Leaving clinical medicine- An Interview

Today we have a anonymous guest post from a doctor who has left clinical practice. An emergency doctor by training, he practiced for more than a few years and then decided to give it a go in a non-clinical role. For any one who imagines leaving clinical work one day, I thought it would be interesting to hear someone’s perspective of how they got there. If you know anyone else who has also taken a less traditional doctor’s path, please let me know. I would love to interview them.

With no further ado, take it away…Oh, and we have no financial relationships. 

 

Tell us a little bit about yourself and your former career as a clinical physician?

First, let me thank you for the opportunity to speak to your audience.  I am an avid reader of your blog and appreciate your many contributions.  Thank you again.

I trained in emergency medicine and practiced for almost 20 years at the bedside.  Working in a number of different healthcare systems (27 practices across 7 states), I held many different roles as a provider.   

I enjoyed my clinical practice, but always enjoyed my personal time as well and am now married with 2 young boys.

Like most emergency physicians, my work schedule was erratic and favored a strong on/off type of career.  We all shared the holidays, myself included.  This was not so much of a problem for me until my wife and I started to have children.

Early in my clinical career I was able to take advantage of the ER schedule.  I traveled lots and accumulated a number of lifetime memories.  But now with my focus on family, the night shifts and the missed holidays seemed increasing grueling. 

It was about 18 months ago when I permanently left the bedside.

 

Ed. The Er schedule is attractive. Being able to lump together shifts so that you have 2 or 3 weeks off is ideal for traveling. The downside are the nights and weekends, oh wait, Cardiology has that also. 

 

What was it that got you thinking about doing something else?

In addition to the lifestyle, and my focus on my family, I think I was also burned out intellectually.  I witnessed first-hand many of the changes in medicine as more and more health systems accumulate solo/group practices and regionalized their “care-networks.”  I saw the profound impact this was having on bedside practice.

Following this trend, and interested in seeking other long-term opportunities, I pursed other medical roads. 

I had at one time or another during my career dabbled in all different roles and medical businesses.  Working as a CMO of a startup housecall business or as an international telemedicine consultant.  I even worked Hurricane Relief Efforts as an emergency physician.  I was always interested in exploring the many different aspects of medicine and how it’s practiced.

Still, I never seriously looked at non-clinical jobs before this time, but once I started looking I was absolutely amazed at what’s available. 

As almost a coincidence, at about the same time I started looking for a non-clinical career, I 

was also approached by a medical malpractice attorney to assist him with his case.

I was honest about my experience with him, but I was also convincing that I would be able to answer his questions and “manage the medicine” as he like to call it.

And that’s what I ended up doing!  He would ask me medical questions to support his theories or ask me to write a medical brief and so forth.  It was quite an experience, and I enjoyed every minute.

I decided to pursue a career as a medical legal consultant. 

 

Ed. Quite the career. I imagine the Hurricane Relief Effort gig may have been really interesting. Seeing the large scale organizing to provide care for people under sudden and horrendous circumstances is an experience. 

On the other hand, working as a house call doctor seems attractive. I imagine it is exactly as portrayed on Royal Pains. 

What do you do now? Including what your typical day looks like.

Today I own and operate my own Medical Legal Business firm.  I consult with attorneys and help with the medical aspects of their cases.

Most of my clients are Personal Injury or Worker’s Compensation lawyers.  I also work with Medical Malpractice and even some Real Estate attorneys believe it or not.

I have one employee who assists me with some of the administrative duties. Starting the business from the ground up, I continue to develop it.  As I mentioned, I wanted to keep writing and reviewing, and researching and learning. 

My weekly schedule consists of a combination of 3 specific roles, as author Michael Gerger states in his book, The E-myth:  the technician, the manager and the entrepreneur all covering the many aspects required for a successful small business.  (If you click on the link and buy the book I make some bling).

Technician

Depending on my case load, I spend a portion of my work as a consultant reviewing and responding to medical questions regarding the cases I received.  This type of work is rewarding.  I get a chance to speak with the patients who were affected and connect the problem to a person with a family and a specific problem.  I also enjoy the research and learning about the current trends in medicine.  It is very interesting to me intellectually.

