In this podcast episode, John interviews TJ Oshun, founder of CallonDoc, who shares his remarkable journey from practicing medicine to fearless medical entrepreneur. 

Starting with a simple solution to help patients access care outside regular clinic hours, TJ transformed a basic telephone consultation service into a comprehensive telehealth platform now serving all 50 states. 

TJ's transition from healthcare provider to tech company CEO offers valuable insights for medical professionals interested in entrepreneurship and digital healthcare innovation.

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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. 

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

For Podcast Listeners

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From Medical Practice to Tech Innovation: Building a Telehealth Empire

TJ's entrepreneurial journey began with a failing clinic in Texas, where he discovered patients struggled to access care during regular business hours. By starting with simple phone consultations and gradually developing a custom technology platform, he built CallonDoc into a comprehensive digital health solution.

The company now offers telehealth services, lab testing, white-label solutions for medical practices, and software licensing – demonstrating how healthcare entrepreneurs can scale beyond traditional medical services into technology-driven solutions.

Keys to Being a Fearless Medical Entrepreneur

Success in healthcare entrepreneurship requires both medical expertise and business acumen. TJ emphasizes the importance of gaining clinical confidence through experience before venturing into independent practice or entrepreneurship.

He advocates for continuous learning through audiobooks, coaching, and formal mentorship programs. He also recommends building strong partnerships and maintaining a focus on the patient experience and satisfaction.

Summary

TJ can be reached via LinkedIn for professional inquiries and networking opportunities, particularly from medical professionals interested in telehealth or healthcare entrepreneurship. You can explore opportunities through CallonDoc by visiting their partnerships page or contacting their business development team.

Links for today's episode:

• CallonDoc
• Light Your Entrepreneurial Fire and Create Your Ideal Life
• How to Practice Hospital Medicine and Found a Startup
• How to Start a Thriving Educational Company with Dr. Andrea Paul – 073
• How Do I Generate Awesome Income with Telemedicine Services? – 222
• What Is the Latest Telemedicine-Supported Specialty? – 173
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 382

Introducing a Fearless Medical Entrepreneur

- Interview with TJ Oshun

John: Sometimes I find myself really in awe of the healthcare professionals who, they recognize a problem in medicine or with patients or something, and then they just run full speed into trying to solve that problem. I'm talking about entrepreneurs, of course. So today's guest was one of those people that recognized a problem well before the pandemic that patients didn't have the kind of access that they needed to their medical providers. And so in spite of maybe not having a background in IT, I don't think he did, we'll talk about it, but he jumped in and started working on telehealth and telemedicine. So let's welcome TJ Oshun to the podcast. Hi, TJ.

TJ Oshun: Hello, John. How's it going today? Thanks for having me.

John: It's going well. It's a nice quiet day before Thanksgiving. For those that are listening, of course, that'll be two weeks ago, but we're still going to have fun on this otherwise relatively slow day.

TJ Oshun: Well, I wish I could say the same. It's actually quite busy on my end of town as we wind down and ready for the holiday. Usually we telemedicine around the holiday season when the clinics are closed, that's when we get our spikes. It's been a hectic week to say the least.

John: Yeah, that makes sense. While we're all trying to cool things down and go home, the people covering those off hours and those emergencies are getting busier. So it's good to have you backing us up, you know?

TJ Oshun: Yeah, absolutely.

John: All right. So you're an entrepreneur. I'm going to have you tell us a little bit about your story, but the reason I wanted you to come on today, for several reasons, you run a company that could be of value to physicians, you sometimes hire physicians, but you also support them. And as an entrepreneur, we can learn from you about that aspect because a lot of my guests, I mean, a lot of my followers really and listeners are interested in doing other things besides direct patient care. So why don't you start by just telling us what you're famous for?

TJ Oshun: Yes, absolutely. So what I'm generally, I guess, popular for, the company is popular for is the company cell, which is CallonDoc, a telehealth platform. I think we've actually grown beyond a telehealth company to more of a digital holistic medical platform, right? In the sense that we not only offer the direct patient care, we offer lab services, we offer software as a service where we're licensing our products to other doctors, we're providing provider services to all the telehealth companies. So we do a wide range of things to facilitate healthcare delivery virtually, right?

And at this point, I actually consider myself as a tech company versus a medical company. I spent 70% of my time in marketing and technology versus the medical side of things. So we position more on the technology and patient optimization component of it. But that's essentially what we do, a digital company that is out there to optimize access to healthcare in every way we can, from partnerships to optimizing technology and offering quick access to medical care.

John: Very good. Why don't you tell us a little bit about your story because I know that you started out, well, you immigrated, you started out in healthcare, going to being a PA and then going to med school. And at some point, this urge and this interest in doing what you just described started. So what prompted that? How did you start looking at even starting such a company?

TJ Oshun: Yeah, absolutely. As Will mentioned, it started when I was a hospital in a Texas hospital, UT Southwest. And so I worked there for two years. That was one of the best experience I've had, gave me all the confidence in the world to feel like I could practice independently. So I was there for a couple of years. Then I saw this failing clinic. I have a thing for buying into failing practices. It started even when I was in college where I bought a failing barbershop where I used to get my hair cut. It was closing out and I bought it and I revamped it and turned into a profitable company before I exited.

But the same concept happened. I wanted to start a practice, but then I found this local clinic in Irving, Texas that was failing. Partnered with a couple of my colleagues back then, invested and we turned it around and became profitable within a year. Because I knew what wanted it to happen was just optimizing again, the patient experience, looking for the pinpoints that patient needed and grow from there. But anyway, there were a couple of roadblocks as you can imagine, but we were able to stabilize and became profitable by year two. So as the clinic grew, and I wanted to expand, I couldn't expand past the four walls of the clinic as you can imagine.

So that's one of the things I've learned also as I grew a company, that when you start now, with a brick and mortar, you're limited to the ZIP Code, right? No one is going to travel 20, 30 miles to your clinic, even if you are the best doctor in the world, right? So to scale that, I thought, okay, it had to be something virtual. It had to have some element of technology because if you want to scale, you need to have technology involved and virtual. So it started with a phone call. I surveyed my patient at that time.

And as you can imagine, clinics open 9:00 to 5:00 and I knew there were a lot of no-shows and I started surveying my patients and figuring out why they were absent for their diabetes follow-up visit. And the primary, number one reason they gave me was that you guys open 9:00 to 5:00 when I get out of work. So I had to think outside the box.

How can I see my patient outside of the hours? I started extending hours, but obviously there were limitations to that. You can't open 24/7 at a primary care clinic. So the only way I could do that was actually reaching out to them and seeing them at home. The first thing that came to mind was a phone call because obviously technology wasn't available for telemedicine back then. So I called the medical board, Texas Medical Board of, I'm like, "Is it okay to see a patient virtually over the phone?"

They were like, "There's nothing like that. I can't really tell you what to do as long as you're establishing medical necessity and documenting that you're actually helping and documenting it." So we started that way and we just offered it to the self-pay patient only because there weren't any reimbursement for insurance at that time. So we didn't go that route. So it was only for patients that actually needed the medical service that could not make it and we can establish medical necessity for a phone visit.

And it were always the follow-ups, the patient that compliant with their medication that just needed refills, right? But couldn't make it because of office hours. So we started that way. And I remember telling the medical board on that time to email me so I can have it as an insurance in case something happened.

So I still have that email now in my inbox saying it was okay to treat patient virtually. So it started as a phone call, but I needed to do more. So I created, I went on GoDaddy, developed a website where, because -- and the reason why, yeah, let me just go back a little bit and I hate to dwell on this, but I think it's important, is even the phone call, I had to stay on the call for a long time getting the medical history.

So now the medical intake itself is about 15 minutes. So I'm like, why don't you just create a website where I can actually get all the information at hand. So the actual visit will be discussing the intake, right? And it will be sort of addressing the pain point. So create the website, collecting the data so I didn't have to need, I didn't have to involve a medical assistant. So I collected information on the website.

Then the phone visit would just be addressing those problems or areas and providing solution and refills in labs if I needed to. So that's how it started. Then we started scaling to other parts of urban Texas and Houston and other parts of Texas. And we're able to scale to neighboring states as well, providing telehealth. And this is now more from just a phone visit to more of a digital and video conferencing in some part. And COVID hit, but because we were prepared for that, we were able to scale rapidly to all 50 states within a couple of months of COVID.

And we were able to offer, I think, about 350,000 visits for a couple of months during the height of COVID in all 50 states. So that was how we were able to establish the credibility. And because I also made sure patient experience and satisfaction was the forefront of what I did, we were able to scale even faster. We retained our patient and grew from there.

John: Oh, boy. There's a lot I can ask you about in that whole journey there. So many businesses went out of business during the pandemic. You're one of the few, and I guess the other telehealth and telemedicine companies that actually exploded during the pandemic. But I would say there are a lot of physicians that have an idea and think, oh, I could do that. I'm going to solve this problem, whatever it might be. It could be recruiting, it could be patient care, whatever.

But there's always, if there's a tech component, they usually, they get stuck. Either they've got to invest a lot of money. How did you overcome that? How did you go from being a telephone and a website, which is pretty basic? I mean, now I know you've got these visits there. You can choose from the visits. You can populate the information. You can then talk to whoever you need to talk to. How did you get through that hoop?

TJ Oshun: I think the biggest thing for me, which was painful in the beginning, was actually investing in a homegrown technology. I think most people tend to license a software that may not be customizable or scalable and limiting, right? So we were able to invest in a homegrown technology that scaled with us.

So I was able to figure out what my patient wanted, the pain points, reiterate, customize it, take that out, optimize it. And I listened to the patients, right? I know exactly what they wanted, how they want it. And I gave them options, right? On how to see their doctors, right? So listening to a patient, optimizing the technology. Again, a homegrown technology will allow you to do that versus a legacy or a company that you only had what it offered you.

So that helped us a lot. And I quickly brought in, because I understand I quickly brought in, again, I see myself as a technology company more than a medical, right? So I could handle the medical side. So I was able to quickly bring in software engineers from the beginning, hire a team to power it from the beginning. So my medical, my technology team actually grew faster than my medical team.

