Saturday, February 28, 2009

Getting Reconnected - How Time Flies

I had a really nice chat the other day with someone I hadn't spoken to in several years. We briefly chatted about health information technology, MIT, medical education, Web 2.0, and a local pharmacy school. It's great to have social networking resources to stay connected with people. Thanks you LinkedIn and Facebook. It's important to maintain relationships because you never know when you may need a professional reference, a job lead, or even a potential lead for a colleague.

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Best Online MBA for a Physician

This question comes up all the time: "What's the best online MBA for a physician?"

There's no easy answer, since it probably really depends on what that physician wants to do with that MBA. Is he/she interested in starting a business and becoming an entrepreneur? How about running a hospital? (in which case a master's in medical management of a master's in health administration may be more beneficial). What if you want to go into pharma? Do you need an MBA? No. However, if you want to work on the marketing side of pharma, then it may be very beneficial to have some marketing expertise.

An MBA can also be very useful if you want to go into finance or consulting. I've discovered that most physicians don't really understand the corporate business world. By "most" I mean those who go straight from a biology/chemistry/science undergraduate degree to medical school. They lack any "real world working experience." They've been a lifelong student!

Do some research before pursuing an MBA. Don't simply look for the "best" since one size doesn't fit all physicians. There are so many different non-clinical opportunities for physicians and you may find that an MBA is not usually required for most of them.

Free MIT education: Open Course Ware

Earlier, I mentioned free MIT education through the MIT Open Course Ware. If you're interested, take a look here:

It's a great way to spend time if you're in transition. Learn some new skills and be better prepared for your next opportunity. It's about lifelong learning.

Balancing Full-Time Jobs and Part-Time Education

It's tough enough balancing a full-time job and a personal/family life. When you add an educational degree on top of that, then it gets to be very tricky! There are many people who find that they are more productive when they're pushed to the limit. Of course, you can get burned out very quickly if you're being pushed to the extreme, so you have to know your limits.

For me, I enjoy reading and learning new things. In some ways, I wish I could be a lifelong student (as long as someone pays me so that I can pay the bills, take care of my loans, etc.). However, the reality is that we need to be productive with our time, resources, and talents. I enjoyed getting my MPH (master's in public health) while I was working full-time. It was motivating and stimulating. I admit that there were days when I just wanted to be finished with my MPH. Once I was done, I felt a huge sense of relief. However, I also know that I can do it again - and that's why I've been thinking about business school. I'm still not sure where (and if) it fits into my life and my career plan, but I hope that it will at some point.

If you've been considering a part-time education and you're currently working full-time, keep this in mind: many schools offer you the option to enroll in one or two classes as a non-degree student. This gives you the flexibility to test the waters and try things out first. If you find that the work/life/school balance is too difficult, then you may need to reconsider your options. However, I'd have to think that many people would find the balance manageable - as long as you prioritize wisely. If you have the luxury to stop your day job and enroll in a full-time educational program, then you're very lucky. That's probably the best learning option if you can afford such an investment. As for me, I need to play the balancing act of work/life/education in order to stay alive and support my family. That's the practical side of life.

Business Exchange

If you frequent BusinessWeek online, then you may have stumbled upon Business Exchange. It's still in beta, but it appears like a solid social networking site where you can exchange thoughtful ideas, opinions, and resources. Have you been thinking about business school? If you have unsettled questions about b-school (regarding tuition, online classes, etc.), then you should take a look.

For those healthcare professionals who are planning a transition to a non-clinical career, it may be a good investment of time to take some online business courses. Some are even offered for FREE, so why not?

Friday, February 27, 2009

Working in Medical Education

I've had many people ask me about the world of medical education. One might think that medical education is fairly simple and straight forward, but it's much more complex because of the need for certified continuing education. Then you have promotional medical education activities that may look like a robust educational program (but you have to recognize them as promotional activities).

How do you get your CME/CE? Do you attend major medical meetings? Do you participate in online educational activities? Do you read journals? Online web portals and online courses offer very convenient ways to get continuing education.

Thursday, February 26, 2009

United Healthcare, Aetna, and Kaiser Permanente

What do these 3 health plans have in common? United Healthcare, Aetna, and Kaiser Permanente

They now offer expanded coverage of continuous glucose monitors (CGM) for patients with type 1 diabetes. It's great to see advances in technology that have tangible impact on disease management.

Last month, the American Diabetes Association (ADA) published its 2009 Standards of Medical Care in Diabetes. The new standards recommends the use of CGM in the following ways:

  • Continuous glucose monitoring (CGM) in conjunction with intensive insulin regimens can be a useful tool to lower A1C in selected adults (age ≥25 years) with type 1 diabetes.
  • Although the evidence for A1C lowering is less strong in children, teens, and younger adults, CGM may be helpful in these groups. Success correlates with adherence to ongoing use of the device.
  • CGM may be a supplemental tool to SMBG in those with hypoglycemia unawareness and/or frequent hypoglycemic episodes.
One of the studies that provided robust data on the use of CGM was this New England Journal of Medicine article:

The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group: Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med 359:1464–1476, 2008

Online Continuing Education

How do you get your continuing education? Do you take classes? Read? Online programs?

Many more people are getting their continuing education online. Do you ever consider getting an online master's degree (say an MBA, an MPH, an MEd, an MS, or an MA)? You've probably seen ads for Walden University, the University of Phoenix, Capella University, DeVry University, and others.

But did you know that some of the most prestigious universities offer online master's degrees? For instance, Johns Hopkins offers an online MPH program where the vast majority of the coursework is Internet-based. Emory University offers a similar online MPH.

Getting a master's degree has many benefits, even if you're a seasoned healthcare professional. There's a reason why executive MBA programs are so popular among senior-level corporate executives. There's so much you can learn in the classroom, but more importantly - there's so much you can learn from each of your colleagues and peers. If you're planning on a career change, then you may want to look at some sources of continuing education. Maybe it will be worth your investment to even enroll in a degree program.

