Visionaries and Educators

When you must shutter your practice

Injury, unforeseen life change, whatever the situation might be; you are no longer seeing patients. What to do? Read on.

By Guy M. Kezirian, MD, MBA, FACS

The scripted life of a physician can make the transition from medical practice to another occupation unsettling, even unnerving. Our training makes us experts at basically one thing: practicing medicine.

But, whether by choice or due to disability or other circumstance, physicians who leave the practice of medicine before it is time to fully retire can find themselves wondering what to do.

While treating patients is at once rousing and exacting, we generally follow a well-charted course to get to that point. Medical school leads to board exams, (passing boards) leads to internship followed with more boards, residency follows with yet more boards and then into practice. Show up to work, treat patients, go home, repeat the process. It is not an easy life but we generally understand the broad outline — it’s those details we love — and we do it well.

Life after practice is quite different.

ONE PROVISO

For one, it is not predictable. There is no predefined path to specialization, and there is no straight line course to success. Yet opportunities abound. Physicians have so much to offer, particularly when they also appreciate and understand the perspective of their clients. Industry, consulting, research and development, sales and entrepreneurship are all eager to work with physicians, but with one proviso: The physician must speak the language of business.

Business education is fundamental to many pursuits, yet most physicians have woefully little business training. For some, the very idea of learning business is terrifying. The administrators and executives who use business jargon to exert control over physicians have successfully intimidated some doctors into thinking business is complicated.

Business is not complicated. The concepts are commonsensical, the technical aspects stray seldom beyond Algebra 1, the reading can educate and many concepts seem obvious – once they are explained.

I earned an MBA later in life, and these points struck me:

1. Business training goes beyond accounting and finance; it includes leadership, negotiations, operations, marketing, organizational change, strategy and other subtopics.

2. Business concepts are not hard to master and are universal in their application.

3. Most business programs take an excessively long time to complete.

The third issue is a problem. Whether practicing or seeking to start a new career, the time-consuming nature of business programs presents a barrier to entry for physicians.

So I started the PHYSICIAN CEO program at the Kellogg School of Management at Northwestern University. We designed it specifically for physicians, so it overcomes the time problem. This program offers accelerated business training in four, five-day modules spaced over nine months, and participants leave the program with their go-forward plan. Each module is dedicated to one topic (for example, procedure pricing models; leading highly effective teams; and strategic talent management.

DOWN WITH BARRIERS

Trying to learn business from a book is tedious and inefficient, and the online programs can be similarly mind-numbing. The best way to learn business is in person, and at a top-ranked school. The reason: the best schools provide a more engaging experience.

Kellogg is consistently rated at the top for executive education. Physicians are often surprised to learn that business school curricula are not as consistent as medical school curricula. While all business schools offer the core topics of accounting, finance, operations, marketing and so on, most have an area of emphasis that forms the basis of their reputation. I approached Kellogg because it emphasizes a positive, “grow the pie” approach to business that is very consistent with the values of most physicians.

OTHER AVENUES

Many physicians have successfully made the transition from practice to new careers. I have done it, and many others have as well.

Here are specific tips to help you, based on real-world experience:

• Deal with the emotional issues first. Some physicians who choose to leave practice may be happy to leave, but for those who can no longer practice due to disability or other issues the change can be accompanied by a profound loss of self-worth. It is important to acknowledge the emotions and manage them in a productive, positive way. As physicians, we have a lot to offer and the question is not what you will do next, but what you will choose to do from among many options. Focus on the opportunities and the future, not the past.

• Take an inventory of your skills and talents. For most physicians, medicine is our most highly developed skill. To leave medicine entirely would be to throw away years of training and experience. Your background provides a strong foundation, and you should take advantage of it. Expertise in one area does not convey to other fields; a highly trained physician is a neophyte in law or business. Find a way to apply your medical knowledge and experience in other areas.

• Don’t wait to make yourself attractive to businesses. You must understand the language of business to participate. Put aside any concerns you have about learning new skills, and jump in.

Consultants can only contribute when they understand the businesses that need help. Many physicians may have entrepreneurial ideas, but most lack the skills to put them into play.

Business training is an asset to any physician and is particularly valuable to those who want to work in the business of medicine outside of practice.

Other opportunities exist for physicians with clinical expertise besides consulting and working in business:

• Teaching can provide a very satisfying career path for nonpracticing physicians. The remuneration is generally less than in business, so those who want to teach should consider working with medical device companies to train their colleagues to use new technologies. Business training is vital in this setting as device companies are financially driven.

• Hospital administration work is another field for nonpracticing physicians, particularly in settings that value physician leadership. Again, business training is a prerequisite.

• Physician expertise is valued in clinical trial work. Rewarding positions are offered at many large pharmaceutical and medical device companies. It can take time to learn the ropes of clinical trial administration, but the work is interesting and there are opportunities to make significant contributions.

Many physicians find rewarding positions after medical practice. Physicians who have some years of practice experience are generally more valuable than those who do not. Consider your expertise, your skills and your experience as the foundation of a new career, and seek whatever training you need to succeed in that career.

I am happy to speak with any colleague who is seeking a new challenge. Feel free to contact me. OM

Guy M. Kezirian, MD, MBA, FACS is a board-certified, nonpracticing ophthalmologist living in Scottsdale, Ariz. He is the founder of SurgiVision Consultants, Inc., which provides regulatory, consulting, software and educational services in ophthalmology, including the PHYSICIAN CEO program in collaboration with the Kellogg School of Management at Northwestern University (PHYSICIAN-CEO.com). You can reach him at Guy1000@SurgiVision.net.