Before we get to the interview, I must mention that my NEW focused mentoring program, called Become CMO in a Year, is the sponsor for today's episode.

In this program, you’ll launch your career as a hospital or medical group Chief Medical Officer. Then, over three to four weeks, we develop a plan together to get the necessary experience you need to become irresistible to recruiters and health system CEOs.

To learn more about the program, visit vitalpe.net/cmomentor.

OK, let’s get to today’s interview.

Career Transformation with Dr. Michelle Mudge-Riley

Dr. Michelle Mudge-Riley is a physician career coach, consultant, and entrepreneur. She was my guest on Episode 010 of the podcast.

She has spent the last ten years coaching physicians and creating helpful resources for those seeking career change. She’s come on the podcast to explain the 5 Stages of Career Transformation that she has come to recognize during her long career.

Photo by Suzanne D. Williams on Unsplash

For each step, she describes the common emotions you feel and actions to take to move through the stage.

She also describes where you might get stuck, and how to overcome the obstacles you may meet during each stage. She notes that some physicians reaching Stage 5 may need to circle back and re-engage at an earlier stage once or twice during the process.

And, she reminds us that the greatest mistake you can make is doubting your ability to navigate this process successfully.

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

Physicians Helping Physicians 2.0

At the end of our conversation, Michelle provides us a glimpse into her latest resource for physicians. It’s a membership site at Physicians Helping Physicians with a complete explanation of the 5 Stages and how to progress through them. And, it offers 30 videos that you can work through at your own pace, as well as other resources that she described during our conversation.

If you’d like to check out Physician Helping Physicians 2.0 simply go to vitalpe.net/php2. Use this link to access this wonderful resource AND receive a 25% discount.*

Physicians Helping Physicians 2.0*

Thanks again for listening. I hope to see you next time on Physician NonClinical Careers.

As always, I welcome your comments and feedback.

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

Disclaimer:

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

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

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

*As an affiliate for this program, I may receive a stipend in exchange for helping to promote it. This will not affect the price of the program.

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

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

The post How to Survive the 5 Stages of Career Transformation with Michelle Mudge-Riley – 055 appeared first on NonClinical Physicians.

Mike is a family physician, entrepreneur, speaker, author, medical marketing strategist, and consultant. He completed his master's degree in public health at the University of Michigan, received his medical education at Wayne State University, and completed the family medicine residency at the Mayo Clinic.

He started a software company and led the email marketing strategies of several multimillion-dollar online health companies. Mike also produces education for physicians seeking to create their own clinical or nonclinical business.

I’ve come to know Mike through interactions on Facebook and LinkedIn. He provides insights for group members related to non-clinical “side gigs,” internet marketing, and entrepreneurship.

As you’ll hear during today’s interview, he began his entrepreneurial ways even before he finished his family medicine residency. He's always been drawn to owning his own business and supporting physicians who want to do the same.

Mike's Story

Most of his insights come as he describes his multiple business ventures. He describes so many interesting twists and turns in his career, that it’s pretty remarkable. And I think we only scratched the surface.

Here's a list of some of his business ventures and other topics that we discuss:

1. Making extra money while in residency, teaching undergraduates how to apply to medical school successfully;
2. Generating income using Google Ads on his blog, and using freelance writers to supply much of the content;
3. The importance of networking to develop relationships with mentors and potential partners;
4. His success developing a software company;
5. How he was able to maintain his license and return to clinical medicine by doing locum tenens work;
6. Starting his wellness and weight loss clinic, then branching into medical spas;
7. The failure of medical education to teach basic financial topics or how to negotiate an employment agreement;
8. His passion for helping burned-out physicians find new career options, and how the death of a colleague inspired him;
9. A new course he developed in which he teaches physicians how to become a writer, author, blogger, and consultant and how to market their businesses.

You may need to listen to the interview more than once. There are so many different side-gigs mentioned, and so many great observations by Mike, that I didn’t catch all of the pearls until the third time I went through it.

You can listen using the above player. If you prefer, you can listen on iTunes.

Physician Business Ownership

We covered a long career, with a lot of different options to pursue. What struck me is that physicians have so much experience and knowledge that there are many ways to capitalize on it if we need to.

Mike is very optimistic about the future of medicine. But it depends on physicians adapting and taking their place as leaders and business owners.

In Closing

I'll be presenting another episode of Physician NonClinical Careers next week. Be sure to sign up for my newsletter so you don't miss it, using the form below.

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Please, join me next time on Physician Nonclinical Careers.

Here is a list of resources mentioned in this episode:

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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.

[*Affiliate link: I make a small commission when you buy a product through my blog, but this does NOT affect the price that you pay. It will be exactly the same price as if you went to the web site directly to purchase the item. I only recommend products that I have used myself and can attest to their educational or entertainment value, usefulness and/or quality.]

The post Entrepreneur and Business Owner – Interview with Dr. Mike Woo-Ming – 019 appeared first on NonClinical Physicians.

During the recent SEAK NonClinical Careers for Physicians Conference, I was surprised by the number of times LinkedIn was mentioned. It is a critical tool when seeking a nonclinical job. In one presentation the speaker noted that LinkedIn was the primary method for finding jobs as a medical writer.

In this week’s podcast, I address two of three major issues related to LinkedIn. The third issue will be addressed in the follow-up episode next week.

The three major aspects I'll describe are:

• Exactly what LinkedIn is;
• Why it is so important that you create a LinkedIn account; and,
• How to set up your account and use it.

What is LinkedIn?

LinkedIn is a social network designed for the business community. The site allows members to establish networks of people they know and trust professionally.

It’s a social media site that was founded in 2002. It is now owned by Microsoft. With over 500 million users worldwide, it boasts about 130 million users in the United States. It currently posts about 10 million jobs.

The primary feature that defines LinkedIn is each member’s profile. Think of this profile as a dynamic visual resume. But there are several other important LinkedIn features. These features make it critically useful to the physician pursuing a new career. These include networking, writing and posting articles, and online education.

That’s what it is. Let’s move on to…

The Top Reasons to Use LinkedIn

I believe that LinkedIn is a must for those planning to pursue a career in any nonclinical field. It is especially useful for physician managers and executives, consultants, coaches, and medical writers.

Here are the reasons I find it so useful. Most of them relate directly to its status as an online resume.

Reason #1. Job Hunting

My Story

Three years ago, I updated my LinkedIn profile and submitted my name to the job listings page. A short time later, an entrepreneur contacted me. He indicated to me through the Messaging feature that he was looking for a physician with my background. And he wanted me to consider joining him as a minority partner in a new venture: to open a new urgent care center.

He had devoted a couple of years to researching the business opportunity. And he had plans to open a clinic in a region north of Chicago that had a deficit of urgent care services. He thought that I had the necessary skills to partner with him. And offered to meet to discuss the opportunity.

About six months later, following some negotiation, I signed several agreements. I purchased stock in the new company. And I gave notice to my current employer that I was leaving my job as chief medical officer.

Fast forward two and a half years. Our clinic, called PromptMed Urgent Care, has grown from an unknown entity to a very thriving healthcare facility, treating 40 to 50 patients per day.

LinkedIn Has Helped Many Colleagues

I know of several other physicians who have found jobs in this way.

By creating and updating your profile and participating in LinkedIn jobs, you can constantly receive alerts about new jobs that match your search criteria. As an online resume, it works best if your profile is detailed, clear, complete, and authentic. However, it can present much more information.

It should contain your complete employment history (no gaps), and educational background. It should also list other experiences, including volunteer work. And you must include endorsements from those who know you well (professionally).

Think of this as creating your own personal brand that can be used for a variety of purposes, but especially job hunting.

Reason #2. Connections and Followers

LinkedIn provides recommendations for potential connections on an ongoing basis. You can cull your existing email lists or manually search for connections to add. But LinkedIn also facilitates the process of identifying new connections.

It will use your first-degree connections to identify second- and third-degree connections. You can message them and invite them to connect.

You can identify people in your workplace, and alumni from your undergraduate school, medical school, and residency programs to connect with or follow.

