A New Q&A Feature

Here are the top 4 questions John has received in recent months about nontraditional careers, and his answers.

Every three months we will answer three or four questions from subscribers, podcast listeners, and mastermind members.


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Top 4 Questions

John responds to these questions in today's recording:

  1. What are the highest-paying nonclinical jobs? Physicians who have developed their own independent, freelance businesses and have been able to scale them make the most money. A career that allows you to monetize your abilities and enthusiasm. Another advantage of starting a business like that is that you may be able to sell when you retire.

    The highest-paid position in pharma, hospitals, or CME firms, on the other hand, is something with the term “chief” in it. Chief medical officers, chief medical information officers, and chief quality officers are examples. 

  2. Are there affordable resources for those pursuing a nonclinical job? Yes, there are numerous low-cost options. John has discussed this idea in several podcast episodes. There are at least five or six wonderful books that talk about everything from the mindset to preparing and pursuing the most popular nonclinical. You can also find Facebook Groups, online courses, and mastermind groups.

  3. What nonclinical jobs can an anesthesiologist pursue? The majority of nonclinical positions are open to almost any physician. These jobs are available because of the need for someone with a medical degree, clinical experience and knowledge of the healthcare system. Most nontraditional jobs do not rely on experience in one particular specialty.

  4. What are the options for a side gig? There are numerous examples of physicians who have developed side gigs around their clinical activities. However, the process is essentially the same as beginning any other business. In simple terms, the process involves finding a product or service that you have expertise in, that excites you, and that meets a need that clients or customers are willing to pay for.

Summary

In this week's show, John provides his thoughts on 4 common questions he gets from subscribers, podcast listeners, and mastermind members.

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


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Transcription PNC Podcast Episode 287

Top 4 Questions from Clinicians About Nonclinical Jobs for February 2023

John: I often receive unsolicited questions from listeners and subscribers, and I also get questions through surveys that I send out from time to time that some of you may have actually received. And since there are trends that I see over and over again in the questions being asked, I sometimes actually devote an entire podcast episode to address one of them. However, sometimes the questions really don't deserve a full 20 minute plus episode, but I still think they're worth answering.

So, I decided to start presenting an episode every once in a while, devoted to a Q&A where I take three or four questions, if it's appropriate. So, if it goes well, and if the response is good, I plan to devote future episodes to other questions like this in the future. So, let's get right into this week's Q&A. All right, here we go.

Here is the first question. "What are the highest paying nonclinical jobs or careers?" That's an interesting question and I understand. I have the same question as I was thinking about doing something from a nonclinical standpoint. In fact, one of the reasons I actually made the leap was the pay was so good as chief medical officer and even as VP for medical affairs, particularly compared to my salary.

Are there certain jobs, certain careers that pay more than others? Well, obviously there are. Now I don't advise that be your primary reason for selecting a career or a job that you're going to pursue. It has to align with your passion or your purpose in life. It has to align with your values, and it should align with your personality and what you're interested in. If you're not really interested, it's going to become either boring or tedious very quickly. So, we don't want to go down that path.

It's also something that should have a need. Obviously, if there's a job out there and jobs are being posted by the different industries, then there's definitely a need from that standpoint. But sometimes that need does relate to the pay. In other words, the higher the need, the higher the pay, as long as it's an industry that can support it. So there might be really huge needs for physicians in rural America as we know on the clinical side, but sometimes it just can't afford to pay enough to get people to go there given the other considerations.

But going around this question and tap dancing a little bit, let me see if I can answer the question as concretely as possible. First thing is, if you look at the highest paid people in general in terms of what they do, there's a big category that we normally see that really generates the most income, and that's usually business owners. Now that's not really a particular job, but I just wanted to start with that because really the same thing is true for physicians.

The physicians who make the most are those who have created their own independent, often freelance business and have been able to scale it. I know of, let's say, for example, physicians who have become coaches. Coaching and an hourly rate doesn't put you at the top tier of earnings. But if you create a business that hires other coaches and leverages your skills and their skills and brings them together, those people who have created an actual LLC or a corporation and a business, they're going to make more income. And instead of it being a W2 type of income, it's going to be income or profits from that business.

