Is Telemedicine A Perfect Solution?

Telemedicine has been the subject of many recent discussions between me and this guest author, Murdoc Khaleghi, MD, MBA, FACEP, FAAEM.

Keeping up with the healthcare trends is essential, whether you are practicing clinically or in a non-clinical job because those trends determine tomorrow’s opportunities.  The Supreme Court decision regarding the Affordable Care Act set certain wheels in motion regarding future mandates and legislation.  However, we would argue that the US health system is in the midst of innovation and change regardless of the judicial system.   Some of the problem like rising costs, older, sicker people and consumerism are independent of any federal legislation.

Technology solutions aim to solve some of those problems and have been written about on this site.   Jeff Barson discussed how medical outsourcing is becoming standard practice for certain specialties (http://freelancemd.com/blog/2010/12/6/physician-outsourcing-technology-will-flatten-the-medical-wo.html).  Arlen Meyers wrote about different interface technologies that are intended for non-medical use but have potential medical or healthcare applications or value (http://freelancemd.com/blog/2010/12/12/working-on-the-edge.html)

Telemedicine or telehealth appears to be one of the fastest growing areas of health care.  Physicians like the flexibility of when and how much they work, without the tie to the office.   Not having to work in an office also reduces overhead significantly, while allowing physicians to work from anywhere.  It seems telemedicine may be another tool for the doctors who are looking for help improving and expanding their practices or exploring a non-traditional medical area.   One doctor had this to say,

“I can consult from the comfort of my deck, or easily schedule exercise and breaks into my day.  I am even planning a few consults per day at a vacation home.   There are no refills to sign for, no urgent care calls in the middle of the night.”

Obviously, telemedicine does not take care of all medical issues, such as those that require procedures or immediate interventions, but for preventative care and low-acuity complaints, telemedicine can be an effective form of healthcare delivery.  For example, telemedicine can take advantage of many internet-based features.  Health information, diagnostic tests, consultations, and recommendations can all be performed or shared with providers and patients via the cloud.  A recent article published online on June 22 in the British Medical Journal reported that for patients with long term conditions, telehealth can reduce 12-month mortality by nearly half.  Other benefits included reduced hospital stay and mean number of emergency admissions.

WellnessFX and ISelectMD are two telemedicine companies that seem to be doing something unique and innovative.  WellnessFX has a focus on preventive medicine but hires doctors of all specialties.  Companies like Teledoc, American Well and Ring-A-Doc also continue to bring new and useful products and services to market.  These companies all hire doctors as consultants to do work on a part time or piece meal basis.   Some doctors want to launch concierge medicine services and others want to bring in more clients and offer service outside of traditional working hours. 

As physicians, we are always interested in patient outcomes and patient satisfaction. Many patients like telehealth because it allows for more flexibility in scheduling appointments and they can avoid time in waiting rooms.  Going back to recent health reform trends, with more regulation and legislation, patient satisfaction scores are becoming more important as a reflection of overall quality of care.  Interestingly, telehealth seems to be meeting patients’ needs.  From these actual notes, it seems apparent to us that telehealth not only meets patient needs but also can contribute to coordination of care. 

"WellnessFX saved my life. Without it, I would have struggled through more specialists, different drug treatments, and continued fatigue and ill health. Now, I'm in control to optimize my health."

"I would like to take the time to thank ISelect MD for helping me over the weekend. I tried several times to reach my doctor over the weekend who did not return my call. I called ISelect MD and within 10 minutes I received a call from one of your doctors.

He asked me a variety of questions relating to my issue and knew all about the problem. He spent a great deal of time on the phone with me….and directed me to a specialist who I now have an appointment with.  I was surprised by the concern that the ISelect MD people have for me. Since the initial call, I have been contacted by the doctor and the staff at ISelect MD three times for follow up.  This has been the best experience I have ever had concerning my medical needs."

What do you think of telemedicine?  Is this a solution to some of the problems in healthcare?

Doctor, Do You Have The Right Attitude?

Do you feel like you have nothing to show for the efforts you’ve put into your career change?

It’s easy to feel frustrated and lose motivation when nothing seems to be coming from all the work you put into things like Linked In, calling recruiters, revising your resume or networking.   

