great.

John: You're still glad you left that group?

Dr. Helen Rhodes: Which one?

John: Whichever group. The original, the one 10 years later. You don't look back and go...?

Dr. Helen Rhodes: No, no. I think I love the autonomy most of all, because I'm doing exactly what I want to do. There's things obviously I can't control. I can't control what I get paid by the insurance companies for the work that I do for my patients, but there's so much that I can control. And it's very rewarding when I go to New Mexico because I deal with some very underserved women who really have limited to no access to quality care. And it's great to be a part of that team. And I get to be in the mountains once a month. I live by the shore here, live by the beach. So I get the best of both worlds. I get to travel and I love it.

John: When you go and you're in New Mexico, I'm assuming that the organization, the hospital, the clinic, whatever, and the patients are happy to see you, right? They don't take you for granted, don't yell at you because you're five minutes late or anything like that?

Dr. Helen Rhodes: No. I feel very appreciated. I actually am developing my own kind of practice within a practice there. I have patients that wait for me to come and they're my patients. And then we all take care of the obstetrical patients, but the surgery patients, I'm starting to do some surgeries there. They're very excited about that.

They've worked with me in terms of which equipment I need. And there's a general surgeon actually that comes two weeks a month. He actually lives in Florida. He was doing what I'm doing now. He had his practice in Florida and he was working at this hospital in New Mexico. And then he decided to close his practice. Basically he works two weeks a month and has two weeks a month off. And he's very happy. But yeah, I feel appreciated. I have friends there. I have an apartment there. I have a social life there. And the climate is so much better than what I have here. There's no humidity there.

John: Well, okay. What kind of advice would you have for physicians who are kind of plugging away and maybe they're unhappy or they're frustrated or they're actually burnt out or whatever?

Dr. Helen Rhodes: Yeah. I think most importantly is you just have to think outside the box and look at many, many opportunities and cast many lines in the water and expect to get a lot of no's and don't get discouraged. Cannot underestimate the power of networking and mentorship.

That's so important. To connect with another professional that's doing what you think you'd like to do and brainstorm with them. I've been doing some mentoring of individuals who are burnt out. I've been helping a couple physicians transition. We can help each other. Don't give up your licenses. You hear a lot, people step away from it for a couple of years and then they go back. I think it's wise to keep your board certifications and keep your licenses active. And for an OB-GYN, I would say don't step away from OB for too long because it's really hard to get back into it.

John: Even if you were doing, let's say, OB maybe temporarily for a few months each year somehow, or backed up other people one week, a quarter. I mean, would those things you think would keep it up enough to satisfy the hospitals?

Dr. Helen Rhodes: Yes. I think doing what I'm doing, because I'm not only going to New Mexico, I'm still doing weekend locums at other places in Kansas and Texas. And there's such a need right now, especially in OB-GYN, especially in rural areas. They don't have enough doctors and there's lots of opportunity where you could do it one weekend a month. To keep your skills up. It's very feasible.

John: Now, I'll digress for one minute on the locums. Do you find that there's much flexibility in your ability to negotiate? I mean, I've heard horror stories of someone saying, well, they're only going to pay this much and turn around and found out they would pay like almost 50% more than that if you just asked or kind of held to your guns.

Dr. Helen Rhodes: Yes. We are terrible negotiators as physicians. It's very important to learn that you are really in the driver's seat. You are providing the service that they need and want. So, don't be afraid to negotiate for what you want.

John: Okay, good. Good. That's what I have heard, but I've never done locums, so I don't know how aggressive one can get. But if you have information, if you've done it at other places, at least it gives you some benchmark. But if you're going in for the first time, you probably have no idea.

Dr. Helen Rhodes: And it's best if you can negotiate directly with the hospital system, if possible, and not through a recruiter. That's pretty difficult to do because of liability. Usually the recruiting company is going to pay your liability, which for OB is kind of high. It is high. But if you can get the middleman out of it and directly negotiate with the hospital, you're going to get a much higher rate of pay.

John: Awesome. That's good to know. Well, this has been very inspiring and very interesting and helpful for everybody. And you talked about you mentoring a few people. So if somebody would like to reach out to you just for a question or something, shall we use the LinkedIn? I know you're on LinkedIn.

Dr. Helen Rhodes: LinkedIn is great. Or my email address is hrhoads62@att.net. And I'm happy to communicate with people who are interested in my story and how I can help them.

John: I think especially people in your specialty everyone kind of naturally wants to hear it from someone that has had a similar training and background. So it's good to if there's someone who's doing OB out there that might be struggling, then hey, why not reach out? Like you said, networking is awesome. Mentors are great.

Dr. Helen Rhodes: Absolutely.

John: All right, Helen. Well, I really appreciate the time that we spent together today. And we'll have to keep in touch. And you can let us know if you ever get that telemedicine going or anything new that comes in with your practice. But thanks again so much for being here with us today.

Dr. Helen Rhodes: Thank you very much.

John: Hey, you're welcome. Bye-bye.

Dr. Helen Rhodes: Bye.

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Now Find Happiness and Meaning with The Purpose Code

John Jurica — Tue, 07 Jan 2025 13:46:18 +0000

Interview with Dr. Jordan Grumet – 386

In this podcast episode, John interviews the author of The Purpose Code, Dr. Jordan Grumet.

As the host of the Earn and Invest Podcast and a physician-turned-author, Dr. Grumet combines insights from his hospice patients with his own experiences to offer fresh perspectives on finding authentic purpose and creating lasting impact. His new book, “The Purpose Code: How to Unlock Meaning, Maximize Happiness, and Leave a Lasting Legacy,” challenges traditional views about purpose while providing practical guidance for those seeking greater fulfillment.

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We're proud to have a NEW EPISODE SPONSOR: Dr. Armin Feldman's Prelitigation Pre-trial Medical Legal Consulting Coaching Program.

The Medical Legal Consulting Coaching Program will teach you to build your own nonclinical consulting business. Open to physicians in ANY specialty, completing Dr. Armin Feldman’s Program will teach you how to become a valued consultant to attorneys without doing med mal cases or expert witness work.

For more information, go to nonclinicalphysicians.com/mlconsulting or arminfeldman.com.

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

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

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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.

Redefining Purpose for Modern Life

Dr. Grumet introduces a fresh perspective on purpose by distinguishing between two distinct types: “Big P” and “Little P”. This approach challenges conventional wisdom about how we view and pursue purpose in our lives.

Through his research and personal experience, he explains why pursuing Big P purpose often leads to anxiety and frustration, while Little P purpose offers a more accessible and fulfilling alternative that anyone can implement.

The Path to Lasting Impact

Drawing from compelling real-life stories and evidence-based research, Dr. Grumet demonstrates how small, meaningful actions can create profound and lasting impacts. His insights reveal why some of our most significant contributions may come not from grand ambitions, but from authentic engagement in activities that naturally resonate with us. And that often leads to unexpected but meaningful legacies.

Summary

For those seeking guidance on finding meaning and happiness while building a lasting legacy, “The Purpose Code” is available at Dr. Grumet's Website and major booksellers.

Dr. Grumet's approach offers practical tools for creating a more fulfilling life by reimagining how we think about and pursue purpose. This is particularly relevant for professionals experiencing burnout.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 386

Now Find Happiness and Meaning and The Purpose Code

- Interview with Dr. Jordan Grumet

John: I'm pleased to welcome a fellow physician podcaster to the show today. He's an internist, hospice medical director, and an author. Actually, that's why he's here today for the most part, because he has a book coming out called "The Purpose Code: How to Unlock Meaning, Maximize Happiness, and Leave a Lasting Legacy." So that's coming out right as this is being released, actually. So with that, I'll say hello and welcome, Dr. Jordan Grumet.

Dr. Jordan Grumet: John, thank you so much for having me. I'm excited for this conversation.

John: Yeah. And my listeners may know you if they listen to earn and invest podcast or have seen that, you know, that term out there, then they're already familiar with you. But I think probably there's many people that haven't either met you, seen you, or even read your previous book. So we're going to get into it right now. But let's start by you telling me and the audience a little bit about your medical training and experience and kind of what you're doing right now, everything a little smattering of what you do.

Dr. Jordan Grumet: So basically, at the age of seven, my father was 40 and he was an oncologist, and he died suddenly from a brain aneurysm, was actually rounding at the hospital. And right then and there, I decided I want to be a doctor. I think part of it was that I think I could cosmically fix this wrong that happened, this trauma that I went through, by walking in his shoes and fulfilling his role. And that's exactly what I did. I went to college and medical school with the certainty that was my sense of purpose, that was my identity, that was what I was going to do. Did my training in internal medicine, and basically after a few years of practicing, really started to burn out. I realized that maybe this was my father's sense of purpose and not mine. There were things I loved about medicine, but the paperwork and the feeling like sometimes you weren't making a difference and the long hours started to grate on me. And I started looking for a way out. And strangely enough, at the time I was writing a medical blog, and this guy named Jim Dally wrote me, and he said, "I just came out with this book called 'The White Co-Investor.' Would you review it for your medical blog?" I reviewed it. I learned about financial independence. I realized that my parents had given me great modeling when it came to money and probably was already financially independent. I was very emphatically joyful for about a moment because I could leave medicine, the thing that was burning me out, until I realized that I had no idea who I was or what I wanted to do.

And that basically started a long road where I got rid of everything in medicine I didn't like except hospice care. I was doing it almost as a side hustle, and I loved it. So I kept that and started doing it 10 to 15 hours a week. But because I was only doing that 10 to 15 hours a week, I had all sorts of time and I started blogging about personal finance because that's what got me there. Eventually it turned into a podcast. And what was really interesting is I'd have on my podcast all these authors, entrepreneurs, people who are making lots of money. But when I asked them about what enough look like, or why they were doing what they were doing, a lot of them couldn't answer. And I was finding the answers from my dying hospice patients who could talk about regret and what was really important to them. So I wrote my first book called "Taking Stock," about what the dying could teach us about money and life. And one of the big questions, or one of the big premises of that book was that we should put purpose before we build the financial framework. I went out to market this book and I got all sorts of angry people saying, "You keep on saying find your purpose and I can't find it. I've been looking forever. It's pissing me off. Please stop saying this." So I did a deep dive into purpose and I eventually wrote the book, "The Purpose Code," to answer all those naysayers who are having what I call purpose anxiety, this idea that they can't figure out their purpose and they don't know what to do. I found a lot of us people are in that exact place and I wanted to answer that question: How do you "find your purpose?"

John: Well, yeah, I mean, that is a very common conundrum for some of us. I mean, you talk about mission or the meaning of life, purpose, sometimes what's... yeah, I don't know. There's all kinds of terms people use and they're like, "I just, it seems like it's something that should just flow from my heart, it should just be obvious. Why should I have to look for it? It doesn't come to me naturally." So I think this is going to be really good, a good book. So we're going to dig into that a bit, and the fact that you have this history in hospice is awesome too. I mean, like you said, where else to really learn about, but at the end of life, you know, the purpose and meaning of life, which you address everything in the book, 'cause I've had access to it for a little while. So I appreciate that. So was it just obvious after the first book? When did this decision to actually write a second book and to focus on this area, how did that come about?

Dr. Jordan Grumet: Well, after having people come up to me angry at the end of conferences and public speeches about this idea that they were angry that I was telling them to find their purpose, I did a deep dive and I found two things that seem to contradict each other. The first was there are tons of studies about purpose in life and it's been shown to increase health, longevity, and happiness, like really clear studies, tons of them. But then I found other studies that show that up to 91% of people at some point in their life have what's called purpose anxiety. This idea of purpose makes them frustrated, angry, depressed. And so the question is, how can purpose be the most important thing, but also cause us so much unhappiness? And the answer is that we get purpose wrong. We usually think of it as one thing. It's probably two things. And one of those things is probably much more associated with that anxiety, and the other is probably more associated with the health, happiness, and longevity. But the problem is most people go after that more toxic version of purpose because society has told us that that's what we should do. I call it big P purpose. It's big, audacious, goal-oriented purpose. And from the day we're born, we are sold this idea that that's what we're supposed to base our life on. And so it leaves a lot of people feeling frustrated when they can't find that one thing that's supposed to make everything better.

