Working From Home Part II – Telemedicine

Author: Heather Fork, MD, CPCC

Imagine you are in your kitchen, enjoying your morning cup of coffee, catching up on the news. In a few minutes you will walk down the hall to your study and start helping your first patient of the day – on the computer!

Last week, in Working From Home Part I, I discussed doing Chart Reviews. In today’s post, I will address the growing opportunities for physicians doing Telemedicine.

With all of the advances in digital information and communication, telemedicine is an up and coming area for healthcare growth.

More and more companies are springing up that offer telehealth services for minor, primary care health issues.

A physician working for such a company is provided electronically with the medical records and chief complaint for the patient. The “patient visit” will take place either via email or over the telephone. Sometimes only advice and information is given, other times a prescription may be recommended. If the doctor feels it is indicated, the patient will be referred to seek medical care in person.

Working From Home Part I – Chart Review

Author: Heather Fork, MD, CPCC

I’m hearing from more physicians who want to work part-time from home. The reasons vary: more time with the kids, a less stressful environment, greater job flexibility and some extra income.

With advances in communication technology and the availability of digitalized information, the opportunities to work from home are increasing in many professions, including healthcare.
While the electronic medical record may be challenging for a variety of reasons, it is providing more options for physicians to work in the comfort of their own home. Two areas that are a natural fit for this type of work are doing Chart Reviews and Telemedicine.

Today, I will be discussing Chart Reviews, and in Part II, I will cover Telemedicine. Chart Reviews, also called Independent Reviews, provide a third-party evaluation on a matter relating to patient care.

Doctors who quit to stay at home (and work from home)

The other day, I was speaking with a physician who wanted to quit a career in medicine to stay at home (and to continue working, but from home this time). This person wanted to know what type of work was available for doctors who want to work from home. Here are a few options to consider for physicians who want to work from home:

• Medical writing/communications
• Chart review
• Medicolegal review
• Consulting 
• Journalism
• Scientific review
• Blogging
• Sales/business development
• Market research
• Financial analyst 

The list could go on, but the bottom line is that there are a number of jobs where people can work from home. However, it's not easy to break into a job where you're working from home unless you choose to work as a freelancer or independent contractor. 

The joys and challenges or working from home

I've worked from home in the past. I still work from home from time to time. However, I'm primarily in the office for my non-clinical day job as a medical director of an education/publishing company. I work from home when I'm involved in freelance/contract consulting jobs, blogging, (yes, blogging is work), career counseling, etc. I call it "moonlighting at home" and I try to balance work/life carefully.

There are certain joys and challenges of working from home that one must consider before choosing this path. My intent is not to compare self-employment vs. salaried employment. Many salaried employees work from home as telecommuters. I'm simply looking at the concept of working from home, whether you do this 5 days a week or 1 day a month. Let's take a look at some of them:

Joys:

• Extreme flexibility. You can set your own hours (unless you're simply a telecommuter). You can work in your pajamas. I think you get the picture.
• More time with family. It may not be as rosy as you think. If you're really to be productive while you're working at home, then you'll probably need to be in an office where you're not interrupted. However, even if you set strict boundaries, you can still spend more time with your family if you take breaks for lunch, snacks, etc.
• Less time in the car (train, or bus). This translates to savings on gas/commuting fees/parking/etc. Also, you now have time to exercise and do other things instead of traveling to and from the office.
• More privacy. If you're working in a company, your privacy can be limited. Suppose you're in a cubicle and all your colleagues can listen to all your phone conversations. You may have very little privacy. If you set up an office at home, you can control your privacy.
• Increased productivity. You may not believe it, but studies have shown that disciplined people who work at home are more productive than when they're in the office. You will probably have fewer interruptions and meetings if you're at home compared to the office. As a result, you can get much more done in a shorter amount of time.
  

Challenges:

• Difficulty managing others. If you're in a position where you're expected to manage others, this can be much more challenging if you don't interact with these individuals face-to-face.
  