Once you’ve developed this network, you can sort and categorize them for the information you want to send them. You can message them, ask them questions, and consult with them in ways that help each of you professionally.

My Networking Story

About 2 years ago, I started with about 100 connections, mostly people who worked at the hospital where I was working as Chief Medical Officer.

After I started my blog, which targets physician leaders and executives, I made a concerted effort to nurture and grow my network, gradually adding mostly physician leaders. I would attend professional association meetings, then afterward reach out to physicians I had met, and connect with them on LinkedIn, adding them to my network.

I now have over 600 first-degree connections. And unlike Facebook and other social networks, there is no one spamming me or trying to convince me to join multilevel marketing schemes or forward chain letters.

For the physician pursuing a career transition, this networking feature is the second important feature of LinkedIn and it may actually supersede the importance of the Job Listings. In his book, Do You Feel Like You Wasted All That Training?, Michael J. McLaughlin describes the extensive amount of time he devoted to networking and its importance in assisting him in leaving plastic surgery and securing his first nonclinical job in the medical communication industry.

He does not specifically mention using LinkedIn, but had it been available it would have greatly streamlined his networking efforts.

Reason #3. Get Published

I enjoy using LinkedIn to post articles and showcase my expertise and writing skills. Posting on LinkedIn enhances my authority and reputation by allowing me to share articles from other sources, or my own original writing.

My Story

I posted my first article in August of 2015. It was a simple description of my wife’s business, a Home Helpers franchise that she opened in 2009.

After that, I posted articles focused on topics I thought would be of interest to physician leaders. The topics included physician employment, contracting and compensation issues, management, CME planning, quality improvement, patient safety, and communication.

So far, I’ve posted about 20 articles. Most receive less than 100 views. But I had one article (The Best Hospitals Are Managed by Physicians) posted in December of 2016 that has been viewed by 562 LinkedIn members so far.

I also post links to my blog articles and this podcast, both to my main feed and to some of the groups that I have joined on LinkedIn.

Share Your Articles

In addition to posting articles on LinkedIn, if you write for other outlets, like Medium or KevinMD, those can also be shared on your LinkedIn home page.

The article mentioned above (The Best Hospitals Are Managed by Physicians), and shared on LinkedIn, was picked up by Doximity. While most of my popular blog posts generate about 150 to 300 views, that one generated 1,000 views in one day, and so far over 2,800 views since it was posted in July of 2017.

Writing can help with career advancement, network development, and promotion of your side business or consulting practice if you have one.

Reason #4. Groups

There are thousands of groups on LinkedIn that can expand your reach and serve as a source of education and networking.

I’m personally a member of 14 groups, most of which are related to physician leadership, hospital executive interests, and non-clinical careers. I also enjoy the conversations posted to the Writing on LinkedIn Group.

Group members can interact even if they’re not otherwise connected on the site. I can post specific articles and opinions to my groups and thereby encourage interaction with other members. I sometimes post questions to experts in the groups.

Group members can help to identify nonclinical careers and share their experiences and answer questions you may have about various career options.

Reason #5. Good Source of News

I receive an ongoing flow of information from LinkedIn, including posts and articles on my feed from my connections and group members. I’m also able to find new authors to follow by managing my feed preferences. By clicking the “More“ icon on any post, I can add persons to follow from the Improve My Feed list, or the Followers list.

News and other content is also delivered to me daily from each of my groups. When I enter the Groups Area, I’m presented with Today’s Highlights, which is a personalized selection of conversations from my groups.

Reason #6. LinkedIn Learning

LinkedIn Learning grew out of LinkedIn’s purchase of Lynda.com. It has taken this content and merged it with its professional networking.

The content is free if you have a Premium Membership. There is a monthly fee to access LinkedIn Learning if you don’t.

There is a library of over 9,000 digital courses. And LinkedIn Learning will create personalized recommendations of courses for you, based on your interests and expressed needs. These courses can be accessed anytime, anywhere, on cell phones and other personal devices. And they’re very professionally produced.

Bonus Reason #7: It’s Free!

One of the big reasons to sign up is that you get all of this for free. Sure, there are premium services that can sometimes be useful but are often not required.

I’ve been growing my network on LinkedIn for about two years, mostly using the free membership.

In Closing

There you have the top reasons to join LinkedIn. If you are serious about pursuing a new career, especially a non-clinical one, you MUST use this platform.

If I’ve convinced you that you need a LinkedIn profile, you can go ahead and set it up now, or wait until next week when I'll walk you through Steps to Create an Awesome LinkedIn Profile. With that episode, I will provide a downloadable set of instructions to use if you need them.

I want to thank you so much for joining me today.

If you’ve enjoyed the podcast please tell your friends to check it out and Subscribe on iTunes

Let’s close with a quote.

Resources

Here is a list of resources mentioned in this episode:

[table id=10 /]

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

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

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

The post Top Reasons to Use LinkedIn – 008 appeared first on NonClinical Physicians.

Besides, numerous surveys of, and interviews with, successful business leaders and entrepreneurs report the importance of following one's passion. 

But there are two serious statistical concepts at play that place such advice on shaky ground.

Bad Advice

The first is that correlation does not equal causation. To the contrary, it's quite possible that success fosters passion. It's perfectly logical to become passionate about a career that has brought fame and fortune.

The second is survivorship bias. Yes, a high percentage of successful persons declare that passion was responsible for their success. But for every successful business owner, there are often many unsuccessful business owners.

About 60% of new restaurants fail within 3 years. Most of the founders were probably passionate about starting a restaurant. But if they were all passionate when they started (including the failures), then the correlation with success is zero at best.

Yet we never hear from the unsuccessful business founders or career seekers. Who would interview someone about being a failure?

So, the presence of passion itself probably does not correlate with success, just as the TV show American Idol has demonstrated that passion for singing does not correlate with the ability to sing well.

This particular example was mentioned by Ben Horowitz  when he spoke at some length about passion while presenting the commencement address to the class of 2015 at Columbia University .

He described why passion is probably overrated as a reason to follow a career path or create a business:

1. You probably have several passions, so which do you choose?
2. Passions change over time.
3. Your passion does not always correlate with your abilities.
4. Following your passion is too self-centered.

Horowitz’s advice was to “follow your contribution.”

Lessons From “Dirty Jobs”

Mike Rowe of Dirty Jobs fame, seems to agree with Horowitz. Based on his talking with dozens of people doing “dirty jobs,” he's found that his hosts often developed a love for a particular job after they had done it for a while and become reasonably good at it. He clearly advises against following your passion.

He recommends following opportunity to select a job. Look for what's needed in a market, get good at the job, and prosper by being good at it. The excitement and passion follow because the job has become so prosperous. He also agrees that passion and ability often do NOT correlate, so pursuing a career based on passion, but lacking in ability, can be a terrible waste of time.

Unexpected Findings

Several years ago, I was reviewing the results of our recent Top 100 Hospital designation. At the time, there were nine categories that hospitals and health systems were ranked on. These nine compromised a pretty good balanced scorecard and we had put several specific programs in place to address the Top 100 measures.

As I looked over our results for each of the nine categories, I was surprised by the following observation. We had performed slightly below average to somewhat above average on most of the measures. There were only two in which we had performed significantly above average.

Yet, here we were, one of the top performing hospitals in the country based on this basket of quality, financial and satisfaction measures. And we were certainly not top ranked in most of them.

I found that it was more important to rank average to above average across the board, than to perform exceptionally well in one or two measures. Apparently, most hospitals have difficulty performing average to slightly above average in all measures, even though they may be spectacular in one or two, because very few hospitals are able to achieve a Top 100 rating even once.

By consistently pushing on all of the important domains, from mortality rate, to length of stay, profit margin and patient satisfaction, we were able to outperform most of the other hospitals in the country in terms of overall performance.

That was an eye-opening realization for me.

Unorthodox Career Advice

The second bit of advice concerning preparation for a career change has to do with those who have not yet decided exactly which career to follow. Especially if you're early in your clinical career and uncertain of which direction to go, the tactics for finding a new career, in addition to forgetting about your passion, may be to abandon goals and start acquiring skills.