So we were able to power that through and customize and optimize based off of that. And obviously we can analyze patient journey, optimize accordingly and go from there.

John: Now, before we got on the call, we were talking about how your company is continuing to expand and diversify and becoming more of a tech company and even supplying the infrastructure, I think, for some practices. But I guess if someone who has like an issue, whether it's an app or thinking about technology, is there any advice on where to find software engineers or where to find the tech people you might need to create something like that?

TJ Oshun: It's always a challenge. I have to go through a series of engineers, companies. There were a lot of politics that went behind that also. I had terrible experience. It wasn't always fun, by the way. One of the first technology company I actually partnered with actually sold my technology to a different telehealth company. Right, right.

So it's challenging, don't get me wrong. The good thing is I was cautious about what sort of information I revealed to them. So what they sold was actually the entry level, the MVP of my ideas. So that saved me there. So which I think the other company got stuck with that product because I was already ready to move to the next level. But it's difficult, right? It's difficult. It's about finding the right company that best fits you and has your best interests at heart. And as you can know, it's partnership.

You have to let them understand that this is a partnership. I'm with you if you guys have my back and compensate them accordingly so they can grow with you, right? If they know as you go, because the company I've been with, I've been with them for six years now and they power all my software engineers.

So I don't have to deal with the hiring process of scouting and recruiting the technology. So they do all of that for me. But as I grow, they grow also. They won multiple awards based on the growth that we've had. So they're growing with me and we continue to grow, right?

John: That's awesome.

TJ Oshun: So yeah, it's about finding the right partnership and someone that can actually grow with you, yeah.

John: I want to get your opinion on another thing because along the way you have hired physicians who actually work and do the telemedicine or answer, and maybe it's PAs and NPs as well. What's your advice for someone who's maybe just coming out of PA school or medical school residency, and they're thinking, I don't know if I want to be employed by a big hospital. Maybe I want to just do telehealth, telemedicine. It seems more flexible. What advice do you have about that for them?

TJ Oshun: Yeah, absolutely. It's always a good thing to try to be independent, but it has to be something that you want to do because starting a business is still at the end of the day a business, right? So you may be a provider, but if you don't have the knack for the entrepreneurial spirit or the ups and downs that comes, resiliency that comes with that, it may be challenging.

There are times where I've hit roadblocks and it would seem like we need to pack the things and go home, but you just have to persevere, right? So that's really, really important. That perseverance is very, very key. And if you don't have the bandwidth to be able to power through that, it may be challenging. So that's number one. It's still at the end of the day, it needs to be perceived as a business that needs to grow and be profitable.

So that's number one. Number two, I think having the medical confidence to be able to run an independent clinic is also important. So like I said, I said, I worked at UT Southwest and that gave me the confidence to be able to practice independently. So getting out of school and starting a company is definitely not advisable. Make sure you have that medical chops where you can confidently treat patients. And it could be just whatever you're comfortable with.

It could just be diabetes, but you have to be comfortable managing those patients independently. So the combination of your medical background, be confident in that, and also the medical chops of being able to run a company because you will do everything. You do everything from marketing, accounting, software development. You are going to be the first couple of years, the guy or person that will drive the force before you start bringing a team that will support you. So you have to have a thing for being an entrepreneur as well.

John: Yeah, and I think you made a good point that if you're going to be on your own and really being primarily responsible for, even if it's "during the off hours" or whatever by telemedicine, maybe it's best to do two or three years, make sure you're really comfortable practicing and then jump full-time into the remote type of telehealth.

TJ Oshun: Absolutely, because it's an isolated world there. You're by yourself, right? There's no one to call sometimes. So you have to be able to navigate independently, right?

John: I want to remind people again, the website where they could at least take a look at what it looks like when someone signs in is callondoc.com, right? C-A-L-L-O-N-D-O-C.com?

TJ Oshun: Correct, callondoc.com. Yes.

John: It's pretty interesting. And so it just gives them an idea of what you've built. But I didn't want to wait to just to the end to do that because sometimes people don't listen to the very end. All right. I want to ask you about some other things. So we've touched on this business and the entrepreneurial part of it. I know somehow, because I think you were in a podcast where you were actually being interviewed by, I think you would call this person a mentor, a coach.

She was through a very well-known company I recognize. So I just wanted your opinion as you've been going through this process. I don't know how long you've been involved with that particular, you might even call it a mastermind or coaching. What's your opinion of that? Why do you do that? And what advice do you have for other potential entrepreneurs or physicians that want to grow in there, even in their practice about that particular aspect?

TJ Oshun: Right. So being a CEO and founder of a company is isolating, you're up there by yourself. You sometimes feel like you're not getting genuine feedback or you may be doing something incorrectly and you just need that sort of reinforcement and reassurance. So even though as a company we were growing, it just felt like I was by myself.

I felt isolated. I felt that I needed to do more and reach out to like-minded thinkers like me. So I found V-Stage online for some reason and I was assigned to this amazing coach. Her name is Margaret. We meet once a month, one-on-one. And I had meet with my group once a month as well where we just talk about each other's problems and give honest feedback and how to address it.

And she takes time to dive deep into my business and try to figure out how we can resolve things, right? One of the things she asks me is, what can I do for you? What do you want to talk about today? So she's like my therapist really, where I can actually, more on the business side, but I can actually let her talk about things, right? Whether I'm struggling with an employee or try to hire someone. So it's just someone to sort of bounce ideas.

And when you talk through things, it actually gives a different perspective. And one of the things actually she gave me, advice she gave me, which actually has worked is I have a lot of ideas in my head, but I never write it down. She's like, "TJ, you have to write it down."

John: Or they just disappear. They float away for a while.

TJ Oshun: Absolutely, right. It just disappears, or you're not as organized as you think you will be. But when you start writing things down, putting things in perspective and assigning timeline and resources to things, it gives you a lot more structure. I say that to say this, that you need the support system, which you may not get from employees, right? I don't have a strong executive team like [inaudible 00:21:07]. When I say strong, it's more of, I'm the CEO and sometimes act as a COO sometimes.

So I don't have, so like a maid that can bounce ideas or an independent thinker. I think that's the best way to think. Someone independent with no vested interest in the company. So she gave me that honest opinion without bias.

John: Well, I'll tell you why I was so interested. First I was a CMO for a hospital and our CEO took advantage of the same company and we had a coach. And so he would meet with that coach and then he would meet with a group every month. And then at some point he found it so helpful that he actually brought that same coach into the organization for the senior executive team. So we were meeting as an entire group, the senior hospital team with this coach or whatever mentor. And then individually, we had the opportunity to do the same thing.

And I've always, I have addressed this on the podcast several times and the advantage or the benefits of having a coach, having a mentor, and even participating in basically what's like a mastermind where you get in a group with your peers from other organizations. So I think that's fantastic.

TJ Oshun: Absolutely, absolutely. And it highlights your strength and weaknesses. It's someone looking in and just giving you their honest opinion. So always, always helpful.

John: Yeah, I think it was that question that you mentioned and sometimes the way my mentor would put it is, what's the thing today that you really don't want to talk about that you should be talking about? And there are a lot of those. All right. So let's shift gears again, because I think what my listeners want sometimes is motivation and encouragement, which they've gotten just kind of hearing your story.

They want to learn some practical things, but some of them might need your services, not as a patient. So we were talking earlier and you have expanded your services. So explain what that's about in terms of how you can partner with individual doctors, individual practices to help cover some of their downtime.

TJ Oshun: Yeah, absolutely. And I'm happy to answer that question. I wanted to throw this in before I forget. So one of the things I do a lot of is read books. I didn't go to business school, right? I learned as I go, but to fast track that I've read a lot of books from people have gone through this already, and I just sort of like, it's like a cheat sheet in a way, right?

But I read a lot of books and I'm not the type that reads hardcore. I just listen to the audio books as I drive or walk down the street of New York. That's one of the things I do when I first wake up in the morning, take like an hour walk in New York, listening to e-book and you get a lot from there. By the time you get back, you have all these things and action plans so that you can go implement that practicable, right?

So I encourage people to actually, your audience listening to read a lot more of this sort of self-development book. And depending on your weaknesses, where I have, if I want to learn more about marketing, I pick up a book about marketing. If I need to scale or hire someone, I pick HR or HR related books. So I think that's very, very helpful. And in terms of how my software can actually help doctors.

So we have a lot of doctors willing to join our team. So I think hiring more doctors is not the way to go now. But what we do is again, we're a tech company. We're licensing our services to clinics. So we've been powering clinics throughout the U.S. Like I mentioned, you're about to retire or a clinic that is closing at six, eight o'clock. We can actually power them after hours if you need to go on vacation and you just need to keep your practice open.

We can come in, white label our platforms so your patients still have the experience as if the way we are cleaning. But it will be powered by our medical providers. You can still do the billing. We negotiate the rate, but we will power those clinics and medical practices. And we've had practices on telehealth companies, actually, that are local, but want to expand to all 50 states, but don't want to have to deal with the headache of hiring doctors in all 50 states. So we power them.

They do all the marketing. We see the patients and deliver the care for those patients, but they still own the business and practice, but it's all powered by CallonDoc. And by the way, most of the partnerships that we've actually been having are all the telehealth companies, which inherently are competition, but we negotiate rates that are not competitive, but we do all the software and medical services in the back end.

John: Nice, nice. So that's another entrepreneurial thing to do, expand really what you're offering outside of the initial services. So that's good. So how would someone that's in that situation that is looking to get someone to cover, and yet, like you said, white label or coordinate with their practice, how would they get ahold of you?

TJ Oshun: So absolutely. So just go on the website, callondoc.com. There's a tab in the menu at the top called our partnerships, our business, fill out a questionnaire, and someone from my business development will reach out to schedule an intake. The questionnaire is just learning about your practice and what sort of partnerships you want, and the right person in our BD will contact you to set you up. Very quick entry. We've done this multiple times. We can launch a platform within a day or a couple of weeks, depending on how demanding the interface is, but it's something we can quickly do just by filling out an intake form.

