Career Change Q & A - Questions clients often ask

Author: Rebecca Kiki Weingarten M.Sc.Ed, MFA

Here are some questions clients often ask - any of them sound familiar?

"When is the right time to make a transition?"
"Am I too old/young to be feeling this way?"
"Am I too old/young to be making a career transition?" "HOW can I make the transition? It feels too difficult."
"I'm in the midst of making changes but having trouble dealing with my feelings about it, I'm not sure, I can't take the reactions of the people around me, I don't want to hurt anyone else by my actions."
"Maybe I AM a cliche but am I supposed to sacrifice myself and the rest of my life in order to keep on living the way I have and hating my career, life situations?"
"I'm in a career that I hate and would like to make a change but I need to keep working while I do it, it's getting harder and harder to get up in the morning..."
"Why do I feel guilty putting myself first and making a change that will make my life better?"
"What do you mean by 'tolerating negative feelings'"?
"What causes burnout or the desire for a change? Are there things that are 'normal' and those that are just silly and unrealistic?

So You Think You Need A New Job...

Author: Lisa Chu, M.D.

"One cannot alter a condition with the same mind set that created it in the first place." - Albert Einstein

I'm guessing you showed up on this website because things have reached a certain point in your life. The system of clinical medicine just isn't doing it for you anymore. Or maybe it's even more vague than that - just a feeling that you aren't living your right life.

I'm guessing that you've reached the end of your rope, and you feel like you have to find a way out of your current situation. Something MUST change. Now.

I love meeting people when they are at this kind of crossroads in their lives. I've found that only when the messages of pain - physical, emotional, or mental - get intense enough do some of us stop to really listen.

Normal, everyday suffering - the kind we willingly put up with just to get through our days - does not jolt us awake. Each of us has a different threshold for tolerating this kind of suffering. We may not even know that we are suffering.

5W System(sm) for Contemplating Change

Author: Rebecca Kiki Weingarten M.Sc.Ed, MFA

Lots of what I need to know about coaching I learned by teaching 1st grade. Clients don't have to raise their hands to ask a question or take the pass when they go to the restroom but so much of the work leads back to the beginnings of learning something new and substituting new skills and mindsets for old ones. Reading comprehension was a real toughie, especially for children who were new immigrants to the US but using the 5Ws worked in most cases.

Here are the 5Ws for contemplating career change.

The 5Ws sm? Simple. Who, What, Where, When and Why.

* Who are you today and who would you like to be a year from now?
* Why do you want to make the change? Emphasis on YOU*.
* What changes in behavior and shifts in attitude will you need in order to make the changes and achieve your goal?
* Where can you get support to help you make the change? People, books, websites, journals etc.
* When is the best time of day/week/year for you to make the change? To evaluate the change? To take action toward achieving the change?

A webinar on physician suicide (scope of problem and evaluating data)

Too often, depressed physicians who struggle with employment or other problems end up committing suicide. We need to do a better job identifying these physicians and providing them with resources and help. Physicians who lose their ability to practice medicine (due to medical licensure revocation or other issues) can be very vulnerable to depression and suicidal ideation. Many are not even thinking about non-clinical career opportunities because they are not aware of the possibilities.

There is an upcoming webinar from the AMA focusing on the topic of Physician Suicide: What is the Scope of the Problem and What Does the Data Show?

This event will examine the following:

• What has the data shown as to the extent of the problem?
• Are suicides committed by physicians and physicians-in-training comparable to those in other professions?
• What are the current gaps in research on physician suicide?
• What are some best practices and model programs for suicide prevention that can be replicated by others?

Date: Wed, Sep 7, 2011
Time: 12:00 PM CDT
Duration: 1 hour 30 minutes
Host(s): Sonja Boone MD

An entire section on "Career Change 2010" on Forbes

Are you thinking about a career change? There are a number of different articles on Forbes.com about "Career Change 2010." Some of the titles include:

• When You Need A Completely New Career
• How To Become A Financial Advisor
• Give Yourself A Resume Makeover
• How To Get A Job At A Hedge Fund
• How To Get A Job In The Arts
• How To Take A Sabbatical From Work
• The Most Outlandish Resume Mistakes Ever 

You can read those career change articles here on Forbes.

Career Change May Open New Doors

There's an article titled, "Career Change May Open New Doors." It's an October 2003 commentary by Lorne E. Weeks, MD and Rob Priddy and it's on CareerLab.com. You can read it here.

If you're feeling frustrated about your career, maybe it's time to explore some alternatives. Maybe it's time for a career transition. Perhaps it's time to get ready to open some new doors as the new year approaches.

Make sure to follow NonClinicalJobs.com for daily updates, articles, and news about non-clinical career opportunities for physicians and other health care professionals.

American Academy of Pediatrics: non-clinical career resources

The American Academy of Pediatrics is providing some non-clinical career resources to their members. One article is titled, "Transitioning to a Non-Clinical Career" and you can read it here.

