As A Physician, Can You Work For Someone Else?

How important is our autonomy as physicians?

Have you ever wondered how difficult it might be to work for someone else, when we're wired and trained to value our autonomy as one of the perks of being a physician?  Many physicians making a transition from clinical practice struggle with the impact of losing autonomy in their decisions and actions.  Here are some observations from my experiences that might help you as you contemplate making some changes in your life and career.

First, recognize that your biggest challenge as a physician in moving to working for Wall Street, a pharmaceutical firm, a start up company, an insurer, or just about any job that doesn't require you to be in direct patient care, will be adapting to your role in a heirarchy. Most physicians at ACPE cite this transition as their most difficult. After some awkward moments in making the transition, we all learn what we were never taught in our medical training!

To give up absolute autonomy doesn't mean that your input isn't important.  It's just one piece of input among many others. Good group process and good decisions requires multiple viewpoints, disagreement, and vigorous discussion. Physicians trained in the military, who are familiar with leadership principles, say the first step to good leadership is to understand "good followership".  Sometimes we're members of a team, other times we're asked to lead a team.  You've got to understand both roles.

Second, recognize that a good boss doesn't necessarily have anything to do with being a physician.  One of my top two bosses over the past twenty years was an insurance executive.  Chain smoker, equally comfortable in a plaid sports coat or a pin stripe suit, he was one of the most ethical, honest, and exciting people I've ever worked with. 

We disagreed frequently on issues, but I supported him when his actions made physicians upset because he never crossed an ethical boundary, and his intentions were good.  For example, one day he said he wanted to notify all physicians on our networks that their physician-owned malpractice company was going broke.  I told him the physician leaders of the company, who were also key figures in the medical society, would be furious.  As an insurance executive he felt obligated to notify the malpractice carrier's insureds that they could be left high and dry.  He asked for my support when the physician leaders reacted.  I gave him my support, and was there when they had that contentious face to face conversation in his office.  And the malpractice carrier did become insolvement about 9 months later.

In contrast, some of the worst bosses I've ever had were physicians. Maybe they turned out that way because they were so focused on themselves, and their autonomy? Conversely, maybe I didn't understand good followership? Whichever it was, it wasn't good for any of us.  

Third, keep your "physicianhood" in perspective. Though we're all very proud and honored to be part of our profession, other people and professionals are also proud of their hard work and commitment to their occupation or calling. Think of your training as a physician as the foundation for whatever else you want to do in life. If, because you're a physician, you think and act superior to others in business, art, publishing, or at the machine shop, you'll have a hard time working for someone else. 

Our "tribe" - physicians - makes it hard for us to venture in different directions from our clinical care training. We have to be aware of that, but be determined to listen to the pull of other non-clinical interests that are attracting us to new ventures. By exploring the issue of autonomy, and seeking to behave differently from our training, the path will become much clearer.

Doctors in a Tail Spin - You Are What Your Record Says You Are

I’m a big football fan. However, my team, the San Francisco 49ers, aren’t doing so well this year.  They have a losing record, and it looks like that they will miss the NFL playoffs once again.  Growing up in Northern California as a kid, cheering the likes of Joe Montana and Jerry Rice during their championship seasons, It is frustrating to hear the players and coaches dole out their excuses after another disappointing loss. “We’re a lot better than our record shows”, they’re quick to point out.

I often reflect back to what famous football coach Bill Parcells used to say – No matter how rigorous the schedule, the oh-so close losses, and the bad breaks, he was unwilling to give any excuses for a loss.  He would say “You are what your record says you are”. You are exactly where you should be. Better run teams have winning records. Team in disarray with poor planning end up with losing records.

That same principle can apply  in life.

For unsatisfied doctors, a significant number point to external factors to their unhappiness – declining reimbursement, government intrusions, an overall lack of respect for physicians, from CEOS to patients. But when it comes down to it, if you are not happy in the position you are, you are ultimately responsible to where you should be. Coach Parcells would say again “You are what your record says you are.”   

I  have a relative who was involved in the burgeoning tech industry in the late 1970s. He was trained to learn a very specific computer programming technology in his corporation.  He spend years educating himself on the programming, as well as training others, and then only to find out just a short time later the technology would soon become obsolete, as was his employment, as dictated by corporate headquarters. Soon there after, he found he was out of a job, a casualty of mass layoffs. He had no choice but to reinvent himself, going back to school, with new training, and a hope not to be made “obsolete”.