Just as the top healthcare organizations don't have to be the best in every major hospital performance measure, the most successful leaders may not need to be experts in every leadership skill.

In his book How to Fail at Almost Everything and Still Win Big, Scott Adams describes how he came to be a nationally recognized, award-winning writer of the Dilbert cartoon.

He explains that it wasn’t his passion or intense study of humor or drawing. It wasn’t his having spent 10,000 or 20,000 hours learning his craft.

It resulted from his being mediocre to reasonably good in several, apparently disparate, fields:

1. Drawing
2. Business
3. Writing
4. Early adopter of technology (the Internet)
5. Sense of humor

He writes that combining his mediocre skills in each of these areas enabled him to achieve outstanding success in the area of writing a funny comic strip about characters in an imaginary work setting. And he had no idea that these skills would come together to make him wildly successful. He also suggests that his success contributed to his eventual passion for writing Dilbert.

Increase Your Odds of Success

His rough estimate is that each additional skill doubles our chance of success. Here is the list of skills that Adams recommends everyone become reasonably good at:

• Public speaking
• Psychology
• Business writing
• Accounting
• Design (the basics)
• Conversation
• Overcoming shyness
• Second language
• Golf
• Proper grammar
• Persuasion
• Technology (hobby level)
• Proper voice technique

To reiterate, Adams is a proponent of “stacking average skill sets” until a combination of skills creates an above average mix.

My Take On Choosing Skills to Stack

I don’t completely agree with Adam's list, especially for physicians looking to move into a new (nonclinical) career. I would probably make some adjustments, dropping golf and combining some items to come up with my starting list:

• Writing (includes, spelling and grammar skills)
• Public speaking (includes “voice technique”)
• Second language
• Accounting (and finance)
• Psychology and persuasion (includes negotiating skills)

I'm assuming that most clinicians have already developed a set of skills that serve them well and are already in play:

• Leadership
• Composure (ability to work under pressure)
• Strong work ethic
• Communication (one on one)
• Logical thinking and a working understanding of the scientific method
• Human physiology and biochemistry
• Focus/Concentration

Then stacking additional skills would open the possibilities for other career choices:

• Legal concepts and resistance to criticism, to be an expert witness
• Healthcare finances, running meetings, project management and writing, for hospital or medical group management
• Case management and conflict resolution, to be a medical advisor
• Basic or applied research, writing, and statistics and epidemiology, to be a medical writer

In reality, many of these careers share certain skill sets, as shown in the following graphic.

Final Take-aways

When considering a career in management, or any other nonclinical field, I recommend this unorthodox career advice:

1. Don't spend too much time worrying about finding your passion. Ultimately, your passion may find you, or develop along the way.
2. Identify and develop useful skills that will compliment those you've already acquired during years of education and training.
3. Focus on acquiring additional skill sets (quantity) rather than on perfecting a smaller set of such skills (quality or mastery).

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Can you think of times when adding new skills was more important that honing established ones?

Was there a time when following your passion was a waste of time, or even harmful?

Next Steps

Please add you're thoughts in the Comments.

SHARE this post, SUBSCRIBE Here and complete a SURVEY .

Email me: at johnjurica@nonclinical.buzzmybrand.net or record a voice message.

Until next time.

The post Effective But Unorthodox Career Advice appeared first on NonClinical Physicians.

It also required a thorough review of workers compensation and occupational medicine. And I needed to take a mandatory course and exam by the National Registry of Certified Medical Examiners in order to conduct physical examinations for interstate commercial motor vehicle drivers.

As a result, I was not able to attend any recent American Association for Physician Leadership Annual Conference or Institute.

However, I am now registered to attend the 2017 Spring Institute and Annual Meeting! They run back to back from April 18 through April 23, in New York City. And my wife will be attending with me because she loves New York.

As the name implies, the event is actually two meetings in one.

The AAPL Spring Institute

This part runs from April 19 through April 21.

The AAPL lists the following benefits of attending:

• Live interaction with world-class faculty
• Learning with peers
• Opportunities for networking
• Concentrated learning (time efficient)
• Fun group activities
• Personal education advising sessions

The Spring Institute focuses on in-depth study of topics from its Physician in Management Series. I have participated in several of these educational activities that in the past. They address management topics such as:

• Quality Improvement
• Negotiation
• Finance
• Marketing
• Teamwork

Physician leader Atul Gawande

The presenters are always polished and very knowledgeable. For this meeting, I heartily recommend sessions presented by:

• David Nash
• William “Marty” Martin
• Kevin O’Connor

Each of them is very engaging and effective in meeting the objectives of the presentations.

For the beginner physician leader, it is probably best to start with Managing Physician Performance or Three Faces of Quality.

As a more seasoned participant, I have decided to attend the sessions devoted to Resilient Leadership and Coaching and Mentoring Physicians to Higher Performance.

The American Association for Physician Leadership Annual Conference

This year’s Annual Meeting officially runs from April 21 through April 23. The educational sessions don’t begin until Saturday morning, April 22.

It is designed differently from the Institute. There are two keynote presentations, and two workshops. The rest of the educational material is presented in the form of Peer-Led Learning Labs.

What is a Peer-Led Learning Lab?

It is one of forty-seven 20-minute presentations covering the following categories:

• Leadership
• Healthcare Organizations
• Finance
• Communication
• Careers
• Management
• Patient Care/Quality
• Health Care Professionals
• Innovation and Technology
• Health Law and Policy

As I look at the list of topics, several appear quite interesting. I recognize several of the presenters. They all currently hold leadership positions in many different types of organizations.

I can also recommend the session by Jeremy Blanchard. He will be discussing Language, A Fulcrum for Physician Engagement and Culture Transformation on Saturday, April 22nd, between 10:30 and 11:30 AM in the Madison Square Room (according to the schedule I have been provided). I interviewed him for this blog back in January.

There will also be opportunities for networking, and other formal and informal events.

I will be helping out as an “Ambassador” for the meetings. That means I will be introducing Edward A. Walker at the start of Coaching and Mentoring Physicians to Higher Performance on Thursday and Friday, and helping to manage the peer presentations Saturday morning in the Bowery Room (three presentations each for Lab 1 and Lab 2).

I would love if any of my readers stopped by and said hello.

How I'm Preparing for This Conference

There are some things can be done to help maximize the value of this or any other conference. I’ll admit that I have not always followed my plan for this meeting.

That's in part because I am an introvert and find it difficult to strike up conversations with strangers. But networking is probably as important as the content I will be trying to learn during the meeting.

Attitude

• I want to be intentional with this conference; to participate with curiosity and a willingness to meet other participants.
• As a committed introvert, I will overcome my hesitance to engage with others.
• I will strive to remain coachable.
• I commit to speaking up and contributing verbally when asked to do so.

Goals

I am approaching the conference with specific goals in mind. My primary goals are to:

• Learn new ways to be a more resilient leader;
• Achieve a deep understanding of coaching and how to effectively coach others to achieve their personal and career goals;
• Meet at least five new colleagues from the AAPL that might consider being interviewed for this blog in the near future;
• Pick up some practical tips from the Peer-Led Learning Lab in the Leadership and Management content areas;
• Get to know more of the AAPL staff by working as an Ambassador; and,
• Promote this blog to at least one hundred conference participants, in networking events, before and after presentations, and at any exhibits that may be held at the meetings.

Recent business card to bring to the meeting.

Further Preparation

One of my Institute sessions requires completing pre-conference work (a personality inventory), so I have already completed that .

I have taken a closer look at the faculty for my sessions and have looked them up in more detail on LinkedIn, as a way to better engage with them during the meetings.

My Advice

I recommend that you seriously consider attending this meeting if you are in a leadership position or thinking about moving into one.

Next Steps

My next steps are to:

1. Check that my flights and hotel room are confirmed;
2. Get all my work (including blog posts) caught up, prior to departing on April 18;
3. Review any instructions from the AAPL regarding my role as an Ambassador;
4. Take copious notes at the meeting;
5. Write a blog post or two based on inspiration from the meeting.

For more of my thoughts on healthcare and leadership Subscribe here.