Tuesday, February 24, 2009

Distance Learning: Online Education

As e-learning technologies improve, graduate-level distance learning programs are becoming stronger than ever. Want to see what your classmates look like? Then schedule a video conference call to work on a group project. These types of interactions are becoming more and more popular among today's online degree programs. Don't have time to sit in a classroom? Then watch the lecture online on your laptop.

There are obviously pro and cons to online education. However, for busy doctors and other healthcare professionals, the pros may far outweigh the cons. This may be especially true if you don't live in a major city where you may have access to executive and evening programs (such as an executive MBA). You'll have to decide after you do your research.

Master's in Medical Management

What do these 4 universities have in common?
  • Carnegie Mellon University
  • University of Southern California
  • Tulane University
  • University of Massachusetts Amherst
They offer either a master's in medical management (MMM) or a master's in business administration (MBA). Plus, they are the four schools that are ACPE partners.

The ACPE (American College of Physician Executives) is an organization that fosters the growth and development of physician leaders. You don't need to have a master's degree to be an excellent physician executive. However, there are many benefits of formal education in professional leadership, management, and business.

Growing Your Social Network

Because of the current economy, activity on social networking websites has gone through the roof. When I visit the forums and discussions on LinkedIn, I see many recruiters and job candidates actively looking for various types of opportunities. Some are in complete career transitionwhile others are simply looking for a minor change.

Have you been growing your social network? Even if you're in a stable position and you don't see yourself going anywhere anytime soon, I'd encourage you to maintain relationships with old colleagues, classmates, and co-workers. I admit that networking can be tiring and time-consuming, but the intangible benefits are worth that periodic investment.

Monday, February 23, 2009

Should I do a Medical/Surgical Residency?

I often get asked this question by medical students: "Should I do a medical/surgical residency if I KNOW that I never want to practice medicine?"

I always try to encourage medical students to go through residency. There are many types of non-malignant programs out there. Plus, you may find that you actually enjoy certain things about clinical medicine. Some residency programs to consider include preventive medicine and PM&R. No matter which program you select, residency can feel brutal if you end up isolating yourself from family and friends. Plus, you may suffer serious emotional burnout and psychological distress if you're not truly prepared to be a physician.

There are many non-clinical opportunities for medical school graduates who never go through a residency. The transition from the clinical world to the non-clinical world can be slow and arduous, but many have traveled this road with great success.

The European Commission Approves Efient (prasugrel

No, not Effient (which is the proposed US tradename). Efient (prasugrel) has been approved in Europe for acute coronary syndrome (ACS) patients undergoing PCI. The annoucement was made by Daiichi Sankyo Company, Limited and Eli Lilly and Company.

Two of the major prasugrel studies are:
  • TRITON–TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel–Thrombolysis in Myocardial Infarction), and
  • TRILOGY ACS (TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes),
Prasugrel is a dihydropyridine that is currently under FDA review. The other dihydropyridine you're probably familiar with is Plavix (clopidogrel) which is marketed by sanofi-aventis U.S. LLC and Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.

Sunday, February 22, 2009

The American Physician Scientists Association

If you're a medical student of a physician with a strong background/interest in research, then you may want to consider attending the American Physician Scientists Association (APSA) meeting this year in Chicago. There are different levels of membership and it appears that you don't have to be an MD/PhD or a DO/PhD to be a full member.

Re: Non-Clinical Opportunities for International Medical Graduates

Someone recently asked: "Tell me about non-clinical opportunities for international medical graduates (IMGs or FMGs)"

My reply:

The opportunities are mostly the same when you're looking at things related to medical communications, consulting, writing, etc. In most of these cases, you don't need an active US medical license. Hence, whether you are an international graduate or a US graduate, the opportunities may be very similar. I'm not going to get into issues related to getting a work Visa because that's an entirely complex topic in and of itself.

Student Doctor Network Salary Expectations Survey

The SDN has a nice article based on a series of polls regarding salary expectations. Salary ranges among healthcare providers can vary so much that it can be very difficult to decipher published salary guides. The article on SDN also has links to mean wages from the U.S. Bureau of Labor Statistics (BLS).

Saturday, February 21, 2009

Online MBA at a "Top Tier" B-School

Is it possible to get an online MBA through a "top tier" b-school in the USA? I suppose it depends on how you define "top tier."

BusinessWeek has a list of top 30 full-time business schools. Within that list, Indiana University (Kelley) is the only school that offers a true online program. Carnegie Mellon (Tepper) is also on that list of top 30, but the online program they offer is very selective and you have to live within specific cities to participate in that program.

Thunderbird is considered a "second tier" school by BusinessWeek. They offer an online MBA. Arizona State (Carey) and Babson are other "second tier" schools that offer an online MBA degree.

There are many other schools that are ranked on BusinessWeek (either for their Executive MBA or their part-time MBA). Some of them also offer online programs. Schools that come to mind include: Drexel (LeBow); the University of Florida (Warrington); Villanova; U Mass Amherst (Isenberg); and several others.

I find that the phrase "online MBA" or "distance learning MBA" can be leading because some programs still require a considerable time on campus. Therefore, it's important to clarify and to differentiate which programs are 100% online. I often meet physicians and medical students who are interested in online MBA programs. Most of them are interested in the didactic learning and less motivated by the social networking aspects of b-school. I suppose it really depends on your reasons for pursuing an MBA and your overall career goals.

Friday, February 20, 2009

Jobs in Health IT

There are a growing number of jobs in health IT. If you have an interest in that industry, then start getting familiar with companies like:
  • GE Centricity
  • Nextgen
  • Kronos
  • Cerner
  • McKesson
  • Lawson
  • Meditech
  • Epic
  • Eclipsys

MD, MBA Program List on the Student Doctor Network

There's a great list of MD, MBA (or MD/MBA) programs on the Student Doctor Network

If you already have your MD and you're thinking about B-school, then you've come to the right place. I have some resources here about getting an MBA for physicians and other healthcare professionals.