You can view these Career Change resources here. Keep in mind that the AAP makes a disclaimer:

These resources have not been investigated by the American Academy of Pediatrics (AAP). The AAP takes no responsibility for these resources.

Speaking of the AAP, I know a number of pediatricians (both men and women) who have pursued non-clinical careers. Some may continue to work clinically part-time, but many are now spending 100% of their working time doing something non-clinical. Some work from home as medical writers. Others may work for a pharmaceutical company or a biotechnology company. Some are now working for the FDA or a state health department.

217,000 new jobs in the heatlh care industry

According to the July 2010 report from the U.S. Bureau of Labor Statistics, the health care industry gained 217,000 jobs over the past 12 months. We saw roughly 9,000 new jobs in the month of June.

Is the health care industry "recession-proof" as some would like to think? It's probably more "recession-resistant" compared to many other industries, but I wouldn't say that it's recession-proof. I know quite a few doctors who are having difficulty finding employment right now.

In June, the unemployment rate was 9.5%. There are approximately 14.2 million people who are unemployed right now. Maybe you're one of them and you're thinking about a career change. Perhaps it's time to go back to school or find an entry-level position so that you can effectively "break in" to a brand new industry.

15% of physicians move each year

According to SK&A’s report titled, “Physicians on the Move," approximately 15% of physicians move each year.  Here's a snippet from the press release:

IRVINE, CA - June 8, 2010 - SK&A, A Cegedim Company, today released an update of its “Physicians on the Move” report, which reveals the rate of change of office-based physicians by practice specialty. According to the report, the three-year average of physicians who moved to a new location or practice, retired, or passed away was 15.2 percent. Such changes create obstacles in maintaining quality physician-targeting databases and lists necessary to execute high-performing sales, marketing and market research initiatives.

The move rate of physicians has declined steadily in the three years that SK&A has been producing the report, indicating recent stability among the specialties surveyed. It has gone from 18.2 percent in the 2008 reporting period to 15 percent in 2009 to 12.4 percent in the 2010 period. Allergists / immunologists, pulmonary critical care and internal medicine / pediatrics were the top three practice areas for the most stable physicians, with annual change rates of only 7, 7.1 and 7.9 percent, respectively. Hepatologists, hematologists and osteopathic physicians were among the most volatile doctors, with change rates of 19.9, 19.4 and 19.2 percent, respectively.

How to explore alternative physicians careers

What's the best way to explore your options if you're thinking about an alternative physician career? Should you search on the Internet? I'm not sure that you'll find much. Should you read books? Books can be helpful, but I've found that most books tend to focus on only a few realistic options.

One of the best ways to learn about alternative physicians careers is to speak with other physicians who have successfully made career transitions. This way, you can get a sense of what ought to be realistic for you. Additionally, you'll learn about some of the obstacles and roadblocks you may face as you try to make a career transition. Perhaps after speaking to several people, you'll decide that you really don't want to pursue an alternative physicians career. It's better to know that before you leave medicine since it may be difficult to go back if you've been gone too long.

I'm constantly speaking with physicians about their desire to leave clinical medicine. They want to pursue other options. Many are not aware of the alternatives and even more physicians don't know many doctors who've successfully left clinical medicine. How do you find these people? A good place to start is LinkedIn. You can find many physicians who are currently working in different types of industries ranging from the pharmaceutical industry to managed care. Some work for medical device companies. Others are medical writers. Some have consulting experience and others have worked for venture capital firms. You don't need an MBA to find an alternative career, but you need to outline a plan so that you can make the transition successfully. There are so many different types of careers you could choose, so make sure to learn about your options before you leave your clinical job.

An opportunity of a lifetime?

How would you define an opportunity of a lifetime? Starting your own company? Making a successful career transition? Having a family? Leaving clinical medicine? Getting married? Becoming an entrepreneur?

Maybe you've recently been faced with a few scenarios that you would describe as potential "opportunities of a lifetime." Are you willing to take some risks? I'm generally a fairly risk-adverse type of person, but I've been listening to some great business podcasts from iTunes U (the U is for University) and I've been inspired to take some risks in my life.

These are exciting times given that we're going t see some significant advances in medical technology and adoption in health IT will increase dramatically. As our nation goes through health care reform, new challenges will also mean new opportunities for those who are creative and who are forward-thinking.

Career Change Advice: The 10,000-Hour Rule (TheLadders.com)

According to this article on TheLadders.com: "It takes 10,000 hours of dedicated effort to become an expert performer in any field."

