The title of this post is intended to have two meanings. Any manager, leader, or executive generally finds that there is rarely growth without discomfort. Growth and discomfort (sometimes outright pain) are usually linked. It also indicates that this blog itself is due for some growth.
When I jumped in and took my first executive position as vice president for medical affairs, it began a period of growth that I had not experienced since medical school and residency.
During that time, I was constantly feeling a sense of discomfort. I was only partially prepared for my new role. The experiences that felt especially uncomfortable were:
- Being the outsider at meetings with the CEO and other members of the executive team, who had worked together and met weekly for years before I joined them;
- Learning to interact with, support, lead and inspire the directors who actually ran my division;
- Accepting full accountability for my own performance and that of my division; and,
- Understanding and embracing budgets.
When considering a career pivot, mentors and advisors often include an admonition to follow your passion as a key piece of advice. After all, following one’s passion means that you will stick with it. You won’t easily be swayed from working on something you’re passionate about, so you’ll see it through, even when there are big challenges. To do otherwise would seem to be unorthodox career advice.
Besides, numerous surveys of, and interviews with, successful business leaders and entrepreneurs report the importance of following one’s passion.
But there are two serious statistical concepts at play that place such advice on shaky ground.
The first is that correlation does not equal causation. To the contrary, it’s quite possible that success fosters passion. It’s perfectly logical to become passionate about a career that has brought fame and fortune.
The second is survivorship bias. Yes, a high percentage of successful persons declare that passion was responsible for their success. But for every successful business owner, there are often many unsuccessful business owners.
About 60% of new restaurants fail within 3 years. Most of the founders were probably passionate about starting a restaurant. But if they were all passionate when they started (including the failures), then the correlation with success is zero at best.
Yet we never hear from the unsuccessful business founders or career seekers. Who would interview someone about being a failure?
So, the presence of passion itself probably does not correlate with success, just as the TV show American Idol has demonstrated that passion for singing does not correlate with the ability to sing well.
About a year ago, I wrote about the need for a business degree. In my post, I listed Four Reasons to Seek a Business Degree. Since then, I have witnessed some of my colleagues enroll in MBA programs. All healthcare organizations benefit from owners or leaders with knowledge of business principles, including private practices. Is it time for you to pursue a business degree?
I am re-posting the material from my previous article. However, I am adding 6 additional benefits completing a business degree provides.
More physician leaders have recently acquired an MBA, MHA, MMM or MPH (an MPH is not actually a business degree, but a significant number of physician executives have one). A business or management degree is definitely not a requirement for a career as a physician executive.
There are many successful physician leaders without such a degree. There are numerous physician CEOs, working in hospitals, insurance companies, medical groups and nonprofit organizations who don’t have one.
However, if you have not already graduated from one of the 65 joint MD/MBA programs, then you will likely consider obtaining it or a similar degree after completing residency. Pursuing such a degree is a big commitment. The costs will run into the tens of thousands of dollars. It will require hundreds of hours of study and up to a three-year commitment to complete.
I am sometimes asked: what does a CEO look for in a CMO? I’ve heard this discussed at the American Association for Physician Leadership (AAPL) meetings and American College of Healthcare Executives (ACHE) meetings, and it was a topic of discussion during the week-long tutorial for the Certified Physician Executive (CPE) qualification. I’ve looked at dozens of job descriptions which also provides insight into identifying the essential abilities the CEO wants in a Chief Medical Officer.
There is no one set of skills or abilities, of course. Each organization and CEO will be looking for a set of skills to meet its unique needs. But there are some common themes.
After the hospitalist movement began, it wasn’t on the radar at our 300-bed hospital for many years. Robert Wachter and Lee Goldman made the case for dedicated hospital-based physicians years earlier. And as DRG payments failed to keep up with inflation, and inpatient care became more complicated and costly, it seemed our medical staff was not becoming any more efficient with inpatient care.