There are two possible reasons why things might not be working for you.  Maybe you are doing the right things but you lack a solid strategy.  Or perhaps you are doing everything right – but your attitude isn’t right.

I want to talk about the second scenario.
 First, let me explain what I mean by “attitude.” When you look at the people who successfully transition despite their own personal obstacles or any external obstacles (like a bad economy), the thing they typically have in common is an upbeat outlook.  They are engaged in their own personal success and motivated to move forward despite continued rejections or dead ends.  They are also serious about not projecting desperation. 

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The Best Way To Find And Choose A Good Career Coach?

Are You A Physician Who Needs Help With Your Non-clinical Career Search?  

Have you been thinking about transitioning for a while and are you considering hiring a coach to help you?

Here’s some advice for choosing the right person to help you.

Know who’s giving the advice: Make sure the person you’re hiring is the actual person doing the coaching rather than a salesperson who has staff doing the actual coaching.   By the same token, stay away from resume mills that have staff do all the client work.

It is often better to work with someone who has experience:  Consider that “certified” coaches often have very little actual experience helping people find jobs. Many have tried to break into coaching/resume work by taking an inexpensive certification class that gives them “magic” initials after their name.  The certification isn’t the problem, it’s that these people have little prior job search or coaching experience.  

Choosing a physician versus a non-physician: A coach with a physician background has the unique perspective of what works for another physician and usually understands the challenges unique to a non-clinical transition.  Most physician coaches do a good job helping other physicians translate their CV’s to good non-clinical resumes.  If the prospective coach is not a doctor, make sure he or she has worked with doctors before and has successfully helped them find the particular jobs and companies that work well with doctors.

Understand what “success rate” means: Success is often defined by job placement but a coach is not responsible for placing someone into a job.  A coach should be guiding and leading you towards the right job and situation and connecting you with people who may further help you in your goals.  Remember that you are ultimately responsible for your success, even if you are working with a recruiter who does place individuals into jobs.  Instead of evaluating a coach on job placement, talk to the prospective coach about his or her past experience with others.  Asking for references is another good way to help you determine how a coach works with other clients. 

Make sure this person “gets” you: Explain your career issues, past work, individual work/life balance needs and geographic restrictions during an initial call. Ask questions of your prospective coach to understand how he or she will help you overcome your specific barriers and work within your situation to fulfill your needs.

Remember that cheap isn’t always quality: Quality coaches charge more.  Coaching is a personal service, and you get what you pay for here.   A good rule of thumb is to plan on spending more than a few thousand dollars but less than $10,000 on coaching.  Remember that physician career transition is very difficult (otherwise, why would you be hiring someone to help you in the first place?) so paying this sort of money is usually justified.

At some point, you’ve got to just make a decision:  As you weed through opposing opinions, remember that if you ask ten people about your resume, you’ll get ten different opinions, often conflicting. Open your mind to alternative approaches and determine which opinion seems right for your specific situation. 

Ultimately, it’s important to remember to go with your gut: Your gut is usually a pretty good judge.  Make sure you feel comfortable with this person from the onset.   Usually you’ll get a sense of that from the initial phone call and e-mails as you ask this person questions about their services.

In the recent years, "coaching" has become a fad.  That's unfortunate because it gives coaching somewhat of a trendy feel and can be seen from a slimy/slick perspective by others.   I appreciate that Atul Gawande, such a master of words and communication, has given the world a thoughtful view of coaching.  His article can be viewed here: http://www.newyorker.com/reporting/2011/10/03/111003fa_fact_gawande

A word of disclosure – I’ve served as a coach for physicians looking to transition to a non-clinical career for the past eight years.  However, I’m not the only one on FreelanceMD who provides this valuable service.  In addition, there are others out there (physicians and otherwise) who also coach doctors looking to make a transition.

How Do You Diversify Your Skills As A Physician?

How Do You Move Into A Nonclinical Job Or Diversify Your Skill Set?

If you are trying to work towards diversifying your career or transition into a nonclinical career, you may wonder if you have the skills necessary for a job outside of direct patient care.

As a doctor, you can do just about anything you want to do.  But it’s not easy to be confident when you don’t know how to proceed and we aren’t taught to ask for help.