As doctors many feel we lost our position as being the decision maker in healthcare. It  pains me to see an industry where over 50% want to get out of the industry, yet feel powerless, to do something about it. Yet many of us as physicians have assets and fund of knowledge that we can use and apply in different ventures besides clinical medicine, as evidenced by the numerous examples we have in Freelance MD.

Last weekend, I conducted a workshop to a group of physicians who were all at different stages of their career. I commended them for attending, and remarked that unlike many of their colleagues, because they were willing to start something new and out of their comfort zone. Many doctors aren’t willing to reinvent themselves, because what economists refer to as an “opportunity cost”. For example, many physicians feel because they have spent so much time and money in medicine anyway, that if they do something different there is an additional lost opportunity cost. That is by starting something new, it would make  the years missed and the money spent all for not, and  instead they feel forced to continue to work in their current vocation,  even to the detriment of their own happiness. There is also the feeling that they are “giving up” if they choose an avenue that the rest of their colleagues would not follow. Albert Einstein, said the definition of insanity is “doing the same thing over and over again and expecting different results". Does this quote apply to you?

If you are not happy where you are, it may be time to start taking control and reinvent yourself. If you wake up and dread going to work, it may be time to take a mini-vacation or consider a new endeavor. If you feel like you’re going through the motions in your career, and not making a difference in the world, it may be time for a new challenge. Just as a team with a losing record, it may be time for a new coach, a new offense, a new strategy.

As Coach Parcells would say, “You are what your record says you are.”

2011 Medical Fusion Conference Faculty

Medical Fusion faculty members talk between sessions. From left to right: Dr. Natalie Hodge, founder of Personal Medicine; Dr. John LaPuma, New York Times best-selling author and founder of ChefMD; Dr. Jeffrey Segal, founder of Medical Justice; Dr. Steven Peskin, Executive VP and CMO of MediMedia

The next Medical Fusion Conference will be November 11-13, 2011 at the Aria Resort in the new City Center development on the Strip in Las Vegas.  

For those of you who have never attended one of our Medical Fusion events, the purpose of this conference is to help physicians learn how to apply their medical training in unique ways.  We scour the country to find experts who can help those in clinical medicine develop career niches using their medical expertise, and we have a good time learning from these experts while we hang out at a fabulous Vegas resort.  

Basically, the Medical Fusion Conference is Freelance MD come to life, a place where you can meet and interact face to face with many of the authors and experts here at Freelance MD.

For 2011, I am pleased to announce yet another incredible faculty list.  We have individuals from many niche areas who will be teaching conference participants how to take control of their careers and apply their medical knowledge in many unique ways.

So without further ado, here's our 2011 Medical Fusion Conference faculty:

• Dr. Julie Silver, Chief Editor of Harvard Health Publications
• Dr. Steven Knope, author of Concierge Medicine: A New System to Get the Best Healthcare
• Dr. Barry Silbaugh, president of the American College of Physician Executives
• Dr. Setu Mazumdar, founder of Lotus Wealth Solutions
• Dr. Kenneth Cohn, author and founder of HealthcareCollaboration.com
• Dr. Mike Woo-Ming, internet entrepreneur and founder of IncomeMD.com
• Jeff Barson, founder of MedicalSpaMD.com , co-founder of FreelanceMD.com
• Dr. Alan Neuren, independent disability consultant
• Ms. Ashley Wendel, consultant for physicians pursuing nonclinical careers
• Dr. Gary Taff, serial entrepreneur and real estate investor

Together this faculty represents the best source of information for physicians interested in developing a unique and meaningful career.  

Topics for the 2011 Medical Fusion Conference include concierge medicine, monetizing your blog, cosmetic medicine, product development, writing/publishing, internet entrepreneurship, real estate investment, developing your niche as a consultant, physician career transition, financial management, and much more.

I'll be writing more in the future about this faculty and some of the interesting personalities you'll meet at our event.  

If you're interested in attending the Medical Fusion Conference or just have some questions for us, feel free to contact us here at Freelance MD or call our event offices at 866-924-7929 .  Be sure not to wait around, though, since this event will fill up quickly and we want every one of our Freelance MD readers to have the opportunity to attend.  

If you like Freelance MD, you'll love the Medical Fusion Conference and we'd love to have the opportunity to meet you face to face.

Non-Clinical Careers: Working For A Large Corporation

Physicians looking for non-clinical careers in industry can learn from the mistakes of others.

