Friendly Theme

Hey all, I’ve updated the theme used here at MedSchoolHell.com. I know there were some problems with the old theme, particularly with Safari-based browsers (Safari, Chrome) rendering comments in an all-too-fucked-up manner. That should be fixed now.

I’m keeping it simple as I want to focus on the content without the flare. It’s still incomplete at this stage, but I’ll get it finished at some point. If shit looks crappy in Internet Explorer, it’s because you suck. Get a real browser, please.

Just giving a heads up.

Non-Clinical Opportunities After Medical School

This is a guest post from Dr. Kim, who writes for Non Clinical Jobs.

If you hate medical school, but you don’t want to quit, then maybe you should consider a non-clinical career after you graduate. I get asked about this all the time. Over the years, I’ve had a chance to meet different people working in various companies and industries.

First, ask yourself what you enjoy. After all, if you don’t enjoy clinical medicine, you don’t want to end up doing something else you’re not going to enjoy. Then, start networking like crazy. Leverage all the online social networking sites (like LinkedIn, Facebook, Plaxo, etc.) and get reconnected with old colleagues, classmates, and friends. Find out what people are doing. They may help you get connected to some key people. You may find some of the best opportunities this way. If you’re a woman, you may want to check out MomMD (www.mommd.com) and join a community of women who are seeking non-clinical opportunities ranging from part-time to full-time work.

The following list of opportunities is clearly non-exhaustive and many of these areas have significant overlap. This list is based on my personal interactions with people in these roles and as I meet more people, this list grows.

Here is my growing list of non-clinical opportunities for medical school graduates (not in any particular order).

1. Healthcare administration, medical management, hospital administration, managed care – Are you a seasoned healthcare executive? Do you enjoy making administrative decisions? Then join the American College of Physician Executives (ACPE) and run a hospital or a managed care organization. If you have a strong interest in managed care, then check out the NAMCP (National Association of Managed Care Physicians). You may want to get an MBA or an MMM (masters in medical management) if you don’t already have one. An active US medical license is required for most (if not all) of these positions, so plan to do your residency.

2. VC (venture capital), finance, Wall Street, market research, etc.- Got an MBA? If not, are you thinking of getting one? Some will argue that once you have an “M.D.” after your name, it may not matter as much where you get your MBA. However, I would argue that your MBA is your path to networking opportunities, so where you get your MBA is critical if you want to have a solid network. Once you get your MBA, you can work for venture capital (VC) firms, dig into market research companies, or work for Wall Street. Heard of the Gerson Lehrman Group (www.glgroup.com)? No clinical experience necessary for many of these opportunities, but it’s always helpful so that you can effectively communicate with KOLs (key opinion leaders) in the field. Many joint MD/MBA students have ventured directly into very successful careers this way. Also, an MBA is not necessary if you have some good business skills and understand the healthcare industry. You will need strong people skills and a willingness to work long hours.

3. Writing and medical communications (includes promotional education, certified CME/CE, consumer health education, and much more) – Do you enjoy writing? Many physicians and non-physicians have very successful careers as medical writers. The field is open to people who enjoy fiction writing, publications, research, or other types of writing. You can get involved working on journal publications, developing promotional content for marketing campaigns, or developing CME programs. Join the AMWA (American Medical Writers Association) and look for opportunities. You can work from home as a freelance writer and have a very flexible schedule. Or, you can work for a publisher or another type of healthcare communications company. You can find a list of some companies by looking at the North American Association of Medical Education and Communication Companies, Inc., (NAAMECC) website. No clinical experience / residency necessary for many of these types of opportunities.

4. Technology and Informatics (health information technology, healthcare informatics, EHR/EMR, PHR) – Want to develop or improve an electronic health record (EHR) system? Do you love informatics? Then join the CCHIT (Certification Commission for Healthcare Information Technology), the AMIA (American Medical Informatics Association), and the AHIMA (American Health Information Management Association). Clinicians use EHRs and patients (or consumers) use PHRs (Personal Health Records). There are many companies attempting to integrate the data between PHRs and EHRs. There is a national initiative to improve and standardize public health informatics, so now is a great time to enter this industry. No clinical experience necessary (but is always helpful), and you should be familiar with ICD, CPT, and other billing codes used in this industry.

5. Disease management, Personal health record (PHR) – Managed care organizations (MCOs) are always looking for better disease management (DM) programs for their plans. Some MCOs develop their own DM plans and others outsource them to external companies. These companies create and deliver various services to managed care organizations, including DM, wellness programs, personal health record (PHR) services, etc. Do you ever get educational pamphlets from your own health plan? Who puts them together? Who designs and develops these wellness and preventive health programs? It’s not always WebMD. There are other companies that provide similar services.

