Many Doctors Seek Nonclinical Jobs If you're a doctor who is getting frustrated with medicine, you may be looking for other options. It can be a scary proposition. You may wonder whether you could really find a job that pays as well, that can be a good fit for you, and that inspires your passion. The answer is that there are many jobs that could work for you, both inside and outside of healthcare, and many of them can pay well, although possibly not as well as working as a physician. You just need to decide which one suits your needs and interests. If you are considering a switch, you're not alone. In 2016, 13.5% of physicians were planning to look for a nonclinical job in healthcare in the next 1-3 years, according to a survey by the Physicians Foundation.[1] Some young physicians leave clinical medicine soon after becoming a physician; they may enjoy the field, but realized in med school or internship that they didn't want to practice as a physician. The majority of physicians who leave do so in mid-career because they're frustrated and burned out. And another group leaves when they're near retirement, often to fulfill a "bucket list" career dream. Despite many hurdles, however, plenty of doctors still decide to make the leap. If you're ready to consider something new, here are the 20 options for second careers, including options suggested by physicians who commented on Medscape. CME and Career Expertise 1. Produce CME Presentations Doctors can help organize and write presentations for companies that host continuing medical education (CME) for physicians and other health professionals, an industry that generates more than $2 billion in annual sales. These companies must meet a demanding set of requirements from the Accreditation Council for Continuing Medical Education (ACCME), such as documenting their target audience, stating course objectives, explaining how the course fills gaps in knowledge, and testing participants afterward. Talented doctors can rise fast in the CME industry. For example, Joseph Kim, MD, who runs a website for doctors called NonClinicalJobs.com,[2] joined MCM Education, a small CME company in Newtown, Pennsylvania. He then became president of the company, making an income similar to that of practicing physicians, before starting Q Synthesis LLC. Dr Kim says he brought skills in both writing and computer software to the company. As an MIT undergraduate, he wanted to combine his interest in technology with population-based health, so he enrolled in medical school and trained in internal medicine but didn't go into practice. "I just felt I could apply my skill set better somewhere else," he says. So he went to work at a consumer health company, where he helped build some computer-based education modules. But he preferred writing for doctors, which brought him to CME. Recently, he earned an MBA. "A lot of doctors have to learn executive skills to be successful in business," he says. According to the ACCME's latest data report, the total income for accredited CME providers exceeded $2.5 billion in 2016, and the number of educational events had increased 7% over 2015.[3] Accredited CME providers differentiate themselves from medical communications companies that work with pharmaceutical companies to provide seminars to doctors. Commercial support from pharmaceutical companies accounted for 28% of accredited providers' income, according to the ACCME report. Pros: Physicians with writing and computer skills can thrive at CME companies. Cons: The production process is often cumbersome, because it must meet a variety of accreditation requirements. 2. Become a Physician Career Coach Lots of physicians stay busy these days serving as career coaches for their colleagues. And considering the high percentage of doctors in the Physicians Foundation survey who reported that they wanted to change careers, demand for this new field may not yet be fully tapped. In addition to counseling on career change, coaches help physicians upgrade their current careers, brush up on their management skills, and develop new sources of income for their practices. They may work with clients one-on-one, speak to small groups, or give seminars and speeches. There are even courses and certification programs for career coaches, who can earn six figures once they've established themselves. Dr Philippa Kennealy, MD, in Santa Monica, California, left her post as a hospital CEO in 2002 to start her own coaching company in Los Angeles. First she taught leadership skills to physician executives, department chiefs, and medical staff presidents. Now, in a business called The Entrepreneurial MD, she coaches physicians who want to start their own business. "It was a natural fit for me, because it allowed me back into the helping relationship that I enjoyed when I practiced medicine," she says. When Heather Fork, MD, left her dermatology practice in 2004, "I didn't have a clue what I wanted to do next," she recalls. "I sold my house and pretty much everything in it and rented a cabin in the country. I did the Walden Pond thing, without the pond." "It's important to create some space in one's busy life for something new to come in," she explains. Through that process, she chose career coaching. She now runs The Doctor's Crossing in Austin, Texas. Pros: Demand for coaching is high, and the income can be good once you get established. Cons: You'll have to work hard to build up a client base and keep getting new clients. The Worlds of Finance and Technology 3. Work in Financial Planning Physicians who are successful in financial