John: So distinguish the Big P and the little P, since you mentioned that. I mean, so how should we go about searching for our purpose and distinguish those two things?

Dr. Jordan Grumet: So big P purpose is that toxic purpose and it's big and audacious. And if we think about America, it's this idea of you can think it, you can build it. And so often this kind of purpose is really huge. Like "I'm gonna become a billionaire, I'm gonna cure cancer, or I'm gonna have an eight-figure business." The problem with that kind of purpose is you got to be the right person at the right time saying the right things with the right genetics and a whole lot of luck. So big audacious purpose or big P purpose is easy to fail. It's all or nothing. You either succeed or you fail. And it's usually winner takes all. Let's think about "I want to be president." Well, only one person can be president. So there's going to be a bunch of losers and one winner. Because of that, Big P-purpose is often easy to fail and it's very scarcity mindset oriented. Only a few people are going to get there. Let's contrast that to little P-purpose. Little P-purpose is not as much worried about goals as it is the process. So it's this idea of find things we love doing and spend our time doing those things. So instead of being scarce, those are really abundant. Think about all the millions of things you could enjoy doing. Instead of being all or nothing, it's all or all and it's almost impossible to fail. And so that's the difference. Big P purpose, I think really brings out a lot of anxiety. Little P purpose, the kind that actually most people don't strive for, is a lot more reassuring and nurturing and is much more tangible as opposed to big P purpose, which is very ephemeral and pie in the sky. And I wanna do these crazy things, but I'm not sure how to get there.

John: But you know, you give several examples in the book and I wonder if you could talk about the one that I really remember. It was going way back, baseball cards, maybe just a little review of that story because it was pretty touching in a way.

Dr. Jordan Grumet: So there was a gentleman who changed my world and he did it without even trying. And he did it with little P purpose. And this is the importance of this story is, A, it helps us define what little P purpose is, but it also shows the impact. And so I get this argument all the time. The reason I go after big audacious goals is I want more impact and legacy. And that's fine if you happen to succeed in your big audacious purpose, which most people don't. But I think little p-purpose actually can be more impactful. And the guy who taught me this was Roman. He owned an antique store. He was a baseball player, actually had dreams of becoming a baseball player. His version of big p-purpose was becoming a baseball player, but he blew out his knee. And so after high school, he called it quits. Instead of going to college, he decided to run his father's antique shop. And he liked refinishing furniture. And so he would get various pieces of furniture, he'd refinish them and sell them. And one day a gentleman brings in an armoire and he says, "Okay, I can fix this and sell it." So he buys it and he's in the middle of refinishing it, opens one of the drawers, and there's a stack of baseball cards there. So he says, "Okay," he calls the guy back. He says, "You know what? I have these baseball cards. You forgot them. Do you want them back?" The guy says, "No, keep them, do with them what you want." Roman had no idea what to do with these things. So he just put them on the counter and left them there. A few days later, a woman had come in with her teenage son and you know how snarky teenagers are. They pretend they don't care, but when he came up to the counter and saw these baseball cards, he all of a sudden got interested. He flipped through them and he looked up at Roman and said, "How much for these cards?" Roman had no idea. For him, it was just on the top. It didn't matter. So Roman says "10 bucks" and the kid says, "Fine," takes out 10 bucks, gives it to him. Then he spreads the cards out on the table and points out three or four of them. And he said, "These three are worth a hundred dollars on their own." Now, Roman was enthralled. He could have been pissed, but he wasn't. He was actually excited. There was something about this that lit him up and he knew all of a sudden that this was something he wanted to be engaged in.

Maybe it was the fact that he played baseball himself. Maybe it was memories of having the cards himself and putting them in the spokes of his bike, or maybe it was going to Wrigley Field with his dad and sitting in the bleachers. He can't remember exactly what it was, but this lit him up. But here's the thing: he could have just given up there, or he could have just waited for something to happen to him, but Roman realized that you don't find purpose - you kind of build and create it. So he had to take action. So he hired the snarky teenager right there to help him. He started researching baseball cards, and he started buying them, selling them in his antique store. And believe it or not, within a few years he was selling more baseball cards than he was antiques.

Here's the interesting thing: Roman did this because it just lit him up. It wasn't that he wanted a better business plan. He never thought it was going to make that much money. But what he also didn't foresee was there was a group of kids, a community, who found themselves surrounding his antique store and these baseball cards. I was one of these kids. And I had a learning disability, and my dad just died, and I had no friends. I was kind of one of those nerdy kids. And he built a community of these nerdy, geeky kids who had nowhere else to go but loved baseball cards. And this meant everything to me.

And I think back... As I got older, as many of the kids who went to that baseball card shop, as they got older, we carried with us a sense of community and belonging and even a new sense of self-confidence. Roman himself actually got cancer and died a few years later. His antique shop closed. But 30 years later, I'm still talking about him, which is interesting because he never set out to change my life. He never set out to fix all these kids. He just... performed his sense of little P purpose. He just got involved in something he loved.

Let's compare that to Mickey Mantle. Mickey Mantle was notably one of the best baseball players to ever play. He was one of the baseball cards that I sought after when I was a little kid. I always wanted his baseball card. If I instead had decided that I wanted, or if Roman instead had decided that either of us wanted to be Mickey Mantle as opposed to enjoy the little P purpose of baseball cards, there are many reasons it would have never happened. Me? I didn't have the genetics, the skill, the talent. I didn't have any mentors to teach it to me. Him? His knee had blown out. He physically just couldn't do it anymore. But if that had been our version of purpose, this big audacious purpose, we probably both would have failed and been unhappy and we wouldn't have accomplished anything. We would have had what I call a purpose anxiety. But instead, Roman's Little P purpose built a community, and we're all better for it. It still affects my life today, all these years after he's gone. And so Little P Purpose not only lights us up, but it changes the world. And I think if impact and legacy is what you're looking for, you're a lot more likely to get there with Little P Purpose than Big P Purpose.

John: Let me ask you more about the purpose, this whole thing. Should we try to imagine where if we are working, and you know, we have to put money on the table and we can make a lot in job A, maybe a little less than job B, but job B is maybe a little closer to my purpose. What are your thoughts about going for the... the P instead of the money?

Dr. Jordan Grumet: And I actually get this criticism all the time. People are like, "Well, you are a doctor. You made all sorts of money, realize you're financially independent. Of course you can talk about purpose." That's kind of, they use the other P word, privilege. And here's what I say to that. And it's a complicated answer, but I think it's a really important one. If we look at our lives, we all know this, we're doctors, right? You're born one day and you die hopefully many years later, and you get a set amount of time. You don't know how much time that's gonna be. And yeah, maybe you're exercising, you wear your seatbelt, you do some things to help it along and maybe get a little more time, but mostly it's set. And here's the problem: Time passes and we can't control it. We can't buy it, we can't sell it, we can't exchange it. The only thing you can really do is control what activities you're involved in as time passes. That's it.

Winning the game is if you look at life as a series of time slots. You want to fill as many of those time slots with things you love or little p-purpose and get rid of as many things that you loathe as possible. So that's what we want to do from the time we're a young adult till we die - we want to continuously look at our schedule and improve those numbers. So this is where the conversation about work comes in. We look at money as a very important tool in living a life of purpose. And we think, well, if we have lots of money, that's privilege, and then we can do whatever we want. But if we don't have a lot of money, we're kind of lost.

Well, I'd like to tell you, we have a lot more tools than just money. We have our youth, our energy, our communities, our relationships, our joys. So we have a bunch of tools, and then we also have some levers. We can use the joy of addition, which means we add in purposeful activities to our life. We can use the art of subtraction, which means we just get rid of things we loathe. And then we can use substitution, which means we can change one thing for the other.

So here's the thing: If you really want to win the game and make your calendar better every year for the rest of your life, where you're doing more things you love, unless you loathe, you got to use those tools and those levers to make a better life. And for each person, that's going to be a little bit different. And so if you're young at the beginning of your career and you have a job and you don't love it, but it makes lots of money, you've got a different tool, maybe not a huge amount of money yet, but you've got the tool of your energy and your free time. Maybe you're not married. Maybe you don't have a mortgage. So for you, you can work 60 hours a week and probably still spend three or four hours on a Sunday doing something purposeful.

So you've used the joy of addition to add in purpose to your life. So already you're winning the game because you're adding more purpose to your life. You might monetize that, turn it into a side hustle, and then not only are you doing three or four more hours of purposeful activity a day, but maybe you have a little more economic margin to cut back on that job you don't love. And so what we really want to do is use these tools and these levers, and that's going to look different at different times in our lives and different times of our careers. And depending on how much family we have and what our economic needs are.

So there's not a simple answer of, do I go with passion and purpose and not get the high paying job or vice versa? The answer is we want to continuously use our levers and tools to bring in more purpose and get rid of more things we loathe. But we have to do that in such a way that we can financially manage. And I don't think it's a difficult equation, but we've got to be really thoughtful about how we do it. And so maybe I have a job I don't love and I can't add in more purpose and I can't subtract out things I don't like, but maybe I can work for a different boss at the same company. Maybe it's the boss that's making me loathe this. Maybe I can do the same job but for a new company. This is all substitution. So I'm just trying to bring out ways we can use these tools and levers to make the calculus better. But there's not a simple answer. It really depends on you and what your situation is.

John: Well, you know, some of the guests I've had before, and when I hear from my listeners, you know, they're physicians, sometimes they're burned out and they feel like it's all or none. And what a lot of us talk about on this end is, well, you don't necessarily hate healthcare. You hate whatever you happen to be doing right now. So why not volunteer for something on a board or become a part-time physician advisor? Only takes a couple hours a day if that. You might like it, you know, and look at these other opportunities instead of saying, "Well, I'm just going to drop it all and just go become a, I don't know, a mutual fund investor or something."

Dr. Jordan Grumet: The mistake that most people make is they don't do enough thinking about little p-purpose. So they realize they're burning out and they realize that work's overwhelming and they realize it's the only way they think they can make money. But because they haven't invested at all in little p-purpose, they don't even know what to strive for. And so for instance, look at me: I was a practicing internal medicine physician and I was exhausted, but I didn't go into hospice immediately. When I eventually realized I liked hospice and I would do it even if someone wasn't paying me for it, I was lucky enough to have this tool of money such that I could get rid of everything else and keep it. But what if I understood purpose a little better at the beginning of my career? Even though I didn't have much money, I could have gone into hospice in the first place. And that could have been a version of Little P-Purpose for me. And yes, I would have made less money, but I don't think I would have burned out my career so fast. And so I would have had much longer career longevity and I probably would have spent more of my time doing things that I love.

So this calculus would have been much better for me if I just went into hospice in the first place. And so most of us haven't done enough deep thinking about what purpose looks like in their life. And so we can't improve. Who knows? I love writing. A lot of medical practices actually have a blog or create content and will pay doctors to do some of those things. I could have brought that into my work life even if I didn't love my job itself. There's a lot of tools and levers. We just got to be real thoughtful about them and we've got to have a better understanding of what purpose looks like in our life.

John: Well, I want to talk more directly about the book because we're touching on the big P, the little P and some other things. So maybe give us a little... a glimpse of what else is in the book. What kind of things do you talk about in the book? What kind of problems do you solve in the book? And then just tell us where we can get the book at that point.