Finding Jobs on

Instead of using multiple different job boards (like Monster, Career Builder, and Yahoo Jobs), why not use a single source that aggregates all the potential opportunities that are out there. I'm not talking about Google. Try

Raptiva and the FDA

As more stories emerge about progressive multifocal leukoencephalopathy (PML) in patients using the psoriasis drug Raptiva (efalizumab), the FDA has issued a public health advisory. Raptiva is a biologic agent and in October 2008, a black box warning was added to the product label. Raptiva is manufactured by Genentech.

More and More Jobs on LinkedIn

There are more and more jobs popping up on LinkedIn

Some of them are appearing only within specific "groups" on LinkedIn. Therefore, if you're looking for a job or a complete career change, you may have a lot to gain by joining LinkedIn and building your electronic social network.

Thursday, February 19, 2009

Build Your Social Network

I recently had the opportunity to get reconnected with some old colleagues. Then, I received this email from a physician resident who decided that residency wasn't the right fit and is now actively looking for a job. My advice was this - build your network and get reconnected with old classmates, colleagues, and friends. Your best probability of finding a job might be through those connections. Also, I suggested that this person make the best use of professional social networking websites like LinkedIn, Plaxo, etc. Finally, I mentioned that executive recruiters can be very helpful in helping you find a job when you're making a career transition into the non-clinical field. They have connections and they may also know of opportunities that aren't posted anywhere.

Wednesday, February 18, 2009

Inactive Doctors and Active Medical Licenses

LocumLife has an article on how many clinically inactive doctors hold and maintain active medical licenses. Many of these physicians are women who may take extended "breaks" from medicine to have children, raise a family, etc. Others are physicians who venture into non-clinical careers and they find themselves being drawn back to the practice of medicine. You may even get some physicians who pursue an early retirement, only to discover that they need additional income to maintain their current lifestyle.

The study was conducted mainly among pediatricians by the University of Michigan Child Health Evaluation and Research (CHEAR) Unit and the American Board of Pediatrics. I suspect you'll get some skewed responses since many of these physicians are women and many either work part-time or they tend to take long career breaks. I think it will be interesting if a similar study is conducted among all the specialties.

Hospital Pharmacy Performance Index by McKesson

McKesson has a new survey called the Hospital Pharmacy Performance Index. There's been a lot of talk about increasing physician performance, but there are significant needs to improve corporate performance at hospital and pharmacy levels. So how does your local hospital score? To find out, have your hospital take the online assessment here:

The assessment is based on the 8 dimensions of pharmacy practice: leadership, medication preparation and delivery, patient care services, medication safety, medication use policy, financial performance, human resource management, and education.

VGX Pharmaceuticals: PENNVAX and CELLECTRA

Dr. J. Joseph Kim (no, not me) is president and CEO of VGX Pharmaceuticals. We're both MIT alumni, so we share one similar connection. There have been some exciting news from VGX recently.

Here's the headline from a recent press release: "VGX Pharmaceuticals Proprietary DNA Vaccines Delivered with Electroporation Achieve Immune Responses Superior to Recombinant Adenovirus Serotype 5 (Ad5) Vectors"

That sounds very exciting to me because there is such a need for better vaccines. Plus, we really need an HIV vaccine. This press release deals with some results on the PENNVAX HIV Vaccine Program. Researchers have been working on delivering the PENNVAX™ DNA vaccines using a novel electroporation device called CELLECTRA®.

Collaborators include the University of Pennsylvania, VGX, and Merck. These results are truly exciting and they reflect what can happen when you apply novel technologies in healthcare. Perhaps we will see a safe and effective HIV vaccine someday.

Extended-Release Tramadol

It appears that the FDA has tenatively approved the extended-release tramadol capsule. Tramadol - also called Ultram - is a non-controlled substance. However, because it is derived from opiates, it has a theoretical potential to cause addictive behavior (well, maybe I shouldn't say it's theoretical since there are clinical studies documenting addiction, abuse, and misuse).

The extended-release tramadol capsule is being developed by Cipher Pharmaceuticals Inc. (not to be confused with the Cypher drug-eluting stent for coronary heart disease)

American Board of Preventive Medicine (ABPM) Certifications

The American Board of Preventive Medicine (ABPM) was incorporated in 1948 and has gone through quite a few changes over the years. Instead of offering certification in a single medical specialty, it offers board certifications in several, including:
  • Occupational medicine (1955)
  • Aerospace medicine (1953, formerly called Aviation medicine, name changed in 1963)
  • General preventive medicine (1963) - which is now called public health and general preventive medicine (1983)
  • Undersea and hyperbaric medicine (1989)
  • Medical toxicology (1992)
So, if you're considering a non-clinical career, you may wish to explore some options in the world of preventive medicine. The latest certification was added in 1992 and I won't be surprised if a few more get added over the next few decades.

The Board consists of members from the following organizations:
  • Aerospace Medical Association
  • American College of Occupational and Environmental Medicine
  • American College of Preventive Medicine
  • American Medical Association
  • Association of Schools of Public Health
  • Association of Teachers of Preventive Medicine
  • Trustees of the American Board of Preventive Medicine
Have you ever considered being a NASA astronaut physician?

9 comments so far on the Forbes story on Concierge Medicine

An interesting article popped up on Forbes last month titled, "Should You Dump Your Primary Care Physician?"

So far, there are 9 comments and several are from physicians who are actively practicing boutique or concierge medicine. This is a growing industry and may see a huge burst depending on what types of changes occur within the nation's healthcare system.

Bureau of Labor Statistics on Healthcare Professional Salary

Here are the National Occupational Employment and Wage Estimates from 2007. So many salary statistics tend to be inflated and completely inaccurate. I would hope that the government would provide more reliable data. By glancing through this list, you see physicians, pharmacists, nurses, therapists, and other clinicians.