Manager

I also divide some time in my week for the managing responsibilities such as the bookkeeping, administrative, and legal/compliance aspects of my business.  This has been a challenging aspect for me. I can see why so many people reach out for assistance.  I can appreciate why there is such a big market for consultants who can help do this or that for you to help you get off the ground. 

There is an endless amount to learn, it can be overwhelming if you have no experience at all.  A good mentor will help you with your ideas and keep you out of the weeds.  Just start basic and build continuously as you get more time and gain experience. 

Entrepreneur

The third and final aspect of your business is the entrepreneur or visionary role.  This is where I plan for the future with my networking, marketing, and business development.  I look to stay current with trends in my field and understand what is happening around the issues I consult.

My work is a combination of these three each week.  The flexibility is amazing, but it does require discipline too.  I work from a home office, but treat it as almost another location.  I let my family know that I am working and close the door with few interruptions.  I “go to work” each day. 

 

Ed. Honestly this seems like way more work then being a clinical physician. Like Sir Richard Branson said, “Entrepreneurs are the crazy people who work 100 hours a week so they don’t have to work 40 hours for someone else.”  But being your own boss is truly a beautiful thing. At the end you are responsible for the good and the bad. 

How did you transition into your current career?

Some physicians are fortunate and develop relationships in practice and are able to transition away from the bedside easily.  I can think of a MD/PhD who began helping Ely Lilly with clinical trials and then before long had signed on full-time.  It looked like a natural progression for her and her abilities, but this is not the norm.

For most physicians, we don’t have a clear pathway to a new career.  And that’s ok.  I would recommend you spend some time on two important aspects which I think determine your long-term success.

Step one: What is it that drives you beyond clinical work

First, what you want to do.  For me, I enjoy writing and reviewing charts and working with attorneys coordinating the medical details.  I would ask what is it about this job that attracts you and says “I want to do that every day.”  And this may take some time to explore and think about what you want out of a successful career transition.

Step two: Researching and networking

Second, I would recommend spending some serious time researching online and talking to people in your field of interest. For instance, I just did a quick search for [nonclinical careers for physicians] and found the following results:

  • Pharmaceuticals (safety, development, regulatory, marketing, sales)
  • Medical Devices (safety, development, regulatory, marketing, sales)
  • Biotechnology
  • Insurance (health, disability, life)
  • Medical Administration
  • Physician Recruiter
  • Career Coach
  • Physician Advisor
  • Government (Federal, State, Local)
  • Occupational Health
  • Education
  • Communications
  • Marketing
  • Informatics (IT)
  • Consulting
  • Media
  • Writing

There are really a ton of nonclinical job opportunities out there for physicians.  (You just have to put in the work.)  And that’s probably the biggest hurdle for most physician’s transitioning careers.  But it doesn’t have to be.  Let me explain.

Accumulate knowledge

I would begin by accumulating as much knowledge about the subject as you can.  For instance, if you always wanted to do some medical corresponding, I would look to network with anyone involved in this area, read, volunteer, introduce and welcome partnerships with those businesses involved in this type of work.  Learn from the giants in the field about what and how they accomplished what they did.

Personally, I have attended writing courses, speaking courses, publishing conferences.  I’ve taken business classes outside of a university, and hired a handful of coaches along the way.  I’ve read a great number of books in and around sound business practices and wealth building.  I’ve failed and made a ton of mistakes along the way.  And I’ve gained some invaluable knowledge and experience which serves me well today.

I would also hire and work closely with a physician business coach.  Although you could find all the information yourself and do it yourself, I think the insight you get from a good coach is invaluable.  The unique ability to steer you in the right direction and help you avoid unnecessary problems not only saves you countless hours, it also improves your chances of success.

I’ve also learned to work with my coaches and know what to ask of them. I’ve even started to help coach some physician colleagues.

The concerns

And in my experience, I’ve talked with many physicians who have tried to transition to a nonclinical career and there are 3 recurring and common concerns:

  1. Money
  2. Experience
  3. Time

I’ve found the best way to navigate these hurdles and lowers your risk of failure is to start a side business while you are still at your current position.