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Feel free to email me directly at john.jurica.md@gmail.com with any questions about anything. I am here to help you excel as a physician leader.

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Thanks so much and see you in the next post!

The post The Looming American Association for Physician Leadership Annual Conference appeared first on NonClinical Physicians.

Participating in CME (continuing medical education) has been a big part of my professional life. After completing my residency, and joining a hospital medical staff, the first committee I was assigned to was the “Program and Education Committee” (a.k.a. the CME Committee).

I really liked participating in this committee. It was more altruistic than some of the other hospital committees, where politics or power struggles often prevailed. We spent most of our time sorting through possible lecture topics and contacting speakers to travel from Chicago to provide a dinner or noon lecture.

Due to lack of interest by other members of the committee, I quickly found myself chairing the committee. I started attending the Illinois State Medical Society (ISMS) workshops for CME providers. I needed to understand the requirements for ongoing accreditation.

Within 18 months, we underwent our first accreditation survey. We we did pretty well. I had read the accreditation manual, so I was prepared to answer the surveyors' questions.

Joining the ISMS Committee

We were reaccredited without any major deficiencies. Shortly thereafter, the Chair of the ISMS Committee on CME Accreditation asked if I was interested in joining their committee. Technically, I was nominated by the Kankakee County Medical Society.

I joined and began attending monthly meetings. Because we were providing a service that enabled physicians to obtain high quality CME through local hospitals, I really enjoyed the work.

Sometime later, the ISMS chose me to chair the Committee on CME Accreditation. Early in my term, Murray Kopelow, the new President and CEO of the Accreditation Council on Continuing Medical Education (ACCME), visited us during one of our committee meetings. The ACCME is the body that promulgates all of the rules for achieving and maintaining accreditation for CME providers.

Getting to Know the ACCME

As a consequence of Dr. Kopelow’s visit, I later became a member of the Accreditation Review Committee of the ACCME. The ARC is the committee that reviews all national CME providers for compliance with its Criteria for Accreditation, and provides its recommendations to the Board itself for final accreditation decisions.

For more than 20 years, I have been doing surveys for new and ongoing CME providers for the ISMS and the ACCME. And I have attended many of the annual meetings of the Alliance for Continuing Education in the Health Professions (ACEHP). Hence, I have spoken with many CME planners.

And I still help in planning CME for the Kankakee County Medical Society and for a private education company that creates internet and print-based CME.

Needless to say, I have seen many changes in the CME world over the years. I have witnessed the consolidation among CME providers as they attempt to reduce costs and staffing needs.

CME Providers Give Up

I have seen providers simply exit the CME “business” because of increasing paperwork requirements and seemingly more stringent accreditation requirements. Some of these new requirements resulted from reports that CME credit was allegedly being offered for what seemed to be vacations at ski resorts and tropical islands.

Many state medical societies have seen a drastic reduction in intrastate accredited CME providers. From 2008 until 2017, the number of state accredited providers dropped from about 1,600 to under 1,200. The number of hours of instruction has also declined over the past decade.

Interestingly, the hours of instruction by national accredited providers has remained fairly stable.

In spite of these changes, there is an ongoing need for CME. Most states have requirements for their physicians to participate in accredited continuing education.

Physicians are committed to lifelong learning. They often prefer to participate in CME through local accredited providers. And they certainly want to obtain American Medical Association Category 1 Credit for their CME participation.

Last CME activity before the program closed down.

They also prefer to take advantage of local, low-cost education that is relevant to their practices.

And, in spite of its need to “tighten-up” the planning process (by ensuring that proper adult learning principles are applied and commercial influences are avoided), in my opinion the ACCME is committed to helping its CME providers more easily meet its requirements. For example, it has eliminated requirements that were redundant.

Reintroduce Your CME Program

I am writing today to encourage those of you that have abandoned your CME program to return to CME. And to suggest that if you have never been accredited to grant CME credit, now may be the right time to do so.

The lecture hall is ready to go.

I offer the following reasons to encourage you to jump back into CME. These reasons apply to hospitals and large medical groups, primarily.

Keep in mind, too, that other groups of professionals, including nurse practitioners, physician assistants, and pharmacists, can benefit from these activities.

Let me start by defining some terms:

• A lecture, online educational session, conference, symposium, series of regularly series, etc., will all be referred to as an activity (rather than a program).
• The accredited entity that grants AMA (American Medical Association) credit is called the provider.
• The CME program is the structure, policies and procedures that produces activities by the provider for its audience.

One more thing: this entire article reflects my own thoughts and opinions. In no way do I represent the ACCME or its policies or opinions.

Without further ado…

Top 25 Reasons to Get Back Into CME

It's not as difficult as it used to be…

1. There are more resources and support than ever. Between the ACCME itself and organizations like the Alliance for Continuing Education in the Health Professions (ACEHP), many state medical associations, and state and regional chapters of the ACEHP, there is plenty of help to start and run a CME program.
2. There are more educational formats than ever. As a surveyor, I have seen every imaginable format for CME. Live lectures, conferences and national meetings are still popular. But you can use “enduring materials” such as written monographs and journal-based CME. There are also multiple forms of Internet-based activities from live activities to archived courses. I've even seen providers use Google Hangouts to offer valid CME activities.
3. It does not have to be complicated. If properly planned and designed, a CME program need not be overly complicated or expensive to maintain. Many hospitals design their programs to be able to grant credit for regularly scheduled series (RSS) that they wish to hold anyway:
   • grand rounds
   • tumor board
   • quality committees
   • patient safety committees
   • lung nodule clinics
   • any similar meeting in which clinical information and educational content is included, as long as it meets the definition of CME and the planning requirements.

Patient Benefits

1. You will achieve better patient outcomes. This is the ultimate goal of effective CME. There is good evidence that participation in CME enhances physicians' care and produces improvements in outcome for patients, especially if it is integrated with QI efforts. As I discussed in Benefits of CME/QI Integration, not only can QI be integrated into your CME planning, using QI data for needs assessment and evaluation is one of the best ways to apply your CME resources. Well designed and utilized CME helps elevate the competency of a medical group or hospital medical staff.
2. New medical technologies, services and medications can be introduced. A great way to introduce new equipment and technologies that are underutilized is through a CME activity. There are countless examples of the slow adoption of new technologies and protocols. For example, screening for CAD in heart failure patients is still underutilized, as is the use of ICDs after acute myocardial infarction in older patients. Ideally, this will be part of a concerted plan to develop indications, contraindications and proper referrals for new techniques.
   
3. Patients expect it. Patients expect their physicians to interact with experts and to continuously maintain current knowledge in their specialties. Consumers are attracted to healthcare organizations that demonstrate a commitment to using the latest technologies and systems of care.

Cleveland Clinic Miller Family Pavilion

Organizational Benefits – Improved Quality, Image and Referrals

1. Producing CME can enhance your image to referral physicians and institutions. If your organization promotes its educational activities to local, regional or national audiences, and especially if you feature your physician faculty, the organization becomes known as a center of education and learning.
2. Physicians can be featured and promoted.* Medical and surgical specialists often use cutting-edge technologies that referring physicians are not aware of. When experts present evidence-based protocols to primary care physicians, they generate more (appropriate) referrals for the specialist.*
3. Hospital length of stay can be reduced. Hospital LOS is a measure of quality and care coordination. Developing educational activities that support care management can help reduce LOS. This will reduce costs and meet patients' desire to return home as soon as possible.
4. CME can help reduce readmission rates. High readmission rates result in penalties to hospitals under  the Hospital Readmissions Reduction Program. Content that focuses on care coordination, better communication with patients, medication reconciliation and prompt office follow-up are some of the topics appropriate to such efforts.
5. Providing CME demonstrates a commitment to lifelong learning. Lifelong learning is important to all participants in healthcare, from support services, to nursing, physicians and executive leadership. Market the organization as a center for learning to board members, the community and other stakeholders.
6. It demonstrates commitment to physician well-being.* If the organization uses CME to address psychosocial issues, burnout, or even improving productivity and patient flow, it will be seen as more concerned about its physicians. This creates good will.
7. CME can be used to address organizational strategic goals.* This is often overlooked. But once your executive team has identified strategic goals for the coming year(s), CME activities can be developed and coordinated to help support the goals. This is one great way to further communicate the strategic vision of your organization to its physician stakeholders.

