Ready to Change Careers?

The world is changing. For docs to consider changing their career was unthinkable just a few short years ago, but gender equality, increasing cultural and racial diversity, the recent switch from majority private practice to majority salaried practices, and a sea change in attitudes and expectations among young docs have put many old assumptions about doctors' careers to the question. Couple these tectonic developments with a widening array of new possibilities and it's game on for publicly visiting this subject.

Medicine is unique in that it involves in some way almost all aspects of human life and activity. So there have always been opportunities for docs to find a niche that suits them where they could be of service and relevant. For example, Somerset Maughm, the great writer and himself a physician, once said that there was no better preparation for a novelist than medical training, with its saturation exposure to life's basic elements.

We know that docs' working hours have been dropping for years, long before the recession. Depending upon your source, call it from 60+ hours a week 20 years ago to barely 50 hours per week today. There are many reasons for this, most of them sensible, but the net result is that there is more time available for pursuits beyond total immersion in a medical practice, the historical norm.

The greater motivator, as executive search professionals (aka headhunters) will tell you, is unhappiness in the current employment/medical-economic environment, whatever the personal specifics. Combine this restlessness with new opportunities opening up and you have a combustible mixture for career change.

And this comes in the face of the greatest scientific developments in terms of helping patients in human history, which might logically mitigate for docs the need to stay in their traditional, increasingly more effective, saddles. Big things must be afoot my friends.

Aside from part time hobby interests, some of which might occasionally bloom into a full-time career given more available time, there have long been some professional alternatives for docs outside of the traditional lock step office based practice. Public health, teaching, research, whether corporate or academic (or the sometimes uneasy combination), military medicine, missionary work, and forensic practice come to mind, for starters.

And new specialties have been developing to where there are now about two dozen extant and more in the offing. Some are economic reorganization-based (rapid growth in hospitalists), and some are science-driven (advancements in DNA and genetic research). Some docs get training in multiple fields, as the science progresses, or sometimes, as the individual's interest shifts.

Interesting (and this is not a new development) is a fact related to me by the head of a clergy training program. In his experience, the number one field from which he got career changer applications, and to which he lost career changers, is medicine (http://www.spiritandmed.com/sm/partnerships.php). Even in this cynical age, it was nice to hear that altruism is not entirely moribund.

Two other somewhat related areas of practice that have been growing over the years are ex-patriate medicine and cruise ship medicine. The former because so many Americans now live and work abroad and so many locals with money and knowledge want the benefit of US medical training. The latter is because international travel has become a commonplace and the number of ships with medical positions is at a historical high.

Another area that has grown because of non-medical technology is work in the media. We have a 24 hour news cycle and in turn many, many outlets grasping for content to fill the time. So the occasional doc with a winning smile and the gift of gab has been lured away from direct patient contact to a mass information and entertainment role. Drs. Edell and Oz come to mind.

The two most interesting, and new, areas for docs looking at changing careers to consider are in that of organizational medicine (less of an oxymoron than previously) and entrepeneurial activity. The latter has been fueled by the fusion of accelerating technological advancement and the development of financial structures to encourage and reward such activity.

To name a few, venture capital and their spawn, the IPO (Initial Public Offering), and the trend toward patenting discoveries in medical science which, while enabling the investment of large sums of money, certainly represents a great shift in the ethical standard that used to say such discoveries should reside in the public domain.

The introduction, or as some say, the co-opting, of doctors into the organizational hierarchy of hospitals and other previously physician-free positions like corporations, have provided another outlet for docs who are unhappy in their current situation (or those who see a new opportunity for service or advancement, using talent and/or new, non-medical training).

Dear reader, you know how I have tilted at the windmill of archaic, inadequate medical curicula that do not include this kind of business and organizational background that we inevitably find, belatedly, that we need. Happily, at least, postgraduate programs in these important areas for docs are growing.

Executive MBAs, Masters in Medical Management, certificate courses at business schools and the Certified Physician Executive award from the American College of Executive Physicians (my alma mater, and in my experience, appropriately, the best run affinity group for docs that I have belonged to ACPE.org) are examples of educational opportunities growing to fill a huge gap in our medical training.

So what about the money? This is a finance oriented column, after all. Well, it varies from little for the missionary and garage inventor, to huge for the CEO and the lucky recipient of an IPO payoff. For the bulk of folks changing out of medical careers, or into other medical fields, once you've taken the hit of extricating yourself, possibly moving, and getting re-positioned (not a small effort or expense, bear in mind) the pay and perks are roughly comparable to other areas of medical employment.

But that will probably be irrelevant to most, once the basics of supporting your family are met. No, docs changing careers are after bigger fish to fry, in terms of personal fulfillment, among other concerns.

But don't even think about financial writing for docs; the job's taken.