This is more work… absolutely.  But you gain invaluable experience and still have room for mistakes without worrying about your current expenses. 

This transition is temporary, and the strategy of a side business can protect inexperienced professionals from serious and permanent losses.

Please remember to reach out and ask for help.  Your medical career was built over many years.  You can make this transition too if you have the right help, and the right resources.

Good Luck!  And here’s to a successful transition to your nonclinical career!

p.s. If you get stuck, or still don’t know where to start, you are welcome contact me through DadsDollarsDebts. 

 

Ed. What a great interview. I definitely appreciate our guest doctor for taking the time to answer some of my questions. I hope his experience will be a guide for anyone looking to branch out from clinical medicine. It may be a lot of work and risk, but the rewards can be life changing.

Let us know your thoughts below and if you have any experience with non-clinical doctoring. 

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DadsDollarsDebts

I am a Dad and Doctor trying to find financial freedom by owning my dollars and debts. Helping dads with their finances so they can focus on the family.

20 thoughts on “Leaving clinical medicine- An Interview

  • January 10, 2018 at 5:52 am
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    Zestful post! Non-clinical skill sets of doctors most of the time convey them better pay, less stress, and far more regular hours. If it makes someone happy its not bad.

    Reply
    • January 10, 2018 at 7:27 am
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      Thanks for checking out the post. It takes a leap of faith to do it but can be quite satisfying.

      Reply
  • January 9, 2018 at 5:56 pm
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    I’m in awe of doctors and I’m always delighted to see doctors scratching an entrepreneurial itch. Great stuff, sir. Hope the consulting gig goes well.

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    • January 9, 2018 at 9:40 pm
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      Thanks Mr. G…don’t be in awe of us, we are just regular folks with over active desires as children.

      Reply
  • January 7, 2018 at 12:02 pm
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    Good post, but you make it sound daunting. The conferences, coaches, making no mistakes etc.

    The problem (your Time issue) to a side gig for Physicians is that most of us have young kids when we start to have a real interest in non-clinical medicine. So we have to choose between part time with the extra time for kids or part time with the extra time for another career. There is the dilemma.

    Seems like you started a family late, I suspect this is a large reason why you are having success with your firm. More quality research time. I think another large reason is the ER career. It’s no coincidence that WCI and PoF have careers in shift work with large chunks of time off if desired and much less daily patient and family phone calling, followup studies, add ons during a full schedule etc that come with a cardiology or oncology choice. These things can wreck the best laid plans and eat up the day and are a major reason 9-5 isn’t possible for most Physicians. Many of my days I have a routine follow up with new metastases or a treatment toxicity. 10 minutes on the schedule is now an hour, see you after dinner kids.

    One personal reason I don’t want to start a side gig yet is because, like many docs, if I do something it’s going to be done right. Until I can “research a lot of available material” as you say, I just won’t be comfortable enough to succeed. I’m not a fly by the seat of my pants person. This is the main reason I am not yet in real estate for example.

    I have about 4-6 free hours a week between my busy practice, family and keeping fit, sometimes less. I’d be interested in future interviews if the time commitment to these side gigs can be more precisely clarified, not merely estimated. This would include research time before even starting. I bet it’s momumental. I know my blog alone takes a few hours a week and that’s just commenting on other excellent posts (like this one) not even writing my own posts!

    I’ll look forward to future posts on the topic. You’ve really hit on something with these interviews on leaving clinical medicine.

    Reply
    • January 7, 2018 at 5:39 pm
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      You make a lot of great points here. Having a child makes focusing on side gigs much harder unless your spouse takes the brunt of the work. For me, my wife does take a lot of the work, but I do not work on my blog unless my son is asleep or otherwise occupied. He is slowly learning self play and thus more time will free up.

      For trying a side gig, the time investment is high but I suspect this is with most side gigs. I am often busy with work and in baskets, a benefit that anesthesiologist, ER docs, and radiologist don’t deal with as much but there are other pluses and minuses to our various jobs. Also we make so much money as doctors that the time to money ratio on side gigs are not worth it. We have to go into the side gig as a potential for future earnings and not so much immediate earnings. I hope to bring more interviews but need people willing to do an interview. If you know anyone please refer them my way! Thanks for your thoughtful comments.