John: Okay, excellent. That's going to be helpful. All right. Well, I think we're getting close to running out of time here. So, well, we've covered a lot today. So before I let you go, is there any other places that you typically would, if someone had a follow-up question could they maybe send that to LinkedIn, something like that?

TJ Oshun: Yes, they can send that to LinkedIn. I'm active on LinkedIn, but that's the only social media platform I'm really active on.

John: That's cool. As long as they have a question, at least with LinkedIn you can do a little screening, make sure it's appropriate, instead of like, oh, just give us your home phone number. How about that? All right. No, we're going to let you go in a minute. So I guess the question I usually end with is if the physicians in my audience they have different things going on, some want to get out of medicine, some want to do -- they want to change, they want to do cash only, there's lots of options.

What advice do you have maybe for these physicians who are maybe a little frustrated with corporate style medicine, or they don't have the control, whether it be your advice for telemedicine, telehealth, or just doing something entrepreneurial, just any advice you might have for those people who are frustrated and don't know where to go?

TJ Oshun: Sure, absolutely. I think with healthcare, there's tremendous ways you can actually optimize or improve patient care, or even the healthcare as a whole, not necessarily just patient, just healthcare as a whole. I think it's just identifying a problem, and not necessarily try to follow what everyone is doing.

Identifying a problem, that's what I did, identify what the problem was, and solving it. Just in your own space find what the pinpoint is, whether it's a problem with a hospital system, or the clinic system, or a patient, right? Identify a problem and try to solve for that problem. If you can solve, you would definitely create a business out of that. And it will be organic. It will be an organic process because you're actually addressing a problem that no one wants to address and not necessarily be trying to be competitive with a hospital system, or I want to change the whole hospital system. No.

Well, how can you optimize whatever deficiencies they have and they will pay for that? Figure out a problem. Your patient will pay, the hospital system will pay, the clinic will pay. How can I help with a deficiency. Like I said, an example is, we know clinics open 9:00 to 5:00. How can I help the clinic after hours rather than competing with them? So that's what I try to do. Find a problem, help them, and be successful at it organically.

John: Nice. Well, that's good advice. And there's so many, I mean, people are getting frustrated because of the insurance payments and so forth, which you have to deal with that I guess in most situations, however, so a lot of cash pay, a lot of people have savings, health savings accounts and other ways that they can pay for the things. And so there's a lot of new ways to solve the problems, as you said.

TJ Oshun: Absolutely. And actually we don't accept insurance for that reason. One of the things that we try to do is offer a quick, easy access to healthcare. Once you introduce insurance, then you have to go through verification, eligibility check. That takes hours sometimes. But we want our patients to be seen quickly within minutes and done. So our constitution fee is average of $40, which is about your copay anyway. So we've never been incentivized to accept insurance. Our patients can still pay for their medication at their pharmacy with insurance, though. They can pay for labs with insurance. But the medical service itself is self-pay.

John: Yeah, good point. You're right. A lot of the urgent care visits, the people pay out of pocket even if they have insurance. Because you're right, they don't meet their deductible and they're going to have to go through so many hoops and we're going to have to go through so many hoops. We both say, you know what, let's just do that $99 visit and move on.

TJ Oshun: Move on. Absolutely. Absolutely. And it works out. Yeah.

John: Yep. And people get taken care of much more timely. All right, TJ, this has been great. I appreciate you coming onto the podcast. We'll have to catch up with you again down the road and see if you've dominated the entire landscape by two or three years from now.

TJ Oshun: That's the goal. That's the goal. That's the mission one patient at a time. Thank you so much, John, for having me. This was fun. I enjoyed the interaction.

John: Me too. You've been a good, great guest. So with that, I'll say goodbye.

TJ Oshun: Bye-bye, John.

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The post Introducing a Fearless Medical Entrepreneur appeared first on NonClinical Physicians.

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

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

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

Our Sponsor

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

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

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

For Podcast Listeners

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

Inside the Role: What a Health Insurance Medical Director Does

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

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

Creating Your Unique Path: Blending Tradition and Innovation

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

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

Summary

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

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

Links for today's episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

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

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

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 379

Health Insurance Medical Director Is Still A Popular Job

- Interview with Dr. Neetu Sharma

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Neetu Sharma: Yes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

John: Okay, bye-bye.

Dr. Neetu Sharma: Bye-bye.

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Disclaimers:

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

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

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

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

PNC Classic Episode with Dr. Rich Berning – 340

Today's podcast episode features Dr. Rich Berning, who explains the truth about medical specialists and UM jobs. It is loaded with practical advice on how to pursue a job as a health plan medical director. He also describes how to find similar positions at an Independent Review Organization or hospital UM department.

Dr. Berning graduated from the University of Cincinnati College of Medicine. He completed his pediatrics residency at Stanford University and his cardiology fellowship at the University of California San Francisco, and he practiced pediatric cardiology before moving to his first nonclinical position.

Our Show Sponsor

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

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

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

Did you know that you can sponsor the Physician Nonclinical Careers Podcast? As a sponsor, you will reach thousands of physicians with each episode to sell your products and services or to build your following. For a modest fee, your message will be heard on the podcast and will continue to reach new listeners for years after it is released.  The message will also appear on the website with over 8,000 monthly visits and in our email newsletter and social media posts. To learn more, contact us at john.jurica.md@gmail.com and include SPONSOR in the Subject Line.

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

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

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

Navigating a Non-Clinical Career Journey in Healthcare

Rich Berning's insightful discussion covers two crucial aspects: his journey from clinical practice to full-time utilization management work, and the multifaceted role of medical director in the healthcare industry. Berning shares his experiences navigating nonclinical career paths within healthcare organizations, shedding light on the opportunities that arose when he transitioned to a state-level plan in the Mideast.

The discussion seamlessly transitions into an exploration of the responsibilities of the medical director role. Rich provides valuable insights into utilization review, case management, and the collaborative efforts required to succeed in this position. 

Negotiating Salaries in Nonclinical Positions

In this segment of the conversation, Rich discusses how the base salary for nonclinical positions can surpass that of clinical roles and the potential for salary growth over the years. They compare the stresses associated with clinical and nonclinical roles, highlighting the distinct pressures in each domain.

Dr. Berning's Advice

Physicians like to take care of patients. That's what we want to do. So, this is just a new way to do it, and it's an important part of the whole system.

Resources and Networking for Aspiring Medical Directors

The conversation shifts to valuable advice for physicians aspiring to become medical directors. Rich describes organizations like AHIP and the American Association for Physician Leadership (AAPL) that provide courses that aid in professional development. 

The discussion concludes with practical tips on enhancing visibility, such as updating LinkedIn profiles, attending conferences, and networking. Rich stresses the importance of leveraging personal connections and reaching out to colleagues in the field for mentorship and job opportunities.

Summary

Dr. Rich Berning shares practical insights on transitioning from clinical practice to nonclinical roles, focusing on medical director positions with large healthcare insurers. He underscores the importance of networking, updating LinkedIn profiles, and attending conferences for career advancement. Rich provides a realistic view of the responsibilities and challenges associated with being a medical director, encouraging listeners to connect with him on LinkedIn for further guidance.

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

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

Links for today's episode:

• Dr. Rich Berning's LinkedIn Profile
• Milliman Clinical Guidelines (MCG)
• InterQual
• AHIP
• American Association for Physician Leadership
• The 5 Most Popular Home Based and Remote Careers – 291
• Dr. Debra Blaine's Coaching Services

Disclaimers:

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

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

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

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

The post The Truth About Medical Specialists and UM Jobs appeared first on NonClinical Physicians.

In today's podcast, Dr. Cherisa Sandrow explains how she created a life with freedom of time, place, and means (money). 

Our Sponsor

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

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

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

Life with Freedom of Time, Place and Means

Dr. Cherisa Sandrow will be launching a new course called, “From Here to There – Leveraging Virtual Medicine“. She was inspired after participating in the Empowering Women Physicians Programs.

Sandrow Consulting gives physicians tools to create a life with freedom of time, place, and means by using telehealth to replace income; especially physicians who are exhausted, stressed out, burned out, or who need flexibility and independence for other reasons.

This new course lasts for 10 to 12 weeks and is supported by a dozen other career transition experts.

Dr. Sandrow will assist you with upgrading your résumé, LinkedIn profile, and bio as part of the application process. The program includes instructions on how to set up the telehealth workspace, the medical component of telehealth, what to expect from physical exams, and then how to document properly and efficiently.

Dr. Cherisa Sandrow's Advice

We live in this world of mentorship and colleagues… there are people that have done what you want to do that can guide you… and that's always been my mindset… the other thing is that we all have this incredible resilience…

Summary

Telemedicine is a proven solution. However, it is not necessarily the end goal. With the freedom and flexibility it offers, we can create space to rediscover our passion and sense of purpose in life.

You can learn more about From Here to There: Leveraging Virtual Medicine by going to nonclinicalphysicians.com/freedom/

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

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

Links for Today's Episode:

• How Do I Generate Awesome Income with Telemedicine Services? – Episode 222
• From Here to There: Leveraging Virtual Medicine
• Dr. Cherisa Sandrow's Website
• NewScr!pt

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 266

Create a Life with Freedom of Time, Place, and Means

- Interview with Dr. Cherisa Sandrow

John: I'm always looking for new programs, courses, books, other resources that will help physicians find more freedom and satisfaction in their lives and maybe also transition to a newer career that builds on their background in medicine. But anyway, that's why I'm bringing back today's guest who's been here before, and she's going to tell us something more about what we spoke about last time and some new things going on. So, with that, I'd like to welcome Dr. Cherisa Sandrow. Hello, and welcome back.

Dr. Cherisa Sandrow: Hi, it's great to be back. It's great to see you again.

John: What you taught us last time and talked to us about last time was so practical. Now it's been almost a year and you've got a new program coming up. And so, I just wanted to catch up with you and kind of figure out what's going on and how it might benefit you, my listeners out there. So, tell me a little bit about what's happened since we last spoke almost a year ago.