planning can use some of the skills they honed as clinicians and attain previous earning levels, but building the business involves hard work over several years. Joel Greenwald, MD, was a practicing internist in the Minneapolis area for 11 years before switching to financial planning. “I was in my mid-30s, and I said to myself, ‘I can’t feel like this for 30 more years,'” he recalls. He says he was always interested in financial planning, which he says is a lot like practicing medicine: Clients come to him with problems, and then he asks questions, comes up with solutions, and develops a program for them. However, the switch took years. First came the required classes and an exam to become a certified financial planner (CFP), which he completed while still in practice. Then he quit practicing to launch his new business, Greenwald Wealth Management. But during the first 3 years, he wasn’t allowed to represent himself as a CFP and didn’t have many customers. When he could finally hang up his CFP shingle, Dr Greenwald realized that his best clientele would be other physicians. Very focused on their work, they often don’t have time to tend to their finances. “Free time away from your practice is a precious commodity,” he says. And because of the MD after his name, Dr Greenwald could gain physicians’ trust, which is necessary when handling someone else’s money. Dr Greenwald has worked hard to get new clients, writing articles on his new profession in major publications and speaking before physician groups. But even with all of the effort he’s put into his second career, he thinks the work is a lot simpler than running a practice. “I serve 80 households of clients, and I have two employees,” he says. “All I need to do is make them happy.” Now that he has a busy practice, “I make more money than I would as a general internist,” he said. Pros: This path is a good fit for physicians who have financial skills, and in time you can potentially match your clinical income. Cons: You need to have a knack for managing finances, and it takes years to establish the business. 4. Work With Digital Technology If you have expertise in computer technology, there are a variety of careers to choose from, including advising on electronic health record (EHR) programs, working in the IT department of a hospital, creating software applications, and even launching a technology start-up company. Doctors often blame unmanageable EHR systems on chief information officers (CIOs) who have no medical background. To correct this problem, hospitals have been hiring physicians as chief medical information officers (CMIOs). These doctors serve as liaisons to the medical staff and apply a clinician’s insights into developing computer technology. In a 2016 survey of healthcare IT leaders, 71% indicated their organization employs a clinical IT leader, such as a CMIO.[4] “When you think about the physicians and CMIOs coming on, they bring in this culture [of] connectivity and analytics,” Lorren Pettit, vice president of market research for the Healthcare Information and Management Systems Society, told EHR Intelligence magazine.[5] A widely acknowledged model for this position is John D. Halamka, MD, who has been CIO at Beth Israel Deaconess Medical Center in Boston for many years. He also writes the Life as a Healthcare CIO blog and puts in time practicing emergency medicine. Physicians can also offer useful input into improving EHR design. A company called Modernizing Medicine, based in Boca Raton, Florida, seeks to bridge the gap between doctors and software engineers by teaching physicians computer coding and having them design specialty-specific EHRs, according to a report.[6] The physicians even go on the road to market their product, while they continue to practice medicine. Beyond EHRs, physicians can play a role in developing a variety of new software applications, ranging from at-home patient monitoring to providing doctors with quick access to best practices. For example, Thomas Osborne, MD, a radiologist in Vista, California, has been reading scans for vRad, a large telemedicine company. Recently, he was named the company’s medical director of informatics. To demonstrate his abilities and get the job, he did IT work and volunteered for a company project. “My successful involvement has in turn put me in a position to be involved in other areas of the rapidly expanding business,” he told Medscape. Some physicians dropped out of medicine to work on software even before they completed their residency. Scott Zimmerman, MD, CEO of Xola.com, a travel booking website based in San Francisco, said he became interested in software coding while in medical school and left a neurology residency program at Stanford to devote himself full-time to the company. “People told me I was crazy,” he tells Medscape. “I only had $10,000 in the bank and nearly $200,000 in student loans, with a six-figure salary just in reach.” But the new company raised $2 million from several investors. Pros: A variety of career paths are available to those who are computer-savvy. Cons: Most physicians don’t have a strong enough background for these jobs, and additional learning and experience would be required. Improving Medical Practices 5. Become a Healthcare Practice Management Consultant Thousands of physicians have started practice management consultancy firms based on a skill they learned when they ran a practice, such as coding, claims processing, strategy, and practice efficiency. “This is good for people who are self-starters,” says Steve Babitsky. Babitsky is