Interview with Dr. Sylvie Stacy – 353

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

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

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

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Addiction Medicine: A Case Study in Unconventional Clinical Work

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

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

Remote Monitoring and Other Unconventional Clinical Careers

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

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

Dr. Sylvie Stacy's Advice on Side Gig Compensation

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

Summary

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

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

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Links for Today's Episode:

• Dr. Sylvie Stacy's LinkedIn Page
• 50 Unconventional Clinical Careers for Physicians by Dr. Sylvie Stacy (this is an Amazon affiliate link that pays a small fee for the referral)
• 50 Nonclinical Careers for Physicians, by Dr. Sylvie Stacy (this is an Amazon affiliate link that pays a small fee for the referral)
• AAPL Online Bookstore
• Forbes Article About Concierge Medicine
• eConsult Company AristaMD
• eConsult Company RubiconMD
• Surgery Center of Oklahoma
• Ear & Balance Institute
• Why You Should Look for Zebras with Dr. Sylvie Stacy – 044
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 353

New Unconventional Clinical Careers Will Set You Free

- Interview with Dr. Sylvie Stacy

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Sylvie Stacy: You too.

John: So with that, I will say goodbye.

Dr. Sylvie Stacy: Take care.

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