Dr. Cherisa Sandrow: Yeah. Great. The world has opened back up which has been awesome. COVID was such a time of isolation for so many. And so, my family and I moved from the Portland Oregon area to Bend, Oregon, which has been our vacation place. It's been one of our favorite places to visit over the past 10 years.

And so, the move is awesome, but also has been a little challenging in regards to community. Between working from home and moving to a new town and COVID, it's challenging to create community, and I know I'm not alone. I actually just saw a post on a Facebook page about a similar situation. I feel like so many physicians and I can speak more directly to female physicians. So many female physicians just feel isolated and are seeking connection. And I'm sure that's true of everybody.

When I in the fall had decided I wanted to put my curriculum onto video, I had been listening to Sunny Smith coach on a semi-retired MD course that I was taking. And as I was listening to her coach, I decided that I wanted to enroll in her summer EWP, the Empowering Women Physicians coaching course. And so that just wrapped up, and it was such a powerful summer of connection and community.

During that course, actually very early on in the course, I was inspired to create this entirely new direction for my consulting business. And so, I'll be launching a course called From Here to There - Leveraging virtual medicine. And I am just in such a different space going into it. I actually was saying I'm feeling like I am lacking joy and connection in my life. And now I feel like I have this entire community and I feel so much more inspiration in my life. So, that's really where I'm at and my girls are just starting school this week.

John: Nice. A little trivia here for the listeners. I'm going to quiz you on this maybe six months from now, but I actually have been in Bend, Oregon once and I was rock climbing with a coach or a guide. It's the only outdoor climbing I've ever done in my life. I'm not a rock climber per se, but Bend, Oregon is an awesome place. It's just like you are living in constant vacation, aren't you, when you're in that part of the country?

Dr. Cherisa Sandrow: That is why people move here. The people that move here are avid outdoor adventurists and love to be active. Basically, it's a town of people that are wanting to live in that environment. And it's grown so much, especially during COVID. Many people from California have moved here, which I think that Californian have moved everywhere.

John: Well, it's a rock-climbing Mecca from what I understand. So, you and your whole family has to learn how to rock climb if you're not already doing it.

Dr. Cherisa Sandrow: When we moved here, it was almost one of the things, not the highest thing on our list of reasons to move here, but it was on that list. So, my oldest daughter is a little rock-climbing prodigy. And so, when we put her on a rock wall a couple years ago, she just went right to the top and we were like, "Holy cow." And so, she rock climbs regularly. She's on the rock-climbing team.

John: Oh boy. Yeah. You're going to have to send some photos out on LinkedIn or something.

Dr. Cherisa Sandrow: Okay. I'll do that.

John: All right. But let's get back to the matter at hand here. Now you have been going through a lot of different things, but one of which is creating this program and kind of expanding it from what I understand.

Dr. Cherisa Sandrow: I'll start with why me, why would I be the person to teach this? So many physicians are wanting to transition to telehealth in the last couple of years. COVID just brought it to the forefront, but it's challenging to know how to even get started and how to make it lucrative, how to actually replace your income with it. And so, I'm a family practice doctor for the first 10 years of practice. I practiced full spectrum family medicine with OB.

And I started working in telemedicine in 2015. I stayed before it was cool and I was doing a little bit of telehealth on the side. And so, I I did that for a year and a half where I was just working with one company, like moonlighting with them, essentially. And in 2017, I transitioned to telemedicine full-time and I was able to not only replace my income, but essentially double my income and cut my hours that I was working in half. And that's what physicians want to do.

And in 2020, I had a lot of physicians that were reaching out, asking me how I did this. And so, I decided to create a curriculum to teach others and I have been coaching one on one over the past two years with using this curriculum. And so, I've created this freedom and flexibility in my life, and I'm super passionate about teaching other physicians who are burnout and wanting a change, how to reclaim and transform their life.

Sandrow Consulting is the name of my company. We help physicians acquire the skills, the tools and the mindset so they can leave their practice and use telehealth as a vehicle to replace their income and give them more time and freedom to figure out what else they want to do in their life. And so, I will take people through all of the steps in the process to get up and running and actually replacing your income will provide the one one-on-one end group support through that transition.

My husband is actually going to be partnering with me on this next phase of our journey. He's been kind of the silent partner as of now, he's been foundational for me though in creating the success that I have. He also is a recovered burnt-out sports med chiropractic physician. He owned a practice, and he has been in the coaching space for the last eight years. And his focus has been really functional medicine and wellness, and his expertise that he's bringing is this is business ownership mindset productivity and system creation, and creating a sense of wellness. And so, our goal is to help physicians just rediscover our purpose and reignite our passion.

Why we went into medicine? We went into medicine because we're super passionate about serving and helping other people. And there's a deep sense of purpose that got us there because in order to get into medical school, we are the top. We go above and beyond. Then you get there and you just spend more than a decade in training and you sacrifice your life and you put everything else on hold and you go into hundreds of thousands of dollars of debt thinking that after you're done with your training, life will be awesome.

And then we get there and life doesn't feel awesome for a lot of physicians and we feel trapped because what else are we going to do? We have all this money to pay back and how else are we going to make a quarter million dollars a year? And we don't realize how much we actually are capable of doing and how many opportunities are out there in the world, which is why I love everything that you do because you start planting seeds and opening people's eyes.

And so, I had my husband go through a program with Caroline Leaf, who is a neuroscientist. She wrote a book called "Switch On Your Brain" and another book called "Cleaning Up Your Mental Mess." She has this neuro cycle program that helps us change our toxic thoughts and rewire our brain. She's studied neuroplasticity for 35 years. And so, she started a facilitator program this year. The goal for me having my husband go through this training is that cleaning up those toxic thoughts and helping people rewire their brain is foundational in recovering from burnout because we just get stuck in a certain way of thinking. And actually, if somebody were to change from a clinical practice or a hospital practice where they're burnt out and they start doing any other thing, if they don't change the toxic thoughts and the patterns that we've developed that is like this work course, just drop work till you drop sort of mindset, we're just going to do the same thing in another field. And so, along that journey of transition, a huge piece of the transition is changing the way our mind is working. And my husband is going to bring that element.

And then the other piece of it is prior to the transition that we made, we were struggling. I mean, we were so close to divorce and we had two children. And my older daughter has some high needs and special needs. And so, through this transition, we were able to heal our marriage and just redefine our core values and redefine ourselves, our own way of thinking. And we are functioning in the world, we are showing up in the world. And so, we are such a great example for other people who are kind of in the same space.

John: Yeah. That gives me a pretty good idea, I think and the listeners too, what kind of got you here. I will say this, that it's funny. Physicians become so desperate to leave, but it's funny because they feel like they're compelled to do something. And the question I get all the time is "I don't know what to do. I don't know what to do."

And I think by addressing all the issues you mentioned in addition to what to do as far as the actual job, but to have the job included, look, here's an easy... Well, it's not easy. It takes work and it takes learning, but here is a proven solution, telemedicine. You can make the same amount of money unless you're a multimillion-dollar high RVU interventional something or other. And you're going to make good money and you're going to have flexibility and freedom and time if they do it the way you do it.

So, I like it. It's not going to be perfect for everybody, but it's going to get people into something quickly and to still pay their bills and pay back their loans. And then if they even want to shift, it sounds like they could do something a little different later, but they have a solution right now.

Dr. Cherisa Sandrow: Yeah, that's absolutely my vision. Telemedicine is not necessarily the end goal. It's freedom and flexibility in our lives and reigniting our own passion and purpose. And telemedicine is a vehicle that I've used. And so, I can teach other people. But then once you get that time back in your life and you heal a little bit from the burnout, then you have the capacity to explore what else you might want to do.

And truly telehealth, the future of telehealth is way more than what most people realize. The American Medical Association adopted a policy back in 2016 that was aimed to ensure that med students and residents learn how to use telemedicine in their clinical practice. And so, this has been like even before COVID a plan for the future of our healthcare system. And in that, they had said as innovation and care delivery and technology continued to transform healthcare, we must ensure that our current future physicians have the tools and resources they need to provide the best possible care for their patients. And for sure, I think once people get into the telehealth world and they start to realize how many opportunities are available, it starts to become more clear how much telehealth and the virtual medicine world is really going to be able to transform our healthcare system. And so, that's definitely exciting.

John: We're talking about, "Well, you could be burned out, you could just be unhappy." What have you. But I'm assuming in your mind, you have a clear picture of who is this ideally, the program you've already been doing with your coaching and so forth, who is the ideal person that would take advantage? I'm sure it's not someone who just had a thought like, "Oh, I'm just a little unhappy." It's probably someone who's really kind of... They don't necessarily have to be burnt out. Tell us about that. Who would be the ideal person?

Dr. Cherisa Sandrow: Yeah. I feel that it's important for people to be in practice a few years before transitioning to telehealth. And so, I don't know that I will turn somebody away who is straight out of residency, but I'm absolutely going to encourage them to do some in-person practice in addition to telehealth, if they want to start doing telehealth early on. And so, really my work is geared towards helping physicians that have been in practice and are struggling to balance work, family and their own life, their own wellness. I think that's most of us though. But not everybody wants to leave practice actually. There's a lot of people that are not even considering the options.

My client is the person who's tired, stressed, and burnt out, or needing flexibility and freedom for some other reasons. When I first put the course together, it was during COVID. And so, my mindset was maybe they're caring for an elderly and they don't want to be exposing them to COVID or maybe they need to be available for their kids that are homeschooling. But there's always life situations that happen and our typical practice doesn't give us the freedom and flexibility. Maybe it's a single mom, a newly single mom or newly single parent, who just has to have more flexibility than our typical practice allows.

