Career Change Alternatives and Strategies for Physicians

As a career consultant, it's not unusual to hear practicing physicians casually or seriously verbalize thoughts about career or job change. The reasons are sometimes similar to those of professionals in other fields, such as feeling under too much stress, workload burnout, thoughts about entering the wrong field for the wrong reasons, financial issues, too much computer or paper work, boredom with the type of work they've been doing for so long, or illness and disability. However, among physicians there are some unique differences impacting on the motivation to actually follow through with changes. Physicians invest extensive effort, time and money to enter clinical practice. 
If you're a physician you may find increasing dissatisfaction with the profession due to changes in the medical system, increased non-clinical administrative requirements, payer issues, your compensation, or the business aspects of a practice; or you may find your work overwhelming and intrusive on living a more normal family life. You may find that you're not doing what you expected when you committed to the profession, but by that time you may have large loans to repay, business commitments, or you may feel locked into a status and lifestyle you can't realistically leave. Besides, you may have always found medicine a "calling"you can't ignore.

On the other end of the career spectrum, you may be considering retirement. However, as a lifetime physician you may want to leave the negatives behind, but not leave the profession altogether. You may need to cut back because of illness or disability, or you may want to pursue other interests. But, being a physician has been your life, you find most of your life meaning in your work, you may feel responsibility to long term patients and staff, you have high status in the professional and social community, your most meaningful relationships are among colleagues and in hospitals, and maybe nothing is realistically on the horizon to replace all that you would leave behind with full retirement. Not the least of this is your self-concept, or loss of what we term in my book (RELAUNCH! Stagnation, Change, and Renewal in Mid-Career and Beyond) the "paradigm of ourselves."

In providing career counseling to professionals and highly skilled workers, I generally encourage limited changes, when possible. In fact, using the 80/20 rule, small changes often lead to large results in what we are seeking. This is also consistent with what such workers, when seeing a need for change, often end up deciding to do with or without career counseling. Although a complete change of occupation is often a presenting interest, exploring options may suggest that the retraining, loss of income, changes in self paradigm and all other concomitant changes are unrealistic.

Alternatives requiring very limited changes exist for physicians by finding the right work environment in which to practice, or by using transferable skills. Environmental changes include finding jobs in a practice setting where the type of patient, culture, organization size, expectations, compensation or business arrangements are different, or by having the option of part time vs full time work. With the most limited changes, the clinical aspects of practice can also be retained. Alternate low-change clinical practice options can include locum tenens work, telemedicine, cash based fee-for-service practices, concierge practices, and limiting practice to alternate care settings such as nursing homes.

Common non-clinical jobs can still apply transferable skills, but usually require greater change and adjustment to new work settings, type of work, and industry, as well as some additional training and skill development. Examples include work for private companies or government agencies in pharmaceuticals and biologics, expert witness testimony, medical claims adjudication, medical education including academic teaching, healthcare management, and healthcare consulting.

Finally, there is a cluster of occupations that use transferable skills but typically require substantial new skills, business development, and/or a great deal of creativity and risk, before significant part time or full time income might be realized. These include developing and marketing online learning programs such as podcasts and webinars; physician coaching; public media appearances; medical journalism; medical language translation; work as a clinical librarian; researching, developing and selling medical devices; subject matter expert in development of medical information technology applications; and medical law. There is also the option of change in clinical medical specialty. This could require extensive time in training and practice to make the transition.

In some instances a complete change of occupations is the best option. This might occur when there is history of a strong hobby, business interest, or opportunity that is likely to offer greater personal and financial rewards than medicine. Other reasons for complete change include legal issues related to medical practice, and competence or personal issues that result in loss of license and damaged reputation. In some cases illness or disability may require a complete change, or  temporarily or permanently ceasing even part-time work. Some physicians seek Social Security benefits in these circumstances to provide a little financial assistance and early eligibility for Medicare. The above referenced book covers this in detail.

Some of the above change possibilities may sound foreign and not resonate as good fits. However, before abandoning the idea of change, consider this. Research indicates that work, including doing and thinking about it, typically takes up over half of ones waking life. For many physicians it's probably well in excess of that. If you are dissatisfied, making even a small change toward greater feelings of passion and meaning in your work can have a significant impact on your mental well being. In my book we show how mid and late career change decisions can be made using what we call the intersection principle. This requires enumerating your strongest skills and of those, the ones you find most interest in using. Then comes assessing the characteristics of your best-fit environment. In other words, what is most important to you where you do your work. Finally, look at the alternate job possibilities, including any you can creatively find based on the skills and the best-fit environment you identified. Then do some deep exploration of potential opportunities using those criteria. Don't eliminate the possibility of multiple roles and jobs. Only you can figure this out, but this exercise may lead you in the right direction to initiate at least a limited change.You will reach your "sweet spot" of passion and meaningfulness when your skills, interests, best-fit environment, and a career and job opportunity intersect. Over time adjustments will need to be made to maintain the sweet spot, but initially finding it is the first step in effective career and job change.

To find out more about the alternative careers and jobs discussed in this blog, as well as other issues regarding career change decisions, use the references below. For more intensive assistance with limited or complete career changes consider discussing your situation with a professionally trained career counselor or consultant who can help with finding the resources you need and with career decision making. As you narrow your search, informational interviews with physicians and administrators in your areas of interest will be helpful. If finances or loss of money through loans and past practice decisions is involved, consulting with a financial advisor would also be important.

References

11 Non-Traditional Career Paths for Physicians (12/13). Health eCareers.  https://www.healthecareers.com/article/career/11-non-traditional-career-paths-for-physicians

Galinskaya, E. (1/15). The Dangers of Alternative Career Lists for Doctors (1/15) https://www.linkedin.com/pulse/dangers-alternative-careers-doctors-lists-evgenia-galinskaya 

How to Handle a Career Change: A Definitive Guide for Physicians (7/19). Medpage Today.  https://tinyurl.com/yye2baro 

Rankin, L (2/14). 10 Alternative Careers for Doctors. https://lissarankin.com/10-alternative-careers-for-doctors 

Simon, S. (2018). RELAUNCH! Stagnation, Change, and Renewal in Mid-Career and Beyond. DocUmeant Publishing: New York. (https://www.amazon.com/dp/B07KJG5D8T)

The Workplace Experience Survey (2014). CoreNet, Global, and Solexo, LLC