      Reply
    • January 7, 2018 at 9:24 pm
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      Not sure I ever viewed Anesthesia as “shift work”. It is not office work but when there are 6 add-ons to the OR schedule, you work till the cases are done and the people are cared for. After I did the OR I went up into the hospital and did pain consults and when all of that was done, I was also a group owner with admin responsibility.

      Reply
      • January 7, 2018 at 9:26 pm
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        I think it has changed over the years for employed physicians. Some shifts are 24 hours but they are still hours and not cases.

        Reply
    • January 9, 2018 at 9:46 pm
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      A Good Life…we have a reply from our guest interviewee in response to some of the comments:

      Raising kids or a 2nd career?

      Maybe. But what about priorities and time management?

      Imagine back when you were a resident or even an intern you most likely had even obligations, meetings, conferences, etc. from time to time. You would have to arrange for childcare, right?

      In terms of a 2nd career, I have 2 more comments.

      First, I think the time commitment is going to increase while you transition. No doubt about it. It almost has to with all of your responsibilities and learning a new career.

      Second, and most fortunately, this schedule is temporary. This period may be stressful and difficult at times, but it is temporary and will not last once you’re in your new career.

      “I want to do it right. And I don’t feel comfortable enough.”

      Thank you! These words can’t be emphasized enough. I just recently had this exact conversation with a family member about real estate investing of all topics.

      They said they were starting to think about investing in real estate. Their friend’s son had been doing it and now their friends were too. They wanted to learn a bit about it, but said that they weren’t comfortable with it and didn’t know enough. It was too risky in their opinion.

      What does comfortable enough mean to you?

      I bet it means many different things to many people. And it sounds like you refer to it in much the same way as my family member (and I once did):

        Having a mastery or being an expert in a given subject.

      Any for many of us who are physicians, and because our work is highly accurate, this level of comfort requires expertise in the subject.

      It’s also not much different with family members’ whose valuable financial transactions also require a similar level of precision to avoid catastrophe.

      It’s totally understandable. I get it.

      Who wouldn’t want a highly trained, accurate physician working with my serious condition or a highly skilled investor guiding my life’s savings in every financial deal and transaction.

      But is this level of comfortable required for all endeavors, or just preferred?
      Was there a way for me to get involved in real estate investing and participate in some of the fantastic success stories without losing my shirt? Did I need to be an expert to be successful?

      I mean real estate brokers, agents, loan officers, investors, relatives etc. were all investing in homes; some good, some bad.
      What factors determined success? Where could I find this knowledge?

      It seemed like there were countless books, seminars, conferences and advice available about real estate investing. Was Robert Kiyosaki’s Rich Dad/Poor Dad program any better than one of the books I found on Amazon? What was credible?

      And at the same time I am asking myself these questions, and out of pure luck, I received a new offering by one of my newsletters. I really enjoyed the opinions of the editors and analysts and after several years of active readership I came to believe in much of what they presented.

      And sure enough this new offering was a self-directed real estate investing course. I bought it and read it enthusiastically. I taught myself the ideas in the course. (There is no reason this course was much different than any of the others frankly, it’s just that I had the confidence in the source.)

      Then, still skeptical of my newly acquired knowledge, I pulled up some sample properties in my area and then pitched a mutual acquaintance who was an accomplished real estate investor.

      To my surprise, he was impressed! He said my calculations were spot on, if not a little conservative. He said I had calculated all the appropriate metrics and did a complete job of my research in terms of remodel costs. Essentially, he graded my course homework, I passed!

      So, led by my enthusiasm from his words and my perceived knowledge of real estate investing I proceeded to buy/rent/sell 3 homes over a 10-year period. I followed the program to the last detail and was successful with all 3 properties. And more importantly, I grew increasingly confident and more comfortable with each subsequent deal as my knowledge and experience accumulated.

      I share this story only to demonstrate to you how a novice like me without any real estate experience, and a non-risk-taker, can find enough time and knowledge to be “comfortable enough” to be successful in real estate investing.

      It’s truly amazing what you can accomplish and get “comfortable with.”

      Very best of luck to you!

