When You’re “Really Anxious to Get Out of Here”

A physician with whom I’ve been corresponding for some time sent me a two-page email the other day outlining seven different career alternative options he was entertaining ranging from a leadership role at a major medical center (where he recognizes a significant cultural difference from what he is used to and espouses) to life science entrepreneurship (where he knows he’d have to put in 2-3 years to earn credibility) with stops along the way like medico-legal work or joining the federal government.

He ended his email by saying: “I’m really anxious to get out of here…”

Here’s a lightly edited and slimmed-down version of the major themes of my reply:

“Thanks for your update. Well, you are certainly getting a birds eye’s view of the challenges of setting a new career direction. It’s not an easy process under the best of circumstances and your travails underscore the message I make most frequently to others – if at all possible, make your current situation/circumstances work.

Some specifics:

1. The degree to which your urge to move away from is >>> than the urge to move towards a particular new career option would concern me. Generally speaking, the odds of success are low if the primary driver is ‘from’ not ‘toward’. There’s no value judgment on my part about your motives here, just my experience as to what works and what does not.

2. Being a physician leader is enormously challenging, irrespective of the size, prestige or prevailing culture of the organization. If you can size up major hurdles as a job candidate then your instincts to take a pass are likely sound.

3. Your instincts that opportunities with other groups, e.g. in Life Sciences Entrepreneurship, would develop over a few years is correct. Non-physicians are a bit skeptical of the physician wanting to dabble and not being cognizant of the challenges and uncertainties of business. You earn your chops here by putting in your time, consistently networking, sharing your ideas and expertise gratis, and by being affable and amenable.

4. However frustrating it may be to hear it, you have significant domestic constraints with children to feed, clothe and educate for years to come. Thus, you must be prudent in not sacrificing your current position until you’ve secured a well-defined alternative. In the time we’ve been corresponding, you’ve never really convinced me that there are better options out there, that after an initial period of relief you’d not be back in the soup again.

Getting a New Career by Degrees

I’m frequently asked about the value of physicians acquiring additional degrees in advancing their career prospects. The short answer: It depends.

Fundamentally, we are programmed in our profession to place a high value on professional qualifications. I’m struck though by the number of physicians who hold degrees such as an MBA or JD and do not use them. While having an extra piece of paper is nice, it sure is a lot of work if you do not put it to use.

So, when asked this question, I emphasize the following points:

* First, be sure that you want to move away from a major focus on patient practice.
* Your primary value to an organization that is recruiting you is almost certainly your medical degree. An additional qualification is secondary; nice, but not essential.
* There are scores of very sharp business minds in every arena of health care without degrees other than their medical degrees. The more you stay in the mainstream of healthcare, the less value there is in an additional qualification.
* Getting an extra degree takes a four-letter word. That’s . . . . . work.
* Don’t presume it will be a piece of cake just because you have a medical degree. There may be more than one reason for economics being called the dismal science.
* As a general rule, the younger you are, the more value there is in getting an additional degree. Typically, the impact on personal and family life is less as it may represent a continuation of the educational path you’ve just been on. Moreover, because you may be coming to a decision to adjust your career focus earlier than most, there is greater potential that your nature is to modify your career path more than most of your peers.
* If you want to work at the interface of medicine and the law, you need a law degree.
* An MBA is a general business degree. You need to think of it a bit like your medical degree. The day you graduated from medical school, people were not knocking on your hall door looking for you to deliver their babies or put in an artificial hip.
* Degrees like MMA (Master of Medical Management) or MHSA (Master of Health Services Administration) may be thought of as MBA equivalents focusing primarily on the healthcare industry. Within the walls of the healthcare industry, they do not differ in value from an MBA. Outside of those walls, that is not the case.

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