Organizational Benefits – Improved Teams

1. Multidisciplinary activities promote more effective teams and collaboration.* By developing educational activities that involve whole teams, such teams can be made more collaborative and effective. Some activities might address teamwork directly. Others might present clinical topics, but with a focus on the unique role of each of the disciplines. A good example is the kind of training that occurs an Advanced Cardiac Life Support (ACLS) courses.
2. CME can promote the (desired) organizational culture.* This requires executive leadership to be involved in planning. Then as activities are developed, attention to desired the mission and vision of the organizations can be woven into the CME planning process.
3. Physician engagement will be improved. As discussed previously, physician engagement is a problem at many institutions. It has numerous negative consequences for the physicians and their employers. Properly planned and implemented CME can be used to encourage teamwork and a focus on quality improvement. These are issues that physicians are passionate about.
4. You can improve physician productivity.* When engagement is better, physicians are more passionate about, and involved in, their work. This leads to more energy, more ambition and higher productivity.
5. Turnover in staff can be reduced using CME.** By participating in CME as a team, a shared sense of mission can be instilled in the participants. This results in more cohesive, productive teams. For this to work, the CME enterprise must focus a significant part of its efforts on multidisciplinary team education.

In the next section, I list some of the direct benefits to practicing physicians. Keep in mind that any benefit to physicians will also accrue to medical groups or hospitals trying to attract physicians, and will often benefit patients.

Physician Benefits

1. Providing CME meets physician expectations. When asked, physicians consistently indicate that they want local sources of CME and expect their employers/hospitals to provide it for them. It is a benefit that will attract physicians to your medical group or health system. Most physicians believe that investment in education demonstrates an investment in them.
2. Local CME reduces the cost of education for physicians. Continuing education can be costly for the participant, whether involving travel or registration fees. Physicians appreciate being able to obtain required educational credits at a low or nominal cost.
3. Live activities promote interaction between colleagues. If planned appropriately, live CME activities can foster interaction among participants that builds relationships and collegiality. Working together through participative CME encourages better coordination of care outside of the “classroom.”
4. It's an opportunity to provide mentorship to young physicians.* Presenters, lecturers, and authors of CME content can serve as formal or informal mentors. Such mentors can support participants and develop long-term relationships with those involved.
5. You can address non-clinical aspects such as professionalism, communication, process improvement, and self-care.* Most of us have been involved in organization that have pockets of disruptive behavior, poor communication, and growing burnout in its professionals. CME can be used to address those topics directly, or can tackle it more tangentially while addressing patient care issues.
6. Local CME will improve interaction between medical students, residents, fellows and practicing physicians (what ACCME calls the “medical education continuum”).* By creating activities that involve physicians at all stages of their careers, faculty can model best practices and develop life long relationships. Involving all levels of learners provides mentoring for the younger members, and a feeling of continuity in the more senior members.
7. Regular interactive CME can improve morale, increase physician loyalty, and reduce burnout.* Anything that enhances inter-professional teamwork, networking, goal setting and deeper engagement can combat burnout. When physicians believe that their needs are being addressed, and work in teams on meaningful projects, loyalty improves.

Its Time to Reintroduce Your CME Program

There is no more rewarding endeavor than providing a service that helps physicians, improves teamwork, promotes the workplace and improves patients' lives. That's what CME can do when well-planned and implemented with pride.

Next Steps

Follow these steps to restart your CME program:

1. Survey your physicians to assess their interest.
2. If there is interest, get someone from your finance department to help you put together a pro forma. Realistically assess the costs of running a bare bones program that will provide at least one monthly activity, including the costs of initial and ongoing accreditation.
3. Present a proposal to the CEO or executive team of your organization to form a team to investigate the feasibility of starting a CME program. Don't forget to include the benefits listed in this post when making your case!
4. If you get the approval to proceed, start by accessing the resources of the ACCME and the ACEHP.

I welcome your comments and questions. And I am happy to assist in any way I can, if you decide to proceed.

John Jurica @ Vital Physician Executive

*These reasons are taken from commentary published by Graham T. McMahon, MD, MMSc, President and CEO, ACCME, that can be downloaded by following this link:

The Leadership Case for Investing in Continuing Professional Development

**From a recent report on interprofessional education titled: By the Team for the Team: Evolving Interprofessional Continuing Education for Optimal Patient Care

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This is a process. Like any new realm of learning, we follow a path from awareness, to understanding, knowledge, competence, and eventually, mastery. This process may take years to complete.

The Chief Operating Officer and I asked the Director of the Laboratory, Sheila, to join us to discuss a challenge she was experiencing with her staff. I was still learning the ropes about working with directors of hospital departments like the Lab. The COO was quite good at sorting through difficult issues and building strong teams.

The director was very frustrated. She spoke about a particularly difficult employee. Peter had been working as a laboratory technician for many years. Every few months he would become the center of some drama in the department. He would be “written up” and then not be heard from for several months.

The employee had certain skills and certifications that made him difficult to replace. In spite of repeated involvement in various kerfuffles that impaired the morale of the department, he never received more than a slap on the wrist for his transgressions.

Sheila described her frustrations in detail. Several technologists and laboratory assistants had come to her with complaints about Peter’s behavior. They felt that Peter was repeatedly allowed to skirt the rules without serious consequences. The staff resented what was happening.

As Sheila described the situation to us, we mostly just listened. The COO occasionally encouraged her: “Go on, tell us more.”

Seeking a Solution

At one point he asked, “How is this behavior affecting the performance of the department?”

Sheila replied, “The turn-around times have gone up because the staff aren't working well together. And one of our new technologists resigned 2 weeks ago, probably because of Peter.”

“How is this affecting your work?” he asked.

“I'm spending much of my time putting out fires and trying to convince the other employees not to quit.”

“What have you tried so far to resolve the situation?”

She described various attempts she had made to work with Peter to improve his accountability and address his behaviors. As she paused during her description, we listened without comment. After a few moments, she continued.

“You know, it's going to be difficult to replace Peter, but I think I have to do it. For the department, and the organization. His presence is too toxic. If you agree, I'll meet with HR later this week to review the process. Then I'll meet with Peter and let him go.”

Preparing to Be a Better Physician Leader

In Part 1 of this series, I wrote about the attitudes and approaches that physician leaders should reflect upon.

In the following paragraphs, I discuss important skills we should hone if we want to be truly effective.

Project Planning

The ability to take on ever more complex projects is an important skill for the physician manager and executive. All physicians have some experience in creating plans to achieve important goals.

After all, we were able to effectively plan the process of admission to, and completion of medical school and residency, and becoming board certified.

In its simplest terms, project planning consists of starting with the desired result in mind, and working backwards, addressing each discrete step as a sub-project along the way. The planner then pieces together the steps, assigning work to involved participates and deadlines to each step.

Below is a very simple Gantt Chart that displays the process for preparing a lecture. A similar process could be used for preparing an article for publication.

On the other hand, the process for opening a 5,000 square foot physical therapy facility would be much more complex, and include dozens of separate sub-projects. Each piece of the planning puzzle would come together, ultimately resulting in the opening of the facility at some future date.

If you are just getting started in management and leadership, the best way to learn this skill is to be part of the planning of a big project and observe how all the moving pieces are coordinated.

Communication

Physicians generally excel at one-on-one communication with peers, patients and teachers and mentors.

Physician leaders must expand those skills to verbal and nonverbal communication, including lectures, group discussions, meetings, presentations and negotiations. Each of these has its own demands.

Often the best way to learn these skills is to just start doing them. Practice is the best teacher.

There are two specific communication practices that really serve leaders well:

• Listening
• Asking questions

The best leaders I have known spent much more time listening and asking questions, than making declarative statements or offering opinions.

Like the COO who allowed my laboratory director to come to her own conclusion concerning her employee, sometimes just asking questions is the best form of communication a leader can use.

