Female Physicians on Creating Alternative Career Paths

Stephanie Cajigal; Jessica Freedman, MD; Farzanna S. Haffizulla, MD; Pamela L. Wible, MD

Disclosures

April 03, 2015

Medscape: What's it like being your own boss?

Dr Freedman: I love being my own boss; it works well for me. In some ways, it is very demanding. Basically, I never have a vacation or a full day off, because I must always be available for "client emergencies" and to help navigate administrative problems when they arise. I have also had to learn a lot about many other fields related to business in which I had no formal training or education.

Being a business owner is similar to being a private practitioner. There are positives and negatives. However, being able to make my own schedule is something that appeals to me.

Medscape: What's a typical day like?

Dr Freedman: A typical day is similar to what I experienced in medicine. I must balance client appointments, writing, editing, administrative duties, family responsibilities, and unexpected client needs.

Medscape: Is this type of flexibility impossible with an academic position?

Dr Freedman: Because of the advent of the Internet and because so much work can be done virtually, if you have innovative and flexible leadership, it is possible for women when they are not seeing patients to do work on their own time, after the kids are in bed. This is especially critical for the academic setting, because only part of your work is actually in the clinical arena. You are writing, you are contributing, you are teaching, you are mentoring. And there are so many different forums now through which you can do all of those things without actually having to be physically at the hospital or the medical school. I think that if women and men were kind of given those options, perhaps everybody would be more productive.

Medscape: When picking a future specialty or practice model, should med students take into account whether they want to have a family or not?

Dr Freedman: Absolutely. It almost seems obvious, yet I find that students don't do that. If you know that you want to be a mom, you need to go find a mom in the specialty that you are considering, and you need to find that person in the academic world and in the community as well. You need to ask them what the good things and the bad things are. Did you ever work part-time? For how long did you work part-time, and how did that work out? I think it's always important to talk to people who are 5 or 10 years ahead of where you are now.

Medscape: Why did you choose internal medicine specifically?

Dr Haffizulla: When I was training, I realized I loved all the specialties. Internal medicine gave me the opportunity to see every different disease process. It was exciting to be able to meld all of the symptoms together and get a diagnosis in place based on question and answer, physical exam, and so on.

Also, I liked the lifestyle that came along with it. I realized I could tailor my practice to accomplish everything to the best of my ability. My original interest of cardiovascular surgery would not have allowed me to do that. I would have been working at the beck and call of a beeper, and I really didn't want that lifestyle. We have four children now, but when I was pregnant with the first one, I was in medical school, so that really shifted my paradigm early on to go into internal medicine and not into surgery.

Medscape: How did you structure your medical practice to make your work schedule more flexible?

Dr Haffizulla: I started off in practice with my father-in-law and my husband. My father-in-law had a very well-established, full-time primary care practice. My husband and I met in medical school, and we ended up training together in residency so once we were finished training, we started off in his father's practice. I did that for about 5 years, and it was more of a traditional set-up. It wasn't something that melded with me; I called it "foot-traffic medicine." There was always the packed waiting room and a small amount of time to see everyone.

I just had a different mindset for how I wanted to practice medicine, so in 2008, I opened a concierge private practice. I take care of one patient at a time, and sometimes I do house calls, or oftentimes I will do a telephone consultation with my patient. If they can't get to me and I can't get to them, we have another means of communication. What is wonderful about it, of course, is me in charge of my own practice.

Medscape: How realistic is it to work part-time in medicine?

Dr Haffizulla: It depends on the woman and what is on her plate at the time.

It's also important to know that the practice of medicine does not just have to stay within the walls of a confined office space. You can do telemedicine or telephone consultations, you can do reviews, you can give your medical expertise. You have to think outside of the box and not just open the traditional medical practice; you have more options available than you realize.

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