Dr. Jordan Grumet: So really what the book is, is hopefully the book is a journey to happiness. And so we start with purpose because I think people get purpose wrong. And I think when we redefine it as little P purpose and big P purpose, it goes from something very ephemeral and difficult to reach to something very tangible and easy. And so that solves the purpose problem. But happiness is not only purpose, I actually say it's meaning and purpose. So in the book we talk about the difference between meaning and purpose and how to build both of them in your life so you ultimately get to happiness. And a lot of the book is spent talking about how little p-purpose, again, leads to legacy and impact. A lot of people like big audacious purpose because they think it's going to change the world and they're going to make their mark. And I spend a lot of time, especially at the end of the book, talking about how little p-purpose actually makes more of a mark. And so that's kind of what the book talks about. And if you're interested in getting it, you can of course get it anywhere books are sold, places like Amazon, or you can go to my website, JordanGrumet.com, J-O-R-D-A-N-G-R-U-M-M-E-T.com where you can get the book, my other book, Taking Stock, as well as see all the places I create content like the Earn and Invest podcast and the Purpose Code Substack.

John: All right. And the publisher is a traditional publisher, is that right?

Dr. Jordan Grumet: Correct. So, Hairman House actually is an imprint of Pan Macmillan. So, it is a traditionally published book, which a lot of people like to self-publish, but I really enjoy the process of working with the editors and the creators and the designers and coming out with a beautiful product and that is always my goal whenever I write something.

John: Excellent. Yeah, because we've had authors out here and we go from everything from self-publishing to hybrid to... traditional and it's just interesting to see what people choose just based on, you know, their preferences and their priorities. So that's awesome. You know, I usually ask like what advice you would have for someone who's in the hospital setting or just in the clinic, you know, a lot of family physicians no longer enter the hospital like myself. And I mean, maybe this is part of the solution to burnout is, is to focus on the P. So tell us more about how they could think about that.

Dr. Jordan Grumet: Yeah. I really believe burnout is pretty much people who are searching for big audacious purpose and either getting there and finding it doesn't fulfill them, or not getting there and feeling frustrated like they're failing. And the problem with big audacious purpose is it's so goal-oriented that a lot of times we spend time doing things we really don't like in service of this goal that we may or may not reach, but doesn't really gratify us for that long. And so I do very much believe little P purpose is part of the antidote to burnout. I think when we start doing things we love the process of doing, regardless of the outcome, it adds to our life. So if you're a busy physician, and again, you're doing it on nights or weekends, you're adding in some gratifying time to your life. But I think as you do that and you connect with other people and you build communities, you can also find ways to build that into your career. Sometimes that looks like changing your career as a physician where you go to a different specialty or focus on one thing that you were doing before, but it becomes your specialty. Other times it means leaving medicine and pursuing completely other types of work. There's no right or wrong. The question is, what could you love the process of doing and how to build more of that into your life? And if we start that process, everyone's going to end up somewhere different. Some people are going to continue that job they don't love, but build purpose in other ways. Some people are going to find that they can move out of that job they don't love, or some people will turn the job they don't love into a job they do love. All of that's possible, but none of it happens until you A, understand better what lights you up - what's your little P purpose. And then B, you got to take action.

John: Sounds like awesome advice to me. I'm going to just record that last two minutes and replay it every time and my podcast. But no, I appreciate you taking the time to tell us about this. Is there anything we missed that we need to know before I let you go? We've got the place to be at the book, website.

Dr. Jordan Grumet: My simple message is just to remind everyone that purpose is easy and it's straightforward. It's not nearly complicated as the world has made it out to be. It's abundant. You can, I don't want to say find, because you don't find your purpose. You build and create it. But you can start creating purpose in your life. It's just some basic simple actions.

John: All right. Well, with that, Jordan, I will say goodbye and hopefully we can catch up with you maybe when you write your next book.

Dr. Jordan Grumet: Thank you so much for having me.

John: My pleasure, bye-bye.

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How to Create A Fantastic B2B Business

John Jurica — Tue, 31 Dec 2024 13:47:19 +0000

Interview with Dr. Nicole Rochester – 385

In this podcast episode, John interviews the founder of a fantastic B2B Business. Dr. Nicole Rochester returns to the podcast 5 years after her initial appearance in Episode 127 in 2020.

Starting as a pediatrician who launched Your GPS Doc, LLC in 2017 to help patients navigate the healthcare system, Dr. Rochester has expanded her business to include consulting for major healthcare organizations, speaking engagements, and coaching other physicians to start health advocacy practices.

Our Sponsor

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

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

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John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
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Building a Career with a Fantastic B2B Business

Nicole's journey from clinical medicine to entrepreneurship demonstrates how physicians can leverage their expertise to create multiple revenue streams while making a significant impact. Dr. Rochester's business evolution exemplifies organic growth through network building and opportunity recognition.

Starting with board participation and speaking engagements about health disparities, she expanded into consulting for healthcare organizations and hospitals. By accepting new challenges and learning as she went – from creating scopes of work to determining consulting rates – she built a successful B2B practice.

Her approach emphasizes the importance of valuing one's expertise appropriately, with payment rates for consulting that significantly exceed clinical hourly rates.

Expanding Revenue Streams

Beyond consulting, Dr. Rochester has developed additional business streams, including coaching other physicians to start their own health advocacy businesses. Her eight-week program helps doctors leverage their medical expertise in the growing field of patient advocacy.

She emphasizes the importance of mindset work for physicians transitioning to entrepreneurship, noting that doctors often underestimate their ability to run successful businesses despite their significant accomplishments in medicine.

Her approach combines practical business guidance with strategies to overcome imposter syndrome and build confidence in their nonclinical roles.

Summary

Physicians interested in exploring health advocacy or healthcare consulting can connect with Nicole through her website or by scheduling a discovery call to learn about her coaching program.

Her journey demonstrates how physicians can successfully transition from clinical practice to entrepreneurship. Leverage your medical expertise, personal experiences, and professional networks and create innovative healthcare solutions and multiple revenue streams.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 385

How to Create A Fantastic B2B Business

- Interview with Dr. Nicole Rochester

John: Today, I'm very happy to welcome back my guest from five years ago. It's hard to believe. And at that time, she introduced us to her new innovative work as a physician health navigator. I think that's the right term; it can probably be called other things. But anyway, her business has grown and evolved since then, and so I thought I'd invite her back to talk to us, provide us some inspiration and share what she's learned and— maybe some things we can apply to our businesses. So with that, Dr. Nicole Rochester, welcome back to the podcast.

Dr. Nicole Rochester: Thank you, Dr. John Jurica. It's so great to be back. Thank you for having me.

John: My pleasure. I know people are just gonna get a lot out of this because what you do is somewhat unique, I think. I know you're teaching others to do it, so that's awesome. But it's somewhat unique and you're running businesses or your business since, I don't know, six, seven years ago. And I see you're doing a lot more speaking recently. So why don't you catch us up? What's been going on for the past five years? You can maybe mention a little bit about your medical background before that, but bring us back up to speed.

Dr. Nicole Rochester: Sure. Yeah, so I'll start a little bit at the beginning, like you said, just for those who may not have heard the prior episode. So I'm Nicole Rochester. I am a pediatrician by training, and I always like to say that I loved pediatrics because I know in this day and age, many doctors are finding their ways into non-clinical careers out of necessity, or they're kind of running away from something. And there's nothing wrong with that. There are lots of reasons to run away from medicine these days. But in my case, I really did enjoy my job and really thought that I would work there until I retired.

And for my situation, it was the life experience that led to my transition into entrepreneurship. It was a caregiving journey with my late father and seeing how difficult it was to get the care that he needed, to communicate effectively with the members of his medical team, to advocate for him. And so I found myself doing these things behind the scenes, realizing that as a physician and an insider, I was really uniquely positioned to advocate for my dad. And then after he passed away wondering, how is everybody else managing this? If it was this hard for me, who's a doctor, one of my sisters is a nurse, how much more difficult must it be?

And so I really felt this calling to advocate for other patients and family caregivers the way I had advocated for my dad. I thought I was making this up; it turns out I wasn't. There's an entire field of what's known as professional health advocates or independent health advocates. And so as I started thinking about this business model and doing research, I discovered that others were already doing it. And so in 2017, I left my academic pediatric career and launched Your GPS Doc, LLC, which started as a health advocacy company where I was working one-on-one with other patients and family caregivers, helping them understand and navigate the healthcare system, which involves a whole lot of things.

So yeah, so that was kind of how I got started. Since then, you know, since I was last on your podcast, my work has really evolved from working one-on-one with clients, which were patients and family caregivers, to working with healthcare organizations and hospitals and health systems. And that work involves some speaking, workshops, and training, as well as consulting. And then, as you alluded to, I also am coaching and teaching other physicians how to launch their own health advocacy businesses. So a lot has happened in the last five years, and honestly, things just continue to evolve. And I think I'm still learning, growing, and figuring things out as I go.

John: Good, we can learn from you and with you then as you know this continues. There are so many things that I could say about your opening comments. I'll start by saying that I bet 99% of the people that go see a physician when they're done with their visit and they go home—if they're really sick or not really sick—they can't spit back 5% of what they were told, except, "I saw the doctor and my blood pressure was okay." I have a 96-year-old aunt who doesn't live close to me, but I keep in touch with her. She goes and sees physicians, and then when she comes home, she asks me all these questions. And she's not even given a piece of paper with what her meds are or what she's supposed to do. It's just like, "Come back in two months." So that's shocking.

But the other thing I wanted to mention when you were talking about, you said there are these health advocates, but at the time you started doing this, what percentage of those health advocates were physicians?

Dr. Nicole Rochester: Yeah, that is a great question, John. I, to this day, have not been able to get reliable, validated data on that, but very, very little. And today, very, very few. You know, there are more, and I'm happy that I've contributed to that increase. But there were very few when I first started. And in fact, I was on a mission to find other physicians who were doing health advocacy, and I found a few, you know, maybe four or five. But it's something that I think most physicians continue to not be aware of. When people find out about me, specifically other doctors, they're like, "Oh my gosh, this is the part of my job that I love the most." And to your point about your aunt, these are the things that most of us went into medicine for. We liked talking to our patients when we were medical students and being able to sit and spend that time. And the reality is that we just can't do that for so many reasons. And so I always get excited when I talk to other physicians about the work because it's the communicating and the explaining and the connecting, the part of our jobs that most of us love but don't have enough time to do in the current environment.

John: Well, I wanna learn more about that aspect of what you're doing. So let's go a little deeper into your GPS Doc business and how it's changed in the last five years. How did you kind of migrate to working with organizations?

Dr. Nicole Rochester: Sure, sure. So in terms of the work now, you know, I think the biggest lesson that I've learned and that I hope that your listeners will take away is that the things I'm doing now were birthed out of opportunities to which I said yes. I didn't go back and get another degree. I didn't go back and get more certifications. And I'm not saying there's anything wrong with that but I allow myself to sit in the space that they're asking me to do these things. How can I figure out how to do them? What do I already know? What do I need to learn? And we know doctors are great at learning and finding information. And I say that because there are opportunities that I easily could have shied away from due to fear, due to imposter syndrome and all those other things that we amazing, brilliant doctors face.

And so I look at where I am now, and I think about like those first opportunities that led to this pivot. And it just reminds me that we don't give ourselves enough credit for all of the knowledge and experience that we have. So what happened with me is that I was on a board. In fact, I just finished my ninth year and just fell off of the board, but I was on the board of an organization in Maryland where I live that basically serves as the primary source of education and training, leadership education and training for healthcare professionals. And so they are deeply connected to the local hospitals and healthcare systems.

And so I was on the board, and in 2020, we had a meeting in June, just a few weeks after George Floyd had been murdered. We were in the midst of the pandemic, and so we were talking about what was going on in the world. And the meeting headed to an end, and I said, "Wait a minute, like, what are we going to do? Like, what, what can we do in this space?" And we were specifically talking about health disparities and racism in medicine. And so me asking that question kind of led to me being, I won't say voluntold, but I was asked, "Hey, what do you think we should do?"