John: Yeah. It seems obvious, when you think about telehealth or telemedicine as opposed to traditional practice, one of the big differences besides being on call and having going to the OR in the middle of the night or something is just usually at 08:00 to 06:00. I wouldn't say 09:00 to 05:00, but there's set hours. Whereas I think in most forms in telemedicine you can choose to have more flexibility. You can be taking calls on the weekends or at night or different time zones. So, that part of it, that's where it sounds like it's very flexible, but you have to be disciplined, I would assume.

Dr. Cherisa Sandrow: Yeah. That's actually very true. Well, we are so used to being so busy with somebody else controlling our schedule that when we transition to probably a lot of remote work, but when we transition to business ownership, we have to create our own schedule. Or we will either end up just doing the same thing, working like never leaving your office or you won't ever get work done, because you'll do laundry and you'll have this appointment and that appointment and you want to work out. And so, it is important to learn how to create a schedule, which is actually something that I teach. I think it's important enough to focus on and learn. We don't learn that.

John: The other question that I come across this fear of the unknown is that the physicians that are looking to make a change, they can't really envision what the steps are. They don't know what they should do. "Should I do a CV? Should I start looking? What do I do?" And I think when they have someone like you that can sort of walk them through the steps, there's certain milestones or things that you'll be looking along the way. So maybe I'm assuming that your program kind of addresses those. Are there some big major milestones that people have to kind of get through in this process?

Dr. Cherisa Sandrow: Yeah. Absolutely. And we do all of that. State licensing, getting licensed in multiple states is the thing that kind of takes the longest. And so, we start that process. We help people start that process really in the very beginning, because that is really the piece that we're going to be waiting for at the end is for those licenses to come through. And then we help people first figure out "What your vision is for your life? What do you want your life to look like? What do you want your practice to look like?" And that helps guide us as to where we're going to go with what companies and what direction we're going to go. And so, we focus in the beginning on rediscovering what our strengths are, what our purpose is, what we're passionate about and how we want to show up in the world.

And then we start identifying what the telehealth business vision is and what our goals are. And then setting up a business foundation is huge. And so, I'm going to have a telemedicine lawyer come in and speak. I have a small business accountant who will come in and speak and a bookkeeper who will come in and speak. I will help people with the things that need to get done. And so, setting up an LLC and talking about business ownership, tax write-offs, that kind of stuff. And then we're exploring the companies and which ones to apply for, which is very overwhelming. There's so many. How to review the contracts with the different companies to make sure that you're aware of what you're committing to.

And non-competes are an issue with a lot of the companies. And it's a reason why I never took a job with any of the telehealth companies, because most of them have these non-competes that make it difficult. If you sign a non-compete in the telehealth world, you can't do anything anywhere in the country. And so, I know that a lot of physicians are struggling with their local non-competes and I think it's really important that if somebody wants to transition to telehealth, then they are looking at taking a job with one of the telehealth companies that they're aware of the implications of the non-competes that they may be signing.

And then as far as the application process I help with updating your resume and updating your LinkedIn profile and creating a bio, and then setting up the telehealth workspace and all of the medicine part of telehealth, what's expected from the physical exams and then how to document. And so, all of those pieces along the way, I'm walking somebody through. And so, yeah, there's actually a lot of pieces in the transition that can become very overwhelming if you're not supported through that transition.

John: I was kind of chuckling a little bit because I had this vision. I have a friend and I think you know this friend I'm talking about. I thought the place where you do this is in a chair on the beach or something.

Dr. Cherisa Sandrow: It could be.

John: It could be.

Dr. Cherisa Sandrow: Actually, if you're not doing video calls, if you're taking phone calls or with asynchronous telemedicine, you can be anywhere. And so, if you're doing video or phone visits, you still want to have a HIPAA compliance sort of space and privacy, it still applies.

John: Okay. Well, it sounds like there's a lot of pieces here and it's probably not all crammed into one week. So I'm just curious how does your program look right now in terms of trying to get through this? And not to get through it, but they have time to digest it, maybe ask questions. So, what kind of a timeframe are we talking about that people would commit to, if they were to pursue this?

Dr. Cherisa Sandrow: It will be 10 to 12 weeks. And I have about a dozen experts that I'm bringing into speak that will help encourage everybody when they're hearing other physicians that have create... It's not just me. There are others that have created this similar success in the telehealth world. And hearing other people's stories and how other people were able to create the success and what their journey looked like is of course encouraging. And then we'll have Q&A time with all of those experts as well.

John: Well, that's 12 weeks, basically, if you're saying to go from A to Z, to go from not even have ever set foot in telemedicine, so to speak. And then at the end to be able to do telemedicine, telehealth, whichever version of the approach you're taking. That's quite a transition in a quarter. But it sounds like there's enough time to really dig into each topic and optimize it and make decisions. Because like you said, I'm getting that there are just so many different versions of telehealth that you can choose from. And I know in our last interview, people should go back, I'll put a link to that, but you explained in detail how to overlap some of these things, or it's not really multitasking, but if there's a downtime in this, you've got this other one you can adjust.

Dr. Cherisa Sandrow: Like how to stack them.

John: Stacking. Exactly. That definitely is something that you want to learn as early as possible, but it does take time I'm sure, once you get going to get that experience and to feel comfortable and to become efficient.

Dr. Cherisa Sandrow: Yeah. I think the important thing though to know is that medicine is still the same. And so, the practice of medicine is still the practice of medicine. And we know that, we've been doing that. The delivery changes. And so, we need to learn, there's a lot of mindset shift and there's a lot of belief that has to happen, but the core skill set, we have that.

For me, the business ownership piece of it is important because we are not trained to be business owners and you can take a job with a telehealth company, but you're not going to have as much freedom and flexibility and ownership of your life and you're not going to be as profitable if you take a job with a company because then you are only able to work in that job. And so, teaching business ownership I think is a huge piece.

John: No, that's absolutely critical, I think, to have that freedom, otherwise you're just kind of back in a rat race to some extent, and you're controlled. And when you were talking about the issue of non-compete, that applies probably to both whether you're employed or even if you do have your own business, if you don't sign the right contract. Because you can get stuck with a non-compete, even if you're an independent contractor.

Dr. Cherisa Sandrow: Yeah. We have to read the contracts and be careful with them, but it can. I think the intention of the telehealth companies with the non-competes is that you're not working with another telehealth company. There is only one company that I've encountered that only required that non-compete of physicians and leadership position. And it was around proprietary information, which makes sense to me. But when a company says you can't work with any other telehealth companies, then if that company is slow, and if you're not busy, then you can't do something else. And then in a lot of them, that non-compete limits you if you decide to leave that company. So, then you can't continue doing telehealth. It's just important to be aware of that.

John: Let's see. Let me refresh the audience's memory here on your site. Your website is sandrowconsulting.com. They can go there and see where things stand. If they want to use a link that I can provide, that's nonclinicalphysicians.com/freedom. And that will take them also to that now. I am helping to promote it. And so, I'll probably come up with some kind of bonus for someone to use that link, but either way they can definitely track it down and I'll put that in the show notes. And yeah, I would love to hear the results of some of your clients, customers four or six months down the road. We'll have to track some of them down and maybe I'll get them on the podcast.

Anything else you want to tell us about the program or any other words of advice or wisdom or encouragement you'd like to give us today?

Dr. Cherisa Sandrow: I just want to encourage physicians to recognize how well trained we are as physicians, but our preparation is to be an employee. And so, we have this really extensive training, but then we end up being put into a job where we're the clinician, we're the practitioner. And that's amazing, but it makes us feel like that's all we can do.

And I want people to understand that there is so much, there are so many opportunities that are available, and there are so many experts that are in these different areas that are available to help guide them. And our whole training model is in this mentorship model. Throughout med school and residency, we're mentored. And even going into practice, we run things by our colleagues all the time. That's how we work. You get another set of eyes to go look at your rash, or you review an X-ray with a colleague or you call the specialist to run something by them.

We live in this world of mentorship and colleagues, but then if we decide to transition out on our own, we think we need to figure it out on our own. So, there's a plethora of information on the internet if we start trying to figure it out on our own, but there are people that have done what you want to do that can guide you. Whether you're wanting to go into pharma or coaching or whatever, real estate, there's these mentors. And I think that's something that I valued always.

And so, when I first started out, I reached out to people and I hired Tom Davis to help me when I first started creating my curriculum because I knew I didn't have some of that business skills. And that's always been my mindset is to hire other people to help me because that's how we're trained, but not everybody realizes the value and importance in that. And so, I think that's really important.

And then the other thing is that we all have this incredible resilience just from going through our training, let alone the rest of life that we've experienced. But as physicians, we are resilient beyond belief. And so, what we have proven in our life that we've already overcome and that we've already have achieved, can get us to whatever that next phase is of our life that we want. And so, I think that it's important for us to recognize that we can do it, whatever it is that we want to do.

John: Yeah, absolutely. We've got the brain power, for sure. We just need a little help and some of these steps to learn things that we're not really aware of or have been exposed to. Physicians are somewhat resistant to coaching in general. They feel like, "Well, that's like asking for help and I'm not supposed to." It doesn't make any sense really. Companies, big hospitals and insurance companies, they've been using business coaches for years and years and they love it. And it's what helps them progress even quicker in their career transition.

So, that's what physicians need to learn. It's that by getting some coaching or training or online courses, or what have you, in a particular field, you could just accelerate your progress so much more. That's why I love bringing out guests like you that have created something that is really valuable and can answer a problem or solve a problem for physicians. So, I really appreciate you coming on today Cherisa and explaining this and dropping a few pearls along the way. That's always useful.

Dr. Cherisa Sandrow: Thanks so much for having me.

John: I encourage everyone to go and listen to the previous episode, because you really gave a good overview of telemedicine and telehealth at that time. This is just a lot of misconceptions about it, for those that haven't done it before. Again, thanks a lot for that. And I will put these links in the show notes and I wish you the best of luck.

Dr. Cherisa Sandrow: And can I just add that you are going to be one of my guest speakers? That is exciting too, I'm really happy about that.

John: I'm looking forward to that because I love talking about this stuff and I'm going to try to dispel some myths from my perspective, as well as give the thumbnail of career transition and how I would approach it briefly. But basically, it just echoes what you've already said here today and that you're teaching in your course. So, I think it'll be fun. It'd be great.