6. Pharmaceutical/Biotechnology/Medical Device- If you’re a medical specialist, there are many opportunities to do research for these companies. If you don’t enjoy research, then you can develop marketing strategies. Direct-to-consumer (DTC) advertisements have become very popular these days. See all those ads in the medical journals? Get ready for that “corporate America” lifestyle if you plan to venture into industry. You may be working even more hours and carrying a Blackberry instead of a pager, but if you climb that “corporate ladder” and play the corporate game, you may qualify for an early retirement. Young people who are fast learners may be very aggressive and advance rapidly. Be prepared to have a younger boss if you’re a seasoned clinician.

7. Independent medical examiner (IME), Expert witnessing, and Legal medicine – Personal injury, medical malpractice, nursing home care, etc. There are firms that specialize in specific areas (like nursing home cases). Want more information? Join the American College of Legal Medicine (ACLM). You can also become board certified by the American Board of Legal Medicine (ABLM). You’ll need an active medical license.

8. Public health, population health, health policy, and government health – Get an MPH, join the APHA (American Public Health Association), and find a local health department. Or, join the CDC and travel the world. Develop strategies to improve population health. Some pharmaceutical companies also have public health sections and are very devoted to public health and international health (Pfizer in particular comes to mind). Bridge gaps in healthcare disparities. Work for the FDA or a state or local health agency.

9. Consulting – The world is open. Want to work for yourself or for a company? Many healthcare companies are looking for experts to help them develop, refine, and improve their products and services. It may be hard to get started unless you’ve already established connections. Once again, social networking becomes critical. Your initial success will depend more on who you know.

10. Research – Academia vs. private vs. industry vs. CRO. You don’t have to go into industry to do research. Look for a Contract Research Organization (CRO) in your area. Join the ACRO (Association of Clinical Research Organizations). You may want to look at PPD (no, this is not the TB skin test). PPD is a large global CRO. Of course, there are also many other CROs.

11. Executive recruiting, search firm, headhunting, human resources – Physicians can work as an executive recruiter to hire and place other physicians. You can also work your way up and manage other recruiters who do the hiring. Remember, these ‘head hunters’ get paid a commission based on the salary of the person they place. The $ earning potential can be tremendous if you’re successful.

12. Start a company – Have an innovative idea? Start a company! New companies seem to be sprouting all the time. Stay connected with people and keep your eyes open for new ideas. Get an MBA and meet people who can help you get a concept off the ground.

Not sure where to start? As I mentioned above, start building your social and professional network. Reconnect with people and ask many questions. Find people who are in various positions and ask them what they like/dislike. Join some associations to build your network and to find companies. Note that some associations are specifically for physicians, but many are open to all types of healthcare professionals. Also, even those that are specifically for physicians (such as the ACPE) offer affiliate memberships for certain non-physicians.

The Obama Deception – March 15th, 2009

Squeezed By The Man And Closing Up Shop

A St. Petersburg neurologist is closing up shop. Why?

After 17 years as a neurologist and part-owner of a private practice in St. Petersburg, caring for patients with everything from migraines to multiple sclerosis to massive strokes, the bottom line showed that his earnings were half what they were six years ago. And he saw no signs of a turnaround.

This isn’t a problem unique to only neurologists, either.

An article in the Feb. 12 issue of the New England Journal of Medicine said the percentage of specialists in independent practice has declined 18.6 percent since the mid 1990s. Primary care doctors have also been migrating to larger groups or jobs as employees of hospital systems or HMOs.

The days of hanging a shingle and practicing independently are having the final nails drove into their dusty coffins as we speak. Now that Obama is in office and spouting “reform” everytime you turn around, I certainly see physicians making the transition from entrepreneur to (underpaid) employee in my crystal ball.

Dr. Franklin’s son speaks up in the comments on the article. I like what he has to say:

As Dr. Franklin’s son, I would like to speak from our personal perspective on his issue. Firstly, my father always wanted to teach. Secondly, he never cared about the money; we live well even with the pay cuts. This article is not about money.

Also, in reference to other doctors, this mass exodus of Florida’s healthcare is a byproduct of all of the legislation against them that YOU, THE PATIENT, supported. It’s a two way street whether you like it or not. Also, I’m becoming a lawyer.

Going to school for 8 years and another 3-7 years of postgraduate training to work for the government just doesn’t seem right.

But, I do think that’s where it’s headed.

Third Year

The following is contributed by Cousin Throckmorton.

When will it end?
Between the boredom
And bourbon
I haven’t much left

Empty
Hours
And hours
Of dry books and disappointed looks

Of diabetic feet and discharge sheets

Wading through patients
And patience
Knock kneed and faceless
From hackneyed cases

A doctor
Of guile
Hiding behind false smiles
Sweating away my soul
Into a day old shirt

I’m sinking
Gradually
Then suddenly
I haven’t much left

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