Considering a Career Change? Going Nonclinical May Be the Right Path

Andrew N. Wilner, MD

Disclosures

July 03, 2019

If you're a physician who has come to a fork in the road of your career and are considering a move into a nonclinical role, John V. Jurica, MD, MPH, has some advice for you. Jurica made the move from practicing physician to medical director for PromptMed Urgent Care in Waukegan, Illinois. On his blog (VITAL Physician Executive) and weekly interview podcast (Physician Nonclinical Careers), Jurica highlights the ways he and others have successfully made the transition to a nonclinical career. Medscape contributor Andrew N. Wilner, MD, recently spoke to Jurica about his work and the reasons behind his career decision.

Making the Pivot

As someone who has balanced working as both a writer and a neurologist, I have a soft spot in my heart for nonclinical careers. Can you tell me a little bit about your background and how you pivoted toward a nonclinical career?

If you have a medical degree, particularly if you have also some clinical experience beyond that, then you have a lot of really good skills that can be valuable to many employers.

I took kind of a safe, slow route. When I was practicing as a family physician, I became interested in management and projects. I noticed that the hospital that I worked at didn't really have any physician leadership beyond an informal medical staff.

I was able to take some classes and learn about management and business. I then approached the chief executive officer and said, "Do you need a vice president for medical affairs?" He said yes, and I took that job part-time, for about 70%-75% of my time. I was still practicing clinically, but then gradually I completed that pivot and became a full-time chief medical officer, senior VP at that hospital.

What was your attraction to a nonclinical career?

My reason was that I loved quality and working on projects where I could impact thousands of patients rather than just the patients I was seeing on a one-on-one basis. Family medicine can be a little tedious at times, but helping 100, 500, or 1000 patients reduce their mortality and morbidity, and ensuring better services in the hospital, was very attractive.

Sometimes when you're in the clinic and can only see one patient at a time, at the end of the day you look down and ask, "What did I really accomplish?"

I remember there was a physician, Don Berwick, who ran for governor of Massachusetts. Part of his justification was that he could scale up his willingness and ability to help people, because it's at the state or federal level where budget decisions are made that affect Medicaid. With stories like that, you're suddenly reminded that being an administrator—which is close to a four-letter word in some people's minds—can actually be a very positive, caring profession.

Absolutely. Like in my case of being a hospital executive, I could impact a lot of patients. Really, the best hospital systems in the country are run by physicians. There's just something about that patient-physician relationship that can translate into knowing how to run a healthcare organization. I think we need more physicians doing that.

Why Physicians Go Into Nonclinical Fields

I've noticed a big interest among many physicians in moving toward nonclinical careers. Is this a case of them being dissatisfied or burned out, or is it more about people who maybe think, I'm kind of entrepreneurial at heart and my current practice is very narrow?

Oh boy, I've heard so many different reasons for that from people I've interviewed. Many of us have spent so much time getting our degree and completing our residency, that we're so far removed from when we made that decision and our motivations and priorities have changed. Then when you throw in some of the boredom, disillusionment, and even the burnout that some people experience, it just makes sense.

But then there are many others who really just found, after getting into clinical medicine, or even after just finishing medical school, that they really don't like seeing individual patients one by one and working clinically but don't want to abandon their medical education and career. If you have a medical degree, particularly if you also have some clinical experience beyond that, then you have a lot of really good skills that can be valuable to many employers, or even as an entrepreneur.

And there's a huge demand for physicians who want to make that pivot, with so many career options waiting out there.

I'll be giving a lecture next week to residents about career options. As part of that, I put together a slide presentation on the list of job options available in 1989, when my official career started, and their job options in 2019. Their list is a lot longer.

Beyond all of the subspecializations that are going on now, you also have a need for physician leaders in almost any healthcare-related industry. There's a belief that you get more engagement by physicians clinically if you're an organization that has more physician leaders. Plus, the federal government has laid on all of these regulations and requirements, from utilization management to coding and documentation to you name it. Physicians are needed as experts to connect clinicians with those sorts of nonclinical aspects. So the demand for these nonclinical careers is just growing almost exponentially.

Physicians Helping Physicians

You just returned from a meeting on this very topic. What was it all about?

That was a meeting put on by Dr Michelle Mudge-Riley, who has a company and a website called Physicians Helping Physicians. This was its first-ever networking meeting, which was designed to bring together physicians who wanted to learn about a career change, for a variety of reasons. We had a good mix of people from all across the country who were there to talk to physicians who had pivoted to a new career and to learn more about how to do that, and maybe even to find out what different careers were available.

What kind of topics did the meeting cover?

It fell into four major categories. First there was the general setting of the stage, with mindset issues like overcoming self-limiting beliefs. Then there was a focus on foundational skills, like how to write a résumé, how to interview, and even how to use LinkedIn most appropriately to find that new position. Then there were courses and workshops offered on some very specific topics, like how to go into utilization management, informatics, hospital leadership, or pursue entrepreneurial opportunities. Last, we had some talks that were really beyond these traditional career opportunities, like how to brand yourself, become a TV personality, or run a podcast. It was a good mix of very specific and more general sessions.

What did you personally speak about?

I was involved in three sessions, but the one that I spoke about alone was how to move into a hospital management career. I discussed some of the courses and resources you could use to improve your knowledge and skills, how to do some volunteer activities, and those sorts of things, to get some real experience before actually moving into an executive role. Most physicians go on to serve in a medical director role first, and then they'll move into something like a VP of medical affairs, chief medical officer, or chief quality officer, which is a big one.

You've developed a very broad perspective on this issue. What are you doing now?

I'm still working a little bit clinically, which I had previously stopped. Now I'm doing 8 days a month, so that's enough for me clinically, given that I'm the medical director for an urgent care center.

I also spend a lot of my time producing a podcast, in which I primarily interview physicians who have made the career change, or coaches who work with physicians pursuing career changes. The reason I started the podcast was to be able to learn about physicians making that pivot. I'm still learning.

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