In general, physicians are an independent breed—and have traditionally been captains of their own ship. Some may have gone to medical school partly to become their own boss. Private practice allows for such independent-spirited behavior.  

All this seems to be changing, doesn’t it? Rapidly, one way or another, physicians are becoming part of large organizations. Very few graduates of residency programs are starting their own practices—and the number joining a private practice is shrinking. Many are becoming salaried employees of large medical groups or healthcare organizations.  This may say something about the lack of independent business sprit among physicians, or it may say something about their lack of options in this regard.

Some may be coping with the situation reasonably well.  But what about those who are looking for non-clinical roles in industry? If you choose to pursue a career in a leading medical device or pharmaceutical company, you could be adjusting to a new reality—working for a very large corporation, with tens of thousands of employees. One of the pharmaceutical giants now has over 120,000 employees! 

I have worked in both the medical device and pharmaceutical industries for 30 years. My career has involved senior management roles in companies ranging from $100 million in sales and 300 employees to over $15 billion in sales and 20,000 employees. While the overall experience has been very positive, the process was not always smooth for a physician learning about business in real time.

Now, don’t get me wrong. I don’t want to give the impression that the view from the top is not worth the climb in industry. You may very well find the right company with an incredibly rewarding role for the next chapter of your life. But you should go in with your eyes open.  

I want to share some observations and insights I have gained in the process of adjusting to working for a large corporation. Yes, there are many books on how organizations should work. But then, corporations don’t always read these books. So, I will draw from my own experience—and the mistakes I’ve made in my career transitions.  Why should I be the only one to learn from my mistakes?

First mistake: I thought it would be easy. Since medical device and pharmaceutical companies are in the healthcare arena, I thought the organizations would make it quick and easy for a physician to work in industry.  But my experience in medicine did not prepare me for the way a staff member of a large organization has to move at the speed of the whole organization—and in paths the organization had laid out. Large organizations are complex, and their decision-making processes may be convoluted.  Organizations have their own cultures and hierarchies, and each has different channels for information.  And it isn’t just that the decision-making is a slow and complicated process.  Just learning how it works (and how to make it work) requires considerable time and effort.  Get ready to learn a whole new language and set of acronyms for each business. 

Second mistake: I assumed the organization would adjust for me. The culture of an organization is a complex set of behavior patterns, values, and beliefs. Joining a large corporation requires that you become a part of this culture. Thinking that you can change the culture is hopelessly naïve.  Of course, the culture of any organization must evolve, and you may be an important part of this evolution.  But ultimately, you will be expected to adjust to the organization rather than vice versa.    

Large organizations are a great pool or resources, but these resources are not always there to help you. Change or development in one area usually means de-emphasis in another. As a result, some of the organization will always be skeptical or threatened by change—and may act in ways intended to protect their area at the expense of others. Moreover, even with conceptual support for what you do, everyone is very busy keeping his or her own house in order—and may not have much time to assist you. At times, it feels as though you succeed in spite of the organization rather than because of it. 

Third mistake: I assumed I’d have better work-life balance. A clinical practice can be very rewarding.  Unfortunately, this comes at a price—for the demands are high, and the hours are long. When I decided to work in industry, I expected there would be some trade-offs. I thought I would have to give up something financially—but I would have more time for family and other interests.    

What I have learned is that the demands can be just as high, and the hours can be even longer in a senior management role in a large corporation. Performance expectations revolve around delivering results (measured frequently) and creating value for shareholders and staff as well as patients. Senior executives are expected be available virtually 24 hours a day, seven days a week.  And some roles may require a significant amount of travel—and time away from family. While some companies talk about work-life balance, this could prove to be an unrealistic expectation.        

Social Media For Non-Clinical Physician Jobs?

I wonder if social media is used by a greater percentage of physicians who are looking for non-traditional or non-clinical jobs than their clinical counterparts?

AMN Healthcare’s "2010 Social Media Survey of Healthcare Professionals," which was released December 14, shows findings suggesting that traditional recruitment methods such as referrals, online job boards and search engines are still more preferred by job seekers than social media; however, social media is now more preferred than methods such as newspaper ads, career fairs and other methods. Additional findings from the survey include:

• Thirty-eight percent of clinicians surveyed are currently seeking employment, and 12 percent of current job seekers have been looking for more than a year.
• Nurses have had a significantly shorter job search than their fellow professionals, averaging three months, compared to just less than seven months for physicians and allied professionals, and nine months for pharmacists.
• Thirty-seven percent of clinicians reported using social media for professional networking; nurses had the highest use among healthcare workers at 41 percent.
• Ten percent of healthcare professionals are using mobile job alerts, but only 3 percent have received an interview, 2 percent have received a job offer and 1 percent secured a new job.
• Physicians are by far the heaviest users of mobile devices for professional reasons among their medical colleagues; 37 percent used healthcare-related applications and 17 percent used mobile devices for healthcare-related content or jobs.
• Sixty-four percent of the clinicians surveyed would choose Facebook, the clear favorite, if they could choose only one social networking site.

