Outside the Box: Doctors in Nontraditional Careers
My favorite part of medicine is the moments I spend in direct patient care and in talking with specialists about patients. All the rest of it I find pretty unsatisfying. I feel limited by my inefficiency as well as pretty painful hand arthritis, so I had mixed feelings about the prospect of increasing my hours
by Autumn Dawn Galbreath, MD, MBA
"My favorite part of medicine is the moments I spend in direct patient care and in talking with specialists about patients. All the rest of it I find pretty unsatisfying. I feel limited by my inefficiency as well as pretty painful hand arthritis, so I had mixed feelings about the prospect of increasing my hours doing medicine after my kids were launched."
So began Dr. Ann Tsen’s journey from clinical practice to a nontraditional career. She is not alone in her dissatisfaction with some aspects of medical practice and her search for an alternative career path. Many physicians at varying stages of life are finding themselves considering alternative career paths—often, much to their own surprise.
It’s safe to say very few of us graduated medical school intending to do anything other than practice medicine. We weren’t sure where the healthcare system was going or what our practices would look like exactly, but we knew we wanted to care for patients. We slogged through the mire of medical school and weathered the long nights of residency with that goal ever before us. For most of us, the goal was what got us through. Without our love of patient care, we might have quit long before graduation day.
It was all so clear then...
But somehow, like Ann, a great number of physicians now find themselves less certain. Even those who still love caring for patients often find the pressures too much to bear. The time away from home and family, the continually increasing administrative burden and decreasing remuneration, the litigious atmosphere, the hospitals and employers appropriating our time as if it were their own. On some days, even that grateful patient who brings homemade cookies to the office doesn’t balance out the pressures. Many of us are tired, harried and stressed, and we feel like we have lost touch with our purpose as physicians.
Debbie Cardell, MD, says she struggled with “unhappiness and untenable pressures. There were competing interests and pay structure that punished good doctors. Our current healthcare industry and health education system is not changing in ways that I agreed with.”
For Debbie and many others, this toxic cocktail leads to burnout, and they find themselves evaluating other career options.
“What if I hadn’t gone to medical school? What would I be doing instead?”
“I’m a highly educated professional. Surely there is some other job out there that I can do.”
“I’ve got to get off this treadmill and take control of my own life. I have to make a change.”
Of course, there are other jobs out there, and a change might be appropriate for you. There are options for adjusting your clinical practice: job sharing, part-time, shift work, missions, executive wellness, concierge medicine, regulatory or workers compensation or insurance physicals, occupational medicine, locum tenens, on-site healthcare and others. There are non-clinical healthcare jobs: pharmaceutical industry, healthcare administration, insurance, writing and medical communications, expert witnessing and legal medicine, public health, consulting, research and others. And if you want to leave the healthcare industry altogether, there is no limit to your options.
I have a chance to reflect the light of Christ through my work with non-Christian colleagues. I am supporting my medical colleagues in their work, and that is a satisfying ministry.
—Clydette Powell, MD
But how do you evaluate your options? How do you make this kind of decision?
I recently embarked on a small study of physicians who are working in nontraditional careers. It was not a scientific survey, but more of a collection of anecdotes. I talked to eight physicians, both male and female, ranging in age from 40 to 70. Their nontraditional roles include medical writing, medical administration, insurance review, executive wellness, nutrition and health coaching, missions, missionary education, non-profit administration, public health and international development, life coaching and even a church pastor. Their reasons for embarking on nontraditional careers varied, but some important themes emerged as I explored their career choices. And I believe these physicians have some wisdom to share with the rest of us.
You Don't have to leave clinical practice.
Seven of the eight physicians surveyed are still involved in clinical practice to some extent. As they moved into nontraditional roles, they maintained their medical licenses and continued to practice, sometimes with reduced hours in their prior clinic setting, sometimes in a different type of practice, sometimes on short-term mission trips and sometimes moonlighting outside of usual work hours. Some of them did this out of love for patient care, and some to supplement income, but all noted that it is valuable to maintain licensure and keep their clinical skills up to date.
I feel my impact has expanded. If I can help a woman physician regain her sense of mission and joy in practice…then she is able to impact her patients, colleagues and family in a much greater way.