When I was trying to do it, I got caught up in how unsure I felt about what I wanted to do and how to actually do it.  As a result, I lost confidence in myself and that was a mistake.   Without confidence in myself, I didn’t have the positive thinking needed for translating my skills and seeing all the opportunities out there.

Many doctors wonder if they need to go back to school to take the next step in their careers.  While you can never go wrong getting an education, defaulting back to a full time alternate degree program is rarely the best way to go.  It isn’t the “next logical step” to spend more money and time back in school.   However, if you choose to pursue an MBA, MHA, MPH or some other degree, there are many excellent programs, some specifically tailored towards a physician.

But remember this; becoming a doctor gives you a unique skill set that can be translated to fit almost any industry.  Think about how often you’ve dealt with conflict and how often you’ve contributed to increased growth and revenue.  Why is that important?  Does that confuse you?  You’re not alone.  We aren’t trained to think that way in medical school, residency or beyond.   But these are the ways your skills are valued in a non-clinical career and your skills are translatable. 

Here are a few ideas on how to get started or how to move forward if you have already started considering diversification of your skill set and exploration into the non-clinical realm. 

1. Determine if there are associations or societies dedicated towards professionals in the fields you want to explore.  For example, if you are interested in healthcare information technology, make it a point to explore the resources on the Healthcare Information and Management Systems Society (HIMSS) website.  Since you are reading this post, you have already found Freelance MD and you should make it a goal to fully explore all the resources and people available here.
2. Look into certificate programs in the area(s) you find interesting and are the subject of current hiring trends.  Quality, process improvement, leadership and information technology are areas of opportunity right now.  Resources like the American College of Physician Executives are helpful for these opportunities but there are other resources for certificate programs. 
3. Consider the big picture.  I made several mistakes when I was transitioning and I try to help others avoid pitfalls by making sure they take everything into account.  Things like lifestyle, salary requirements, geographic location, etc. are equally important in this journey.  If you don’t consider them, even your perfect job may seem like the wrong thing.  It’s important to set yourself up for success as much as possible by looking at all aspects of your life.
4. Put together a Personal Development Plan (PDP).   Please see a previous post on why is this important and how to do this at http://freelancemd.com/blog/2011/7/5/mid-year-career-strategy.html.
5. Consider nonclinical options and network with other doctors who are also interested in other options.  Not sure where to start doing this?  In addition to Freelance MD, there are resources with information directed specifically at physicians and non-clinical careers.  For example, visit the Physician Renaissance Network at www.prnresource.com. 

Mid-Year Career Strategy

Have You Updated Your Personal Development Plan For 2011?

Why not? 

This is a good way to do some serious self-reflecting.  It will help you identify and pinpoint your internal and external strengths and weaknesses.   Most importantly, it will help you prioritize your projects for the rest of the year and plan for the direction you’d like your career/life to go in 2012.

To make sure this happens mid-year (and that’s now), you will want to do two things.

Deal with your resistance to planning

Maybe you don’t have extra time now to devote to planning for your future.  It’s summer, the weather is nice and family vacations are taking up your time and energy.  It may seem better to do a task like this several months from now when there is less going on so you can do the best job possible.  

Failing to plan now can leave you without clear direction three months from now and before you know it, Christmas will have come and gone and you won’t have made any progress towards your career or personal goals.  Time will inevitably pass and by taking a proactive approach you can put yourself in the driver’s seat to take charge of your life and career.

Set time aside this week

Make room in your week for working on this.  Commit to spending one to two hours on it.  Sometimes just getting started gets your momentum going and motivates you to continue and finish. Better yet, getting started now may reveal some key planning or action items you need to take care of this month so you can be that much closer to where you want to be two months from now.

How should you get started if you haven’t ever created a personal development plan?