Because in general, in the United States, people that ultimately make higher amounts of money are not those that are working for other people, but those that have created their own business and then that business actually hires and leverages other people. And none of this is bad or good, that's just the fact. If you can do that and it's a set of skills that are not easy to acquire, then you can make more money. And I actually think we might be getting to one another question that kind of relates to this, but if you're the type of person that can do a lot of different things, not only do you have the personality, do you have the endurance, do you have the drive, but maybe you have a knowledge of finances, maybe you've worked in other businesses before becoming physicians.

So, if you can think of a job where it'll apply your skills, your passion, and it can be scaled at a big level, then you'll make more money. And some of the people I've interviewed in the past have actually been those who were really going for some company that would eventually be publicly traded. Now, you don't start that way, but there are people that have done startups in technology and informatics and that kind of thing. Also, people who are doing recruiting, or matching physicians to locums. There are all kinds of options. And if you can scale that, then chances are you can build a business that's going to ultimately be worth a lot.

And the other advantage of building a business like that is you at the end of that process can sell it. So even if it's generating let's say $200,000 - $300,000 to the bottom line, that's not an enormous amount, but if that continues and it's growing after 10 or 15 years, you would decide to sell it, well, you're going to be able to sell it at a multiple of that. So maybe your cash out will be a million or more dollars. And you can even go bigger if you are a startup and you look for venture capital or angel investors, things like that, to build let's say a business that depends a lot on technology or you need to hire a lot of people to get it going. So, that's the one answer.

Now I think what most people are thinking when they ask that question though, is what about just routine or standard kind of jobs where I'm working for some company in pharma or in hospitals or in CME companies or what have you? What are the highest paid? Well, the highest paid, typically, if you're looking at the position, is something that has the word "chief" in it. Like chief medical officer, chief medical information officer, chief quality officer.

Now, those are all positions that can be held in hospitals for sure, and they pay very well. I think I just talked about this in an episode or two ago where just the average salary for a chief medical officer as a generic term is over $400,000 a year according to salary.com. But it depends on where you're working. If you're working as a CMO in a federally funded clinic, then it's kind of a misleading term. But there are some people in those situations or the organization, the local sites rather small, and they might call you as the main physician there, chief medical officer but that's not really the same as working in pharma or a hospital or an insurance company, as I said, which have the highest salaries across the board if you're looking at just the title.

That would be my advice. Now, the thing is you have to plan ahead because most people don't go from a fully clinical job to a chief job. And by the way, this applies to chief nursing officers as well. And again, as I may have mentioned in a previous episode, there are more chief nursing officers who go on to become chief executive officers of hospitals than there are chief medical officers as far as I know. The CNOs becoming CEOs in the past at least has been much more common than a CMO becoming a CEO for whatever reason.

But anyway, what you'd want to do then is to understand that that's a possibility. And if that's your goal is to at least optimize your salary to some extent, then look for the jobs. And in the hospital setting, there's a natural transition from let's say a half-time to a full-time medical director and then to some kind of VP level and then to the chief medical officer or chief quality officer or something along those lines.

When you get to that level, you're going to have to invest a little bit more in some education, the CPE or maybe a master's degree of some sort can be helpful, but you don't have to have that completed before you start on that journey. I don't recall that there's other occupations in major industries like let's say in utilization management or clinical documentation improvement or any of those things that pay above average. They do pay well and they compare very well with the physician's salary. The bottom line is start your own business or become a chief medical officer in some large organization. And again, they have those in life insurance companies, health insurance companies, pharma and hospitals and health systems for sure. I guess I'll leave it at that for now.

All right, I'm going to go to the second question that I saw recently and the question was "Are there affordable resources for clinicians when it comes to pursuing a nonclinical career?" Well, a simple answer to that is, yes, there are a lot of affordable resources. Now we could have an argument about what is affordable.

And I'll go off on this tangent for a minute. I'm not going to promote right now any of my own products or any of the products that many of my guests produce but I will say the thing about purchasing a high priced resource such as an expensive course or a yearlong coaching, is that it really puts you in the game. In other words, we don't all have $5,000 or $10,000 just laying around to invest in coaching or an online course that goes on for six months with live meetings and videos and audio files and homework and workbooks and so forth. But you have to understand that if you're going to make a major commitment, and you do one of those programs, it is going to psychologically motivate you to try to get as much out of it because you see it as such a huge investment.