—Ann Tsen, MD
Dr. Tsen said, “I have considered quitting (practice) completely…but I do not feel called to do that and would really miss seeing patients. I really enjoy exercising my mind in a scientific, diagnostic way while helping people navigate their healthcare.” Her nontraditional career path as a Physician Life Development Coach allows her to do both.
You might do more than one job.
Again, seven of the eight physicians surveyed are working in more than one job. A transition to a nontraditional career does not necessarily involve closing one door and walking through another. As Gloria Halverson, MD, experienced, there is often a “gradual transition over time” from full-time clinical care into full-time nontraditional work. And often there is a long-standing combination of jobs, allowing a physician to find the “best of both worlds” by working in varied jobs, each utilizing a different set of skills.
You have to have experience.
Every physician in our sample set had significant (at least five years, many more than 20 years) experience as a practicing physician before making a job transition. Particularly if you plan to work in a nontraditional role within the healthcare system, it is imperative that you understand the system well. Experience in clinical practice also brings credibility with fellow physicians, who are known to be reluctant followers of an administrator. You need to speak the clinical language and understand all aspects of care delivery in order to be effective in any administrative role in healthcare.
In addition, glean as much experience as possible in non-clinical areas. Serve on committees, spearhead projects, do the dirty work others shun. Learn to lead effectively within an organization.
You might want another degree.
Some of our physicians had additional degrees, specifically a master’s of public health and a master’s of business administration. According to our participants, an additional degree is helpful, but not necessarily required, depending on where you wish to work. If you decide that you want to pursue an additional degree, you do not have to stop working and go back to school. Numerous executive master’s degree programs are designed precisely for working professionals, and some of these programs are even specific to physicians.
Your medical degree is extremely valuable.
Even if you are leaving healthcare entirely, your medical training is a valuable asset. It taught you how to communicate. It taught you how to work as part of a team. It taught you sympathy and empathy with others, and it taught you how to work with people in crisis. It gives you credibility in a variety of settings, because physicians are known to be intelligent, capable, goal-oriented people who are willing to work hard.
Your new role can enhance your sense of professional and personal fulfillment.
A nontraditional job, whether pursued instead of, or in addition to, clinical practice, will teach you new skills and utilize skills that have long lain dormant. Dr. Tsen commented that it is “nice to know you can do more than just medicine and discover other skills you have outside of doctoring.” And Brian Byrd, MD, echoes that his role as an executive pastor “allows me to use gifts that don’t get exercised during clinical practice.” Clydette Powell, MD, said she is “challenged in a positive way to search for…solutions.”
In addition to the professional fulfillment, Dr. Cardell summarized the difference her career change has made in her personal life: “I have more time with my children, more time to take care of myself and be the example I like to be for my patients. My marriage is better than it’s ever been and I LOVE motivating people to be healthier. I feel I am working at the opposite end of the spectrum than I was working before.”
Your ultimate goal is to further God’s kingdom.
In their most important advice, 100 percent of our participants noted that they made their career changes as a result of God’s calling in their lives. They said their ministry is different from what they had in full-time clinical practice, but they continue to minister to those around them. Their jobs are platforms for their lives as Christians, just as their practices were. Some even said that they have more opportunity to minister in their new roles.
As you evaluate your career options, be mindful of God’s guidance. How has He gifted you? How can you use those gifts to glorify Him? What are your motives—are you running away from something, or are you running to something better? Where can God best use you to further His kingdom?
CMDA’s Senior Vice President Gene Rudd, MD, found that God’s guidance crystallized as he grappled with these issues during his career transition: “For months I was reluctant to consider leaving clinical medicine, thinking God had placed me there for ministry. He had placed me there, but it became clear that calling had come to an end. He used the transition to grow my faith. I had to be willing to ‘turn loose’ of what I had in order for Him to show me the next step—not knowing the destination, but trusting that He knew where to lead me.”
As Christian healthcare professionals, God promises to direct our steps, even as we are making our own plans. As Proverbs 16:9 says, “In their hearts humans plan their course, but the Lord establishes their steps” (NIV 2011). Despite the changing healthcare landscape and all the swirling questions, that reassurance is more than enough!
Editor’s Note: Dr. Galbreath presented pieces of this research and material at both the 2014 and 2015 Women Physicians in Christ annual conferences, and both sessions were highly received by attendees facing the same problems of burnout, dissatisfaction with healthcare and others. For more information about Women Physicians in Christ, visit www.cmda.org/wpc.