Planning and Running Meetings

Meetings can be the bane of a leader's existence: too many meetings; boring meetings; meetings that take too much time and accomplish too little.

Leaders must employ several of the leadership skills already discussed to use meetings as intended: to obtain input, create action; move a project along and achieve important goals for the organization.

While many meetings are dreaded by invitees, it is possible to plan and manage a series of meetings that participants WANT to be invited to.

Such meetings are seen as exciting, challenging, inspiring and productive.

The chair of the meeting is responsible for achieving these outcomes, by following the process that I outlined in an earlier post. But it basically boils down to these steps:

1. Create an agenda that is designed to achieve the charge of the committee as quickly as possible, sharing it prior to the meeting so that everyone can come prepared;
2. Maintain control of the meeting so that EVERYONE contributes and there is respect for the participants’ time (start on time, and end early if possible);
3. End the meeting by clearly stating the next steps for the team;
4. Cancel any meeting that is not likely to produce results.

If you are not the organizer, in your next few meetings observe whether these steps have been taken. Gently encourage the team to adopt these recommendations.

Measurement

The best leaders become experts at measurement. It is only by using meaningful metrics that performance can be improved.

When I started as the Chair of the Quality Committee at the local hospice organization, I was impressed with the work that was being done. The Quality Director and her team were following infection rates, falls, and other meaningful quality indicators.

In addition to providing input and direction to the process, my role was to present updates to the Board of Trustees of this organization.

But I found that quality data were being presented as a written description of the monthly findings, with steps taken and planned improvements interspersed with the actual measurements.

Such a document would take the board hours to go through, since there were similar reports for all of the other major departments.

I asked the director if she could present the data in a way that was more concise and easy to understand. Ultimately, she was able to summarize the performance in a small number of easily understood graphs that displayed the trends in the outcomes.

Great leaders are able to identify good measures and communicate them to other stakeholders. They also use them to continually drive improvement in the performance of the department, committee or organization being led.

Measurement is key to driving improvements in quality, patient safety, employee performance, patient and employee satisfaction, and financial performance.

Teamwork

Creating effective teams is a critical skill. Like organizational culture, a strong team does not just develop by chance. I have discussed this issue before and have pointed to Peter Lencioni's book, The Five Dysfunctions of a Team,  as a good starting point to address trust and conflict.

According to Lencioni, leaders should reach of these stages in order to create a highly functioning team:

1. The members know each other at a personal level and they trust each other to NOT be judgemental or overly critical when expressing an opinion. Such team members have learned to listen carefully and provide honest, constructive comments.
2. The team engages in appropriate conflict in the form of full expression of opinions. A leader does not want a team of “yes-men.” Rather, all points of view must be freely expressed before a fully informed course of action can be developed.
3. Consensus almost never occurs. But once an issue has been discussed and debated, and a path chosen, everyone commits to supporting that decision, in spite of personal reservations. Team members will NOT undermine the plan once it is put in motion by second guessing or failing to support it.
4. Each member is accountable to the organization and its plan and holds each other accountable.
5. The team remains focused on achieving results. Each team member supports other departments and divisions, even if it means forgoing some of its own resources to achieve the overall goals of the team.

As you participate in different teams, try to observe whether the members are participating at this level. Or are they protecting their silos of responsibility and undermining others to achieve their own personal goals?

Management

To some extent, managing others involves using all of these skills to bring out the best in those that report to you. Communicating with clarity, listening well, planning well, building teams and measuring and reporting the right metrics enables us to support and encourage highly productive direct reports, committee members and colleagues.

The best CMOs, CMIOs, CQOs and medical group administrators have spent a good deal of time preparing to be a better physician leader. And, as with clinical care, such leaders are committed to lifelong learning.

In Closing

In presenting this and the previous post about preparing to be a better physician leader, I have attempted to demonstrate that:

• Physicians are natural leaders.
• The medical profession needs more leaders.
• Many of you will be drawn into leadership roles.
• You need to learn new skills to be an effective leader.

Next Steps

Observe these skills in others. See what works well and what does not.

Informally approach those with the best leadership skills for advice and counsel. Use them as mentors, as I described in Why Both a Coach and Mentor Are Vital.

I welcome your comments and questions.

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What is a Career Pivot?

The author defines a career pivot as “Doubling down on what is working to make a purposeful shift in a new related direction…an intentional methodical process for nimbly navigating career change.”

In Blake’s book, she notes that most career paths consist of a series of pivots. Based on her work as a career development professional for Google, her book provides many examples of career pivots. Many involve pivots to entrepreneurial ventures, but some also involve pivots within an organization.

Her method appears to be a valid approach for a clinician to make the transition to executive leadership, as I will explain below.

Pivot Stages

She describes her Pivot Method as a 4 stage process:

1. Plant. Like the basketball player preparing to pivot in another direction, this step consists of establishing your foundation.
2. Scan. Look for opportunities – not just for a new position or career, but also for learning opportunities.
3. Pilot. Test ideas – start small and move into bigger pilots over time.
4. Launch. Make the move – it could be a partial move, a transition within a company, or a big launch to a brand new career.

Let’s walk through each step individually. But first we need some self-assessment.

Self-Assessment

Before embarking on this journey, Blake recommends that we assess our readiness. According to her, pivots work best for those that are “impactors.” She describes an impacter as someone with the following characteristics:

• Loves learning
• Action-oriented
• Enjoys new projects
• Problem solver
• Generous and cooperative
• Possesses a strong desire to make a difference
• Has a growth mindset

She goes on to describe the four possible Career Operating Modes of pivoters: inactive, reactive, proactive or innovator. Only the final two modes are consistent with successful pivoting. She describes proactive as “seeks new projects;…learns new skills; is open to change;…willing and interested in helping others.”

The innovator, she says, is in the best position to consider a pivot. Such an individual has proactive qualities and “fully taps into unique strengths, focuses on purpose-driven work…creates new solutions to benefit others.”

My Story

When I was a few years into my medical practice, I found that I was drawn to involvement in other endeavors. I was a family physician, but I found that I enjoyed the discussions that occurred in other hospital departments, so I attending pediatric, emergency medicine and obstetrics and gynecology medical staff department meetings.

Among the hospital committees, many were somewhat political, such as the Credentials Committee and the Bylaws Committee. Hence, I was drawn to the CME Committee because it was apolitical and its mission seemed to be more altruistic: to help patient care by providing high quality educational activities for our medical staff.

The author's advice is to look at our attitudes and approach and consider a pivot only if we're a proactive and/or innovative person.

Stage 1: Plant

Perhaps you have become frustrated with daily clinical medicine. The paperwork is overwhelming; the patients seem unhappy with rushed exams and delayed communication; and the documentation requirements seem to never stop growing.

And, it is not just the frustration of practice, but the fact that you have a vision and goals for your career that cannot be met in this environment. Perhaps you have a desire to help more patients, in a more global fashion. You miss working in teams. You enjoy the challenges of interacting with other professionals on big meaningful projects.

According to Blake, the Plant Stage is the time to identify our vision, values, and mission. It is a time to define our ideal day. By pivoting, what is it we wish to accomplish for ourselves? What are our priorities?

It is at this point that we may wish to write down our vision for one year from now. And perhaps list our one year knowns and unknowns with respect to location, finances, projects, people, results and lifestyle.

More of My Story

It would have helped me to write down such a vision when I began my journey to hospital executive. I did not have Blake’s questions to respond to, but I remember thinking to myself: “I want a career that…

• can fulfill my interest in population and public health, improving medical care for larger groups of patients, working in continuing education, quality and performance improvement;
• offers a better balance of lifestyle, with less call and long hours away from home;
• provides an opportunity to challenge myself, learn new skills and assist my colleagues in achieving their goals;
• is consistent with my values of integrity, industriousness, loyalty and professionalism.
• offers financial security and an opportunity to grow and advance;
• creates variety in my work – with multiple projects and new challenges along the way;
• will allow me to stay near my family (moving across the country for the “ideal job” is not an option).'