an attorney who runs SEAK Inc., a Falmouth, Massachusetts-based company that trains physicians, including those who want to switch careers. David Zielske, MD, an interventional radiologist in Tennessee, founded a company that addressed the difficult coding requirements of his specialty. “The coding for interventional radiology is unusually complex and error-prone,” he says, but he enjoyed the challenge. “I’ve always had a passion for coding.” In 2000, Dr Zielske took his coding skills and cofounded ZHealth in Brentwood, Tennessee, to help physicians and hospitals deal with interventional radiology coding. For a while, he operated out of his home and had to continue practicing for a few years to keep up his income. The transition was “a very expensive, long-term process,” he says. “You can’t just quit and think you can be successful right away.” The company has prospered since then, branching out into coding for vascular and cardiac care, and Dr Zielske has also written books, hosted webinars, and given speeches and seminars on coding. Some physicians who start consulting firms keep practicing medicine. For example, L. Neal Freeman, MD, a practicing ophthalmologist in Melbourne, Florida, is president of CPR Analysts, coding and physician reimbursement analysts. The work can build on basic skills learned in clinical care. “Consulting is like the problem-solving you do in medicine,” Dr Fork says. “You have to take a project from beginning to conclusion.” Pros: You can build on a skill you learned in running your practice. Cons: It may take many years to establish your business. 6. Help Payers With Utilization Review There’s a growing demand for physicians to help payers with utilization review. “The health insurance industry has been booming,” says Babitsky, citing changes still in effect under the Affordable Care Act. Although some physicians may view this as working for the wrong side, it’s “actually a chance to do good,” Dr Fork says. “Your role has to do with stopping overuse of services within the healthcare system and helping to provide quality care for value.” The advantages are that you can use your diagnostic skills as a physician; you’re often able to work out of your home; and, if you work full-time, it may be possible to make as much money as you did seeing patients, although many utilization review physicians work part-time. Heidi Moawad, MD, a neurologist in Cleveland, served for several years as a utilization review physician, working part-time out of her home while raising her young children. Working with a radiology review company that contracted with several health insurers, she dealt with preauthorization requests for radiology from fellow neurologists. Although she felt some trepidation before starting the job, she says she did not feel under pressure to deny payments and felt little resistance from the physicians whose requests she was reviewing. In fact, she says many of them would even ask for her guidance. “They would tell me, ‘This is the story; what do you think?'” she recalls. “When I said the test was unnecessary, they were actually relieved.” She says the job helped her get on the Practice Guidelines Committee of the American Academy of Neurology. When her kids got older, Dr Moawad switched to a teaching job, but she looks back fondly on her utilization review career. She believes that utilization review physicians will be under increasing pressure to closely follow practice guidelines, rather than follow their own inclinations. Amy E. Odgers, MD, an internist in Chicago, also switched from clinical practice to utilization review work. Initially she worked in a call center, handling physicians whose charges were being challenged. “At times, the work can be contentious,” she said. “Doctors don’t like to be questioned about why they’re ordering tests.” After 9 years of reviewing claims, she now has a new position at the same company, studying ways to improve workflow. Working just 20 hours a week, she said she doesn’t make as much money as clinical care physicians, but she isn’t in debt either. Plus, she has time to pursue gardening and ceramics. “I love the balance I have between work and other things,” she said from a cell phone while in her garden. Pros: Reviewing claims pays relatively well, and in many cases, you can work part-time from your home. Cons: The work is becoming more and more regimented. New Challenges and Shaping the Industry 7. Work at a Management Consulting Company A management consulting company helps organizations—including hospitals, government, and insurers—improve performance by looking for improvements in operations. This could be fulfilling work for ambitious physicians who like problem solving and working in teams, but expect to put in long hours and being away from home a lot. Many doctors work for such companies as Accenture, Boston Consulting Group, Deloitte, McKinsey & Company, and Milliman. The work involves making in-depth studies on behalf of clients. Salaries at the top firms start at around $150,000, with the chance to earn raises each year. Consulting firms often recruit doctors directly out of medical school, but also hire them in mid-career. McKinsey has a web page to answer questions from physicians and other people with advanced degrees looking for jobs there. Dr Fork says that assignments can last months, and usually consultants work on-site for most of the week. “In many cases, you’re traveling 4 days a week and putting in long hours,” she says. This makes it impossible to work in clinical practice even at a minimal level. As a fourth-year medical student in 2001, Michael P. Ennen accepted a position with McKinsey. Physicians attracted to this work often cite a “fear of reaching a professional plateau,” he wrote in an articlein JAMA, just after accepting the job.