It's very difficult to find salary surveys among non-clinical medical professionals because of the extremely wide range of figures that are out there. It's interesting to see salary ranges displayed within specific industries like: managed care medical directors; CME professionals; pharmaceutical physicians; finance/consulting/market research physicians.

Tuesday, February 17, 2009

Medpedia Medical Wiki

The Medpedia medical wiki project is now live and active. Of course, it's much more than a wiki. Let's see what type of participation we get on this site. Will this be medical social networking at its best?

Congrats to Dr. Deborah Dunsire!

Congrats to Deborah Dunsire, M.D.!

The Healthcare Businesswomen’s Association (HBA) announced that its 2009 “Woman of the Year” is Dr. Deborah Dunsire, President and Chief Executive Officer of Millennium: The Takeda Oncology Company. She also spoke at the 2007 MIT Sloan BioInnovations.

Uloric (Febuxostat) approved by the FDA for gout

Uloric (TMX-67 or febuxostat) was approved by the FDA for the treatment of gout. It's been over 40 years since the FDA has approved a new drug specifically for gout. Febuxostat is a highly potent non-purine selective inhibitor of xanthine oxidasewas and it was approved by the European Union (EU) last year, and now we have the FDA approval this year. We're always lagging behind the EU - I wonder if we'll ever catch up. Uloric is made by Takeda Pharmaceutical Company Limited.

Monday, February 16, 2009

Medicare and Care Coordination - a disappointing study in JAMA

There's an interesting article in JAMA this month. It's titled, "Effects of Care Coordination on Hospitalization, Quality of Care, and Health Care Expenditures Among Medicare Beneficiaries"

Here's the bottom line: Care coordination programs don't seem to reduce healthcare costs among Medicare beneficiaries. This is very disappointing since you would hope that patient education would improve clinical outcomes. In this instance, nurses were contacting patients roughly twice each month. Since the patients mainly had heart failure, heart disease, and diabetes, these were patients with significant medical problems.

In my opinion, patient education that only occurs twice per month is not enough. We now have ways to automate and tailor messages. These can be sent via phone, SMS, e-mail, and a variety of other ways. When this study was designed, these resources may not have been refined like they are now. I'm sure a better study could be conducted that utilizes some of these automated technologies. After all, now we have older patients with implanted defibrillators living at home where wireless data is being captured and sent to clinicians in hospitals and offices. These types of systems can all be integrated with a robust care coordination program that can alert patients when they need to make some changes in their lifestyle before they end up being hospitalized.

Welcome to this new URL. This is my dedicated blog about non-clinical jobs, opportunities, and careers for physicians and other healthcare professionals:

I hope you'll find some of the information useful.

Experimental Advanced Prosthetic Arm Systems

I've always loved biomedical engineering. When I went to MIT, I thought I was going to pursue a career in biomedical engineering. Now, the concept of biomedical engineering has evolved in bioengineering (tissue, molecular, and genetic biology) and of course you still have people working in biomechanical engineering (that would have been my choice many years ago).

There's a really neat story in JAMA about patients using experimental advanced prosthetic arms. Does this remind you of a movie with Arnold Schwarzenegger? I love the Terminator series. I think it's great to see advances in engineering that are improving healthcare.

Sunday, February 15, 2009

Physician Disability

You may be surprised to know that a physician may claim disability and continue to work in a non-clinical setting. Physician disability insurance can be very specific about your specialty. So, if you're a disabled surgeon and you change your line of work and start seeing patients as a non-surgical primary care physician, you may still qualify for medical disability since you're no longer able to operate.

Sounds interesting, doesn't it?

Furthermore, if you're a disabled physician, you may find yourself doing some non-clinical things like medical writing, consulting, teaching, and research. You may still qualify for disability since you're no longer working in direct patient care.

The Healthcare IT Language

The healthcare IT world uses a totally different language. Remember when you were a medical student and you had to learn acronyms like BID, PO, TID, QHS, and PRN? That was just the beginning.

Well, if you're interested in healthcare IT, get familiar with many more acronyms. Here's a brief teaser:

ANSI: American National Standards Institute

EHR: Electronic Health Record

EMR: Electronic Medical Record

CDA: Clinical Document Architecture

CPT: Current Procedural Terminology

HL7: Health Level Seven

ICD-9: International Classification of Diseases and Related Health Problems

NLM: National Library of Medicine

XML: The Extensible Markup Language

Now, if you can define these acronyms, then that's great! However, can you explain what each represents? That's where it can get quite complex. Also, can you really drill down into the current issues that surround the complex Health IT challenges?

Non-Clinical Medical Opportunities for Physicians and Other Clinicians

- updated on 1/15/2011

If you're a physician and you're considering a non-clinical career, you may be wondering about all the opportunities out there. I get asked about this all the time. Over the years, I've had a chance to meet different physicians working in various companies and industries.

The following may apply even if you're not a physician. If you're a clinician (nurse, nurse practitioner or advanced practice nurse, pharmacist, physician assistant, medical researcher, podiatrist, physical therapist, psychologist, counselor, etc.), many of these opportunities may still be appropriate for you.

First, ask yourself what you enjoy. After all, if you don't enjoy clinical medicine, you don't want to end up doing something else you're not going to enjoy. Then, start networking using an intentional strategy. Leverage all the online social networking sites (like LinkedIn, Facebook, Plaxo, etc.) and get reconnected with old colleagues, classmates, and friends. Find out what people are doing. They may help you get connected to some key people. You may find some of the best opportunities this way. If you're a woman, you may want to check out MomMD ( and join a community of women who are seeking non-clinical opportunities ranging from part-time to full-time work.

The following list of opportunities is clearly non-exhaustive and many of these areas have significant overlap. This list is based on my personal interactions with people in these roles and as I meet more people, this list grows.

Here is my growing list of non-clinical opportunities for physicians (not in any particular order).