The Plant Stage also requires playing to our strengths, those skills and attitudes that make us successful now and will support our new pivot. Blake states that, if possible, this new pivot should be consistent with our “zone of excellence and genius,” what others call flow, where our competencies become unconscious in manifesting themselves.

It is during this stage that we should also be pragmatic and consider the length of our career runway. Do we have a side hustle to support us as we begin to pivot? Does the side hustle actually provide experience or insight into our possible move?

Stage 2: Scan

Blake writes that this step is for research and exploration. We have defined our values and vision. Now, let’s figure out what type of work will align with those factors.

In this stage it is helpful to seek out mentors, coaches and advisors. Speak with them about potential career pivots. What is it really like to work in management? Would working as a consultant, writer, expert witness or utilization or quality reviewer meet those needs? What does it mean to be a physician leader?

I Scan

For me, this was a time to try out different part-time paid positions, like medical director of an occupational medicine clinic and family planning clinic. I also started to volunteer, both as a board member of the hospital I eventually worked for, and in my county and state medical societies.

As a result of my work as chair of the hospital CME Committee, I was appointed to my state medical society Committee on CME Accreditation. I later became chair of the committee, learning important new skills along the way. In that capacity, I also attended quarterly state medical society board meetings, where I could meet and learn from other physician leaders.

I took advantage of an informal coaching relationship with a seasoned physician, the Chief Medical Officer for a large regional hospital. I talked with him about his transition into an administrative position and sought his advice from time to time.

This is a time when we might join professional societies whose members are seeking the same goals we are. Reading about physician leadership and attending courses by the American Association for Physician Leadership helped me to better understand the field and firm up my intention to pursue that path.

Beginning formal course work can become part of this exploration, or the end result of a mini-pivot from full-time clinical work to part-time student. But if the coursework is not exciting or rewarding, it can be dropped and another pivot considered.

During this stage, Blake advises us to develop new skills. She advises us to bolster skills that are lacking, while remembering to play to our strengths as we position ourselves to launch a new career.

Stage 3: Pilot

The goal in this stage is to do small tests. In the area of product sales, she would advise us to create a minimal viable product and see if that sells. The corollary might be to try our hand at leading a project for our hospital. Consider an apprenticeship. Jump into the MBA and see if it is resonating with us. Volunteer our time, but not just as research, but to contribute. Strongly consider the side-hustle mentioned earlier.

My Story Continues

I took a paying position as a utilization reviewer for my hospital. I became certified as a utilization reviewer. I did course work for my master's in public health. And it felt right.

Then I cut back my clinical office hours and began working as a part-time vice president for medical affairs. I attended as many meetings with the executive staff as I could, but was given the freedom to accommodate the demands of my part-time practice.

Blake advises that we pause, review and repeat this process in small ways, confirming our commitment, and allowing us to re-plant and pivot to a slightly different direction if necessary.

Stage 4: Launch

At some point, Blake says, we must make the decision to complete the pivot. We may already be 70 or 80 percent of the way there. But this is the point of starting the new business full-time, leaving the old job and side hustle behind and fully embracing the new career.

It is at this time that we must complete any fierce conversations that have not occurred. We must inform our boss or partner(s) of our plans to move on and launch a new career.

My Launch

I remember telling my partner that I had made the decision to go full-time as a hospital executive. With about 6 month’s notice, we worked together to move all of my patients to her practice. I transitioned the responsibilities of managing the practice to her over time.

Devoting full attention to my duties as VPMA, I stopped taking office call. Shortly after going full-time, I was promoted to Senior Vice President and Chief Medical Officer.

Even after the final pivot, there are no guarantees. Things don’t always work out. But we've taken steps to minimize the chance of failure. Even a so-called failure can serve as a good stepping stone to the next pivot, however. The author provides plenty examples of failed pivots that ultimately led to raging successes.

Summing Up

Pivot provides a great model for considering and implementing a career change. The model definitely applies to the emerging physician executive.

There is a potential fifth stage that applies only to work inside organizations. This additional chapter is devoted to applying the Pivot Method within an organization as a way to promote internal mobility.

I strongly encourage anyone thinking of making a pivot to read the book.  Each section has numerous accompanying online resources that include podcasts and downloadable templates and worksheets. I encourage you to take advantage of the worksheets if you are thinking about a career pivot.

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He later sold his practice to Concentra, a large provider of urgent care and occupational medicine services that is very well-known in the urgent care arena. I know the company because when I was looking to leave my position as hospital CMO, one of the companies that interviewed me was Concentra.

The company was in the process of buying up and integrating urgent care networks. Concentra itself was acquired by Humana in 2010. It was sold by Humana to a private equity fund in 2015.

I was intrigued by Dr. Earl’s story after I became medical director of an urgent care center in 2014. I began hearing about education provided by UrgentCareMentor in 2015. I started to read the blog posts and other free content.

Dr. Earl’s company appeared to be the only online provider of occupational medicine, workers compensation and urgent care education. His material is actionable and more sophisticated than material being provided by some of the urgent care associations.

Then, in 2016, I started this blog and immersed myself in the world of physician bloggers and the technologies and tools used to create and monetize a blog or website. And, trust me, it is no simple feat to create an online presence, especially one that produces regular education and training that physicians are willing to pay for.

Larry impressed me because he is one of a small and elite cadre of physician entrepreneurs that have been able to thrive in this world of bloggers, webmasters and producers of online courses and ebooks. This group includes bloggers such as James Dahle (White Coat Investor) and consultants and coaches like Dike Drummond (The Happy MD), Helane Fronek (Doctors Coaching Doctors), Michelle Mudge-Riley (Physicians Helping Physicians) and Philippa Kennealy (Physician’s Odyssey Program and The Entrepreneurial MD).

So, let’s get to the interview…

Presenting Lawrence Earl, MD, of UrgentCareMentor

Please provide our readers with a little background about yourself.

I entered the “Target MD” 7-year combined program between the University of Wisconsin-Milwaukee and the Medical College of Wisconsin with an undergraduate degree in Medical Science.

I was a surgical resident at the Swedish Hospital program in Seattle, but realized that the surgical life wasn’t for me. I thought I might like to pursue an ER career, but there were no such residencies in Seattle at the time, so instead I started working in some of the first urgent care centers in the country.

Well, I fell in love with urgent care and never looked back.

When my wife and I started having babies we moved to my native New Jersey where I worked in a busy urgent care center (Immediate Medical Care Center or IMCC) for about 3 years.

The owner, my mentor, taught me all about the “patient experience” a decade before it became “a thing.” Delivering service beyond expectation. Delighting patients with our accessibility, efficiency and integrity.

But something was missing for me. It was a great practice but no opportunity to move ahead and the owner wasn’t looking to expand to new locations.

What was the first position you took that involved work beyond clinical practice?

A head hunter called me one day about an opportunity to become medical director for a growing group of 6 centers. The CEO, an orthopedist, was familiar with IMCC and our patient-centric focus, something he had not been able to achieve in most of their existing centers. And he wanted me to bring that to his organization. I signed on.

This was predominantly administrative, 80-90%, and allowed me to learn the “business side” of medicine, working directly with the CEO, CFO, billing managers, sales VP, etc.

I hired and trained dozens of doctors, fired a few, built new centers, did budgets, expanded services, helped with acquisitions, started a workers compensation PPO, among many other responsibilities.

We grew to 14 centers in 3 states and the group was sold in the mid 1990’s to Coastal Healthcare, a NASDAQ listed physician management company – so I was even involved in the “dog and pony” shows for prospective buyers.

[VPE – This sounds like the kind of work experience that could really fan the flames of the budding entrepreneur’s passions.]

What factors led you to seek a non-clinical job in management?

I never felt satisfied if I wasn’t able to make improvements and create growth and new opportunities.

What other jobs did you do between the first non-clinical job and your current job?

After that first group was sold, I bought two “IMCC” urgent care centers. One was the center I had left to become the medical director, mostly urgent care; the other was a former partner’s, predominantly occupational medicine, and I ran those for 16 years. We expanded to have corporate clinics, a travel clinic and 5 DOT [Department of Transportation] exam clinics.