[7] They like “the challenge of continually working on new problems and shaping new industries as a source of professional satisfaction.” Ennen emphasized the need to adjust to a team approach. “To be successful, physicians must modify their expectations about their role in a hierarchy, their individual input, and the service being provided to clients,” he wrote. Pros: The work is challenging, and the pay is good. Cons: You’ll work long hours and travel a lot. 8. Get Involved in Venture Capital If you want a chance to earn millions, consider a second career at a venture capital company. These companies provide financing for start-up companies and small businesses that are thought to have impressive potential for long-term growth. This work involves great risks and the potential for great rewards. The fortune of the venture capital company depends on its predictions that the companies it invests in will succeed. The work is best suited for those with strong analytical skills and an aptitude for finances and statistics. You would closely analyze start-up companies in healthcare—in such areas as software, drugs, and medical devices—and help determine whether the venture capital company should invest in them. Companies are often looking for young physicians with MBA degrees, but they also hire physicians who have proven their chops as consultants. Doctors can work full-time directly for the venture capital company or be hired as a freelance consultant. Physicians even start their own venture capital companies. Marlene R. Krauss, MD, left an ophthalmology practice and worked for 8 years at an investment bank before starting KBL Healthcare Ventures in Manhattan, according to the company website.[8] At KBL, Krauss helped launch several groundbreaking healthcare companies, including Lumenos, Candela Corp, Summit Autonomous, and Cambridge Heart Inc. Dr Fork says physicians consulting with venture capital firms earn $300-$500 per hour. Working directly for a firm pays about $150,000 a year for entry-level positions, whereas some in the upper echelons can potentially earn millions. Pros: Competitive physicians with strong analytical skills can earn as much or more (way more) than they could in medicine. Cons: It’s hard to break into this field—and it’s a real pressure cooker once inside. Finding Other Industries 9. Enter Retail or Manufacturing Some physicians enter businesses that have little or nothing to do with healthcare and do quite well, thanks in part to skills and temperament learned in practice. In business, “you need to be a smart, hardworking person who can stay focused,” Babitsky says. “Those are things that physicians do quite well.” Babitsky recalls a doctor who opened a bagel shop near him on Cape Cod. It was a shrewd move, because there were still no bagel shops in the area. The doctor worked hard and the business flourished. It wasn’t a sure thing, because many restaurants and other retail businesses fail, especially when the economy sags. Physicians even get involved in manufacturing. Daniel E. Kohn, MD, an emergency physician in Baltimore, switched from work as an emergency physician to running a manufacturing company full-time. Like many physicians, he had for many years been investing in real estate, buying old buildings and rehabbing them, when in 1997 he came across a dilapidated factory. The factory housed a shirt company that was about to go out of business. Dr Kohn decided to buy the company, called Aetna Shirt, and bring it out of bankruptcy. “It was kind of a fire sale,” he says. “The price was reasonable, and there was a book of business already there.” As an emergency physician, Dr Kohn had experience bringing back patients from near death, but rescuing a whole manufacturing concern proved to be a greater challenge. “I didn’t understand how relentless the financial needs of this kind of enterprise can be,” he says, “but I was determined to make it work.” He left the emergency department and introduced a new product he knew intimately: white lab coats. “I never found a decent lab coat,” he said. He set about producing a sturdier product that could also be custom-tailored to create a more fashionable look. The lab coat business, called On Call Medical Coats, now makes up 70%-80% of sales. After 17 years in business, Dr Kohn still hasn’t recovered his full investment, but the company is firmly in the black. To find customers, he used to go to 20 medical meetings a year, but he cut back that schedule as business improved. “It’s still a work in progress,” he says. “I want to continue to grow this company.” Pros: A successful business can provide a great deal of satisfaction and financial rewards. Cons: You’ll have to work hard, and failure is a very real probability. 