1. Healthcare administration, medical management, hospital administration, managed care - Are you a seasoned healthcare executive? Do you enjoy making administrative decisions? Then join the American College of Physician Executives (ACPE) and run a hospital or a managed care organization. If you have a strong interest in managed care, then check out the NAMCP (National Association of Managed Care Physicians). You may want to get an MBA or an MMM (masters in medical management) if you don't already have one. An active US medical license is required for most (if not all) of these positions.

2. VC (venture capital), finance, Wall Street, etc.- Got an MBA? If not, are you thinking of getting one? Some will argue that once you have an "M.D." after your name, it may not matter as much where you get your MBA. However, I would argue that your MBA is your path to networking opportunities, so where you get your MBA is critical if you want to have a solid network. Once you get your MBA, you can work for venture capital (VC) firms, dig into market research companies, or work on Wall Street. Maybe you've heard of the Gerson Lehrman Group ( No clinical experience necessary for many of these opportunities, but it's always helpful so that you can effectively communicate with KOLs (key opinion leaders) in the field. Many joint MD/MBA students have ventured directly into very successful careers this way. Also, an MBA is not necessary if you have some good business skills and understand the healthcare industry. You will need strong people skills and a willingness to work long hours.

3. Writing and medical communications (includes promotional education, certified CME/CE, consumer health education, and much more) - Do you enjoy writing? Many physicians and non-physicians have very successful careers as medical writers. The field is open to people who enjoy fiction writing, publications, research, or other types of writing. You can get involved working on journal publications, developing promotional content for marketing campaigns, or developing CME programs. Join the AMWA (American Medical Writers Association) and look for opportunities. You can work from home as a freelance writer and have a very flexible schedule. Or, you can work for a publisher or another type of healthcare communications company. You can find a list of some companies by looking at the North American Association of Medical Education and Communication Companies, Inc., (NAAMECC) website. No clinical experience necessary.

4. Technology and Informatics (health information technology, healthcare informatics, EHR/EMR, PHR) - Want to develop or improve an electronic health record (EHR) system? Do you love informatics? Then join the CCHIT (Certification Commission for Healthcare Information Technology), the AMIA (American Medical Informatics Association), and the AHIMA (American Health Information Management Association). Clinicians use EHRs and patients (or consumers) use PHRs (Personal Health Records). Keep up with HIMSS. There are many companies attempting to integrate the data between PHRs and EHRs. There is a national initiative to improve and standardize public health informatics, so now is a great time to enter this industry. No clinical experience necessary, but you should be familiar with ICD, CPT, and other billing codes used in this industry.

5. Disease management, Personal health record (PHR) - Managed care organizations (MCOs) are always looking for better disease management (DM) programs for their plans. Some MCOs develop their own DM plans and others outsource them to external companies. These companies create and deliver various services to managed care organizations, including DM, wellness programs, personal health record (PHR) services, etc. Do you ever get educational pamphlets from your own health plan? Who puts them together? Who designs and develops these wellness and preventive health programs? It's not always WebMD. There are other companies that provide similar services.

6. Pharmaceutical/Biotechnology/Medical Device- If you're a medical specialist, there are many opportunities to do research for these companies. If you don't enjoy research, then you can develop marketing strategies. Direct-to-consumer (DTC) advertisements have become very popular these days. See all those ads in the medical journals? Get ready for that "corporate America" lifestyle if you plan to venture into industry. You may be working even more hours and carrying a Blackberry instead of a pager, but if you climb that "corporate ladder" and play the corporate game, you may qualify for an early retirement. Young people who are fast learners may be very aggressive and advance rapidly. Be prepared to have a younger boss if you're a seasoned clinician.

7. Independent medical examiner (IME), Expert witnessing, and Legal medicine - Personal injury, medical malpractice, nursing home care, etc. There are firms that specialize in specific areas (like nursing home cases). Want more information? Join the American College of Legal Medicine (ACLM). You can also become board certified by the American Board of Legal Medicine (ABLM).

8. Public health, population health, health policy, and government health - Get an MPH, join the APHA (American Public Health Association), and find a local health department. Or, join the CDC and travel the world. Develop strategies to improve population health. Some pharmaceutical companies also have public health sections and are very devoted to public health and international health (Pfizer in particular comes to mind). Bridge gaps in healthcare disparities. Work for the FDA or a state or local health agency.

9. Consulting - The world is open. Want to work for yourself or for a company? Many healthcare companies are looking for experts to help them develop, refine, and improve their products and services. It may be hard to get started unless you've already established connections. Once again, social networking becomes critical. Your initial success will depend more on who you know.

10. Research - Academia vs. private vs. industry vs. CRO. You don't have to go into industry to do research. Look for a Contract Research Organization (CRO) in your area. Join the ACRO (Association of Clinical Research Organizations). You may want to look at PPD (no, this is not the TB skin test). PPD is a large global CRO. Of course, there are also many other CROs.

11. Executive recruiting, search firm, headhunting, human resources - Physicians can work as an executive recruiter to hire and place other physicians. You can also work your way up and manage other recruiters who do the hiring. Remember, these 'head hunters' get paid a commission based on the salary of the person they place. The $ earning potential can be tremendous if you're successful.

12. Start a company - Have an innovative idea? Are you an entrepreneur? Start a company! New companies seem to be sprouting all the time. Stay connected with people and keep your eyes open for new ideas. Get an MBA and meet people who can help you get a concept off the ground.

Not sure where to start? As I mentioned above, start building your social and professional network. Reconnect with people and ask many questions. Find people who are in various positions and ask them what they like/dislike.

Join some associations to build your network and to find companies. Note that some associations are specifically for physicians, but many are open to all types of healthcare professionals. Also, even those that are specifically for physicians (such as the ACPE) offer affiliate memberships for certain non-physicians.