• More distractions. Are you disciplined? Or are you easily distracted? When you're at home, you're surrounded by more distractions (TV, kids, chores, etc.), so you need to know yourself really well so that you can evaluate whether it makes sense to work from home. If you're easily distracted, then your productivity will obviously suffer and you place yourself at risk for job loss and unemployment.
  
• Limited brainstorming sessions. If you're not interacting face-to-face with your colleagues, it can be more difficult to have effective brainstorming session where you're writing on a whiteboard, drawing diagrams, using hand gestures, etc. Modern video conference call technology and tablet computing may overcome many of these barriers but nothing replaces the true face-to-face interaction.
• Isolation and less personal connections. Let's face it. When you're in an office, you can chat with people casually and learn about their personal lives. As a result, you can get to know your fellow colleagues really well. If you're at home, you're more isolated. It's more difficult to really get to know your colleagues or your boss.
• You're always working. Many people who work at home have a difficult time separating work and home. As a result, you're always working. Your family may eventually accept that, but you could also get burned out. Sometimes it's much healthier to leave work at work so that you never bring work home. However, if you're working at home, then your work is right in front of you all the time.
  

So, what do you think? Should you work from home? Have you ever tried it? Are you disciplined? Will it interfere with your work/life balance? If you thought that working from home would be "ideal," then perhaps you need to give it another thought.

In general, it can be more difficult to secure a new job as a telecommuter unless you have a proven track record of being an effective telecommuting employee.

Maintaining a healthly work-life balance

How do you balance work and life? Many physicians have a tendency to become workaholics. I admit that I'm one of those people. It's easy to feel like you have so much on your plate that you have to work all the time. At what point do you determine that you need to reduce your workload? If you're not constantly evaluating your work-life balance, then you may quickly find that your family life has deteriorated to the point of no return. This is probably one of the major reasons why some physicians have such high divorce rates. If you're not cultivating your family life and maintaining a healthy balance outside of work, then that world outside of work may disintegrate.

So how do you balance work and life if you're a physician? Perhaps you've decided that working in the clinical setting is killing your marriage. Maybe you are still working too many hours as a physician. Are you sure that switching to a non-clinical career is going to improve things? Or will you simply turn into a corporate workaholic trying to climb the ladder or keep up with your busy workload? Perhaps you want to work from home so that you can spend more time with your family. Does that mean that you'll be working all the time? What if you have difficulty separating work from family life if you're working from home?

Over the years, I've found that people who are workaholics in the clinical setting tend to also live as workaholics in the non-clinical (or business) side of medicine. Therefore, if you're a physician and you're looking for a non-clinical job so that you can spend more time with your family, make sure you're being realistic. Perhaps you can make changes now and have a healthier work/life balance. Perhaps you don't need to transition into the non-clinical sector to attain that. Some physicians who move into the business side find that they have even less time for family life because of all the new and different types of work-related responsibilities they carry. I hope you're constantly evaluating yourself so that you can maintain a healthy work/life balance.

Work part-time or switch to a non-clinical career?

One question that I often get asked is: "I'd like to have more flexibility in my life. Is it better to work part-time in a clinical setting or to transition to a non-clinical career?"

The answer obviously depends on your level of clinical responsibilities and duties. If you're a trauma surgeon, I don't know how many part-time positions you'll find where you'll gain more flexibility in your life. If you're a pediatrician, then I'm sure you can find other partners who'd be willing to split schedules with you.

The transition into the non-clinical world isn't for everyone. The corporate life probably isn't suitable for most physicians. A flexible small business may be a better environment where certain people may thrive while others need the pressure-driven corporate environment that's often surrounded by rigid policies and clearly-defined structure. Some people like to "wear many hats" while others like to have a single, focused role.