10. Join a Pharmaceutical Company Physicians can easily develop a second income speaking to colleagues about a medication for a pharmaceutical company. Landing a full-time job at one of these companies, however, is very difficult without prior experience in pharma, such as working on a clinical drug trial. Some physicians work on the marketing side, but most are involved in research and development. Demand tends to be higher for physicians in prescription-heavy specialties, such as oncology, cardiology, gastroenterology, neurology, and psychiatry. In addition to experience with drug trials, recruiters are also interested in applicants who have worked for the US Food and Drug Administration (FDA) for a few years. FDA pay is comparatively low, but the experience can be a springboard to a career at a drug-maker, where salaries start at $130,000 and top out at about $500,000 plus bonuses. Another way to share the wealth of pharma industry is to start an independent agency that contracts with drug companies. Former plastic surgeon Mike McLaughlin, MD, cofounded Peloton Advantage, a New Jersey-based medical communications company that works with pharma, biotech, and medical device companies. Dr McLaughlin also runs a side company, Physician Renaissance Network, which provides information for physicians seeking a career change. “I quit clinical care all at once,” he recalls. “I wouldn’t recommend doing that, because it’s important to test the waters to make sure it’s a good fit.” Pros: Being a physician can help open some doors, and successful employees can match their old clinical income. Cons: Landing a position often takes a lot of networking and effort.
Recruiting and Hospitals 11. Become a Physician Recruiter One unusual but financially rewarding job is to recruit physicians for various positions, such as clinical research, hospital employment, and group practice. As with many other jobs that require interaction with a lot of doctors, it helps to be a physician and understand what makes them tick. John Goldener, MD, runs a company that recruits doctors for drug trials. Although it took years of hard work to get Goldener Executive Search Associates, in Bryn Mawr, Pennsylvania, off the ground, he said he’s now making more money than he did in clinical medicine. In 2000, Dr Goldener traded his lab coat for a position with an executive search company that worked with pharma companies. It meant giving up clinical work. “If a client calls and wants to talk to me, they don’t want to hear that I’m seeing patients,” he says. Three years later, he founded his own company, but a noncompete clause in his contract meant he couldn’t solicit any of his old employer’s clients. “I had to start at the bottom,” he said. That meant making cold calls to pharma executives asking to do their physician searches and driving to New Jersey to meet with them. “I’m rather introverted, so I had to learn how to call people one after another,” he says. It took him 6 months before he landed his first search. As with any job that involves working with physicians, it helps to be one of them and demonstrate that you understand medical concepts, Dr Goldener adds. Pros: Physicians who are willing to be patient and work their contacts can earn a high income. Cons: It can be a tough field to break into. 12. Enter Hospital Administration Hospital administration is a long-standing option for physicians, and opportunities are expanding as hospitals try to get physicians to align more closely with them. For a practicing physician who is no longer feeling challenged by patient care, this is a chance to make a big difference across a whole institution and still earn a good living. Although chief medical officer is the traditional role of physicians, many more positions are opening up for doctors, such as chief operations officer, chief integration officer, chief administration officer, chief strategy officer, chief innovation officer, and chief transformation officer. Typically, any of these career paths first involves serving on hospital committees for a few years. Once appointed, you may be able to rise through the ranks. But you’ll need to deal with business issues that you might not be familiar with. Above all, some colleagues won’t view you as one of them any more. Dr Kennealy became CEO of UCLA Medical Center in Santa Monica, California, in the late 1990s. She took the traditional route—serving on hospital committees—in order to build her reputation. She volunteered for her first committee because she wanted to help out after an earthquake hit the area. Then she began to relish the role. “I realized I was unhappy in my own practice,” she says. “I decided there was a lot more that I could contribute in administration.” She left her practice in 1996 to become a hospital medical director, and then she became CEO. Dr Kennealy thinks her experience as a practicing doctor made her a better executive. “Another physician really does understand the physician’s point of view,” she says. On the other hand, “it’s a tricky role, because there are physicians who think you’ve moved over to the dark side.” Healthcare organizations abound with administrative opportunities for physicians. Eight in 10 healthcare organizations have at least one doctor in senior management, according to a 2010 survey.[9] Multihospital health systems and academic medical centers were most likely to have several physicians at the top, whereas more than one half of community hospitals did not have any physicians in key roles. Physician leaders can help hospitals reach out to their most important resource, physicians, and establish a trusting relationship. In a 2016 survey, only 45% of hospital-employed physicians said that hospital leadership delivered on its promises, and only 34% were satisfied with the level of communication in the organization.[10] Physician leadership is linked to the more highly regarded hospitals. A 2011 research study found that specialty hospitals headed by physicians rank about 25% higher on U.S. News and World Report’s Best Hospital list than those run by nonphysicians.