      Reply
      • January 10, 2018 at 8:47 am
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        Wow! Thanks for the extensive reply.

        It’s reassuring that you see the education part as heavily front loaded, sort of like medicine or personal finance, with an easier and gratifying maintenance phase. I do like learning though which is part of the fun of a new career.

        I think your right about feeling like an expert before I take the plunge, but there is risk in these things. Medicine is not very risky, you study hard and you’ll probably have a good high paying job, so I must be risk averse, which is why I’m not an entrepreneur. I’m also a radiation oncologist. I live in the world of slow, evidence based decisions with the ability to read about new cases and change things multiple times. I’ve outgrown my analysis paralysis, but I still need lots of info before making a move. It doesn’t mean I don’t have the desire to start something new that I created, I’m mean, I read this post and commented : )

        You describe a good path to trying a new venture: front-loaded studying, find a mentor, test it small and then go bigger. You’ve done the work too, so you’re giving first hand knowledge. Seems like my first step is identifying what to do, then when to do it (older kids and less hours working) and start searching out a good mentor during the process. No so daunting maybe, an definitely exciting to try something new. Great post DDD.

        Reply
  • January 6, 2018 at 11:08 pm
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    Interesting post. What I see is how many physicians don’t like being employed but would prefer to run their own shops or just do 1099 work. Part of the reason I quit was the “corporating” of medicine. That’s the best part of living in America and reaching FI is once there you can call your own shots.

    Best

    Reply
    • January 7, 2018 at 8:09 am
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      It does seem like being an employee is part if the frustration. There is something nice about not having.ti.worry about your paycheck coming in but we sacrifice Independence in the process.

      Reply
  • January 6, 2018 at 12:17 pm
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    I think 20 years should be considered a full medical career. Other stressful fields understand this, e.g. police, fire dept., and military. That is the point I’m at and I downshifted to part-time. I didn’t want to give up on clinical practice but I knew I would benefit from a change.

    Reply
    • January 6, 2018 at 12:18 pm
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      I agree with the 20 years rule. I always thought 10 years practicing something, anything is adequate to be considered competent. This could be carpentry, medicine, or any other trade/practice. Shifting to part time is a good way to stay in the game while enjoying other aspects of life.

      Reply
  • January 6, 2018 at 8:57 am
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    Thanks for sharing this story!

    Many physicians are unaware of the non-clinical skill set they possess. At the same time, navigating this process on your own can be daunting.

    A good starting point is to figure out if you can adjust your clinical practice to make you happier, or if going completely non-clinical is the way to go.

    Agree that starting a “side gig” initially is a great way to explore your options.

    Reply
    • January 6, 2018 at 9:00 am
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      It can be daunting…also trying to figure out what can make you happier is sometimes difficult to do. For instance, I often analyze our current practice model thinking of ways to improve it for both patient and physician well being. Even when there are some good ideas, it can be hard to place into practice.

      Agree with you though, start with the side gig and then growing from there.

      Reply
  • January 6, 2018 at 8:33 am
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    Great post and I love the message. Thinking outside the box can lead to some pretty cool and interesting gigs. There’s big risk, but bigger reward. An attorney friend of mine mentioned that I should look into being a medical expert witness, and honestly I had never even given it the thought before. I must admit that it sounds interesting and might start considering it. Thanks for sharing your story!

    Reply
    • January 6, 2018 at 8:37 am
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      Big risk and big reward for sure. It takes a leap of faith. It might be worth looking into. As a side gig, it is a way to make extra cash…or you can just leap into it for full time work. Either way it is worthwhile checking it out.

      Reply
  • January 6, 2018 at 8:03 am
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    Very difficult, particularly in the setting of our higher than most incomes. For instance most non-clinical jobs I could get would pay $180 to $200 k to start which would be a drastic pay cut for me.

    Reply
  • January 6, 2018 at 7:58 am
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    Fascinating post! Thank you both. So a clinical practitioner with a keen interest in research, and a lot of discipline, could go far in this type of consulting. And the list of other non-clinical opportunities is vast.
    But yet, I imagine it’s difficult for many to stray from the defined career path they set out on,

    Reply

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