Dr. Cherisa Sandrow: Well, thanks so much. It was great to see you.

John: All right. You take care. Bye-bye.

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The post Create a Life with Freedom of Time, Place and Means – 266 appeared first on NonClinical Physicians.

In today's podcast, Dr. Laura Clapper joins us to discuss jobs in leadership roles with health plans and self-insured organizations, and how to best prepare for those positions.

Our Sponsor

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

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

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

Leadership Roles with Health Plans

There are numerous positions in Fortune 50 companies, including Medical Director, Contracted Physician Reviewer, and Physician Consultant. The entry-level positions are in utilization review and benefits management. With more experience, these jobs can lead to leadership roles with health plans.

Preparing to Work for Insurers 

Insurance companies perform hospital-like credentialing. Therefore, physicians must be board qualified and remain so with an active license. Also, an active DEA in one of the U.S. states is often necessary. 

Dr. Clapper highly recommends a book by Dave Evans and Bill Burnett called, “Redesign Your Work Life”. It can help readers think about their careers differently.

Networking and shadowing can also be very helpful. Laura describes ways to use those techniques for finding jobs and learning about them before committing to a specific one.

She also suggested completing the Certified Physician Executive (CPE) program through the American Association for Physician Leadership. She maintains that you do not always need a master's degree, but it can be helpful when pursuing certain positions. Taking business and management courses can be a good way to learn business principles and demonstrate commitment to advancing your career. 

Summary

Check out Dr. Clapper's LinkedIn profile to learn more about her training and professional background. You can connect and message her there. She is trained as an executive coach and has been coaching physicians, so you can contact her if you are interested in those services. She has extensive experience coaching women physicians to help them assume leadership positions.

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

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• American Association for Physician Leadership
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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 265

Pursuing Leadership Roles with Health Plans and Self-Insured Employers

- Interview with Dr. Laura Clapper

John: I'm really excited about today's guest because I want to learn more about managing and leading in the payer side of things. It's like a black box to me. Obviously as a CMO, my hospital interfaces with insurers and payers, but I really don't know how they work internally. My guest today has a lot of experience with very large, well known healthcare insurers. And so, with that, I'd like to welcome Dr. Laura Clapper to the podcast. Hi Laura.

Dr. Laura Clapper: Hi John. I'm so excited to be here. We've talked about doing a podcast together almost since you got started. So, I'm really excited to be here today and share about payers and self-insured employers.

John: Excellent. This is going to be very useful and I am going to learn as much as you my beloved listeners today because it's again, something I know very little about. I'm glad you're here. Why don't you tell us a little bit about your background and clinical training and so forth? It is a long list of things. I do have a separate intro that includes most of those, but anything you want to tell us today that would be helpful to get us started.

Dr. Laura Clapper: Sure. I think it's interesting, at least to me, when we talk about an early career path is that my father was an entrepreneur and was in the aerospace industry and really dealt with satellites. And so, I worked with him when I was in middle school, late elementary school through high school till I went to college. And he did AI and was known for pattern recognition. His patents, he helped develop the barcode for Fred Smith at FedEx. He worked on for Hughes for Digital TV.

But the point that I'm getting to is when I went to college, the idea that we could use AI and algorithms data to really improve healthcare was really what got me excited about medical school and going into healthcare. And the Dartmouth Atlas had come out a couple years before that. And so, this idea we could use data to figure out was more hysterectomies happening, one town versus the other and some of the initial Dartmouth Atlas work. I just got really excited about that. We could use data and dashboards to improve care and look at patterns and have algorithms and really leverage technology. So, I think that's a different path than most people take going to medical school. And so, that's why, and if you look at my career, it really did influence the kind of work I've done and kind of the projects that get me really excited.

John: Well, healthcare was behind in terms of implementing a lot of the technology that other businesses implemented. As physicians and being involved with the health provider hospital, boy, it was just interesting to see with patient safety and quality, the ability to measure things and then risk adjust, and then put systems together to find patterns, as you said, and try and use them to improve safety and care. It's just been really fantastic in the last 20 years. So, it sounds like you were right where you needed to be, if that was what your interest was.

Dr. Laura Clapper: Yeah, it's interesting. Because as physicians, we know patients are not the same. They have different genetics, different environment. Their families are different. What they want to get done and their values and kind of what they hope for themselves in the future are different. And so, we really have to think about each patient differently. That's where I think early on clinical practice guidelines and this is the right way on care really didn't take into account patient nuance and we're getting much better at understanding and be able to do risk adjustment and compare patients to patients so we can have cohorts as well as starting to bring in social determinants of health.

John: Now, one thing I would mention to the listeners is you were also in the Navy. I think for 14 years. So, I'm not sure if a lot of that learning was while you were in the Navy or before, during, after. But when you talk about leadership and management, of course, there's a lot of lessons learned there I'm assuming.

Dr. Laura Clapper: Being in the Navy was great and going to the Uniformed Services University, the military medical school. We actually work with the public health service also. It was important in terms of thinking in a much broader way because there's a huge system trying to provide care globally and trying to figure out can someone stay on their ship and get care through the mid-level who's on the ship and get consults over the phone or does the person need to be flown off? Is the person able to stay in the Middle East or do they need to come back for care at a medical academic center in the US? So, all those things were brought into our training.

John: Very interesting. Well, the thing that impressed me or at least caught my attention was the time that you spent at these large national insurers. My listeners are mainly interested oftentimes in finding jobs that they're not really aware of. So, what kind of opportunities are there in working for these insurers? Maybe just tell us your story in terms of what you were doing. And as we go along, just kind of some hints how they might be able to follow a similar trajectory.

Dr. Laura Clapper: I'm a pediatrician. I'm board certified and primary care. And I think that ensures, there's multiple. We think about Anthem, Cigna. I was at Health Net. That's now part of Centene, in Aetna. So, I've been at some really large employers that are insurers. And it's not one job there. And I guess that's my main point. There are multiple jobs.

These are companies that are under fortune 50 or bigger. And they have jobs where they are leadership team jobs, where you're having multiple medical directors work for you. You may have jobs where you're working more quality and clinical practice guideline development. You may be working with pharmacy, researching, pharmacy drugs, and working with the pharmacist and maybe doing support work for either running or being a support staff person for the pharmacy and therapeutics committee or doing pharmacy. You may be sitting as a specialist.

If you're someone who's a neurosurgeon, an oncologist, someone who's doing a lot of more expensive, orthopedic surgeon or back surgeon or anything like that, you, there may be opportunities in the insurance companies where they're doing prior authorization. And that would be something. Even Aim Specialty, Evercore, they're now owned by insurance companies.

So, your job in those roles would be looking as people are requesting back surgery, maybe multiple levels and you're looking against the clinical practice guideline to see if you can approve it or if you have questions then doing it peer to peer. Usually in those situations, you'll have a team of nurses that are reviewing. So, if the person clearly needs it, it gets to approve it as fast as possible. And so, it'll get approved. The health plans are even working. So, if you put all the information in, it could be like auto approved, then it would go to if a clinical team member could approve it. If it's still not meeting criteria, then it's going to go to especially matched physician who can review it and either potentially deny it or say that there's questions or things like that. So that's prior authorization and it's similar too for pharmacy. You need to match up to the specialty.

Also, there's an inpatient review. So are they meeting InterQual or Millman clinical guidelines and working with the discharge planning. Are they going to go to staff? Are they going to go to an assisted living facility? Are they going home? They need a home house. So, working with the nurse care teams on coordinating the care and discharge planning, and connecting them in with their primary care. So, there's physicians who do those roles.

John: Now let me jump in there just to help clarify. I'm assuming that many of those might be called physician advisors. In the hospital side, working in a hospital, usually if you're doing any kind of that benefits management or clearance, it's a physician advisor. Although I could imagine that might also be a medical director role if you have more experience, maybe you're supervising a clinical team, would that be right?

Dr. Laura Clapper: Yes. In the health plans or the insurance companies, we would call them medical directors.

John: Okay.

Dr. Laura Clapper: They might be associate medical director, assistant. There are different titles, but basically a medical director would fall into that category. You may be working with a big team. You may have some people, that the early listeners may have done some work as case-by-case work or per diem, like they're covering certain days for an insurance company.

But the medical director role is really working on that coordination, responsible for complex cases, review, quality review and working across the team with the nurses, the medical directors, and probably some contracted physician reviewers and the contracted or per diem physicians may be called physician consultants. They may be advisors, but usually once you're a full-time employee, you're called medical director.

John: All right.

Dr. Laura Clapper: And I do want to clarify, to be in that role, the insurance companies actually do credentialing similar to a hospital. So, you need to be board certified and currently board certified. You need an active license. It doesn't have to be in every state, but in one of the US states, you have to have an active license and you need to have an active DEA. Usually, you can have a waiver for hospital privileges, similar to primary care where someone else is covering you. They're not expecting going to the hospital, but you need to have quality discussions and represent your specialty as someone who's a respected expert.

John: Got it. Yes. Because you're having those conversations with the attendings and the surgeons and so forth. So, you need to be able to talk to their language and have some authority, it sounds like.

Dr. Laura Clapper: Right. Correct. And I think that's important because people think about them as nonclinical jobs. So, some of the sad stories I hear are people who didn't renew their board certification, or they let their license lapse and then they want to come work for the Health Plan because they see it as being nonclinical. And I have to talk to them about how can you go renew your license because you can't be in a clinical job at Health Plan or insurance company without being... Because you're the clinical voice, internal and external. So you need to have qualifications to really be able to be an expert.

You'll hear about physicians who are not, but you actually need to look for nonclinical jobs at those health plans. So, an example would be if you also knew technology and you wanted to be like an engineer at the Health Plan and you were clinical, but you let things lapse, you wouldn't be able to work as a physician at the Health Plan. You would have to actually take on a sales role.

John: Okay.