Dan Coughlin from The Coughlin Company attributes the conclusion above to the best-selling books “Outliers” by Malcolm Gladwell and “Talent is Overrated” by Geoff Colvin as well as the new hit TV comedy series, Modern Family. Dan writes about his personal experiences as a consultant for 12 years and he says: "From these sources as well as my own 12 years of consulting work, I have found that the key to great performance can be summarized in three words: thought-filled practice. That comprises executing a simulation of the actual performance while consciously observing the outcome." Dan outlines the following "six steps of thought-filled practice:"

• Select a role for which you have passion and strengths.
• Identify the five critical aspects of that role.
• Create simulations of the actual performance that let you focus on improving one or more of the role's critical aspects.
• Gain relevant, timely feedback on the simulated performance from a skilled observer .
• Consider the feedback and make adjustments.
• Repeat steps three to five for 10,000 hours.

Does this also work for physicians who are seeking to change to a non-clinical career? Yes and No. One of the key challenges faced by physicians is this: Many physicians don't know enough about the types of career opportunities that exist out there. So, how can they apply these steps if they're not familiar with certain industries? Are you able to leverage your experience to be competitive in a new industry? Do you know how to present yourself on paper so that people will want to call you for an interview?

To read the article on TheLadders.com, click here.

Non-clinical jobs for disabled physicians

I know many disabled physicians who have transitioned into different areas of non-clinical medicine. They have found some great non-clinical physician jobs. For instance, if you're an surgeon and you develop rheumatoid arthritis, you could transition into family medicine or internal medicine. However, maybe you'll be better in a corporate (non-clinical) environment.

You may get disabled to perform your primary duties as a physician, but as long as your mind is sharp and you're able to communicate, you can probably be very effective in some non-clinical areas of healthcare. Here are a few examples of disabled physicians I've met over the years:

• Surgeon who developed severe arthritis. Now works at Blue Cross/Blue Shield as a medical director.
  
• Surgery resident who developed severe back problems. Now runs his own medical company called Sermo.
• An OB/GYN who was in a serious motor vehicle accident. She now works from home and does some medical writing and public speaking.
  

Many disabled physicians continue to work in some limited capacity. They may not be seeing patients or performing surgery, but they often find a non-clinical physician job that provide them with the flexibility they need. Perhaps you'll want to work from home. Computing technology has vastly improved to easy usability for people with disabilities.

Depending on your type of disability insurance plan, you may still be qualified to receive disability compensation if you don't treat patients as a physician but work in a non-clinical setting. This way, you can work part-time and still receive disability income.

Why are doctors looking for non-clinical jobs?

Some doctors are looking for some non-clinical freelance work because they need supplemental income. Others are changing careers because they are burned out. Some are forced to find non-clinical work because of a variety of reasons. Others wish to explore the non-clinical arena to see what types of opportunities are available. Is the grass really greener on the other side?

What are your reasons for finding a non-clinical job? Are you looking for something part-time? A full-time career transition? Supplemental income? Moonlighting? A "backup plan" in case you end up hating clinical medicine?

These are interesting questions and over the next several months I'll be writing about various examples that outline why physicians and other healthcare professionals are looking for non-clinical jobs. I'm also still working on my new book and my goal is to get that out by the end of 2009. Let's see if that ends up happening.

Making the Non-Clinical Transition

I often get asked, "how do you make the transition into the non-clinical world? Isn't it risky?" The answer is that change can be risky. But, you have to be certain of your talents and interests. If you find yourself very dissatisfied working in clinical medicine, then ask yourself why you're dissatisfied. I try to encourage people to look for another opportunity in clinical medicine where the work-life balance might be a better fit. Many physicians who wish to leave clinical medicine are simply burned out and they need a break. If that's you, then make sure you take a break and be comprehensive as you plan your future. It's important to remember that it can be very difficult to re-enter clinical medicine after you leave.

Non-Clinical Medical Opportunities for Physicians and Other Clinicians

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, 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 (www.mommd.com) 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 (www.glgroup.com)? 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. No clinical experience necessary.

4. Technology and Informatics (health information technology, healthcare informatics, EHR/EMR, PHR, digital health) - 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 - 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. Thinking about getting an MBA? Be sure to connect with others 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 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
American Association for Physician Leadership
(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 NonClinicalJobs.com. I hope you'll visit frequently because we publish new articles daily.

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:
http://mdjosephkim.blogspot.com/2009/02/world-of-medical-education.html

I've also written about CME here:
http://mdjosephkim.blogspot.com/search/label/cme

I've also written a little bit about opportunities for people with no residency experience:
http://mdjosephkim.blogspot.com/search/label/residency

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.

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.

Traveling for Work

One of the major changes that may occur if you switch to a non-clinical career is that you may travel for work. It obviously depends on the type of position you have, but be prepared for that aspect of work. You may think that traveling is fun, but it can also get tiring very quickly. It can also make an impact on your family.

Healthcare Jobs: PhysicianCrossroads.com

I recently receive an e-mail newsletter from this job site called PhysicianCrossroads.com

I've only taken a glance, but the website looks more like a portal for many different recruiters, hospitals, and organizations. Also, it appears like the portal lists jobs for many different types of healthcare professionals. Hence, if you're looking for a new opportunity, it may be worth exploring.