That was sold to Concentra in 2010. I consulted for them for a year, mostly training ER docs in newly acquired centers to do occupational medicine, as well as quality audits and operations consulting.

What is your current title? What are your primary responsibilities in that role?

Today I run Urgentcarementor.com, online training and consulting for urgent care, occupational medicine, DOT Examiners and primary care practices.

Please describe your current business. How does working as an entrepreneur compare with work in a corporate setting?

Most of my work is now online or on the phone, so can be done from home or anywhere. I do sometimes make client site visits.

[VPE – What impressed me was Larry’s ability to take the work that he had done for IMCC, Concentra, and his other previous practices and transition into an Internet-based education and consulting company. Creating and running an independent business takes all of the skills of the physician executive, and then some.]

Would you advise a physician thinking about a career in management to pursue a business degree?

Yes. My experience was unusual in being able to learn business and management by my previously mentioned urgent care group medical directorship, then by running my own multi-site practice for many years.

If I was starting today, I’d want to pursue an MBA or similar business training.

What advice would you give to a young practicing physician thinking about making the transition to a leadership (management, administrative or executive) position?

As above, seek management training in healthcare administration

What do you like best about your current position?

I really enjoy teaching what I’ve learned, and what I continue to learn, about running private practices. I like that I fill a niche in the occmed and commercial driver areas that isn’t covered well in other arenas. And that I have complete freedom to work where, when and how I choose.

What would you have done differently knowing what you know now, to prepare for your career, if anything?

Seek formal management education as a younger physician.

Any other comments or advice you would like to give to readers on this subject?

Managing doctors is tough business. NPs and PAs aren’t much easier. They are all valuable and scarce and they (we) know it. Leadership for these professionals involves clear communication of organizational goals, setting expectations of provider responsibilities and practices to achieve those goals, listening to and addressing provider concerns, building consensus, measuring outcomes, and using management principles to reward positive outcomes. It also requires us to correct outliers, including disciplinary procedures when provider behavior cannot be aligned with corporate goals.

[VPE – Larry pretty much sums up the crux of leading and managing physicians, or any staff for that matter. His list of skills could be the learning objectives of a core curriculum for the executive physician!]

Wrap Up

I want to thank Larry for agreeing to be interviewed. I learned much about Larry that I didn't know! I am inspired by his ability to move from clinician and employee, to manager and leader, business owner and Internet entrepreneur.

I hope his story inspires you to explore your possible career opportunities. Working in “the trenches” in clinical medicine is a noble profession. And it can also serve as a springboard to many other fulfilling possibilities.

If you work in Urgent Care or know someone who does, I would definitely check out the educational material at UrgentCareMentor. You can join for free and take advantage of all of the free content. If you'd like to look at the latest premium content, it can be found at Occupational Medicine for Urgent Care.

If you have any follow-up questions, use the Comments to ask those and I will send them to Larry and report back in a future post. And if you have suggestions for future interviews, let me know.

Next Steps

If you haven't read them already, you may want review what I have written about seeking a non-clinical career:

• Is It Time for a Non-Clinical Career?
• Options for a Non-Clinical Career
• Does an Executive Salary Stand Up to a Clinical Salary?

You might also enjoy looking at these 30 Physician-Authored Blogs to see how others are approaching the online world of blogging.

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The post Interview With Lawrence Earl, MD, of UrgentCareMentor appeared first on NonClinical Physicians.

My partners and I had started a pension plan and we were making regular contributions. But none of us really knew how we should invest our contributions. I realized that I needed to learn about investing.

I needed to go through a crash course on mutual funds, stocks, bonds and asset allocation. And the Internet did not exist, so there were obviously no blogs like White Coat Investor, Physician on Fire or Future Proof MD to read.

So, what did I do?

Like many medical colleagues who seem to be afflicted with (blessed with?) hypomania and obsessive compulsive disorder, it was time for my first round of post-medical education TOTAL IMMERSION!

I’m sure you have seen this in some of your physician friends, if not yourself. You get into something and it becomes an all-consuming obsession. You need to find and devour every possible resource on a topic – written, audio or video. First, you start with the free and easily available, then move to low-cost, and then high cost, sources of information. I've done this with investing, bluegrass guitar playing, rock-climbing, rollerblading, blogging and other subjects.

For this first obsession resources included:

• Reading articles in Smart Money, Forbes, Fortune, etc.
• Requesting free financial newsletters
• Listening to financial radio personalities like Bob Brinker and Dave Ramsey
• Subscribing to one or two newsletters, like Bob Brinker’s Marketimer and The Kiplinger Letter
• Watching CNBC day and night
• Reading the latest books on investing (too numerous to list – and out of date now!)
• Starting an investment club (see Better Investing)

You get the idea.

So, how does this apply to the physician intrigued by a career in management?

Well, you need to decide if it is really what you want to pursue before spending potentially large dollars and lots of time on it. Unfortunately, there are not as many readily available resources about physician management. But there are a few that should be explored before jumping in.

Let me list what I think are the bests ways to learn about management before investing too much time and money in the effort.

4 Steps to Learning About Management

Let's look at the four steps you can easily take to get a clear understanding whether this might be the right career for you.

1. Reflect on Your Motives

This step has the advantage of being totally free. You should reflect honestly about why you are thinking about beginning this journey.

Is it because you are burnt out, or overwhelmed by your clinical practice? Does the fantasy of sitting in an office, giving instructions to a direct report seem less frustrating and stress-free? Are you thinking that management is a nice pre-retirement way to slow down?

The fact is, you may get just as stressed and burnt out in a management position as a clinical position. There are budget and staff constraints, difficult decisions, accountability for your performance, and more work than the available time. You're paid well, so you must demonstrate a measurable return on investment for your salary. And you must not be timid about terminating underperforming directors and managers on your team.

Are you attracted to management because you wish to help larger groups of patients and work in a team on big projects? Do you enjoy big challenges? Are you comfortable with more uncertainty than the typical physician?

Do you prefer one-on-one interactions with patients? Or do you feel comfortable in front of a group of peers or board members? Do you enjoy working on quality improvement and patient safety? What do you think about confronting your colleagues about unacceptable behavior or questionable clinical practices?

If you are not running from an old career, but embracing a new one, then you are probably on the right track. But there are other careers to consider (such as those discussed in Options for a Non-Clinical Career).

2. Talk to Physician Leaders

If you are acquainted with a chief medical officer, vice president for medical affairs, chief quality officer or someone in a similar position, ask them to sit down over coffee and answer a few questions. Ask them how and why they went into management. What were the barriers to entry? Where did they learn about management and leadership?

This is also one of the best ways to find a mentor. Talk with several such persons. And make it a point to follow-up with them several months later. You don’t need to ask them to “be your mentor.” That can be scary to a leader. It feels like they need to commit to a formal role with a major time commitment. But just getting together to talk about management issues and career choices three or four times a year is not so threatening.

3. Read Everything You Can About Physician Leadership

You can scour the Internet for articles using Google Alerts. Look for articles that include keywords like physician executive, leader, administrator and manager.

You can pick up books like Growing Physician Leaders: Empowering Doctors to Improve Our Healthcare, The Six P's of Physician Leadership and Essentials of Medical Management.

4. Join the American Association for Physician Leadership

Here is where an investment will be required. Membership in the AAPL currently runs $295.00 per year. This is well below the annual cost for many professional societies. But it is a small investment given the resources that are available to members. (I have no financial incentive to recommend membership, but I have been a member for about 23 years).

Joining the organization will jumpstart the other three steps, because membership includes access to a journal, books, a job board, and online educational materials. There are several live conferences each year where networking can occur and mentorships can be developed.

I believe it is helpful to join even if you have not made a personal commitment to seek a management position, because the available resources will help to inspire you, and to decide whether to proceed or not.

Start the process outlined above and see if a management career is right for you.

For more of my thoughts on healthcare and leadership Subscribe here.

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Feel free to email me directly at john.jurica.md@gmail.com with any questions about anything. I am here to help you excel as a physician leader.

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Thanks so much and see you in the next post!

The post 4 Crucial Steps to Take Before Choosing a Management Career appeared first on NonClinical Physicians.