To be honest, the survey's decision to categorize online physician job boards — like our own at http://jobs.FreelanceMD.com — as 'traditional' seems inaccurate. I would categorize Freelance MD, and our job boards as 'social media' since it depends upon online interaction between individuals to a great extent.

A Physician’s Journey To Social Media & Blogging

By Richard C. Senelick MD

A Physician’s Journey to Social Media and Blogging

A physician’s life often seems to be programmed. We go from college to medical school to internship to residency to fellowship to practice in a seamless path. Twelve to fifteen years go by without too many questions for we are consumed with the educational process and the brass ring at the end of this marathon event. Another straight line seems ahead of us as we pursue our career.

But, are our lives as physician’s really such a straight line or are they influenced by minor events that have major influences on the paths we travel? Life is like a novel where minor or serendipitous events take us in a different direction until another such event pushes us down another path. Most of the major decisions in our lives seem to be made with inadequate information- the decision to marry someone, become a physician, and choose a specialty.  Who really knows what marriage or a particular career will be like?

A Serendipitous Meeting

I had been in practice 35 years, written eight books and produced multiple DVDs. (http://www.richardsenelick.com/books-dvds) I enjoyed lecturing and writing, but again felt that itch to take that little fork in the road that might open new doors and get the creative juices flowing again.  I am a firm believer in reinventing oneself every 5-10 years. I received an email flyer for Dr. Julie Silver’s course at Harvard on “Publishing Books, Memoirs and Other Creative Nonfiction". I can’t tell you exactly why I signed up, but it seemed like a good diversion from the usual meetings on Stroke, Brain Injury and Rehabilitation. I already had a distribution system for my books, wasn’t looking for an agent, but some intangible nagging resonated with that “fork in the road” part of my brain. It was March 2010 and winter had descended on Boston, with winds blowing the snow horizontally. This was perfect weather to settle in for a meeting and avoid the temptation to walk along Newbury Street and sit at a café with my new iPad. I am famous for not being able to sit longer than 2-3 hours at a meeting. So, I took my usual spot in the last row, convenient for the quick escape. What followed were 2 ½ days that became one of those critical forks in the road for me.

Social What?

I was having a great time and getting all kinds of good information on writing, publishing and meeting people, but nothing seemed to be happening that would make a major difference in my career. It is not unusual for me to blow off the last morning of a 2 ½ day meeting, but my curiosity was piqued by a talk on Social Media by Rusty Shelton of Shelton Interactive. I had a “facebook” account I never used, but didn’t have a website, know how to “tweet” and had never commented on a blog, let alone written one. 

I am your typical cynical neurologist, so I sat in the back of the room with my arms folded as Rusty Shelton started his pitch for the new order of social media and publishing. It is not an understatement to say it was a true epiphany and resonated throughout my body. I instantly “got” social media and saw that door that only needed to be opened. It usually took me a year to write a book and then it was only seen by a limited number of people. Even worse that book might be out of date in six months. 
It became clear. My books were meant to educate healthcare professionals, people with disabilities and their families. With a website and a blog I could instantly disseminate information, keep it up to date, communicate with colleagues, people in need and get instant gratification. I also realized that all of my magazines and newspapers were getting thinner and that I was getting 90% of my information from the Internet. I no longer went to the medical school library weekly to sit in the stacks, but the stacks came to me on my computer screen. If I wanted to be part of mainstream society and contribute on an international level the remainder of my life, I had better get on board the social media train or be left at the station.

It is a little less than a year since Julie Silver’s course presented me with a new fork in the road. With Rusty Shelton at my side, we have developed a website, www.richardsenelick.com with books, articles and an active blog. We developed a professional “facebook” page (facebook.com/richardsenelick) and I am even starting to use Twitter. (twitter.com/richardsenelick)  Interviews and other writing opportunities have followed. It wasn’t much later that I received a major opportunity to blog for the Huffington Post (http://www.huffingtonpost.com/richard-c-senelick-md) which has been more fun than I can remember. I have been asked to guest blog on other people’s websites and am getting fully integrated into social media. Not only has it been invigorating, it has allowed me to play a role in the national dialogue that will ultimately impact providers, patients and their families.