And so I thought about how could we provide education in this space and start to educate healthcare leaders and healthcare professionals about structural racism and how that impacts the healthcare that individuals from marginalized communities receive. So then that led to, "Well, would you be willing to do it? You know, can you develop a talk?" And I have been giving, you know, all of us give talks, right? As medical students, we give talks as residents. I had definitely given a lot of talks as an attending, but I had never given a talk about this. And so this was the first time I said, "Okay, I'm going to say yes to this."

I had already always had an interest in health disparities, even as a medical student, so I kind of relied on that, did a bunch of research, found out, you know, what's going on, looked at statistics, all those things. And I developed a talk called, combating, I think it was called "Combating Structural Racism and Disparities in Healthcare" or something like that. I gave that talk for this organization, and it put me in front of a lot of hospital leaders, doctors, and other medical professionals in my state. And so then some of them reached out after the talk and said, "This was great. Can you come give that talk to my hospital? Can you come give that talk to my medical staff?" And so that led to more opportunities for speaking.

And then an organization that's affiliated with that original organization, the Maryland Hospital Association—actually, I'm sorry, it was the Maryland Patient Safety Center—they reached out, and I had been familiar with the CEO of that organization, who happens to be a pediatrician, a retired pediatrician. He and I had worked together in a hospital. So again, there's a thread here, that leverages network. So he saw the work that I was doing, he attended the talk and he said, "Hey, you know, we're in the middle of COVID. We're seeing that a lot of community members who are minoritized, marginalized are saying no to the vaccine, not only in the community, but we're even seeing healthcare workers who are Black and Brown and marginalized saying no."

And so they had a project where they wanted to address vaccine hesitancy in the context of health disparities. And so he said, you know, "We'd like for you to work for us as a consultant." At this point, John, I had never ever done a consulting job. They asked me to provide them with a scope of work. I literally didn't know what that was. Said yes, got off the phone, Googled how do you write a scope of work, and looked at a bunch of templates and examples, and basically created this scope of work around what I thought would be helpful. And that led to my first consulting gig, which then led to other consulting gigs and more speaking. And now, that has really kind of positioned me as a thought leader and an expert in health equity. And so then that led to some specific health equity projects around maternal health. And it just, you know, the snowball just keeps on going, and it all started with me asking a question in a board meeting and then developing a single talk, which has led to lots of iterations of that talk and many more.

John: All right. So I can ask you many questions about this, but I'm going to focus on two. One is, a lot of people that are trying to get something like that going find themselves having to do some kind of marketing, but it sounds to me like this thing kind of snowballed kind of on its own to some extent. So were you seeking speaking engagements, for example, or doing other things? Number one. Number two. Did you at any point charge for the speaking, or did you just use that as your marketing tool?

Dr. Nicole Rochester: OK. Yes. So I definitely—I had already been doing some speaking within the context of my business, Your GPS Doc. But because I started out primarily working with family caregivers and helping people navigate the healthcare system, the talks that I was giving were really focused on that. So I was giving talks at caregiver conferences, I was giving talks for local departments of aging around that, and some of those talks were paid. Initially, a lot of free talks, and then like many speakers, you start out free, and then finally either you get the courage to ask for money or somebody offers you money and then you go, "Oh my gosh, I can make money." And then you gradually raise your price.

So definitely the talks that I'm describing now were paid engagements. And once I did a few of them and really, really loved it, I did formally market in the sense that I put a page on my website, speaker page. I put a contact form so that people could contact me if they were interested in having me come speak. And I'm very active on LinkedIn, and so I started to post. If I would have a speaking engagement, I would post about it on LinkedIn. I would post a picture. I would usually ask somebody, "Can you please take a picture of me while I'm speaking?" And I would post that photo. I would tag the organization. Inevitably the organization would comment, "Oh, this was such an amazing presentation." You know, maybe they would share my post or maybe they would do their own post. And so that definitely led to some traction on LinkedIn. And so periodically, I continue to get requests about speaking engagements, either from people that saw something on LinkedIn or maybe they went to my website and saw it there.

So there definitely has been some intentional marketing. I will say that one of the things that I am admitting and acknowledging—and I always think about this to myself—is that I really don't market myself as much as I could or should. And I've just really been lucky, blessed all the things with the opportunities that have come my way. And I also recognize that moving forward, I am going to have to probably be more intentional about marketing and making sure that I'm top of mind and that people are continuing to find me.

John: Did you end up, at least on the marketing side and, you know, whether it's emails or posts on different social media, did you hire anyone and you have any assistance or are you handling all that yourself at that point?

Dr. Nicole Rochester: There have been a lot of iterations of having help and not having help. I definitely will say I probably waited too long to get some help in my business. And so I have had a virtual assistant at times, and I've had a social media manager. And I'll also say very transparently that at times those are my two young adult daughters. So, you know, if you have kids, teenagers, young adults, they can be amazing at helping you with those things. And then I've also had other individuals that I've worked with. But a lot of it I do and have done and continue to do on my own, just organically. And I have to, you know, social media is its own beast. Sometimes I'm really good at keeping up to date. And then other times I'll look and say, "Oh my gosh, I haven't posted in a month." And so I try to balance that.

John: Well, it's tough when you're helping patients directly, you're doing the things with an organization, and trying to manage and handle everything. And then, oh, I, got to remember to, you know, go on Facebook or Instagram or LinkedIn or whatever. It it gets overwhelming pretty quickly.

Dr. Nicole Rochester: Yes, absolutely.

John: If you're like me, then you go in cycles, though, when you really nail it for a while and then you drift away for a while. So you had to learn how to basically write a proposal, a scope of work. And actually, like you said, one of the big things was, well, how much do I charge? I don't want to necessarily ask what you charge then or what you're charging now, but maybe like, how did you figure out what? How did you come up with that number thinking, I don't want it to be so high it's crazy, but I don't want to leave a lot on the table? I mean, I'm spending a lot of time researching and doing all this work.

Dr. Nicole Rochester: Yes, that is a great question. That is something that I feel like it's hard to know, and I will say that generally—and this sounds crazy, John—but I just, I make it up. Not completely make it up, but I try to do some research. I try to ask around and see what other people are charging. As you know, a lot of times for many reasons, you don't get straight answers with that. And then I just would try something. I would say typically whether it's speaking, consulting, and even coaching, the initial price was much too low. Like I would significantly underprice my services. And then I would realize, you know, after getting feedback or seeing how it's going, it's like, "Wait, you know, I could be charging more." And then I would charge a little bit more the next time. And If I get a very quick yes, I'm like, "Uh-oh, you know, that probably was too low."

And so you kind of inch your way up as you get more comfortable, as you get more experience. For me though, like I did go in some of the Facebook groups for physicians, nonclinical careers, things like that. And you ask the question and a lot of times you would get kind of a range or people would say it depends. But I really felt strongly that as a physician, regardless of what I'm doing, whether it's consulting, definitely in the consulting space, what I was hearing from other doctors who were willing to share is that they were charging anywhere from $300 to $600, some even more, dollars per hour. And so I felt like, "Okay, let me maybe land in the middle of that and then kind of see if they say yes and then work my way up from there."

I think that we—one thing that I've noticed when coaching physicians is that they often start... When we're talking about the hourly rate, for example, with the health advocacy, they will go to their clinical hourly rate. And if they're a pediatrician like me, we're at the bottom of the pay scale and they'll say stuff like, "I don't think I should charge more than $150 an hour." And I'm like, "Absolutely not." Especially if you're working with organizations and things like that. So I think we all have a tendency to try to compare that work to what we did in a clinical setting, and the two are little like apples and oranges. And getting accustomed to the fact that your knowledge and expertise is extremely valuable and that you know the companies that are hiring you to consult or advise they're doing that because of your unique vantage point and your experience, and that deserves to be compensated. So it's not about taking advantage of anyone, but it's really kind of standing in your truth and trying to understand and figure out what you're worth.

John: That's good advice. You know, I was a chief medical officer for a hospital, so we had consultants always coming in. And, you know, a lot of times there were big consultations, so they wouldn't even give an hourly rate. It would be like just a project that would take a year, and, you know, it would be $100,000 or something like that. Now, you know, you have to do some work backwards, I guess, and see how much time you think it's going to take. But I would say, again, this is based on nothing except just talking to people like you. Like if you're a physician doing consulting and your clinical rate is like $200, $300 an hour, you know, doing whatever you're doing, you should at least double it.

Dr. Nicole Rochester: I agree.

John: What else have you learned in the last five years as you're making this, transition to doing really these bigger things and working with more of an institution? Anything you want to share with us about your mindset?

Dr. Nicole Rochester: Oh, wow. Oh, yeah, mindset. I think what I have learned—I know that what I have learned in the last seven years since becoming a business owner is that 95, if not more, percent of the work is in our own head. It's our mindset. Everything else can be figured out. The information is out there; you can find it. But having the information, like as doctors, we always feel like if I just have more information... But for us, it's here—for everybody, but particularly for us. And I've been really intrigued with my own journey and with now coaching physicians, this idea that we represent—I don't know the exact number, but we're in the top echelon, I believe, in terms of intelligence and things like that. And we do really, really hard things as physicians, like literal hard things, like intubation and putting in central lines and saving lives. And yet when it comes to starting a business—and I'm not saying it's easy, because it is not easy—but we have so many fears and trepidations.

And I've talked to so many doctors that are like, "I want to do this, but I'm afraid to start my own business. I don't think I can start my own business. I don't think I could do it." And it's like, "Are you serious? Like you save lives every day. You're an emergency room physician. You're a critical care doc." And you don't think that you can start a business? So our mindsets are so important. And you know, whatever it takes, whether it's mantras, affirmations—for me, sometimes, John, I will actually go look at my CV, and anytime I have an opportunity to update my CV, it becomes an amazing exercise in boosting my confidence because I start to look back at like all of the talks that I've given and you know, my regular job and all the work I did as a pediatrician. Then to look at the different talks that I've given, the articles that I've contributed to, and the clients that I've had a chance to work with. And that reminds me like, "Nicole, you're doing pretty well,"

And so I think that we discount ourselves so much as physicians, and we just don't appreciate that, yes, we have the medical knowledge, but there's so much more that you can do with that medical knowledge beyond the clinical arena, and really, you know, just embracing that. So mindset, I continue to work on my mindset regularly because every now and then, it's something that you don't conquer, at least for me. Like sometimes I'm thinking like, "I've got this," and then some new opportunity will come my way and I see myself, I see that old part of Nicole trying to sneak back in. So I think mindset is incredibly important.

The other thing I've noticed specifically around speaking as a doctor is that I have had to creatively and respectfully remind organizations I'm a small business owner. And I say that because I continue to speak for free periodically, but it has to be like a very small nonprofit or a very religious organization or just a cause that really aligns with my purpose in life. But there are large organizations, like large John, that will approach me about speaking and then tell me that they don't have a budget or the budget that they have is significantly below what I would charge. And I've gotten to the place now where I just politely decline. And if there is a back and forth, which sometimes there is, I will tell them, you know, they'll say, "Well, Dr. So-and-so spoke for us last year, and he or she did it for free." But they're always naming a physician who works for an employer. And so, you know, you may recall, when I worked in academia, speaking was considered, you know, you do it for "exposure."

I love when they say, "Oh, we thought you would just do it for exposure." And it's not... to sound arrogant by any means, but I don't need—well, I don't want to say I don't need exposure. I always need exposure, but I'm kind of beyond the stage of speaking for exposure. And when they bring up a physician who is employed, I remember when I was employed, absolutely, I gave talks all the time for free. But at that time, I had a goal of, you know, maybe advancing up the academic ranks; like there was something tied to that effort. And so now, you know, my CV doesn't earn me a title of associate professor or professor, and I literally work for myself; I provide for my family.

