The Event This weekend, I’ll be participating in a SEAK conference in Chicago on the topic of non-clinical career progression training for physicians. SEAK has been in business for 30 years, has trained over 20,000 people, and among them, over a thousand practicing physicians. The instructors have successfully migrated to non-clinical careers, the more common payer, provider, pharma, consulting and vendor sectors, but also to politics, government, finance, and the arts, literature, and recruiting worlds.
My Role I was on faculty last year and presented healthcare informatics career opportunities, with a focus on related corporate roles. My presentation incorporated notes and tips on the differences in skills, knowledge and talent required in HCIT as compared with clinical careers. Career management, including understanding and exploring opportunities, is more important than ever given that clinical careers are changing wildly. See Mark Hagland's excellent piece on this topic. My 2009 observations and related presentations are available here:Epic Career Moves - Step One (contains 2008 Informatics presentation by Dr Tonya Hongsermeier)Epic Career Moves - Step Two (contains my 2009 presentation)Epic Career Moves - Step ThreeSEAK 2009 observationsEpic Career Moves - Step Four - AMIA Edition (contains another presentation)This year, I’m honored to be participating as a mentor. I will be posting my observations after the conference.So, Why Did I Choose to Pursue a Clinical Career? My interest in becoming a physician followed a common theme during the 1970s. I was intrigued by the opportunity to have a career that concurrently combined a) problem solving in the scientific realm, b) helping people, c) having a high degree of workplace autonomy, and perhaps an implicit desire to d) achieve an extra measure of societal acceptance.Loved going to work: There are, of course, multiple ways to do any and all of those four. That said, my volunteer work at Maryland's Shock Trauma Unit during my undergrad program cinched it. I loved the drama, the acute care and the esprit de corps amongst the clinical team. I loved the patients and their families. In short, I loved going to work.The dark side of practice: But as I began clinical clerkships, as I did my residency and subsequent fellowships, I saw the huge, recurring problems. Things that should happen in a systematic, reliable fashion didn't always happen that way. There was a lack of integrated, clinical information systems, of course. There was also a lack of procedural systems. There were no checklists that were shared, performed as a group, or published as best practice. There was an absurd reliance on human memory and human tenacity. In short, I was uncomfortable going to work, in part because I wasn’t confident the delivery systems where I worked could function reliably. Every time a patient took an unexpected turn, I asked myself, as every physician does, did I miss something? There was no safety net.The world changes: Also, the external world changed. Economically sustainable career paths, like buying into a clinical practice, or pursuing academic tenure were problematic for many physicians five to ten years ahead of me on their career paths. Reimbursements in primary and non-procedural specialty care were making loan repayment precarious. And I'm not just looking at student loans; buying into a clinical practice in an era of rising patient migration to managed care clearly failed the business case test.A natural career move: With those drivers, clinical informatics was a natural career move. It allowed me to pursue contributing to building a highly reliable healthcare system. It also gave me the health and healthcare economics grounding to understand what kind of value I could generate, understand how it would be valued, and even if it would be valued in a fair and reasonable manner.You cannot focus on everything: At first, I did my informatics work while continuing to care directly for individual patients. After about five years of that, I realized I needed to make a choice between care management and direct patient care. Frankly, it was a hard and painful choice.Seeing Patients: There's a special daily pleasure that comes with successfully diagnosing and treating patients. I met with a dozen physicians at an ACP recruiting breakfast who were the "governors" from their states, most in their early to mid-fifties. The majority were no longer seeing patients. I was surprised.Proficiency? I also worked with a number of physicians who continued to see patients a half day a week in adult or pediatric clinics. They privately confessed that when one of their patients got really sick, they were referred to a physician who had more availability and relevant experience. And the clincher here was there was a relative glut of physicians with my credentials and experience in the geographic area (Boston) I needed to work. So there weren't a lot of practice opportunities.Second thoughts? I don't really have second thoughts about my decision to pursue a non-clinical career or my decision to go into informatics. I like what I do and the industry continues to evolve toward needing more clinically trained individuals who can contribute to evolving systems that coordinate care for all populations: chronic, as well as episodic diseases, wellness, and catastrophic illness.And, very sadly, practicing physicians often paint a downbeat picture of their clinical practices. They love the patient contact, but they're deeply frustrated by their care delivery system, or payers, or government programs, their immediate boss or executive team. Obviously, at least half of their frustration has absolutely nothing to do with clinical practice!Support sources: I received and continue to receive a tremendous amount of support for my informatics career. This is funny but true – one of my earliest supporters for a non-clinical career was my mother-in-law. She's a terrific, forward looking woman. The irony is that the conventional model had always been the pride of saying "my son the doctor" was trumped, even in the 1980s, by an understanding that healthcare information management was going to become important.In my training, undergraduate, medical school, residency, fellowships, public health school, and three corporations, there were always special people. Special people who recognized my interests and talents and often shared them. These folks validated and encouraged my non-traditional career path. Sometimes I sought them out, but more often than not, we met during the course of work not necessarily directly related to informatics.Career Stage Returning to SEAK, the physicians who attend are at various stages of their careers as they consider non-clinical career options. In my experience, nearly all of the conference attendees are in some form of clinical practice, and usually between five and 20 years into their practices. They are considering moving out of clinical practice because it's not satisfying them. In some cases, it actually is a midlife crisis situation. ( www.annbadillo.com/annscan/files/HBR-MidLifechange.pdf)Usually, their world has objectively changed; their family situation (e.g. empty nest) or work situation have evolved (e.g. compelled to sell their practice). They're either being forced to make some change, or appropriately fear that they will be, probably in the not too distant future.When Is a Career Change Not a Good Idea? When your frustration with your current career takes its roots from frustration with one individual, a career change should not be your first choice.
Whether it's your boss, business partner, or the CEO of your organization, situational pain stemming from one relationship should not drive career change. I bring this up because it's actually one of the most common drivers. Another consideration is the "good will" you have in your current organization. In general, you walk away from that when you change careers, especially if you relocate and/or change industries. A third consideration has to do with talent (see definition above). Unlike skills and knowledge, talent, by definition, is not something that can be acquired or trained. So if a contemplated career move is not concordant with your talent, don't do it. This may require some external assessment.
Good Career Hygiene
This requires periodically looking over the fence, considering new roles, and seeking appropriate opportunities. Conferences like SEAK can expedite the process, efficiently providing the knowledge and the networking to help you be even more successful, whether you ultimately stay or go.
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Epic Career Moves – Step Five – SEAK And You Shall Find
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Epic Career Moves – Step Six – "Many a false step is made by standing still."
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