No matter what you are thinking of writing, social media and the opportunities it provides should be a major part of your plan. Thanks to Dr. Silver’s course, it is now a major part of mine.

About: Richard C. Senelick MD is a neurologist who serves as the  Medical Director of RIOSA, The Rehabilitation Institute of San Antonio, and Editor in Chief of HealthSouth Press, the publishing arm of one of the nation’s largest hospital systems. He is a frequent lecturer on both a national and international level. Dr. Senelick writes a regular Blog for the Huffington Post.  Amongst his many books and publications, he has authored Living with Stroke: A Guide for Families, Living with Brain Injury: A Guide for Families, The Spinal Cord Injury Handbook, and Beyond Please and Thank You: The Disability Awareness Handbook.

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Physician Networking

By Michelle Mudge-Riley DO

NetWORK?

Do you avoid networking because it seems like work?  In a negative way? 

You know you should be networking to find a job or create a job – no matter what you are looking to do but especially if you are an entrepreneur.

Here’s the first question you should ask yourself  - when networking, do you enjoy yourself? 

If not, you should.  That is one of the “secrets” of networking – it should be fun.  If you are having a good time with it, chances are, you are making a good impression on the person you are talking with and showing him/her your best self.

But some people have a lot of fun talking nonstop about themselves.  And if you talk only about yourself, you’ll soon find that isn’t the best way to network and definitely does not give off a good impression. 

So the next question is, have you ever thought about networking as just helping someone?

Many of the doctors I work with tell me they are intimidated by networking.  They see profiles of people on Linked In or see individual’s title on a website and assume these people would have no interest in talking with them.  I’ve approached many doctors, chief medical officers, CEO’s, Vice Presidents, etc. and have had about an 80%-90% return rate via an e-mail or call.   I encourage other doctors  to approach anyone they want to talk with and suggest they will experience the same return rate of response.

Why do I have this confidence?  I’m not any different than anyone else – I don’t have a fancy title or sales pitch to get people to call me back.   Most of the doctors I work with have done many more impressive things than I have. I’m not any better or more fun to be around than anyone else (though I often wish I was that quick-witted person everyone always wants to talk to but I can’t tell a good joke to save my life).   What I try to do is have fun and find a way to help someone when I approach him/her.  I’ve found most successful people are willing to consider help from someone else and would also like the opportunity to help someone else.

A few years ago I read a book about this.  At first I felt silly doing it and didn’t really know how I would be able to help someone who I wanted to help me.  But it’s amazing how just by uttering that sentence (“what can I do to help you”), the other person sees you differently than someone who just wants something. 

And the really important thing is, you also begin to see things differently.  No longer are you in it for yourself.  You really want to help this other person and in the process, you learn something about yourself and you build a relationship.

And that is the key with networking, in my mind.   It isn’t just work to be done and then forgotten about. It’s about building relationships. 

Never Eat Alone by Keith Ferrazzi is that fantastic book I just referred to.   The book is all about networking through building relationships.  There are a couple reasons why you should read this book.  First of all, it’s a very easy read.  Second of all, it makes sense.  For example, being authentic and genuine when talking to people will help you feel like networking is fun, not work.   The book also gives a ton of examples of how helping someone can help you build a relationship with that person.

It worked for me.  I help physicians find ways to diversify their careers – be it in non-clinical careers or simply through enhancing their own revenue in some shape or form.   I do this because I wasn’t happy in my clinical career and eventually I found my way – but not without a lot of missteps and confusion and need for sense of direction.   Every doctor I help teaches me something I can use to help another doctor who works with me.  I also work as a consultant to large employers in health promotion and wellness.  About 18 months ago I met an actuary and offered to help him with some medical claims analysis.  That lead to a $49,000 project with some neat outcomes for the employer – a 2:1 return on their investment and a significant decrease in the medical risks (specifically hypertension) for their employee population. 

In my next blog, I’ll talk a little more about tips for approaching people and helping them and about building a relationship so you can find/get work and have fun– not just work – when you network.

About: Michelle Mudge-Riley DO successfully made the transition from clinical practice to non-direct clinical work and now works for a brokerage firm in Richmond, Virginia as Director of Wellness and Health Promotion. She has worked with over 50 doctors located in various locations throughout the United States.

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