And so I think that's another thing that I want to share. You know, certainly in the beginning, again, there's nothing wrong with doing things for free. There's nothing wrong with doing things for lower cost as you are making a name for yourself. But after you've done that, you deserve to be paid. And so I just find a lot of times because we're so altruistic, there's just this attitude that we should come speak to large healthcare systems and pharmaceutical companies even just out of the goodness of our hearts.

John: Wise words there. So it's absolutely true. And when you're going your own and run a small business, you have to earn a living and you have to put money aside for when maybe it gets a little light for a while, you know.

Dr. Nicole Rochester: Yes.

John: It makes perfect sense. That's good encouragement. Okay, now there are some people that like what you're doing and, you know, different aspects, but I'm sure there are people that like the advocacy part because that's something, again, that maybe they hadn't realized they could actually get paid to do. So you're teaching other people how to do that as well, correct?

Dr. Nicole Rochester: Yes. Yes, that is correct.

John: So tell us all about that.

Dr. Nicole Rochester: Sure. Yeah. And that's another thing, you know, there's a theme I'm realizing now. There's a theme in our conversation in terms of saying yes and embracing opportunity. Because with the coaching, I started my company in 2017. I was doing health advocacy. Within a couple of years, I became known in some physician circles as the doctor who does this. And so one, when doctors would say, "Hey, I have a family member who this happened to or this happened to," they would remember, "Oh, Nicole dealt with that when she was caring for her dad," or "Nicole now works with people."

And so I would get tagged in these Facebook posts. And so initially I would get tagged for like helping someone's family member navigate the healthcare system. But then doctors would sometimes say, often in the nonclinical groups, "Hey, is there such thing where I could just like help people understand their medical conditions or maybe when they're hospitalized, I can help them understand what's going on and communicate with their doctors?" And then I started getting tagged. They were like, "Hey, Nicole does that."

And so I would get tagged and then I would reach out to someone, I would hop on Zoom calls and maybe talk for an hour or two hours and just kind of answer their questions about how I got started and all the things. How much do you charge? Do you need insurance? All these things. And so I started doing that and then as I got busier, I didn't have the time or the capacity to have these two-hour Zoom calls. And so then doctors would say, "Well, can you just coach me?" And the first four or five or six or eight maybe times, I said no. I was like, "No, I don't do that." And they were like, "Well, can you just coach me?" "Nope, I'm not a coach."

So finally, around 2020, I started saying yes. I never advertised it. I just, you know, I said, "Okay, somebody reached out and they were like, 'I really would love to learn from you.'" And so I said, yes. So similar to that consulting scope of work package where I had to figure out what it was, I started researching, you know, coaching and like, how much should I charge? And then I thought about my journey. What were the things that I needed to know in order to launch Your GPS Doc? But even more importantly, what are all the mistakes that I have made? What are the things that I wish I knew when I first started?

And so I started developing a curriculum and I took my first coaching client and I worked with her one-on-one, and that was great. Everything went great. And so then, you know, the next doctor that came, I said, yes, I do this. But I never advertised it. I was still afraid. So if somebody came to me, I would say yes. But I wasn't out there saying "Hey, you all, I'm a physician coach." So then that led to me formalizing a curriculum that went from like a three-week program to four weeks to six weeks. Now it's an eight-weeks program. And then I went from a one-on-one to a group model.

And so since 2022, I've been hosting or leading the small group cohorts of physicians who want to start their own health advocacy business. And again, as the landscape changes, as new things pop up with the industry, I go back in, we update the modules. But right now, it's an eight-week program; there are lessons and modules and videos and downloadable templates and things that live on an online platform. And then weekly during the program, we have coaching calls, live coaching calls where I answer questions, where I deal with mindset challenges and coach the individuals. And yeah, we do that, and there's even an alumni program that I started just a few months ago because what I noticed is that a lot of the doctors that would finish, some of them would just take right off. Like they would finish the program, implement everything, start their business.

But a lot of them were still kind of nervous or scared, and they still needed a little more support. And so now we have an alumni program for those who want ongoing support after the eight-week program is finished. And it's just been an amazing thing to see these doctors in various seasons of their career. Some are retired, some have been out on disability for injury or illness, and some are still working full-time or part-time, and seeing them launch their health advocacy business and helping other patients and families has just been amazing.

John: Sounds like, though, from your standpoint, I mean, looking at what you're doing, you're definitely juggling a lot of things here.

Dr. Nicole Rochester: Yeah.

John: You know, you have, but it's interesting. I mean, real entrepreneurs, that's kind of what they do. Maybe you didn't really consider yourself an entrepreneur 10, 15 years ago, but you know, you're just meeting these needs as they arise. And some are, you know, huge, you know, organizations and some are just individuals. So it's really, I think it's very—I was going to say impressive, no, but it's very—it is impressive, but it's just, it's encouraging, I guess. It's like you said, there's so many things you can do if you just have that mindset. You could do a whole thing. It's all the mistakes to avoid because that's really like the, what did a consultant provides: "Don't do any of these things; do these things, and you're going to be where I was only it's going to take one-third of the time or whatever."

Dr. Nicole Rochester: That part. That is so important. Time is compressed when you work with somebody who's already done it. They've already made all the mistakes. Absolutely.

John: So where does somebody go to learn about that part of it, the coaching?

Dr. Nicole Rochester: Probably the best way you can schedule a call with me to learn more about health advocacy and about the program and we can decide if this is a good fit. And that's bit.ly/NHAcall. And N-H-A is in all caps. And they can also just go to my website, which is yourgpsdoc.com.

John: Well, you've covered a lot and you've really given us a lot of inspiration and actual good practical advice as well. So, anything else you—I guess we're going to get to the end here. So, I just would open it up for any advice you have for physicians. You know, my audience, a lot of them are either burned out or they're frustrated or they've been in medicine for 25 years and they're like, "You know, I just don't want to work like a crazy person anymore." What advice would you have for them?

Dr. Nicole Rochester: Yeah, one, I, you know, I—sending hugs because it's really, really difficult to practice medicine now for so many reasons. And honestly, I'm afraid as I get older, like who's going to be around to take care of me because I know that so many of our colleagues are leaving. But I guess the advice I would give is really, really embrace the knowledge and the expertise that you have—not just with your medical career, although that's incredibly important—but your lived experiences, your personal experiences, your interests, your hobbies—like all of those things make you who you are. And all of those things are potentially monetizable.

And I think that's something that I've learned and continue to learn is exactly what I'm always surprised at: What is monetizable? And for me, it's not just making money. Like that's not my, that's never been my motivation: is to make money. I'm excited that I get to make money while I'm still doing things that bring me joy. But realizing that there's so much information and knowledge that we have that can help others and that other people are willing to pay for that information. So it's a win-win. I mean, you have a way of monetizing your skills and your knowledge and you're doing it in a way that helps the broader society.

John: I agree 100% and you're a good example of it..

Dr. Nicole Rochester: Thank you.

John: All right, Nicole. I don't think I'm going to wait another five years, but if I still have a podcast going maybe in two years or so, then I think we're going to have to get together again and see what else you've been up to. But this has been very interesting, fascinating, helpful. And I thank you for being on the podcast today.

Dr. Nicole Rochester: Thank you, John. Thank you for having me. And thank you for this platform. I've talked to a lot of doctors who listen to your podcast, and that's been their motivation to step out into the deep. So thank you for what you do.

John: Well, I appreciate that. All right. Well, take care. Bye-bye.

Dr. Nicole Rochester: Take care.

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First Consider 5 Proven Strategies To Save Your Career

John Jurica — Tue, 24 Dec 2024 12:05:41 +0000

Recent Trends Offer Options for Physicians – 384

In this podcast episode, John discusses how to save your career if you wish to continue working in clinical medicine.

John shares five proven strategies for physicians to revitalize their medical careers while maintaining patient care, drawing from his experience as a Chief Medical Officer to help doctors reimagine their practice rather than abandon clinical work.

Drawing on real-world success stories, he offers practical solutions for physicians who enjoy patient care but struggle with administrative burdens and work-life balance.

Our Sponsor

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

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

For Podcast Listeners

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

Taking Control of Your Practice to Save Your Career

Contract renegotiation offers a powerful tool for employed physicians to improve their work conditions. Key areas for negotiation include vacation coverage, and ensuring adequate support during colleagues' time off through locum tenens or community coverage. Working hours should account for documentation time, and supervisory responsibilities for NPs and PAs need clear boundaries.

When approaching renegotiation, physicians should review their contracts months in advance, engage legal counsel, and strategically time their negotiations, especially as healthcare systems face increasing challenges in physician retention.

Breaking Free from Traditional Constraints

You can explore various practice models to eliminate common stressors while maintaining clinical work. Options include direct primary care (DPC), cash-only practices, concierge medicine, or specialized focus areas. These models often eliminate insurance billing headaches and allow for better work-life balance.

Alternatively, you can consider micro-incorporation, forming an LLC to work as an independent contractor with hospitals, gaining tax advantages and greater flexibility while maintaining the appearance of traditional employment.

Summary

Each approach requires careful consideration and planning. However, there are solutions to the challenges in modern medical practice that preserve the physician-patient relationship.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 384

First Consider 5 Proven Strategies To Save Your Career

- Recent Trends Offer Options for Physicians - 384

John: Okay, today I want to describe several ways that you can fight to save your clinical career. Normally, I talk about nonclinical and unconventional careers to consider when you're fed up or burned out from your practice, but I've learned that sometimes it's not practice per se, but the long hours, dwindling salaries, and unsympathetic bosses that lead physicians to leave practice. You may still enjoy seeing patients and working in a clinical practice if you could get rid of all the other nonsense.

I'm coming to believe that reimagining your practice might be a valid, maybe even a better way to save your medical career and get back on track than just abandoning it and doing something nonclinical, albeit still in the field of medicine or in the field of healthcare.

I've had several guests over the last year or two who have confirmed that belief, and I want to spend a few minutes today to provide a little bit of food for thought on a short list of strategies to get you back on track in your career, bring some happiness and satisfaction without leaving medicine. So let's get to that discussion.

All right, we're talking about considering five proven strategies, and these strategies are designed to save your career. Let me work from this premise that you're in this position and you actually still like seeing patients for the most part. You enjoy practicing medicine, and that's not the problem, but it's all the other stuff that gets in the way.

Things are happening, most of the time it's because you're employed, you feel you don't have a lot of control, and you know what's going on is not really aligned with your lifestyle desires or your values, that kind of thing. And you'd really like to be able to spend time with your patients, make a decent living, and maybe even not be sued and other factors that I'm going to talk about here in the next few minutes.

But while you're thinking about these strategies, remember several things, that most of these will require hiring an attorney, most of them or some of them will require moving at least to a new practice. You might not have to move from your city if you're in a big city where you can actually still commute, but some of these things I'm going to mention do require you leaving your current practice. And sometimes it might not only involve moving to a new practice, but it might involve starting a new practice. So those are big things if you have to sell a house and so forth, they can be a barrier.

But these are all situations where you can continue to practice. And in many of these situations, your practice is extremely rewarding. So I have five strategies for you to consider today, and I'll go through all five right now, and then we'll go through them one by one.

The simple one is to aggressively renegotiate your contract. The second is to hire an agent. Now that might seem kind of unusual. We don't think of using agents for physicians to negotiate their contract. This one usually applies for your first job, but it can apply to your second or third as well. If you can somehow eliminate the billing from insurance companies, that can sometimes eliminate a big chunk of problems in a practice.

Let's say you're in a private practice now, either alone or with others. If you can figure out a way to avoid the need to do billing, hiring staff, tracking it down, working with the big insurers, which is extremely frustrating, that might solve the problem. Possibly you can just narrow your focus, narrow your practice.

I'll give you some of my ideas on that. And then the other is maybe switching from an employee to an independent contractor, even in a similar situation, or what some people call micro-incorporation, that might solve the problem and bring you closer to the practice of your dreams.