But that really wasn't the question I was asked. The question is "Are there affordable resources?" And the answer of course, there are a lot of affordable resources. I've addressed several podcast episodes to this concept. I think I have one when I talk about the nine very low-cost resources. But if you haven't spent a lot of time researching this, you're going to find if you do research that there are books, there's at least five or six great books that talk of everything from the mindset, to preparing, to looking to actually what are the most common nonclinical jobs out there.

Sylvie Stacy has a book that was published by the AAPL. Heidi Moad has a book. And then there's books about specific fields like Andrew Wilder's book about locum tenens. I haven't seen a great book about telemedicine, but there's other resources obviously. I consider books to be pretty inexpensive. I buy books, the drop of a hat, and I'm usually reading something or another. On one hand I'll read a how-to book one week and the next week I'll read a fiction, a novel. So, I like both. But there's lots of books that talk about different nonclinical jobs and also a lot of side businesses.

Well, here you're listening to a podcast. This is cheap as it can be other than your time. It's free. And there are many podcasts that deal with helping you to learn how to do different nonclinical jobs. And so, I'm not going to list those all. I will put some links in the show notes though today. I'll link back to some of my previous episodes and other resources that I'll touch on today.

"How does it cost to find a mentor?" Now, I've talked about this before, but it's almost an essential thing. If you want to do a certain job, let's say you've boiled it down to two or three different jobs. I don't know. I want to be in a big organization and I want to have that opportunity maybe to have my salary go up over time. I really want to be in pharma or medical device or in a hospital or an insurance company.

And so, basically early in that process, what you should do is find a mentor, somebody who's working in that very industry, doing as close to the job that you'd like to do as possible. Now, to take an extreme example, it would be easy to find the situation that I just described about those different industries. But what about if I wanted to become a chief medical officer for MAC, which is a Medicare Administrative Contractor? Well, I can tell you right now you can easily find someone who's a CMO for a MAC on LinkedIn. Because they're MAC, there are 15 or 16 regions in the United States. And I think each one has a CMO, possibly, and maybe more than one. Probably not likely that someone you went to med school or residency is doing that. It's possible.

But my bottom-line answer to the question is mentors are super valuable and you need to take advantage of the other free tool, which is your network and explore your network and find some mentors that are doing the exact job you might want to do. And if you're looking in two or three different industries, then find someone in each of those industries and try to engage, not excessively, but just ask them what did they do, how did they end up in this job. Sometimes it's just random, sometimes it's luck, but most of the time there's a process. And so, there's no one better to teach you about that process than a mentor who's done it already.

I have people all the time to ask me what I would do to become chief medical officer. Well, I can pretty clearly say, here's what I did, number one, number two, here's how I would do it a little different maybe to accelerate the process.

The other low cost one, relatively low cost, are professional organizations. I always push the AAPL for those looking to become leaders in one of these companies. There are professional organizations for medical writing for pharma, for medical science liaisons. I've gone into these before, but you can find an organization for almost anything out there.

And sometimes the organization doesn't focus on those that don't already have the job, but some of them do. The MSL Society, for example, has a whole section on how to become an MSL, how to get your first MSL job. Others might not. But as a member you start to hear the lingo, you can go to the meetings, you can hear what's important to them in terms of what they're learning, what their skill sets are. And even though you're not in the industry yet, by virtue of going to the meetings, whether they're online or in person, then you're going to learn what it takes to apply for and land that job.

And then we also have another resource, our Facebook groups and memberships like NewScript. NewScript right now is still slightly under $8 per month. You can be in a group with 500 or 600 other people that are doing different kinds of nonclinical jobs, happen to be all kinds of professionals in there from PAs, NPs physicians, dentists and podiatrists and so forth. It's a low membership fee, so you're getting a lot of access. Anybody in there could end up being a mentor. We have formal mentors there, but it's very similar to a Facebook group. And I've talked about some of the Facebook groups.

If you're not aware of all these things, and maybe I'm not aware of everything either. So, what you do is you go to your favorite search engine and you throw in nonclinical careers or nontraditional jobs for physicians or for nurses or for pharmacists and then put books or websites or podcasts or Facebook groups, LinkedIn groups. Just put those terms in and you'll see a lot. And some of them will obviously be appropriate and some will be an ad or some high-cost product. But there are many, many affordable resources out there for clinicians looking for nonclinical jobs.