[11] Pros: This is a relatively easy transition, and the income is good. Cons: Former colleagues may distrust you in your new role. Documentation and Writing 13. Be a Physician Advisor at Your Hospital Of the physician jobs in hospital administration, one that has seen a lot of growth in recent years is the physician advisor. It involves working closely with doctors to improve documentation of hospital charges, and making sure they adhere to quality and safety regulations. You may also interface with Medicare’s recovery audit contractors and other regulators. This job was once a part-time position for physicians nearing retirement, but now it’s usually a full-time position for doctors in mid-career. Only about one quarter of hospitals currently have the position, but Dr Fork, the career coach, expects a great deal of growth here, owing to the need for physician alignment, the shift to value-based care, and increasing use of performance data. Physician advisors are usually chosen from within the hospital staff. They have earned their colleagues’ respect and understand evidence-based medicine. “The physician advisor is a clinical educator, diplomat, and tightrope walker,” Dr Fork says. “This role is only for a certain type of physician who is able to handle conflict and deal with different personality types.” Bernard H. Ravitz, MD, has been physician advisor at the 300-bed MedStar Good Samaritan Hospital in Baltimore for 13 years. Beforehand, he had served as an emergency physician at the hospital for 15 years. A key part of his job is to monitor admissions. “If even one hospital day is denied, that means we’re still caring for the beneficiary but not getting paid for the care we’re providing,” he says. Working closely with physicians, he sees himself as an educator, helping with documentation and offering feedback to reduce denials and improve care. “You have to be able to get along with the medical staff,” Dr Ravitz says. “You have to have people skills.” Dr Ravitz is a founding member of the American College of Physician Advisors, which was launched in May. He said there are roughly 50-100 founding members out of hundreds of physicians in the field. The college plans to provide assistance to doctors interested in this career. Pros: This is challenging work for those interested in evidence-based medicine. Cons: You’ll have to deal with pushback from physicians. 14. Become a Clinical or Healthcare Writer If you have a talent for writing, there are countless clinical writing and editing opportunities with pharmaceutical companies, marketing agencies, CME contractors, quality and performance improvement initiatives, and medical publications. In most cases, the work is done on a freelance basis, which means you have to build up your business. Once you have an established set of clients, however, it’s possible that your income can reach $70,000-$130,000 a year, and the starting salary for in-house clinical writers ranges from $75,000 to $180,000. The higher end of the range is usually reserved for those with an advanced medical degree. However, many freelance writers, even physicians, do not earn that much. “If you have the skills, it’s not a big transitional hurdle,” Dr Fork adds. Characteristics of good medical writing include thorough research, accuracy, logical organization, clear thinking, and readability, according to the American Medical Writers Association. This has been a growing field. The medical writing market more than doubled in value last decade, increasing to almost $700 million, according to a report by CenterWatch, which studies the pharma industry.[12] Diane W. Shannon, MD, MPH, a freelance healthcare writer in Brookline, Massachusetts, writes on performance improvement in healthcare as well as other topics. Her exit from general internal medicine in the early 1990s was an act of “self-preservation,” she recalls. “I was less immune than others to the stresses of practicing medicine.” First, she worked as editor and staff writer for a medical communications company for 3 years. As a freelancer, she’s making more money than when she was working in clinics. “Leaving a relatively low-paying job probably made it easier to walk away from clinical medicine,” she says, adding that she uses a variety of medical skills in writing, such as interviewing patients, having to be well-organized, and breaking down very complicated material. Mandy Armitage, MD, also moved from medicine to writing. In an article on Dr Fork’s website, Doctor’s Crossing, she wrote that she stopped practicing sports medicine and rehabilitation after a year, and “I haven’t missed it a bit.” She initially enrolled in a 6-week online writing course and then started a freelance company, collecting such assignments as conference coverage, medical news, and feature stories. “What I love most about freelance medical writing is that I cover fields outside of my own specialty, so I’m always learning something new,” she wrote. “Plus, I can set my own schedule, and this work is much less stressful.” Pros: Physicians who can write well have good prospects in this field. Cons: It may take some time to get established, and for specialists especially, income is relatively low. Educating Others 15. Become a Teacher Many doctors dream of becoming teachers, and for a lot of them, it’s a good fit in many ways. Physicians know how to talk to patients about complicated medical concepts in simple terms, and they have had to speak in front of small groups. However, opportunities are limited to part-time work at colleges, and the pay doesn’t match what can be made in clinical care. Despite the financial drawbacks, doctors