ABLM: American Board of Legal Medicine
ACHE: American College of Healthcare Executives
ACLM: American College of Legal Medicine
ACPE: American College of Physician Executives
ACRO: Association of Clinical Research Organizations
AMDIS: Association of Medical Directors of Information Systems
AHIMA: American Health Information Management Association
AMIA: American Medical Informatics Association
AMWA: American Medical Writers Association
APHA: American Public Health Association
CCHIT: Certification Commission for Healthcare Information Technology
NAMCP: National Association of Managed Care Physicians

Thanks again for visiting I hope you'll visit frequently because we publish new articles daily.  Don't forget to browse our Job Board if you're actively looking for a new job.

Question re: opportunities if I don't finish my residency

I got another question today from a resident (a physician in training, not someone living in a skilled nursing facility). The question had to do with career opportunities for people who don't complete a medical or surgical residency. Since I get asked this quite often, I write about my response.

Here was my reply:

I hope I can provide some help since I know quite a few people who've been in similar situations. Let me start by saying that the types of non-clinical opportunities can vary depending on where you live. How open are you to relocating?

The next issue is more of a practical one: do you have student loans? If not, then you have tremendous flexibility to explore and find the "perfect" job for you. However, if you're burdened by student loans, then you have to make some career decisions based on the practical reality of loan repayment (unless you have other sources of income such as family, spouse, etc.)

You're absolutely right in saying that you would have many more opportunities if you complete your residency and become board certified in a medical or surgical speciality. However, life in residency can be very miserable and it can also change people in different ways so you have to know yourself and the type of things you're able and willing to personally handle. People with unhealthy coping skills may find themselves addicted to drugs and alcohol and heading down a very dangerous one-way path. I'm not suggesting that's going to happen to you, but I always like to emphasize the importance of coping with the strenuous work hours, the tremendous pressures, and the emotional burdens that are commonly encountered in the clinical setting.

Also remember that residency dramatically changes after your internship year. Instead of being the scut monkey who has to run around everywhere, you have more responsibility in teaching and guiding your team. With that added responsibility comes different pressures. Will that be a relief or an added burden for you compared to internship? Many people report that their 2nd year of residency was so much better compared to the first. Also, are you in the "right program?" I'm sure you're aware of how certain programs have a reputation for being very malignant while others are very "cush." Have you beein in touch with your friends and colleagues from medical school? What is life like for them?

Medical communications is very broad. I write about some of the basics here in my blog:

I've also written about CME here:

I've also written a little bit about opportunities for people with no residency experience:

I'd be happy to share more with you as you develop more specific questions about the world of medical communications.

As for working the working environment - this can be a tricky one. You have to assess the culture of each company. The corporate world can be harsh and people may easily work more than 80 hrs/week (you thought residency had long hours!). However, there are companies that are very family-friendly where people stay for many years (hence, they have a very low turnover rate). The most flexible path is to be a freelance medical writer or consultant. You don't need any residency experience to be an excellent medical writer. Some of the best writers are scientists, pharmacists, and nurses. You need strong writing skills and you have to be very motivated.

My final word of advice - discuss this matter with your program director sooner than later. He/she may provide you with some great advice and guidance. However, keep in mind that this individual may not be very knowledgeable about non-clinical opportunities.

Perhaps we can discuss this some more after you've had a chance to think about all these issues. I wish you the best and hope that you'll stay in touch.

Question re: opportunities in medical communications and CME

I got a question the other day re: opportunities in medical communications and CME

Here was my response:

Non-clinical opportunities tend to be regional. If you live in the northeast, you are surrounded by medical communications companies. They tend to cluster around pharmaceutical and biotechnology companies, so you'll also find some in the west coast, Chicago, Kansas City, Indianapolis, and several other cities. This doesn't mean that you can't have a chance if you don't live in those areas.

Many people become very successful as freelance medical writers living anywhere in the country. A really useful resource for medical writing is the AMWA. You can join and get involved in many different ways. It's always hard to start as a freelancer, but if you're a strong writer, you'll find opportunities. To learn more about the CME industry, I'd encourage you to check out the Alliance for CME and NAAMECC.

Non-Clinical Healthcare Opportunities

According to some job sites, here are some of the common non-clinical healthcare opportunities that are out there:

- Medical Receptionists
- Medical Collection Specialists
- Medical Billers (Medicaid,Medicare)
- Medical Coders (Medicaid, Medicare)
- Insurance Verifiers
- Schedulers

Non-Clinical Medicine

To many people (including myself), the phrase "non-clinical medicine" sounds a bit odd. After all, the practice of medicine is clinical in nature.

Can you image the following conversation?

Q: "So what type of medicine do you practice?"
A: "I practice non-clinical medicine."
Q: "Oh, you mean like radiology or pathology?"

See, many people equate clinical medicine to seeing and treating patients. So if you're not actively engaged in direct patient contact and patient care, does that mean you're practicing non-clinical medicine? Not necessarily. The answer to the question above could also sound like this:

A: "No, I work behind in a company developing population-based disease management programs for managed care organizations."
A: "No, I work in a medical education company developing continuing education programs for physicians, pharmacists, and nurses."
A: "No, I now work in Wall Street"
A: "No, I now work for the marketing division of a pharmaceutical company"
A: "No, I work on developing market research surveys on different therapeutic topics."
A: "No, I now work as a medical news reporter."

To some, the phrase "non-clinical medicine" means that you sit in an office and have full-time administrative duties. And yet to others, "non-clinical medicine" just means that you're no longer engaged in anything that directly relates with patient care.

Are public health physicians working in non-clinical medicine? Population health issues may conflict with direct patient care issues since population medicine needs to weigh decisions against the "greater good." Direct patient care is individualized medicine.

I've gone on quite a tangent, but the point I'd like to return to is this: non-clinical medicine is a very broad phrase that means different things to different people. So don't make any automatic assumptions about someone's career if they tell you that they are now engaged in pursuing a non-clinical career.

Mobile Google Health

Anvita will provide a mobile platform for Google Health. Apparently this was announced the Towards the Electronic Patient Record (TEPR+) conference earlier this month. Google is really taking off with this and I wonder what Microsoft is doing with HealthVault to maintain a competitive edge.