Dr. Laura Clapper: Or I know somebody who's a physician, who's actually at Anthem, who's in contracting. But he doesn't do anything as a clinical voice in the company. He actually does all contracting.

John: Got it. Now, are there other jobs that are outside of let's say the utilization and benefits management, those kinds of things within these large industries?

Dr. Laura Clapper: Yes. And so, some of the other roles that people take on would be working in innovation and technology. You would think there'd be a lot of those, but it's actually pretty small. And usually, the health plan wants you to have a day job to work on those. So you may be doing UM and for a nephrologist who may be kind of leading the idea around, or is the expert around nephrology and doing some UM and other things, working on clinical practice guidelines and then working with the technology team on what's needed to support chronic kidney disease and dialysis and act as an expert in that area may work with the contracting team that's working with the large dialysis organizations, providing clinical expertise around his or her specialty. So, you start to be kind of the SNE in that clinical subject matter and area.

Some of the other ones that you and I've talked about is self-insured employers. Usually in the large insurance companies, there's national accounts, sometimes there's strategic accounts, but usually they fall under the clinical support for the national account team. And then you're working with self-insured employers. And most self-insured employers may have some insured pieces and some self-insured, but their primary product is self-insured.

And usually, you work in a team. You're working with a team of clinical consultants, really experienced, excellent nurses who will go out and work in a more frequent manner with the self-insured employer and then you're being their consultant. And then you're going to the client meetings, maybe their annual meeting or for really large employers you may be going like every couple months. If they're like in the top 10 employers for that health plan, they're going to get higher level service and included in that is having a physician consultant that is assigned to you. And you're their person or their medical director.

John: Okay. I'm going to clarify something too. I'm trying to understand this. The employers are self-insured, but they have a relationship with the payer or the health insurance, because they're actually managing the claims. Is that why there is that partnership?

Dr. Laura Clapper: Well, it's a good question. And so, the self-insured employer usually has a broker or consultant. So, think about Towers Watson or you'll have Aon or other kinds that will be helping them coordinate their health benefit package.

John: Okay.

Dr. Laura Clapper: And so, they'll have that team member or consultant, and then you have the health plan. Now employers will sometimes, especially if they're a large employer, will have multiple health insurance plans working with them. Some they want to give a choice. So, they'll give a choice. They may say we have like in California, it's pretty common. You'll have Kaiser and another health plan.

John: Okay.

Dr. Laura Clapper: And then if their employees wanted HMO, they'll go with Kaiser. If they want PPO or some form of PPO, they'll go with the other health plan. Sometimes they'll offer HMO in both with Kaiser and the other insurance, but they'll have a combination. So, you'll see different insurance companies with one employer. But that tends to be a lead insurance company that either has most of their employees that they work with. And they'll tend to coordinate among the three. The self-insured employer, their consultant, and kind of their lead health insurance company will kind of work on when it's going to be open enrollment. What changes are they going to make to their benefit plan? Are they going to change their deductible level? What are they going to need to do to be able to communicate to their employees? What's coming? And everyone works together with that.

When I first started doing this, which was 25 years ago when I first went to Health Net in 1997, none of the employers really had their own chief medical officers unless they were a health-related company. If they were a health system and we were providing their insurance, then they might have a chief medical officer come. But otherwise, they didn't.

And the medical part of the service that the health plan was providing was to have a medical director who would explain clinical questions or if someone was upset, why they couldn't get a surgery, because it had been denied under prior auth. They would act as a second opinion in some ways to kind of look like not that you were that in that specialty, but you want to say like, "Was the process followed correctly?" You might talk to someone about if they had questions about what their appeal rights were. So, you wouldn't change anything, but if you saw something when you went through it, like, "Did you have all the faxes when you made your decision? Because I can see these facts that got maybe added the next day and you might have not seen it or something like that."

So, you would look, was there integrity to the process and then talked to someone to kind of explain what the process is and what are your next steps if you're going to appeal. So, you could play both roles as a physician being kind of like the speaker of truth. Having taken the Hippocratic oath, you're there trying to represent that. I think over 25 years that more companies are hiring their own chief medical officer that would come and sit in the company and represent the companies. I think a lot of times the national account medical directors act as the medical director for the employer, but there is an uptick and I think COVID also increased the chief medical officer that they're being hired by self-insured employers.

You see Delta hiring chief medical officer, other larger corporations because they need someone to be looking at, "Do we have the right procedures in terms of personal safety hygiene? How close can the seats be? Working with the industrial hygienist, OSHA and occupational medicine team and facilities team trying to figure out. And so, they've gone and hired a chief medical officer.

And what I just said about COVID might've sounded like that's crazy to have a medical director working with these different people. But when I was at Cigna during most of the COVID pandemic, we literally were talking to people, working with facilities to pull the diagrams, to look at ventilation, to say, could people be in those parts of the building? What do we know? Could we do something to upgrade the filtration? Because we had people that need to be providing pharmacy or we have the Cigna medical group in Arizona where they are safe in their buildings and were their patients safe and what could we do? So, the medical directors of the plans do get involved in those things. But I definitely keep hearing different large organizations hiring chief medical officers.

John: I guess that leads me to the question on both sides of that equation, both for the insurers themselves and for these large corporations. What kind of preparation can you do if you're practicing and you're deciding, "Okay, maybe that sounds interesting to me. How do I prepare myself or position myself for applying for a job? And where do I look for these jobs? Do I start with the insurers? Do I think about going directly to an employer at this point and try and map that out?" So, there's two questions for you to try and hit.

Dr. Laura Clapper: I really believe there's a book that I really like. I've actually read it twice and I would recommend it. It's called "Redesign Your Work Life" by Dave Evans and Bill Burnett. They wrote "Redesign Your Life" early on. But their big thing is think about like three paths, think about and prototyping. So, I would say to someone who really wanted to get involved with the self-insured employer, maybe there's a large employer in your town. Maybe go figure out how you could talk to them about do they have a need, see what they have going on? Does it fit with what you like to do to go and maybe look at their factory safety data or something like that? Talk to HR people who are talking about insurance. Is that something you're interested in?

So usually there's networking and asking questions, learning about it would be part of prototyping, figuring out if you could go for a day, maybe a tour or follow someone along. Is this something you like? Talking about this is reminding me of someone I know who was thinking about coming to insurance plan and actually went and spent one day with one of the medical directors that I really loved when I was at Anthem.

And after one day she said, "I don't want to be sitting there doing this. I like talking to patients." That kind of blew her. She was like, "No, I don't want to do it." Because she really saw what it was like. So, I think the more you prototype is you try things out and see. Maybe you're just looking. There are jobs where you could be 50-50. When you're not doing 100%, maybe you would love doing patient care. And so, maybe you don't have to decide. It's not like "all or nothing." Maybe you can figure out if you decrease your hours sum and do some case reviews or do some other kind of work with an employer in your town that you can do a combination.

John: Okay.

Dr. Laura Clapper: And maybe that fit is going to give you a lot of satisfaction, being able to do both. And other people might say, "Heck, now that I can do this, I feel like I'm done seeing patients." So, I think if you can figure out ways to test, to maybe take time off work and go do something for two weeks, try to do some ways you can test out your theory, you can get a better idea. Those kinds of questions, do you like working with those different kinds of teams? What do you like? What brings you joy?

John: It is a challenge and I never used to bring up this idea of shadowing as a way to find out about a job. Partly because sometimes it's difficult. Some companies will not allow that because it's HIPAA or proprietary information and this and that. But boy, if you can actually spend a day with somebody and see what the job really entails, that's going to give you some really awesome insights. So, I do now bring that up from time to time as an option. But like I say, I get pushed back from my listeners and others who say "They won't let me do it."

Dr. Laura Clapper: I think you have to be careful, like the instance I've talked about, the person was with one of the ACOs. So, I think in terms of cross training and understanding how they could work together, there was a reason, it wasn't just like randomly showing up. There was like a paperwork trail of meeting together. So, I think you're bringing up some really important points and you just can't randomly go and sit and listen to PHI. There needs to be good boundaries.

John: But if you're working in a hospital that happens to be, have an insurer or a payer that is providing their coverage. Well, then that would be potential in. It's sort of like when you're in practice and you're prescribing medications. You have a salesperson and that salesperson can connect you with the MSL who might then be able to tell you about what they do or even have you join them on occasion. So yeah, you have to be a little more creative I guess and look at what would be the best way to develop that relationship and then have that opportunity.

Dr. Laura Clapper: That's a good point though. If you're in a hospital, you could go and talk to the HR team and say, "Could you listen in on and do a networking interview? What kind of issues did they have? How do they plan about the insurance coverage for the hospital, particularly for the employed staff. So, it tends to be nurses, less physicians, but the employed staff. Could you listen in on a meeting?"

Usually in meetings between the insurance companies and an employer, you wouldn't talk about PHI. It'd be more things like how is the medical cost running, how much proportion the budgets spent for complex high-cost patients versus wellness and other kinds of costs. How are you doing in terms of HEDIS measures that are your mammogram rate, your immunizations for under five, your adolescent physical visits, where you look at the HEDIS and that's a big part of when you're working with the plan and self-insured employers. It's really looking at how's the total plan running, not just on cost, but quality of care.

John: And that's something to research when you're actually applying for a job. So, you kind of know what's going on. And so that's something that we talk about a lot. Things are obviously evolving. Are there certain jobs you think are in more demand now than let's say five years ago that we can kind of look forward to and anticipate some need growing in these areas?

Dr. Laura Clapper: Yes. Several different areas. One is I think telehealth roles are expanding. When I was at Anthem and we were working with live health online, which is kind of a white labeling of Amwell, you could have a small group supported. Now there's a much bigger component with COVID of care and the whole care model. You start to see medical groups that are having telehealth services. And I think everyone's trying to struggle how do you provide good longitudinal care and that satisfaction from both the provider and the patient, as well as provide better extended hour access, make sure someone really needs to drive in and park and do everything to come in just to say, "Oh my incision looks better." And we can do that through a telehealth visit that's better for everyone, yet, if you're in practice and you're trying to make your practice run well, and you have staff who are checking people in, check doing the receptionist, do all these things, it's difficult to do a telehealth visit and have your staff overhead be sitting there and not having things to do.