have a surprisingly strong interest in teaching. In the 2011 Medscape Physician Compensation Report,[13]physicians who wanted to drop clinical medicine chose teaching as one of their top three alternatives. Indeed, teaching is regarded as a relatively stable refuge from the disruptive modern workplace. Among 14 categories in the Gallup-Healthways Well-Being Index,[14] teachers rank second. Dr Moawad was satisfied with the move from her utilization review job to working as a college science teacher. After 4 years in the job, “I’m really, really happy,” she said. The work draws on her skills dealing with patients. “Doctors are used to talking to people who don’t know about the subject matter and have a limited interest in wanting to learn more about it,” she said. She’s an adjunct professor at John Carroll University in University Heights, Ohio, teaching two courses on human physiology and global health. The hourly pay is about the same as in clinical practice, but she works just 10-25 hours a week. Only full-time professors get 40 hours, she said, adding that fewer hours are a good fit for physicians raising a family or in semi-retirement. Her work schedule also puts her in sync with her school-aged kids’ vacation schedules. “College teaching is the best teaching opportunity,” Dr Moawad said. Teaching high school science pays too little, and medical school also isn’t an option, she said. Dr Moawad, who served on the faculty at Case Western Reserve University School of Medicine in Cleveland, said there aren’t any nonclinical teaching jobs for physicians who are not full-time faculty. Pros: Teaching is a good fit for physicians who are raising families or entering retirement. Cons: Opportunities are limited to part-time, relatively low-paying positions at colleges.
16. Start an ‘Encore Career’ An “encore career” is a job switch made by older doctors, often to answer a personal calling. For example, Dr McLaughlin recalls a plastic surgeon who took up sculpture full-time, and Dr Moawad knows a physician who quit practicing to open an aromatherapy and jewelry shop. Responses to the 2011 Medscape Physician Compensation Report included “chef” and “musician,” which sound like encore careers. Steve Babitsky said one of his clients always wanted to work in the outdoors, so he found a job as a park ranger. “The job only paid $30,000-$40,000 a year, but that’s what he really wanted to do,” he says. Michael Alberti, MD, gave up a job as an emergency physician in Scottsdale, Arizona, to become a portrait photographer. Working in a busy emergency department, “I was losing my love of medicine,” he says. Then two things happened: He got a digital camera as a gift in 2001, and his wife had a baby 4 years later. “It rocked my world,” he says. Having already mastered Photoshop, he began taking lots of pictures of his new baby, and within 2 years he had opened a portrait studio. By 2009, he had acquired a steady customer base in his affluent hometown, and he cut back on his emergency department shifts. In 2010, he was diagnosed with cancer, and by the next year he had quit medicine altogether. He isn’t making as much money as in clinical medicine, but his wife, also a doctor, makes up for that. “Giving up my old salary was not easy,” he says, “but I don’t do this to make money. I do this because of the love I have for it.” Pros: This is a chance to pursue a personal passion while heading into retirement. Cons: Income from these jobs is generally low. Other Careers Identified by Readers Medscape readers suggested a variety of additional careers that they had chosen. Here are a few categories. Public Health Needs Experts 17. Use Your Talents in Public Health In a prior Medscape article discussing the switch to new careers, several physicians said that they switched to public health, which allows doctors to continue clinical practice but does not require it. The reasons for their choice? They wanted to go beyond one-on-one care to studying populations. “My passion is more in larger change to help keep people healthy,” one wrote in the comments, and another added, “I loved patient care but wanted the opportunity to address some of the upstream causes of the pathology I was dealing with as a hospital-based [infectious disease] physician.” One doctor wrote that after 12 years as a family physician, he went back to school to get a master’s degree in public health and took a job as a county health officer. “I have some clinical duties, but most of my work is public education, policy collaboration, and administration,” he wrote. “The pay is the drawback, but I have much higher job satisfaction than I did as a physician in private practice.” 18. Combine Medical Knowledge With Legal Expertise Physicians who had become attorneys still kept their focus on medicine—malpractice in particular. “I tired of fighting HMOs at age 50 and went to law school,” one physician wrote in the aforementioned article. Two years after starting to practice law, “I had the great pleasure of winning (with my trial partner) a large jury verdict against a national HMO in a mismanaged managed care death case.” One newly minted lawyer said he continued to practice medicine. He works 7 days a week, “but my life has never been better,” he wrote. “My time off is now fully appreciated, but getting up each morning with a real purpose makes all the effort incredibly worthwhile.” Options With Insurers and Medical Devices 19. Working With Insurers and Other Companies A former family physician now works at a major life insurer. “I enjoyed the challenge of reinventing