MBA pay according to BusinessWeek 2009

MBA pay according to BusinessWeek. It's there in case you're ever interested in quoting numbers. I don't think you'll ever see a chart like this for physicians who have an MBA. I think the salary range would be way too broad.

Saturday, February 14, 2009

Retired Physicians

I met with some retired physicians today. It seems like retirement is when many physicians find the time and opportunity to pursue non-clinical opportunities. Many physicians enjoy teaching, writing, consulting, and doing many other things. Retirement is when they seem to find the time to do all the "fun" things in life. There's a new generation of physicians in today's world. The importance of work/life balance has never been stressed like ever before.

So what do you plan to do when you retire? Are you already preparing for that transition or will there be some major shifts in your life? It's hard to imagine the world of retirement, but I often do think about my current work/life balance.

Friday, February 13, 2009

ASCO's social networking site for EHRs

ASCO has a ning community set up for EHRs. It's great to see ASCO geting into Web 2.0. It makes sense that those who work in the EHR space would want to get connected online and build a social network. Have you taken a look?

Currently there are over 300 members and they are discussing all sorts of issues that are pertinent to oncology, palliative care, and electronic health records (EHRs). I encourage you to take a look if you're interested in the EMR/EHR market and if you have a special interest in oncology.

ASCO is the American Society of Clinical Oncology and it's primarily for medical oncologists. You also have SNO - the society for neuro-oncologists and ASTRO - American Society for Therapeutic Radiology and Oncology. Don't forget about SGO - the Society of Gynecologic Oncologists. And of course you have SSO - the Society of Surgical Oncology. Don't forget the nurses - ONS - Oncology Nursing Society. Plus you have SUO - the Society of Urologic Oncology. Are all these acronymns starting to get confusing? Well, take a look at this list:

  • European Society for Medical Oncology (ESMO)
  • Society of Geriatric Oncology (SIOG)
  • American Psychosocial Oncology Society (APOS)
  • International Psycho-Oncology Society (IPOS)
  • Oncology Nursing Society Foundation (ONSF)
  • Connective Tissue Oncology Society (CTOS)
  • American Society of Pediatric Hematology/Oncology (ASPHO)
  • American Society of Preventive Oncology (ASPO)
  • American Society of Hematology (ASH)
  • American Association for Cancer Research (AACR)
  • American Cancer Society (ACS)
  • National Cancer Institute (NCI)
  • Association of Community Cancer Centers (ACCC)
  • American Association for Cancer Education (AACE)
  • CancerClimber Association (CCA)

There are so many more, but I'll run out of space soon. Can you keep up with all of these?

Thursday, February 12, 2009

Discussions on Sermo

There are some interesting physician discussions occurring on Sermo
Have you checked it out yet? It's free to join as long as you're a US physician.

National Faculty Education Initiative

Have you heard of the NFEI? Well, if you're not very connected in the world of certified CME, then you probably haven't.

The Alliance for CME and Society for Academic Continuing Medical Education (SACME), in collaboration with the Association of American Medical Colleges (AAMC), and endorsed by AHME, launched the National Faculty Education Initiative (NFEI). This program provides online training on the differences between Certified CME and Promotional Activities. Sound basic? Well, you may be surprised to know that many clinicians don't really understand all the rules and regulations concerning certified CME or promotional education.

If you'd like to learn more, then take a look at the website:

The World of Medical Education

The world of medical education can be broken down in so many different ways.

First: professional vs. consumer health education

If professional, then: promotional vs. certified continuing education (or certified CME/CE)

Let's talk a bit more about professional health education since we all know about WebMD and Revolution Health.

The world of promotional education is governed by strict FDA guidelines. Plus, don't forget the PhRMA code. There is no off-label discussion within a promotional activity. Also, speakers are recruited directly by the pharma/biotech/device company. The content does not need to be fair-balanced and there is no governing body that certifies those activities for any type of continuing education credit.

In the world of certified CME/CE, the rules are completely different. Here, you can discuss off-label use of medications. As a faculty speaker, you are to have no communications with the pharma/biotech/device company. Also, you don't get paid directly from a drug company. The educational content must be fair-balanced and the ACCME acts as a governing body to provide rules and regulations regarding certified CME (the CE for nurses and pharmacists are governed by other bodies). The PhRMA code has rules regarding CME.

Surprisingly, many healthcare professional are not aware of the distinction between non-certified medical education and certified medical education. Since the rules are constantly changing, it's important to stay updated on the latest guidelines and codes. The PhRMA code just got revised and the ACCME guidelines are constantly in flux.

Non-Clinical Pharmacy Jobs in Managed Care

If you're a pharmacist, have you ever considered working for a managed care organization (MCO)? There are many different types of opportunities within managed care and to learn more, you should check out the Academy of Managed Care Pharmacy (AMCP).

With rising drug costs, there's a greater need to understand which drugs are most cost-effective within MCOs. So, if you really enjoy looking at numbers, playing around with different cost-effectiveness models, evaluating the ROI on disease management, and looking at ways to improve pay-for-performance (P4P), then consider working for an MCO. Maybe you'll be able to create a novel drug assistance program and help those patients who can't afford their meds. By then, many of those meds should be generic. I'm still waiting for the day when biologic agents go generic. Would you trust a generic biologic agent?

Wednesday, February 11, 2009

Non-Clinical Nursing Jobs

What comes to mind when you think of non-clinical nursing jobs? For me, I naturally start thinking about the nurses I personally know who work in various non-clinical settings. This includes:

  • Healthcare education and communication companies
  • Independent consulting
  • Managed care organizations
  • Disease management companies
  • Electronic health records
  • Consumer health IT
  • Clinical research
  • Pharma
  • Biotech
  • Medical device companies
  • Legal medicine
  • Public health and epidemiology
  • Government health
  • Professional organizations and societies
  • Healthcare staffing
Wow, the list could go on and on. However, this is just a teaser. The bottom line is that there are countless non-clinical opportunities for nurses who want to leave clinical medicine and do something else.