Okay, I'm going to try and get a couple more questions in here. The next one is "What nonclinical jobs can an anesthesiologist do?" Now, I've been asked this question many times with a different term in there than an anesthesiologist. It could be a pediatrician, it could be a cardiac surgeon, it could be a general surgeon, anything. I get the same question, but with a different specialty in it because there's sometimes a misconception that certain jobs are only open to certain professionals, certain specialties in medicine or certain backgrounds in nursing. And it's basically just not true.

Now, there are some that will say, "Look, we're looking for a family physician or an internal medicine doctor because we need a generalist for whatever reason." But I've seen anesthesiologists and radiologists and OB-GYNs in doing utilization management, in benefit management, in doing pretty much any job, any hospital management job.

It would be rare for let's say a strictly outpatient type of physician to end up doing work as an administrator in a hospital because a natural progression is you start working in the hospital as a physician or a nurse or a pharmacist, even a psychologist or a social worker. And you progress in the organization and there are jobs which have much higher levels of responsibility, much broader, knowledge base in terms of not only the clinical, but then melding that with the nonclinical and that it's not dependent on your specialty.

Now, if you're in a specialty where you can generate $400,000 or $500,000 a year working, let's say 50 hours a week, you're probably not going to get that really high salary that's going to match your clinical. But as I've mentioned before, remember, keep the hours in mind. Keep the fact that the mental drain and the burnout and the intensity is much less in these administrative jobs and you're not going to be sued in an administrative position. So, what's that worth to you? It pretty much eliminates the potential of being sued. That to me means a lot.

So, the bottom line is most jobs in nonclinical that I ever talk about and others talk about are open to pretty much any physician. It's mainly dependent on your MD, DO or MBBS or equivalent. It's sometimes based on your knowledge of the healthcare system, it sometimes helps that you have some clinical background and residency. Again, just to get a little more in-depth knowledge of the clinical side.

But to a large extent, any physician can do that with some additional training or experience. If a consulting firm is looking for a physician who's worked in the OR because they're doing a lot of consulting in the operating room setting of a hospital, okay, fine. Then it might be anesthesia, general surgery or ENT or others who are in the OR. But in general, any physician has access to thousands and thousands of nonclinical jobs.

All right. I'm tempted to stop there, but I had one more question on my list and I will address it briefly here. "What are the options for a side gig?" That's another pretty open-ended question. I could give a lot of examples of physicians who have done side gigs that were built on their clinical activities. Let's say owning a practice. So, one side gig is coaching and consulting to teach other practices how to do their marketing. One might be doing a similar thing in showing them how to install their EMRs. Another one might be a physician who just loves the finances and is consulting with other practices and how to create business financial reports and how to track those financial reports to make sure that their business is being successful and maybe enable them to find if somebody's embezzling or see if they can make sure that their account receivable is not getting out of hand.

But basically, when you're starting a side gig, it's like starting any business. And we go back to what I mentioned at the beginning, you need to have some purpose or passion or strong interest in that number one. Number two, you have skills that enable you to teach someone else how to do something. And then number three, there's some customer out there who is willing to pay for it. So, it's three and four. There's customers and they have the ability and willingness to pay.

You could look at ikigai, that Japanese term. That means your purpose for being. Look that up on your favorite search engine and you'll see those four quadrants and how they overlap and what does it mean. And so, if you spend some time looking at those concepts and thinking about it, it should become fairly obvious what side gig you might pursue.

But you're going to have to in some ways create your own consulting or coaching or teaching or advising job and learn how to run a business, talk to an attorney about setting up a proper structure, talk to an accountant about setting up your books. There are some obvious ones. Expert witness consulting is a given. That's a type of consulting side gig that I talk about a lot. There's a new type of medical legal consulting that doesn't involve working with malpractice cases. You can do informatics, do consulting and side gigs on that. These other ones are more one off. They're not so clearly articulated and commonly known as the expert witness type.

But that's basically what I'll say today about starting a side gig. If you can get some help and just a whole conscious of starting your own business, you read a book or watch some videos on YouTube about starting your own business, even if it's not a healthcare business, those things pretty much apply. You just have to apply those business principles to something that you're interested in and have a background in which is more likely to be something like healthcare.

All right. That's it. Those are the four questions I wanted to answer today. I think I'll leave it there.

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