At the end of the day, it's probably going to be easier to find a part-time clinical position compared to making the jump into the non-clinical (or business side) of medicine. However, as you assess your long-term career goals, here are a few things to consider:

• Do you want to have the flexibility to work from home at your own schedule?
• Do you consider yourself to be an entrepreneur?
• Do you actually enjoy clinical medicine? Will you really miss it if you leave?
• What types of family responsibilities do you have?
• How do you prioritize in your life?
  
• How do you define success?
• What motivates you?

Always consider your long-term goals as you set short-term and medium-term goals. You won't achieve your long-term goals overnight, but you need to have a structured plan if you'd like to get there.

Women in Medicine Having Kids

Many people wonder how my wife and I balance work and family. My wife is also a physician, but her work schedule is quite different from mine. We are currently fortunate enough to have family close by, so they help with the kids while my wife and I are at work.

The reality is that you will probably need to make some sacrifices during those early years when your children are very young. I know many women physicians who choose to do some non-clinical work from home during those years when their children are young. This gives them the flexibility to still do some work and maintain a meaningful income while their children are babies. They may even keep up with their clinical skills by moonlighting in the ER and/or urgent care clinics during the weekend. Some find time to do a bit of teaching at local medical schools and others may precept one day a week at a teaching hospital. Then, once their kids get older, some women physicians choose to go back into a clinical practice where they can balance work/family according to their needs. Others build a successful career in the non-clinical side of medicine and even maintain their living by even working from home.

Freelance Medical Writing

What's freelance medical writing like? Imagine a life where you're working at home. You can wake up whenever you'd like. You can work whenever you'd like (assuming that you don't have too much in school loans or bills to pay). The best part is that you can actually wear your PJs while you're working (for some people, this may actually be a depressing thing). Sound enticing? What, you want to hear more?

The life of a freelance medical writer is not as picture-perfect as it may seem. Working from home isn't always easy, especially if you have a family. For some people, it's the perfect setting. If you have school-aged children, then you can work in an empty house while your kids are at school.

Before you consider a career transition from clinical medicine into medical writing, seriously think about a few critical things:

1. What type of income do you need to make? Are you depending on your income for bills and other necessary expenses? Freelance workloads can be like a roller coaster ride (up and down, up and down).
2. Are you disciplined enough to work completely independently? It's critical to always meet your deadlines.
   
3. Are you a good writer? (you may laugh, but you'd be surprised to know that some very poor writers pursue a career in medical writing)
4. Do you enjoy writing? If you think this would be a great hobby, think again (unless you don't need the income and you have the luxury to do this as a hobby).
   
5. Finally, how are your computer skills? Modern medical writers need to be proficient with the computer. Gone are the days of typing on a simple word processor. Medical writers are expected to be quite proficient with Microsoft Powerpoint, Word, Excel, etc. Technology is playing a bigger part in the healthcare industry, so it remains critical to get familiar with things like mobile devices, laptops, and even smartphones.
   

So what do you think? Do you want to learn more about the intriguing career of a medical writer?

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.

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.

Working from Home

I seem to be meeting more and more professionals who decide to get a job where they can work from home. There have been times when I've had to work from home and it can be very challenging if you're not used to it. There are so many potential distractions and ways that you can lose focus. However, if you prioritize and place the important tasks in front of you, then you can do it successfully.

Among those I know who are working from home, the main things they emphasize are:

1. Have strong computer and technology skills. Know how to web conference and make effective use with speaker phones for long conference calls. You'll be e-mailing attachments back and forth so be familiar with various applications and file types.
2. Be available. Use a mobile device if you have to, but make sure that people can reach you by phone and e-mail during normal business hours.
3. Be willing to travel as needed. Depending on your type of work, you may be required to travel for certain meetings.
4. Deliver on time. That will show that you're focused and dedicated.
5. Set time apart for work. Some people I speak to tell me that they work even more hours at home compared to the office. Make sure that you're not trying to do different things while you're working.
6. Balance your life. The home/work balance must be checked periodically. Otherwise, you're entire life may get engulfed by work.