Well then, let's talk about aggressively renegotiating a contract. Now this is for those who are already employed. And I have a fair amount of experience with this because I was a CMO for my hospital and I either negotiated or renegotiated over a hundred contracts. I even oversaw the hiring and then also the recruiting of new physicians from their own practice. In other words, we would buy their practice and we would add them to our group.

But if you're already employed, you have a contract, there are usually certain factors that cause the burnout, that cause the dissatisfaction. One could be the vacation coverage. And it's not that you don't have enough vacation. You may have two, three, four, even up to six weeks or so. The problem is that sometimes you don't take your vacation because you're so busy and you feel like your patients will be let down.

Sometimes you don't take vacation because you don't have enough coverage. And related to that is you don't take vacation because you realize the more vacation that you take, the more that the other physicians who cover you are going to take. And when they're gone, your own time is extremely stressful because you're covering for all their patients while they're gone.

So if you're in a group with six, seven, eight specialists in a certain field, it's not always a big problem to have only one person gone at a time. But if you have three and one leaves for two weeks, then that means the other two are on call every other night or every other day for those two weeks. And so, it's kind of a misnomer, and I realized this even when I was negotiating these contracts, but sometimes we just had these difficulties with the small groups of specialists that it's really not every third or every fourth call rotation.

Because let's say that you have four people working in that. Well, all four of those physicians could conceivably take off three weeks each year, which means during let's say the nine weeks when other people are taking call, you're no longer on every fourth night. Now you're on every third. So your contract is essentially in violation. What they're doing is in violation of your agreement. Really what you should be doing is plan those out well in advance and get locum tenants to come in and fill.

And it's even worse if there's only three of you or two of you, because then when one person's gone, if there are two, then it's extremely stressful. And yet they say, well, we'll work around it, but no, that can be devastating. So vacation coverage is a big deal. And that's something that should be really clarified that if you're really on every fourth, then that means when people are taking off, you should get locums in there to cover or pay somebody in the community to cover.

The hours and salary of course are big deals too, but it's mainly the hours that you're expected to work. And I think we need to start pushing back on the employer and say, okay, I'm including the hours of my documentation. So you shouldn't be seeing patients for eight, nine hours a day. And that's quote your normal office hours when you're going to be spending an hour or two at night doing your charts, there needs to be time taken during the day while you're seeing patients to do your charts. And if that doesn't work out, then you need to come up with another plan.

And the other one that came up a lot when I was doing this was working with physicians and getting enough supervisory time for the NPs and PAs that we had, because we were hiring a lot of them. And it really got to the point where we were struggling to get them coverage and sponsoring or collaborating physicians. And so they could be the designated coverage or sponsor for, let's say some PAs, it could be 5, 10, 12, 14 PAs that could be calling at any time that they're seeing patients. And this is like a minor thing in a contract theoretically, but it's really a big deal.

And so, what you need to do is look at all those things in your workplace that are making you unhappy and take the opportunity to plan for it and aggressively renegotiate your contract so that it actually provides you what you need safely and at a low risk of being sued. Some of these things lead to fatigue and leads to mistakes and all that kind of thing. So that's one option.

Now, this has always been out there, obviously. I think as hospitals and systems are having more difficulty keeping physicians, you can get a little more leverage now that maybe you had five or 10 years ago. So that's the first thing. You can definitely start by renegotiating aggressively. Obviously, you're going to need to have a good attorney and you're going to want to strategize with the months and months before it's time to renegotiate. And you're going to look at your contract and make sure that you give them enough notice that they don't just say, oh, it just rolled over for another three years because you didn't dispute it. That's enough of that one.

The next one is hiring an agent. And this is mainly for your first job and then subsequent jobs. But I interviewed a guest by the name of Ethan Encana. He was trained as an attorney and that was in February of 24. And he has a full time company job and associates who are hired by physicians as an agent to do the negotiation upfront for their jobs. And they're really serving more like they would for an athlete, a professional athlete. They're going to look after you. They're going to approach the organizations that have these jobs posted. And they're going to negotiate even before they get to the negotiation of the actual contract, the arrangement. And the arrangement is that they are going to pay the fee for this agent. And this agent is going to keep all of your best interests in mind and negotiate very aggressively to get you a contract that has all the things in it that you want and need.

And it's again, usually those same issues that include vacation, the hours and salary, the pay for supervising other medical providers, the restrictive covenant. It's tough to get rid of that restrictive covenant, but there's more and more examples where they are getting rid of that. So if for some reason you would want to go private at some point, then you can do that.

But you can actually hire an agent. And again, I had never even heard of this until earlier this year in 2024. And so, I'll put links in the show notes to any of these things that I mentioned in terms of previous guests and resources to follow up on these options.

Hiring an agent is an option. Maybe they can get you a better deal that is to your satisfaction and has a great life work-life balance and so forth. And particularly if you're willing to look not maybe rurally for sure, because they're really having trouble, but even in the suburbs and stay away from the big cities, you're going to find a lot more opportunities because they are struggling to find physicians, but you're going to have to keep them honest in terms of what their contract requires them to do.

The next one, number three is eliminate billing. Particularly if you're already in your own practice. It seems like it's that whole issue of billing and hiring more staff to do the billing and then have to go after payments that are declined, costs a lot of money, you spend a lot of time, you might have to be doing a lot of paperwork and signing off on paperwork to challenge these billing decisions. Really, there are different ways of doing that. But we know, of course, that DPC, direct primary care is a great one.

I've had, I think, two or three guests on. And let's see there. Also, I talked to someone who is doing an infusion lounge, which is cash only. Direct primary care most of the time is cash only based on a membership fee. Concierge is very similar, kind of high end, more expensive.

A lot of the DPCs, the monthly cost is reasonable and patients really are not opposed to paying that because they have such high deductibles and copays that they do better doing DPC. A med spa is another example. Or you could really narrowly focus your practice and do cash only. You could do functional medicine, I think even lifestyle medicine are ways that you can eliminate third party billing. It's not that the patient can't access their billing, they can do that. You just have to give them records that they can then submit their own reimbursement. Of course, a lot of people have health savings account and similar accounts.

So, if you're in your own practice and that's one of the things that's really making your life miserable, then you want to move to a model that doesn't require you to do a lot of billing. Well, at least not billing of the insurance companies because that's where you really get killed. Normally, if you're doing DPC or even free for service, you're going to get paid by your patients because they'll be afraid that they can't keep you as a primary care doctor. Now, if you're doing urgent care, you could do cash only urgent care. Of course, you do need to be paid at time of service for that.

So, let's move along here. Another thing you can do is narrow your focus. We'll look at this and start in a pretty general practice and that's what we get overwhelmed with. Sometimes, if you can focus on just one sub area or two sub areas of a practice, then you have the ability to systematize things. You can master the billing. So, even if you're doing billing, usually if you're only using, let's say, a handful of codes, you know how to document and how to get paid for that.

I'll give you an example. I have a friend, he's sort of pre-retirement. He's a pediatrician. Obviously, he did a lot of different things, was working in the hospital for a long time, eventually stopped doing hospital work once we got some pediatric hospitalists in town. And then he decided that he wanted to simplify his life a bit and so he started doing only care for attention deficit disorders.

Now, he's still charging fee for service and he's not using a DPC model per se, but you could. You can do either one. But the patients that he has, they are so happy to have someone who's really focusing on this area that they'll pay the money rather than go to a general pediatrician who's doing so many other things and isn't necessarily able to sit down and spend the time and doesn't have the staff in the office like this friend of mine who since we're all on the same page, we're all working on the same problems with these patients. Everyone's very knowledgeable and they get a lot of personal care and they're happy to pay for it.

And so, you can do things like that. I can imagine a neurologist focusing on Parkinson's disease or something with some other neurodegenerative disease and have just a lot of patients with that particular condition or certain cancers or certain cardiac disease. And so, think about ways you could focus down, simplify your practice. Again, you'd have to be in practice to do this. In some cases, you might be able to do it in a large group, but you may end up on your own or with a small group to be able to do this. But at least you're still practicing and your patients will really appreciate you.

The last one, number five here is what I'm going to call microincorporation. I spoke with Todd Stillman back in October of this year, 24, and he was recommending, and there's a reason why this makes so much sense too, besides the fact that it's just another option to get more independence. But you're thinking what I just described in terms DPCs and concierge and med spas and narrowly focused practices, you have to build a practice. It's expensive. You have to market it. You have to have space. You have to pay rent. You have to hire staff. You have to have someone to help you with the billing if you're doing the billing. But you can avoid all of that. And to get a lot of the benefits of being in your own practice by forming an LLC, but then using that LLC to become a pseudo-employee of a hospital system or a large group.

And basically you're a 1099, you're an independent contractor, and you negotiate a contract with the hospital. And the hospital contract is not an employee contract. And so they are alleviated of some responsibilities. They don't have to treat you as an employee. They don't have to give you any benefits. So you have to make sure on the other side of the equation that you make up for that.

But the thing is when you incorporate as an LLC or whatever other PLLC, each state's a little different. You work as an independent contractor, but you look as though you're employed by the hospital and you're not opening. As a matter of fact, you're working in one of their clinics and one of their offices. When I was talking to Todd Stillman, he was funny because he actually had owned an office. Now he was leasing that office to the hospital, which was then allowing him to work in that space. And so he was actually making money by leasing the space to the hospital and other physicians have done this.

And then granted, you've got to cover some things like your own health insurance, but you can find good policies and you have more options as an LLC or PLC to actually diversify your income. You can, through that LLC, do other things. You can have much higher limits on a 401(k) and other tax advantaged investments and so forth. And there's a lot of other tax write-offs that can be used legitimately.

If the first three or four options that I talked about involve starting your own practice, it seems too onerous and you don't want to borrow $100,000 or $500,000 to do that, then this micro-incorporation is another way to really achieve the type of practice that you want to achieve, but mostly onus of the investment on the hospital and still kind of maintaining that arm's length relationship, which enables you to do these other things that make up for it, which includes investing in other ventures and maybe even have other side jobs.

And by the way, nobody else needs to know that this is how it is. You can be doing this and to everyone else in the hospital, in the community, it will look as though you're an employee of the hospital, but you've created your own mini-corporation to get the advantages of the flexibility and so forth that you desire. And yet everyone else and you're still participate with committees at the hospital and stuff to meet all the requirements as a physician, but it does add a lot of flexibility. And I think there's two episodes. I'll put links to everything here in the show notes.

There are five ideas for trying to improve your lifestyle, improve your satisfaction without leaving clinical medicine. Some of the prep will involve really start by reviewing your contract right now, even if it's not due for a year, look in there, see what you're restricted. What can you do? What can't you do? How much notice is required? Early on in the process, as you're reaching that deadline, you need to let them know early and say, look, I'm not leaving. I have no plans to leave this organization, but I want you to know that I have some things I'm not happy with and I'm going to be renegotiating this contract. So if that requires me to give you six months notice that I'm leaving, then I'm going to then you give that notice in writing.

But even in that letter, you can say, I'm planning to stay, but I'm giving you notice as required by my contract that I might not stay if some of the concerns I have about my contract are not addressed. And it doesn't have to be anything onerous, doesn't have to be very confrontational. You go in professionally, you talk with your attorney and you go in and say, here's what I want.

From a negotiation standpoint, I would always ask for the moon. And if you have three or four issues, you start with putting it out there and say, I don't want a restrictive covenant. And then you can come back and negotiate maybe something that's much less restrictive than it was in the past. I don't want to work in this office, or I don't want to supervise 10 NPs and PAs. It's too much work unless I get a lot more compensation and cut back my hours in other areas. These are things you can do. You definitely want to talk to either an agent, as I said, or an attorney, and then discuss your options and negotiation strategy before starting that process.