myself after 13 years of clinical practice,” he wrote. He researches, consults with underwriters, and sets writing standards. “The hours are better, there is no call, and we are well-compensated for what we do,” he wrote. One doctor became chief medical officer for a “good-sized” health plan after 25 years of practicing primary care. “After 1 month of being out of medicine, friends and colleagues were commenting that I looked 10 years younger,” he wrote. “Happiest I have been in a long time.” Another doctor became a consultant for a third-party administrator that brokers drug tests and health screening for multiple clients. “I have never been happier,” he wrote. “For those of you struggling with unhappiness in clinical medicine, I urge you: Don’t give up.” After 25 years in clinical practice, one doctor took a managerial job at a cancer center. “Fortunately, in my prior leadership roles my hospital invested in physician executive training,” he wrote. He had “the freedom to pursue whatever problems I found and the resources to accomplish my goals.” 20. Medical Devices and Pharmaceutical Companies One doctor took a job at a medical device company. “I strongly feel that I am doing the most ‘good’ now,” she wrote. “My job involves technical support, education, and the final validation of new products before release.” Although the work is “high stress” and she makes about one third as much as before, she has a steady salary and can be close to her children, she says. Another doctor joined a clinical research organization, starting as a medical monitor and progressing to vice president. Then he helped found a small pharmaceutical company. “Learning the new molecular medicine and immunology of oncology is very intellectually stimulating,” he wrote. “I wonder how practicing oncologists can do it.” The founder of the Society of Physician Entrepreneurs wrote that his group is “dedicated to accelerating innovation in healthcare” and has more than 11,000 members on LinkedIn. Local chapters of the group provide the education, resources, networking, and “introduction to funding sources to launch successful physician entrepreneurial ventures,” he added. Completely Beyond Healthcare One commenter set his sights on real estate. “Buy a bunch of rental properties, have them paid them off by the tenants, and voilà… plan B,” he wrote. Another became a charter airplane pilot. “My retirement after 30 years of ENT surgery was followed by an encore as a commercial multiengine charter pilot,” he wrote. A third operates a cattle ranch. “I now work part-time as a hospitalist and operate a 200-head cattle farm,” he wrote. “Cattle ranching is much more rewarding and still offers the opportunity to use the science of genetics, reproduction, and infectious disease while caring for animals that are quite honestly more appreciative than most humans!” Who Switches Careers, and Why? Doctors have different reasons for leaving clinical care, depending on the stage of their career, their gender, and their specialty. Dr Kim said that physicians tend to leave clinical medicine at distinct stages in their careers. In the first wave, a small group of young doctors leaves clinical medicine right after medical school or residency, or just when they start practicing. Most doctors who leave clinical medicine, however, do so in mid-career, when they’re in their late 30s or 40s. “These physicians have been in practice for a number of years and are getting burned out,” Dr Kim says. “They tend to be very disenchanted about the changes in healthcare. They want to find greener grass.” These doctors tend to go into pharma, health insurance, managed care, or health resource utilization, he says. The transition for this group of doctors into a new career can be very difficult. “They’ve spent much of their career practicing medicine and haven’t been developing other skill sets,” he says. “It’s hard for these doctors to convince a prospective employer that they have something to offer besides being clinicians.” A third group of doctors switches jobs at or near retirement. In this case, “someone aged 50 or 55 years decides to take on a completely different career,” Dr Kim says. In this switch, often called “an encore career,” physicians tend to choose a vocation they are interested in, such as painting or working outdoors. “This isn’t the predominant trend, but it became bigger in the recession,” he says. Career-changing also differs by gender. When their children are young, female physicians often stop practicing or cut back on hours. Almost one half (44%) of female physicians were working part-time in 2011, twice the level of male physicians, according to a study by the American Medical Group Association.[15] When their children are older, women have a chance to rethink their careers and may opt for a new career outside of clinical medicine. No one has pinpointed which specialties change careers the most, but we do know which specialties report the most burnout, which is a factor in career changes. A 2017 Medscape survey[16] found that the highest incidence of burnout was among physicians in emergency medicine, ob/gyn, family medicine, internal medicine, infectious diseases, and rheumatology. Specialty can also be an impediment to career change. Primary care physicians with high medical-school debts and low practice income may be less willing to exit clinical care because they can’t afford a lower income. On the other hand, specialists with high incomes may well find it very difficult to find nonclinical work that matches their current income. Source