I recently read the book Pivot: The Only Move That Matters Is Your Next One, by Jenny Blake. It presented a model for career transformation that can be applied by clinicians seeking to move from patient care to an executive position. In the paragraphs that follow, I am going to explain how her pivot method can help you launch a new career as a healthcare executive.
What is a Career Pivot?
The author defines a career pivot as “Doubling down on what is working to make a purposeful shift in a new related direction…an intentional methodical process for nimbly navigating career change.”
In Blake’s book, she notes that most career paths consist of a series of pivots. Based on her work as a career development professional for Google, her book provides many examples of career pivots. Many involve pivots to entrepreneurial ventures, but some also involve pivots within an organization.
I was about 5 years into my medical career. It was a busy and exciting time. I finally felt confident in my clinical skills and I was ready to immerse myself in a new subject matter. I had not yet considered a management career.
My partners and I had started a pension plan and we were making regular contributions. But none of us really knew how we should invest our contributions. I realized that I needed to learn about investing.
I needed to go through a crash course on mutual funds, stocks, bonds and asset allocation. And the Internet did not exist, so there were obviously no blogs like White Coat Investor, Physician on Fire or Future Proof MD to read.
So, what did I do?
A common question arises when considering a career change to a non-clinical position. If you’re seeking work as an administrator, you may be thinking: “Will I need a business degree?”.
It seems that more physician leaders have an MBA, MHA, MMM or MPH (an MPH is not actually a business degree, but a significant number of physician executives seem to have one). A business or management degree is definitely not a requirement for a career as a physician executive. There are many very successful physicians, including numerous CEOs, working in hospitals, insurance companies, medical groups and not-for-profit organizations.
If you have not already graduated from one of the 65 joint MD/MBA programs (referenced here) then you will likely consider obtaining it or a similar degree after completing residency. Pursuing such a degree is a big commitment. The costs will run into the tens of thousands of dollars. It will require thousands of hours of study and preparation, and up to a three-year commitment to complete.
I was very anxious to hear the results of the election. I was nearing the end of my second year of family medicine residency. I had adjusted to the stress of changing clinical rotations every 4 to 8 weeks. I was starting to feel more confident with the clinical material.
But I was drawn to leadership opportunities. At our program, the chief resident was elected by the other residents. I “ran” for the position against one of my good friends in a low-key, respectful race.
I was very pleased when the residency director announced that I had been elected to the position!
I enjoyed attending the meetings with residency leadership, contributing the residents’ perspective to important conversations. I took on additional work planning events. I updated manuals and created a more comprehensive list of elective rotations available to the residents.
I had no inkling that these pursuits would be repeated later in my career. At the end of my residency, my only concern was to find a good position with a small independent family medicine group. I wanted to continue to hone my medical skills and practice family medicine, including obstetrics. I did not give any thought to being involved with management or leadership.
Eight years later, I started a process that would lead me to a full-time non-clinical position as a hospital executive.
You’ve done some soul-searching. You’re thinking about a non-clinical career choice. You’ve tried to address overwhelm and burnout, perhaps utilizing resources such as:
You’ve come to the conclusion that you want to remain in healthcare, but not in direct patient care. What are your options?
There are numerous alternatives for physicians like us seeking a non-clinical career. We don’t have to abandon our calling to serve patients. We can still apply much of our knowledge and experience in a meaningful way that still challenge and excite us.
Those of us that elect to pursue a non-clinical career usually do so because we are pulled by the of excitement of doing something new AND pushed towards it by the pain of our current situation.
The push often comes from the frustration with practicing clinical medicine:
- Endless paperwork
- Fear of litigation
- EMRs that add more expense and more waiting with little to show for it
- Non-compliant, entitled patients that blame us for the results of their self-destructive behaviors
- Unreliable employees
- Declining pay
There are numerous books and articles written about physician burn-out (for example: Stop Physician Burnout: What to Do When Working Harder Isn’t Working. and Remedy for Burnout: 7 Prescriptions Doctors Use to Find Meaning in Medicine ).The above list is just a sampling of some of the factors that contribute to it.