That's basically it for me today. You know, if you find yourself on the way to burnout, consider taking some of these steps now and go to the show notes for links to the interviews mentioned so that you can learn more about each strategy. And to find those, you can go to nonclinicalphysicians.com/save-your-career.

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The post First Consider 5 Proven Strategies To Save Your Career appeared first on NonClinical Physicians.

This Physician Entrepreneur Offers a New Way to Find a Job

John Jurica — Tue, 17 Dec 2024 13:27:48 +0000

Interview with Dr. Zhen Chan – 383

In this podcast episode, John interviews pediatrician Dr. Zhen Chan whose startup offers a new way to find a job by eliminating third-party recruiters and putting physicians at the center of recruitment.

Through his platform Grapevyne, doctors can earn substantial referral bonuses while helping colleagues find positions with unprecedented transparency and detail. With his unique combination of medical training and business school education, Dr. Chan is reshaping how physicians connect with career opportunities.

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Reimagining Medical Recruitment Through Physician Networks

Dr. Zhen Chan noticed something broken in physician recruitment – endless vague job listings, intrusive third-party recruiters, and a lack of transparency. His solution? Grapevyne is a physician-only platform that puts doctors in control of the hiring process.

The platform incentivizes physicians to refer qualified colleagues while providing detailed job listings that answer doctors' questions about potential positions. In just a few months since launch, the platform has attracted over 315 physician members and eight healthcare organization partnerships, with 40+ new positions currently being onboarded.

Building a New Way to Find a Job While Staying Clinical

Despite the demands of launching a startup, Dr. Chan maintains his clinical practice as a per diem pediatrician while running Grapevyne full-time. He partnered with HealthWorx Studio for initial funding and assembled an expert team spanning technology, recruitment, and healthcare operations.

The platform aims to expand beyond job matching to become a comprehensive career resource for physicians, offering guidance on contract negotiation, healthcare payment systems, and professional development.

Summary

Grapevyne is the next revolution in physician recruitment through a peer-driven platform that eliminates traditional recruiters. The platform offers substantial referral bonuses and detailed job listings. It has already attracted over 315 physician members and eight healthcare clients. Physicians interested in joining can visit grapevyne.health or contact Dr. Chan directly at zhen@grapevyne.health.

Links for today's episode:

Grapevyne.health
Dr. Zhen Chan's LinkedIn Page
Zhen Chan's Email Address: zhen@grapevyne.health
Healthworx Studio – building the future of healthcare by working with founders driven by purpose, passion, and impact.
How to Practice Hospital Medicine and Found a Startup
Introducing a Fearless Medical Entrepreneur
How to Nurture a Career in Cutting-Edge Healthcare Technology – 156
How to Fulfill an Academic Need and Spawn a Business with Dr. Jason Ryan – 081
Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
The Nonclinical Career Academy

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Transcription PNC Podcast Episode 383

This Physician Entrepreneur Offers a New Way to Find a Job

- Interview with Dr. Zhen Chan

John: Well, I like talking with physician entrepreneurs, as some of you listeners know, and today is going to be very interesting. He's a relatively young physician pediatrician who's also running a company full-time. So with that, let's just get into our conversation with Dr. Zhen Chan. Hi, Zhen.

Dr. Zhen Chan: Hi, John. How are you doing?

John: Really good. I came across, I don't know how we met, actually; I think we were introduced basically.

Dr. Zhen Chan: Yeah.

John: When I looked at your website and your LinkedIn profile, I mean, it's really interesting. You're involved with this company. But before we get into that, let's have you go ahead, like we do every podcast interview, and just tell us about your medical training, your background experience, and then kind of lead up to what you're doing now.

Dr. Zhen Chan: Sure, that sounds good. So I'm a pediatrician by training. Didn't do any fellowship, but I graduated residency summer of 2023, which I can't believe it's been that long already. Yeah, I did that up in New York Presbyterian with Weill Cornell in Brighton, Manhattan. And then the rest of my education was all back in Miami where I grew up— Miami, Florida. So, I was at the University of Miami for undergrad and medical school, and I took a year off between third and fourth year for business school as well. It was focused on health management and policy, and it really kind of expanded my knowledge of healthcare beyond just the clinical piece. So that was the seed of some of this extracurricular interest, so to speak. And then during residency, I did a lot of quality improvement work, was able to have the opportunity to lead a couple projects as well, which was super fun. And I think because of how fulfilled I was from doing that, and also some of the advocacy work too, I was like, "Oh, maybe I gotta do some more career exploration and like soul searching." I wanted to apply for Peds Hema Fellowship. Second year, I toyed with the idea of doing PICU. And then I was like, wait a minute, I really enjoy these like back end healthcare solutions. I really think that working on them allows you to really scale your impact. And so let me do some exploring. I networked people all over the field— public, private sector, you name it. And worked in venture capital actually for about a year as like a part-time associate. And that started as a fellowship position just to get to learn and get a lay of the land. And then I really, really enjoyed meeting founders. I really enjoyed people working in early stage startups because of how mission-driven they were and really trying to solve problems that are out there. And that's when I said, "Oh, I really want to build something on my own." And here I am.

John: All right. Well then, tell us what is it that you decided to build and what problem were you solving by building that.

Dr. Zhen Chan: Yeah. So the company's called Grapevyne— Grapevine spelled with a "Y". And the name comes from this, kind of comes from the song. I heard it through the Grapevine, or the saying, "I heard it through the grapevine." Because what we're doing is we're driving physician recruitment and the job matching process through physicians. So, no need for third-party recruiters. We're also, because we're physician-founded and we're building a team around understanding what doctors truly value, we're creating job posts that are fundamentally different from the other job boards that you see out there. So no more of these like vague, undescriptive listings that you're looking at this and you're honestly, you don't know salary, you don't know location, you have no idea what this job even entails. And more importantly, you don't know what it's going to be like day to day, which is very important to understand. And so, as someone who went through a job search myself, I know exactly what we need. I want to, if there's certain specialties, I'll go out and interview those specialists to say, "Hey, in your specialty, what are the things that you really want to see on a job post?" And we'll put that all there. So that's one fundamentally different piece. The other piece is that how we drive the process and that is through referrals. So, once an employer contracts with us and puts a post on our job board, we activate the network and we tell members— who are all physicians right now— to say, "Hey, look at these posts." If you're interested yourself, you can apply. But if you know someone who could be interested and you think they're a good match based on this very detailed listing, comprehensive listing, you can refer that over to them and you will actually get a significant cash payout for a successful referral, meaning like right now, the structure is if someone submits an application because of your referral and it's a qualified application, that you can get $25 on most of our posts right now. If they complete the interview process, you'll get another incremental payout. And then if they actually get hired and truly start the position because of your referral, you'll get the most significant payout. Right now on our job board, every post has a payout of $2,000. That could be different in the future, but that's what all the posts have now. So, we're driving the process through physicians. We're a company led by a doctor— not that I can speak for everybody, I do want to say that. Then we're bringing money back into the process too. So ownership, cash, everything— we're putting back into the physician community.

John: Okay. That's pretty unique and interesting. It seems like there's always processes that can be improved— made less costly, less onerous, less time consuming and so forth. So, let me just kind of think about the different stakeholders here.

Dr. Zhen Chan: Yeah.

John: So, I mean, it sounds like a physician can, if they know of a job opening, and let's say their organization, they can make a referral or put a post or something. Or do they come from directly from the hospitals and the medical groups that are looking for physicians?

Dr. Zhen Chan: Yeah, that's an important distinction. So it's not that everyone can just post whatever opening they have. We do contract with the employer. And then we look at the post that they want to give us. And we will work through because they probably already have some standard materials and bulletins that they're sharing with the traditional recruiters out there and the traditional job boards that are out there. But we will take that bulletin, inject kind of our own flavor into that. If it's an ENT job, we'll try to find an ENT member of our community and we'll try to find an ENT maybe in our personal networks and then say, "Hey, if you were to look at a job, what would actually entice you? What do you need to know? What are the questions that you probably would have had to go through a lot of intermediaries to find out before you actually get a comprehensive understanding of the job?" Let's get all those details and let's just smack them onto the job post. And then for the employers, the reason why it's a better format is- we're creating posts that are more engaging. So, doctors can see these and will say, "Wow, I actually really like what's on here. I know everything I need to know. I'm willing- I wanna apply." As opposed to somebody coming in and saying, "Hey, I have this fantastic job that's perfect for you. It's in a great location. Do you wanna hear about it?" And you're like, "I'm not gonna respond to this email. Like I get a million of those. Like what's gonna make this one any different?"

John: Yeah, I can think about some of the complaints I've heard about the usual process. Like... For some it is they find something online— a job— but they really don't know. Like they might even be blinded in the sense that they don't even really know exactly where it is because the host isn't actually revealing that until they get your name and phone number. And then they apply, they send in the resume and they don't hear anything forever. Sometimes, you know, just they don't qualify, but. So yeah, I mean, there's a lot to improve in that process. So, and the revenues for this that really is supported by the companies, the hospitals and the groups that are looking for physicians.

Dr. Zhen Chan: That's correct. That's correct. We are on that kind of contingency fee structure, but we're able to charge a much more affordable flat fee structure. And right now, since we're early, we're not charging any subscription fees, any listing fees— nothing like that. So there's no downside risk to working with us and we're not expecting any exclusivity. We really just want to solve a problem in this space and be able to reduce the administrative expense that goes out into things that frankly, we are seeing as unnecessary.

John: Interesting. I'm just kind of thinking through the process too. Like if I were, let's say working at that organization already, let's say there's 500 physicians there. I mean, would it make sense for the HR department, whoever's putting these out to actually promote let their people know, I suppose. Sometimes I like to do things, you know, like in a vacuum or quietly. But I mean, they could just let all their interns know that they've got an opening for another internist. They're probably doing it because these internists have asked for it. And so, hey, by the way, if you're gonna help us get the word out, feel free. That would, I would assume, would be something that could work.

Dr. Zhen Chan: Yeah, many groups have internal employee referral programs. What I like to say is this is an employee referral program scaled to the entire network of physicians that are out there and anyone can look at jobs and refer each other. It's not going to be siloed to your facility.

John: Okay. Awesome. Well, let me ask how are things going so far. What's the feedback? I think you are relatively new.

Dr. Zhen Chan: We are. We are. So we launched our first job post in end of September, got another— if I remember correctly— seven onboarded at the end of October, and then we had another 16 mid-November and we're currently onboarding another 40 from a larger health system. We're up to eight clients just in these short few months and in terms of member size, that's probably been the most exciting thing to see— how many physicians really enjoy the idea of this platform and want to support its growth. We've gained now over 315 members, just I would say over October, November, and these first couple of weeks of December, we've gained about three-quarters of that. So it's been tremendous growth.

John: Interesting. So those what do you find? Are they all actively looking, or are they thinking, "Wait a second, doesn't cost me to join? I might need something six months down the road. Why not just join now and find out?" And then when they see the right position, they say, "Maybe I should jump on that."

Dr. Zhen Chan: Yeah. combination. So we have a combination of members who came because they were looking for some things right now. And, you know, frankly, we're because of how new we are, we may not have the right opportunity for that specific person actively looking. But most physicians are passive job seekers, meaning and that I think there's a paper that was put out that it's around 80% of physicians are passive job seekers with a survey from it wasn't a paper sorry, a misnomer. It was a survey of about 1,500 hundred doctors and so what passive means is "I'm not actively looking but if something nice rolls my way, maybe I'll pay attention to it" and so, I'm not gonna be on job boards; I'm probably gonna ignore those text and calls from outside recruiters but if someone I know sends me something that's interesting I'll take a look and that's how our process works so we have a lot of those individuals to and my hope is that as we bring on more employers have more jobs going to be more opportunities for everybody to see. And if they want to apply for themselves, they can. If they feel like there's someone else that's in their network, that's a good fit, they can refer that out. And I see it as a potential to make significant cash too, when you're making a lot of referrals. And I don't think doctors are going to be out there spamming and trying to scam each other for a quick buck in this way. You can lose a lot of trust in that process. And that's exactly why there's so much lost trust in traditional recruitment.