So, if hear people saying, well, they're taking certain half days to do telehealth. You're doing half days. And do you share your office now? Do you add more providers into the office planning because they're taking these half days of doing telehealth visits? If your patient needs to get seen, are we doing more of a group practice and not really individual PA provider practices because we're trying to do both telehealth and in person? Do we have parts of medical groups who just like we have hospitalists now they become the telehealth docs?

They put their notes into the electronic health records. So that's more connected than urgent care is to primary care because you're part of the same group. That you could actually then see in the electronic health record, the primary care visits, the telehealth visits and any ER hospitals visits. So, you could see care that way.

So that's good. But I think we're struggling, how do you do the most efficient manpower with providing this hybrid telehealth, inpatient care? And so, I think there's going to be jobs coming out of that as we rethink that whole care model. And what's the best for hybrid care? And at the end of the day, I think patients want to know that you know them, that they have a relationship with you, that there's trust. And that's what I love about primary care. That you know them, you know the family and I think this is a challenge for us. How is medicine going to be practiced in the next even five years? How do we create a system so we get the care we want to have and we want to have for our parents, our families?

Because not that long ago, physicians were practicing in their communities where they'd go to the grocery store, they'd go to the church, they'd be in community organizations. Their kids were in school. And they would know a lot of things about the community. Like the plant was closing down, there's a new employer coming into town, or there's been clacks in the last week and this family was impacted. You knew things about your patients because you were part of that community.

And now we are practicing a lot of times away from the community. We're on telehealth or we're covering different hospitals, or we're doing different things like that. And so, we don't really know the patients in the context outside the visit, like we did in the past. And I think that impacts our decision making or how confident we feel in our decision making.

To me in the future, we're going to have to figure out how to bring that context. And that's really where we start talking about social determinants of health, knowing more about your patients, knowing do they have housing insecurity? What's happening? Is their daughter bringing their food? Do they have food insecurity? Because they're struggling because the plant closed. Like what do you know about them? And when it's just becoming more as a systemized way to approach people that we used to kind of just know because we knew that family.

And when I think about this whole trust in knowing I hate it. When I go and I have to call someplace and you have to verify yourself multiple times. You put all this security information, they say, okay, and they pass you on and they want it again. I hate that. It feels really inefficient. I feel like you should know me. And I think patients feel like that. They feel like why I have to tell my story to so many people. I'm always trying to think, how can we know people, have a good handoff, make it efficient for the patient?

And I do tie this back to what your question was of where's the jobs in the future. Because there's going to be all those jobs, having a strong care team, a strong care model and who are going to be the physicians who are working on building that, whether it's data, technology. Epic has a big influence on us. Epic and Cerner.

John: Exactly.

Dr. Laura Clapper: When all physicians are sitting around talking about Judy pajama rounds and how they have to do extra hours doing their epic and closing their charts, I'm really a big believer that in the next 10 year... Well, I hope everyone's laughing when they're hearing that because it's really influenced physician's lives or families and everything. It's good having the documentation and you can go anywhere in the system and know if someone needs a mammogram.

That's great, but it's come at a cost. And the cost has been unevenly born by physicians at doing all this documentation that hasn't been taken into account. So, my hope is in 10 years, we have a different addition, whether it's a disruptor in the EHR space or they've evolved with Oracle acquiring Cerner. So, it is not with Scribd, but we actually have a better system.

I think that's just one way where I think there'll be jobs and technologies, especially for people who've practiced a long time because they know how it works and they know how people use electronic health records. They know how to use their phrases and can set it up. And people who are really good at being efficient in the EHR, they did EHR since medical school and residency and things like that. There's a huge gap. And so, how do we close that gap so everyone can be good at it? And I think better technology will do that.

I think that we'll start to see more physicians working with startups and independent boards and advisors with startups that's still growing, even with what's going on with the stock market and venture capital. I think this is kind of a pause, but I think that mostly more of that biotech and biosimilars, genetics, all these areas are growth areas, cellular therapies. They tend to be focused on certain specialties in certain areas. And if you're one of those, that's great, but I think there'll be more roles in those areas also.

And one of the things I pursued during the pandemic was actually working on getting my executive coaching certification. And I think we're going to see more physicians as executive coaches too in all different ways. More working on the team, maybe across the hospital. That would be my hope and dream that we really see physicians as an important part of the leadership team in health systems and having them play that role of being executive coach, be actually executive coaches with different executives, as well as other kinds. I think working as an executive coach/advisor at startups or other kinds of ways where you see executive coaching brought in. And so, I think there's a lot of different roles that will come out in the future.

John: Awesome. That's a good overview. When you were talking, I was thinking back to when hospitalists were first introduced and you talk about not knowing the patient. And then telemedicine another example. And so, how somehow the technology has to bring this all together. And then as far as the coaching, I had a physician once. He was a pretty stodgy old man like me. He was like, I don't get it with all these physicians becoming coaches. And it was just funny because business people have used coaches for years. In fact, I have a friend who requires that. He won't take a job unless they're going to give him a business coach.

And so, physicians are left to wander and learn on our own. It's like, that's not good. So, mentors and formal coaches make sense. I'm glad that you're getting involved in that. And especially executive, when you combine physician and executive roles, that's not something that's easy to navigate when you have no background in that. Even if you get an MBA or something, it doesn't teach you how to be a physician executive by any means. So that's fantastic. Well, we're going to run out of time here. Anything else you want to add to what you've already told us? Give us a glimpse and some ideas to shoot for potentially.

Dr. Laura Clapper: I really like what you said about the executive coach and having physicians who are taking on leadership role, even if it's short-term coaching for their first 90 days or for transition in the role. Other roles on the executive team are having coaches. I think as a physician, I wouldn't even have thought to ask for one. And I think we kind of have to increase our awareness and our negotiation into thinking about that. But you and I also talked about other categories. So there's cellular therapies is more combination around the pharmacy and biosimilars, and I think there's going to be a big change, especially with this inflation reduction act of how pharmacy is going to change. And I think there'll be roles for physicians in that as well as with the medical clinical liaison roles. But I think there's also these roles about how pharmacy and PBMs are going to work because they're going to be changing. And the value-based insurance design and how physicians play a role with that.

But I think also women's health is becoming a big area. I just recently was the chief medical officer in FemTec Health and really thinking about how do we address the disparities in health for women. They have a much higher autoimmune burden in terms of incidents of autoimmune disease. And those diseases tend to take six to seven years to get diagnosed.

John: Yeah.

Dr. Laura Clapper: They tend to be more vague. And so, people don't really think about the autoimmune. So how do we create either pattern recognition or profile to help or earlier identification? I think it is really important. Think about endometriosis. It's a very underdiagnosed condition. People may show up in the ER and say they have abdominal pain. They are having fatigue, different things that are seen as vague issues. And then when they're trying to get pregnant, usually endometriosis starts to be diagnosed either by very heavy period or when someone has infertility issues and then they'll figure it out. So, I think we really need to start. And I think part of it is we don't code it. We don't diagnose, we don't code it. So, we don't find people who need the help early enough. And I think it's partly because we didn't think about electronic health records or other kinds of visit forms to even start thinking about asking the right questions. We don't ask the right questions so we don't think about it. The prompts aren't there. And so, it gets lost. The story I like to think about, they had the Apple watch, everyone loves the Apple watch. It took them actually a couple years before they even added the last menstrual period into the mix.

John: Oh, really?

Dr. Laura Clapper: It was more than two years. And even then, they don't have other kinds of questions. We might have a lot of data. We may have technology and devices, but we haven't really thought from the women's perspective first, how to bring these things together. And yet even the work that we're doing in terms of Medicare and Medicare advantage and all the boomers, the growth that we're seeing in Medicare. There's a lot of startups in the Medicare space. And yet who's in the Medicare space for most of the time? It's older women.

John: Yeah.

Dr. Laura Clapper: I think we're going to have to rethink the care and the guidelines for older women. So, there's lots of new kinds of specialties or areas that I think physicians can take their clinical knowledge and really pursue.

John: Yeah. I think we've probably both been exposed to people that are interested in AI and with AI you can recognize patterns. They're not necessarily markers. They're just like patterns of behaviors or background or exposures, which it's just beyond me. I don't even understand how you would capture all that and put it together. But almost to where it'd be like a dog that could sniff a cancer and something totally off the wall, but it'll get there eventually. So, there's lots of opportunities.

I know that our listeners are going to have a need or a desire to get in touch with you somehow. So, I know you have a LinkedIn profile. You're there and I'll put that in my show notes. Any other ideas of how they can find you? Is that the easiest?

Dr. Laura Clapper: I think that's probably the easiest. The other way is through the American Association for Physician Leadership. I think that if you're a member, you can link up with me or connect with me that way. I teach in the Capstone Faculty. That's actually another thing that I think is a good step towards if you're interested in a more physician executive career.

John: Absolutely.

Dr. Laura Clapper: If you are thinking about getting CPE, you can do it. You don't have to go get a masters. You can take the different courses at your own pace. And I think that I've found that people get a lot of benefit from that. I got a lot of benefit personally from it and I continue to see people learning and having that kind of peer group they can talk to.

John: Well, you're in that group like "Oh, I'm one of these kinds of people. I'm one of those that are doing this medical directorship or CMO role or whatever it might be." And anyway, your comment too is very good timing because I believe that the podcast either before or after this one is my interview with Dr. Peter Angood. You didn't know that, did you?

Dr. Laura Clapper: I didn't, but that'll be great. He will be a wonderful interview.

John: Yeah. He's great. All right. I think that we are over time now. So, this has been really fun, Laura, a lot to think about. And I really appreciate you for spending this time today with me and going through some of this. Maybe we'll have you back on some time down the road.

Dr. Laura Clapper: Thank you, John. Thanks for having me. The pleasure was all mine.

John: All right. You take care. Bye-bye.

Dr. Laura Clapper: Bye.

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