Business school and Executive Management/Leadership training taught me about the SWOT method.  SWOT stands for strengths, weaknesses, opportunities, and threats.  You can use SWOT as a framework for building your career strategy.  Here’s what to consider:

Strengths

Internal positive aspects are under your control and you can capitalize on them in planning for your career/life goals. These would include:

• Work experience
• Education, including value-added features like certifications, etc.
• Strong technical knowledge within your field (e.g. hardware, software, programming languages)
• Specific transferable skills (e.g., communication, teamwork, leadership skills)
• Personal characteristics (e.g., strong work ethic, self-discipline, ability to work under pressure, creativity, optimism, or a high level of energy)

Weaknesses

Internal negative aspects that are under your control and that you may plan to improve could include:

• Lack of work experience in correct field
• Wrong career choice
• Weak networking skills
• Negative personal characteristics (e.g., poor work ethic, lack of discipline, lack of motivation, indecisiveness, shyness, too emotional)

Opportunities

Positive external conditions that you do not control but of which you can plan to take advantage. These may include:

• Positive trends in your field that will create more jobs (e.g., growth, globalization, technological advances)
• Geography
• Your personal network and mentors

Threats

Negative external conditions that you do not control but the effect of which you may be able to lessen. These include:

• Negative trends in your field that diminish jobs (downsizing, obsolescence)
• Obstacles in your way
• Limited advancement in your field because advancement is cut-throat and competitive
• Limited professional development opportunities in your field

Action Plan

 Your key task here is to set specific timetables and deadlines for yourself.  Plan to get started this week.

How Do You Talk About Your Past Failures?

Let’s face it; we’ve all failed at one point or another.

How can you demonstrate your failure in a positive light so that others perceive it just as positively as your successes?

It’s important to understand that failing at something doesn’t mean you are a failure. It took me years to figure that one out! What helped me understand was to learn about a few good examples of failure that came from programs, people and items we only identify with success.

• "I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. Twenty six times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.”  Michael Jordan loved sports but failed to make his high school basketball team as a sophomore.
• Twelve publishers turned down J.K. Rowling before one gave the first Harry Potter book a chance.  Even then, she was told there was no financial reward in children’s books.
• People Magazine named Brandi Chastain one of the 25 Most Intriguing People of 1999.  She scored the winning goal with her penalty kick during the final game in the 1999 Women’s Soccer World Cup game against China.  However, several games earlier, during the quarterfinals of that same tournament in a game against Germany, Chastain scored against her own American team in an "own goal," which is an accidental kick past the goalie into her own net.
• The script for Back to the Future, written and directed by Bob Zemeckis, was rejected by various film studios.  When finally, released, Back to the Future became the most successful film of the year, grossing more than $380 million worldwide.  It won the Hugo Award for Best Dramatic Presentation and the Saturn Award for Best Science Fiction Film. Ronald Reagan even quoted the film in his 1986 State of the Union Address. The film also marked the beginning of a franchise, with sequels Back to the Future Part II and Back to the Future Part III released in 1989 and 1990, as well as an animated series, theme park ride and video game.
• Ruth Handler debuted her doll, known as Barbie, at an American International Toy Fair in New York in 1959. It was not an instant success. Many claimed that Barbie provided little girls with an unrealistic and harmful example and fostered a negative body image. Despite the criticism, sales of Barbie-related merchandise continued to soar, topping 1 billion dollars annually by 1993. Since 1959, more than 800 million dolls in the Barbie family have been sold around the world and Barbie is considered by some to be a bona fide global icon.

Most people avoid discussing failure and some have a hard time seeing their “failures” as positive and moving on. So how do you overcome and subsequently talk about your failures? And why should you talk about them at all? 

Here are some good reasons why you should embrace failure and talk about it:

Failure demonstrates innovation: In order to innovate, you have to accept that your idea might fail. When companies need innovation, they often look for someone who has not only succeeded, but who has also failed. This isn’t true for every industry, but I’ve heard decision makers secretly look for people who have failed at something, even if it’s not on the formal job description (and I’ve never seen it!). Companies who seek to build innovation, Venture Capital backed firms, firms trying to develop new products, and firms in changing industries are more likely to seek a candidate who’s failed than say, a CPA firm.

Failure demonstrates willingness to take risks: People who take intelligent risks create more value than people who don’t take risks. That doesn’t mean you should make plans to jump off your building with a parachute or take reckless business risks. But understand that businesses and people who don’t take risks don’t grow. Experience with failure will enable you to help others decide which risks make sense.

Past failure is a huge learning experience: Failure means that you get to look back on it, and think “what could I have done to avoid this?” or “how could I have made this turn out better?” Past failure means you’ve learned on someone else’s payroll and now have had a valuable learning experience to draw from so you can help others make good decisions. People who have already failed are better at avoiding failure a second time.  These things make you a good candidate in a job interview or a good candidate to take a business risk on.