John: Yeah, I guess it'll be interesting how things pan out, but I would assume that most physicians have a lot of integrity and they're not going to be even making a referral to something that they think is at an organization they're not really fond of or something like that. So, that's awesome. Well, let's pause on this for a minute. Tell us how to go to Grapevyne and do that, and then I want to come back to something else.

Dr. Zhen Chan: Sure. So you can find us at our website, grapevyne.health. That's Grapevyne spell with a "Y", dot health. Our websites allows you to take a look at what we're all about, and then you sign up for our platform. Really the onboarding process, I would say it takes about maybe three minutes-ish to just give some basic info. We use a cell phone number for the sign-on, so we can have that one-step verification with you. We're really keen on not having anybody that's not a physician, be excluded from the platform. So it's a physician-only platform. We have an NPI right now that you use, which the NPI is out there, but that's how we verify. Once you're on, you'll see a dashboard with featured jobs. There's another page with all of our jobs, and we're working on a couple extra features to make sure that what you see is most relevant to you, and that there's a way for you to search, and filter, and everything like that.

John: Awesome. That's good. No, it sounds— I went on there and I only went so far before I thought, "Well, I'm not really looking for a job," but yeah, it was well-designed. And that brings me back to this other question I wanted to ask you. It has to do with running this business, practicing at the same time, that piece of it. And we also like to hear about the business building itself. And, you know, who did you pick out - how did you get this thing built and all that? So we kind of want to know a little bit about the business and what it takes to run this thing while you're still practicing.

Dr. Zhen Chan: Yeah, yeah, yeah. So I'll talk about the practicing piece. I do still practice part-time. I am on a per diem contract, here in D.C., and this is a really good balance for me, based on my interest. Is it going to be the balance for the rest of my entire career? I don't know. But I do enjoy what I'm doing right now and the full time, running a startup aspect of things. It's- I would say hours-wise, it's as intense as I think I had residency. Like, yeah, it's as many hours as it was in residency. Now, do I get to do my work remotely? Do I have my puppy sleeping next to me and I can have my lunch and everything like that? Of course! I'm not going to compare it to the physical exhaustion I was experiencing in residency, but it's a full-time 24/7 type job. I'm working on the weekends, all that kind of thing. And The business side, building out a team is super important. So one of the first things I personally had to recognize was where are my gaps— where are things that I'm not an expert in? I won't be able to be the best person to do this part. And that was dealing with the lawyers, like the legal side, the day-to-day operations. I've never built a business from the bottom up before as a first-time founder, so I wanted to go out and find someone, and I found an amazing co-founder. His name is Drew Mayer, has been a repeat founder of early-stage companies, has been working in the healthcare startup space for a long time and worked with physicians. His father was a physician. So, when we were talking to him and I was developing that relationship, just felt like we were really aligned on the physicians take back medicine kind of push and that sentiment. And then as we move forward, we brought on an engineer. I can't do product development; I can't code. So went out and looked for someone there, brought on an individual who he worked on Indeed job board. And so, you know, had experience and expertise there. And then finally, you know, as much as we are trying to replace the third party recruiters, I have to be sensible and say, "Well, if there's established recruiters out there who are good and who really do care about physicians. Is there someone out there that can give me that expertise and has been in the industry for a long time?" And we did bring someone on just like that who's been working in health systems, in the exec positions and can really, and just bring her expertise and experience in ways that I personally like. So, finding what I don't have and being able to find the others to come in and help team up kind of building this "Avengers-like group" is the way I see it. And building this business— I have to give credit where credit's due, the concept of Grapevyne came from a venture studio. And so that venture studio is based here in D.C. It's called HealthWorx Studio, spelled with an "X". Yeah, we both have like words that are spelled differently. And so HealthWorx Studio, and they are always incubating and coming up with new ideas. And when they think they have enough research to say there's something here, they go out and look for founders to really come in and build out the concept. Like it's like you start with one puzzle piece and then you want someone to come in and build the whole puzzle. So they come out and look for founders that align with the vision or can give their own vision, build out the business strategy, build out the team, and then take it out of the studio. So that's the model that we're working under right now.

John: So are they the ones that provide the capital to support some of this? Or do you do a separate, you know, fundraising? How does that work?

Dr. Zhen Chan: Yeah, so from the conceptualization up to today, it's all been funded by the studio. And we are going out and looking for outside investors. We really want to find well aligned investors, specifically in the physician community— those that are going to be, I think ideally our end users too, right? Because then they can give us feedback, they can be the users of the product, whether if it's for their own practices to help them hire more. physicians or it's going to be physicians who are like, "wow, this is something I can really use." Those are the types of well-aligned investors that we are looking for, but we're starting those conversations now for angels, VCs, etc.

John: Okay. So with the studio, would it be people have used "incubator" as a term, you know, with other is that a similar type of idea that kind of get ideas, get people together?

Dr. Zhen Chan: Yeah. The way I like to explain it using what I understand is typically in venture capital, and you usually associate venture capital with earlier-stage companies or growth-stage companies, there's traditional venture capital firms, which is all about, you know, we're going to financially analyze you, we're going to do our diligence on your product, make sure that you have the right team, all that, and say, "All right, we're willing to give you capital for whatever returns expectations." That's traditional VC. And then you have the accelerators and incubators out there that outside founders will come up with an idea and then apply in, in exchange for equity. They apply in to obtain the expertise, to obtain the support resources, et cetera. Then you have now what's, there's more and more of them coming out, venture studios, which act like this reverse incubator or this reverse accelerator. They come up with the idea, start funding it. When they feel there's something there, they'll go out and bring in founders to take it out of the studio. That's my understanding. There may be listeners who will say, "I don't know if Zhen's right about that."

John: Well, it seems to be your experience, you know? So things do evolve over time, but it's a good explanation. It helps me understand really what's going on a little bit better.

Dr. Zhen Chan: Yeah.

John: Okay. Well, we're going to get to the end pretty soon here. So I want you to go back and kind of re, just restate, like, what do you think, like the big advantages to Grapevyne over, the current way of trying to find a job.

Dr. Zhen Chan: Yeah. So for us, recognizing that traditional recruitment, it's not efficient, it's not effective, and it's costly. And there's not really great guarantees for finding the right candidate. So our process, because it's referral-based through the physician community itself, and we're crafting job posts fundamentally different than the bulletins and posts that you see out there, we believe we're gonna be better, where our posts are gonna be better in engaging. And your jobs are going to be more visible by a larger swath of physicians that are out there. And on the physician side, the source of truth or the, not the source of truth, but the person who's going to be reaching out to you and giving you anything is always going to be someone you are already connected with— a trusted existing connection. So, driving trust, driving transparency, and ultimately for us as boots-on-the-ground clinicians, if I can improve job matching, if I can say doctors will be put into jobs that they are better fit for because the sourcing is inherently better, we can reduce burnout, we can reduce churn and turnover, doctors will stay in these jobs for longer and especially in fields like primary care or especially in practices that are in rural and underserved settings. Physicians are likely to take those jobs, stay in those jobs, and you have better access and better continuity. That's a hypothesis. I hope that plays out that way. But those are all the, I would say, the value props for what I, to me are the three different stakeholders, the employers, the physicians, and the patients, to be honest. And we're also, you know, for physicians, the job board for me, that's one piece of the puzzle. I want to also build out a career center, provide all of those resources that frankly in residency and medical school, we just didn't get that education. We didn't get that training on how to negotiate contracts. What are the different payment systems that are out there? Everybody talks about value-based care and a fee for service and all these kinds of things, the trends. How do I provide education on all of that we missed that I think is very important practicing medicine in the modern day. Because also, if I can provide more of that education in a way that it's digestible and people will actually view it and take it and absorb it, then I think we will also be able to practice medicine better, take back that ownership again— it's aligned with that sentiment— and not be burnt out as much as an entire industry of workers.

John: Now that sounds like a good plan. I think we were talking earlier before we started recording that looking to the future, I think a lot of physicians are looking to do maybe a nonclinical and a clinical.

Dr. Zhen Chan: Yeah.

John: And there would be no reason why that couldn't be something that just normally kind of evolves on this site.

Dr. Zhen Chan: Yeah, absolutely. We are open to posting nonclinical positions on our site. Physicians are looking for them, you know, extra avenues, not just in the form of side-gigs but thinking the similar vein to me— where there are things in healthcare that I also wanna work on. What are the jobs that are out there that can allow me to do that? I think more physicians need to be in those positions. And then you have physicians that are burnt out and are looking for an alternative while still making a difference. Those are out there. So we wanna be a supportive platform for every doctor, no matter what they are looking for in their professional careers.

John: That makes me think of another issue, which maybe you've already reached out to, but what about locums, which is a different kind of clinical job, but it is a clinical job and just need to find them.

Dr. Zhen Chan: Yeah, there are a lot of agencies that are out there in the locum space. And we just felt from a business strategy standpoint, let's not go into them. Would we ever go into them? I don't have an answer for that right now. But for me. There's also an element where Locums is an expensive band-aid to provide access to care. Now, don't get me wrong; it's a great gig for a lot of physicians that are looking for them. And I would never stop someone who is looking for them to, I would never stop them from doing so. But for us, we wanna drive more of those full-time positions right now. And I think that's the right strategy. But again, I think in business, it's not like medicine where we try to be as— well, we do try to be as surefire as possible— but a lot of these strategy decisions, I think, some may say that it's the right call; some may say it's not, and right now we're making the call to not do locums just yet.

John: Got it. Got it. Okay, what if someone wants to reach out to you personally for a question or something?

Dr. Zhen Chan: Yeah, so my email address is Zhen, Z-H-E-N@grapevyne.health. Again, reminder Grapevyne with a "Y". And so you can reach me by my email, and then I'm on like every social media platform. Too many, I think. It's been great. I love engaging with the community on social media. So, I'm on LinkedIn. I'm on TikTok, Instagram, and there's a Grapevyne account and my own personal account. And maybe we'll just link it in the show notes. It'd be it'd be a doozy to list.

John: OK, I'll put a few in and I'll definitely put grapevyne.health. I kind of used the dot com at first when I was looking for you. But no, Grapevyne with a y dot health. I'll put that in the show notes. And I think pretty much people can get information, everything they need to know. Physicians, if they're really thinking they're gonna access this kind of service, your service, then just go to grapevyne.health and do it. Check it out.

Dr. Zhen Chan: Yeah, yeah, yeah.

John: All right, well, this is pretty exciting. I'm glad you could be here and answer my questions. I think it's inspirational to people— physicians who are thinking, "Well, maybe I could do something entrepreneurial. I could do a startup," or maybe not something as this, is a pretty big deal. This is a big thing. You're devoting full-time to it. So it's not like starting a little side gig on the weekends or something. So, I'm really glad you could join us and I'll be watching the growth of this thing. And it should be pretty interesting. And it sounds like that a lot of planning and a lot of investment of time and effort in this. So, you're to be congratulated.

Dr. Zhen Chan: Yeah, well, I really appreciate the support. I really appreciate you inviting me on. And I have to plug this podcast because I forgot to mention that when I was in my exploration journey, I love learning by podcasts. And this was one of the first ones, if not the first one, I hopped on to listen to a whole slew of episodes to learn just what else is out there for physicians to do. And yeah. So, so anybody who anybody who's listening I hope you share this with more physicians out there.

John: Well, I appreciate those comments. All right, Zhen, we're gonna let you go then. And with that, I'll say goodbye. And hopefully I'll catch up with you again, maybe a year from now.

Sounds great. Have a good one.

John: All right. Bye bye.

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The post This Physician Entrepreneur Offers a New Way to Find a Job appeared first on NonClinical Physicians.