Working part-time

I know many clinicians who keep a part-time schedule and fill their other time with non-clinical projects. Do you have an interest in doing some part-time writing or consulting? Perhaps even blogging? Well, the opportunities are out there and you need to search and find them.

Deirdre Connelly Leaves Eli Lilly for GSK

Lot's of movement in pharma. One of the most recent headlines:

Deirdre Connelly Leaves Eli Lilly for GSK

What do you think about that? Deirdre Connelly was named one of the 50 most powerful women by Fortune Magazine. In 2007, her rank was 47. In 2008, her rank moved to 42. What will it be for 2009?

Monday, February 9, 2009

Boutique medicine or non-clinical medicine?

Some doctors may be contemplating some serious career changes because of worsening reimbursement problems. Many are converting their practice to a cash-only boutique or concierge style practice. Others are moonlighting or doing some cosmetic laser surgery.

What about a transition to a non-clinical career? Pharma and finance aren't the only options out there. Yet so many physicians find themselves limited because they don't recognize what types of opportunities exist.

There are some serious questions to first consider:
  • Are you willing to take some risk?
  • Do you have the financial luxury to be unemployed for a few months while you make the transition?
  • What do you really enjoy doing in life?
  • Do you like to learn new things?
  • What do you think about the corporate world? Of business?
At the end of the day, you may realize that a non-clinical path is better than simply converting to boutique medicine. It's important to recognize your options and to do your due diligence. Research your options. Meet people working in non-clinical settings. Prioritize what's important in your life.

Finally, make sure that you're really willing to leave clinical medicine. It may get difficult to go back if you change your mind.

Sunday, February 8, 2009

Google and IBM Joining Forces

Looks like Google is working with IBM to add health data from personal monitoring devices like glucose meters and blood pressure monitors. After all, if all this electronic data is being captured, why not integrate it with your PHR? Weight scales, heart rate monitors, pacemakers, defibrillators, pulse oximeters, peak flow meters, etc.

Soon, all these home devices will be integrated via wireless networks. Whether it's Wi-Fi, Bluetooth, or some other technology, it will all integrate together. The importance of future home network security can't be underscored. After all, people will want to protect their health data.

So will Google Health consume the marketplace? Or will Microsoft Health Vault be the industry leader? Will they all get integrated somehow?

Saturday, February 7, 2009

Non Clinical Physician Jobs

Each month, I get visits from people typing "non clinical physician jobs" into Google search. Since I'm using Google Analytics to analyze my traffic, it's interesting to see what types of things people are typing to get here.

So, if you stumbled here by looking for information about non-clinical opportunities, I hope you gain some insight. Otherwise, I hope you'll leave a comment so that we can correspond.

I also invite you to join a free community of healthcare professionals interested in pursuing non-clinical opportunities by going here:

Thanks again for stopping by.

Medscape Physician Connect

I've been reading some very interesting discussions on Medscape Physician Connect. Unlike Sermo, this discussion board allows users to post topics and comments anonymously. I'm sure that Sermo will implement this type of feature shortly.

There are obviously pros and cons to posting comments anonymously. I'm actually quite surprised when I see people posting very personal comments and then leave their name, phone #, e-mail address, and other contact information. There are some very angry and bitter people on these discussion boards and I'm not entirely sure that I'd want to hand that type of information out to them. I've seen professionalism fly out the window on some of these discussion boards.

Back to the original subject: Medscape Physician Connect. Have you given it a try? Or would you rather stick with Sermo?

The Future of Pharmaceutical DTC Marketing

What is the future of pharmaceutical Direct-to-Consumer (DTC) marketing? Does it work? Is the ROI (return on investment) as high as people think? Is it a money waster?

Most clinicians will say that DTC has caused more headaches in the office. However, there are some cases of public health benefit from some of these DTC campaigns that have increased disease awareness for specific conditions. As a result of some DTC, patients are asking many more questions and bringing up topics that weren't traditionally discussed in the office setting. Is this good or bad? Can it lead to harm? (well, I supposed anything can lead to harm). But what if a patient insists on receiving a medication when it isn't indicated? (well, I suppose that happens all the time anyways).

So, will DTC get shut down? I doubt that it will. The FDA will increase the regulations on DTC, but it will continue. However, my personal hope is that pharma will spend less on DTC and channel its resources in other areas that can really contribute to improvements in public health.

Friday, February 6, 2009

Zynx Health

If you haven't read about Zynx Health, you should get familiar with this company that provides decision support and applies evidence-based clinical recommendations.

Technology + medicine = improved patient outcomes.

It's great to see innovation at work.

Thursday, February 5, 2009

8th Annual ePharma Summit

The 8th Annual ePharma Summit is about to occur in Philadelphia. The use of digital media to drive marketing is increasing rapidly as more healthcare professionals become "tech-savvy." If you have a marketing background and you want to see what types of innovations are coming around the corner, then you won't want to miss this event.

The use of digital medial is also growing in the education industry. eLearning is becoming a hot topic and universities are starting to tailor their curriculums to focus on eLearning.

Tuesday, February 3, 2009

American College of Legal Medicine (ACLM)

Have you considered a career in legal medicine? The American College of Legal Medicine has an upcoming meeting later this month. You missed the 7-day Caribbean cruise that focused on medical-legal issues (among other things). That just happened in mid-January.

However, you can attend the annual meeting that's happening in Las Vegas. Go through the "medical malpractice mock trial" and see what that's like. Maybe you'll be inspired to attend law school and make legal medicine your future career. In any case, you may want to learn more if any of this is peaking your interest.

Check it out here:

Monday, February 2, 2009

The end of axitinib

Pfizer was developing axitinib (a tyrosine kinase inhibitor or TKI) for the treatment of pancreatic cancer. Unfortunately, recent Phase III results were disappointing. As a result, Pfizer has terminated development on this agent. This is just another failure example of all the money, time, and energy spent on drug development research. It really is a shame because we need more effective therapies in oncology.
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