Above all, knowing how to talk about your past failures will give you the confidence you need in any situation.   It does for me and it can do the same for you.

How To Get The Most Out Of Attending A Medical Conference

Making The Most Of Your Time & Money

Last week I attended the American Medical Group Association (AMGA) Annual Conference, “Learning from the Best” at the Gaylord National Resort in Washington, D.C.   This was my first AMGA conference and the first conference I’ve been able to attend for several years. 

There hasn’t been time for a conference in awhile but suddenly, this year I’m attending three of them. I’ll be a mentor or a speaker at the other two conferences I’m planning to attend this fall. These are the SEAK Non-Clinical Careers for Physicians Conference and the Medical Group Management Association (MGMA) Conference where I’ll speak about physician career strategies and avoiding/healing physician burnout.

Conferences are a great way to build your network and see what companies are doing and what opportunities may exist for you.  They are also a good way to find out more about an industry you want to break into and gain experience in. For this reason, when working with physicians to help them find opportunities to enhance their revenue or find non-clinical opportunities, I often recommend attending a conference.

Here are two recent examples of successful outcomes that resulted from attending a conference:

1. Allscripts is a company many doctors ask me about and getting hired by this company has eluded many very well qualified doctors. I believe personal connections can help physicians get directly in front of decision makers. At the AMGA conference, I visited the Allscripts booth where I introduced myself and asked about physician opportunities. That led to an introduction to another physician, a D.O. (like myself) who works with the company and actually designed a technology that is used at the company. He knows of multiple opportunities available for physicians and wants me to follow up with him so we can find a good fit (or two). 

2. A surgeon who’s been working with me attended the Healthcare Information and Management Systems Society (HIMSS) conference on my recommendation. He took time out of his clinical practice and traveled without his family to a strange city where he spent several days in a hotel as he attended the conference. That’s a pretty big investment.  I got a call from him two weeks after he got back. He wanted advice pursuing three very promising leads in consulting and IT work. He’d even created an opportunity in his own community for this work, based on some of the things he saw and learned about at the HIMSS conference.

Attending a conference can be expensive after you pay the conference fee, travel to the geographic location (often far away from you), stay in a hotel and eat while you are there. That means attending a conference requires a plan so you can get the most out of the time and money you spend. Here are some tips I’ve found to be helpful for the physicians I work with to help them make the most out of a conference.

1. Remember it’s going to appear overwhelming.  There will be lots of people you’ve never seen all gathered in one place. It might seem like everyone knows everyone else but in reality, most people don’t know more than two or three other people at the conference. Many are there alone. Introduce yourself to someone. You will be pleasantly surprised that it’s not as hard as it seems to strike up a conversation with a stranger. After all, you already share one thing in common – you’re at the same conference. 

2. Bring business cards – but collect more.  You may have already thought about your own business cards but remember, most people misplace one or two (or more) of the cards they get.  You don’t want to be waiting for the call or e-mail that never comes from someone you really hit it off with and hope to work with in the future.  Be sure to collect the cards and write notes to yourself on the back of each one, reminding you why you enjoyed talking to that individual and what you hope to gain when you follow up.

3. Follow up within a week of the conference.  Going to a conference and networking are useless without follow-up. You may have had the best conversation in the world with someone but without further conversations, you aren’t going to actually move that opportunity forward and work with someone. On this same note, don’t worry if you don’t feel like you made the best impression on someone you met.  The real connection will come with the follow-up. But the follow-up is up to you.

4. Spend some time in the vendor area. It’s a good idea to consider spending at least a quarter of your time here. This is where you will discover companies you didn’t know existed that might be interested in hiring a physician either directly or as a consultant. Ask about this and get contact names/information for people within the company. This will help you avoid the “HR trap” of cold calling a company.

5. Approach the speakers and get their contact information. These are experts in their field and if they are speaking at a conference, they are probably interested in helping someone in the area they know about and understand.  Not only will they be good individuals to ask questions about the industry, they are likely well connected and may be able to provide an introduction or two for you to others in the field.

Good luck! Feel free to comment on what’s worked (or hasn’t worked) for you when you’ve attended a conference.