From Lab Coat to Suit Coat

Joe Zebrowitz, MD, is like a lot of doctors. A science whiz kid, he ended up in a pre-med program before he knew what hit him. But unlike a lot of doctors, he made a courageous career leap from medicine to business - and he hasn't looked back. The 33-year-old former OB/GYN is now working as the executive vice president of Executive Health Resources outside Philadelphia.

Given the increasing dissatisfaction among many in medicine, he's not the first to consider a change. The benefits of a career in medicine can be hard to see when salaries plummet, hours stretch, and patients trust Dr.Koop.com more than their own family physician.

Thirty to 50 percent of physicians say they would not choose medicine as a career if they could choose again, reports the Annals of Internal Medicine. Similarly, when physician recruitment company Merritt & Hawkins surveyed physicians age 50 and older, 56 percent reported they wouldn't enter a career in medicine if they had it to do over.

And because physicians often choose their career - or have it chosen for them - when they are very young, it's not surprising that some discover new goals and priorities as they mature, and feel the need to change. But how big a change is in order, and how in the world does one make it happen?

Making a difference

Like everyone who wants to go into medicine, I was good at science and math, and you kind of get groomed," Zebrowitz explains. "One of the most ironic things about medical training is that you make [career] decisions knowing almost nothing. In pre-med, you think it's all about cracking chests and doing surgery, not spending 14 hours a day in the office and then calling patients for four hours more."

Zebrowitz liked his work as an OB/GYN, but quickly became annoyed by the differing approaches of administrators and physicians. "What goes on behind the scenes is chaotic. Everyone has the best intentions," he says, but there is a communication gap. "There are policies that you know from day one are going to cause problems. The impact of poor administrative decisions is completely underestimated."

True to his ambitious nature, Zebrowitz wanted to fix the problem. After a short stint at a dot-com startup, he joined Executive Health Resources, a 10-physician company that "provides services that usually you don't find physicians available to do," as Zebrowitz describes it. For example, the company helps hospitals with denial management, peer review, and contract negotiations. "It's the perfect blend of medicine and business," Zebrowitz adds.

Physicians he talks to these days seem envious of his new job. "I think it's a case that the grass is always greener," Zebrowitz comments. "Any job does require a fair amount of work."

Still, he feels good about his post. Just like when he was delivering babies, he feels like he's involved in something important. "I'm doing something in healthcare that can make an impact. I may not be treating patients every day, but I'm still making decisions that affect the health of the community."

Know what drives you

It's evident that Zebrowitz is driven to work that matters. The key to making a wise career move is tapping into that sort of drive and having a strong sense of what makes you who you are, says career consultant Steve Rosen, chairman of Celia Paul Associates, a New York City-based career planning company.

Rosen conducted a formal study of people who made good career moves. All of them, he says, "believe their work is a worthy expression of their life and they gain pleasure from it. They have a strong sense of who they are. They think about how their careers change them as people."

Some of his physician clients, for example, created new careers out of hobbies. One surgeon used his Wednes-days off to read financial magazines and take a few classes on online investing. Soon, his own online portfolio was earning real dollars, and his Wednesdays became increasingly precious to him. Slowly, he reduced the hours he spent at his office, devoting more and more time to investing. These days, he's a Wall Street broker.

Francine Gaillour, MD, had a similar experience. After spending 10 years practicing internal medicine, Gaillour knocked on the door of an electronic medical record vendor, offering to serve as a liaison to the physician and payer communities. Today, she consults on healthcare technology and works as a professional coach.

She doesn't see the shift as being all that surprising. "Between the ages of 35 and 50, a lot of adults say to themselves, 'Gee, is this all there is for me?'" For many physicians, she thinks, a career change isn't about disliking medicine, or even about dissatisfaction with the current environment; it's simply a matter of personal growth.

That was certainly the case for Gaillour. Her practice was quickly successful, and, after about two years, her schedule was so packed, she stopped accepting new patients. That was great, but it made life seem a little static. "I enjoyed it, but in terms of things to look forward to - I had already reached a plateau."

Taking stock

Physicians who get the itch for a change can have a harder time than those in other industries, Gaillour believes. Since they spend years training with a very narrow focus, and then spend more years interacting primarily with other doctors, it can be hard to imagine what else there is. Based on her own experience, Gaillour suggests looking inward to help you generate new career ideas.

First, and perhaps most obvious, is to know what you like. "Understand, as clearly as you can, what you get excited about. What are your passions?" Gaillour advises. Think about what parts of your work you really love. Consider what you like about your leisure or volunteer activities. Like doing strategic planning with a church board? Get a kick out of helping kids? "Spend some time understanding what you care about separate from the industry you are in," Gaillour says.

That said, it is not always necessary to make a drastic change to be more satisfied. Rosen says two-thirds of his physician clients make only slight shifts to find a happier fit, such as moving from academic work to direct patient care or joining a new group practice. Others make a bigger change, but stay in healthcare, where their skills and training are in demand, working in administration, for example.

Next, take an inventory of your skill set. Physicians can capitalize on their clinical knowledge as well as their nonclinical talents, such as good communication skills or management experience. Know what you have to offer and cultivate your contacts. Network with others who have changed careers or chat with people in industries you might be interested in joining. Research everything from specific companies to work hours to salary scales.

Zebrowitz has a final piece of advice, which may be hard to swallow - lose the bad attitude. In his new role, he helps hire and interview physicians. Since the work is in healthcare, he studiously tries to avoid hiring anyone who is sick of medicine. "We're looking for people who may be frustrated with medicine, but don't dislike medicine. We want people who can use the skills they developed as physicians in a different application."

Pamela L. Moore, senior editor, practice management at Physicians Practice, can be reached at pmoore@physicianspractice.com.

This article originally appeared in the November/December 2001 issue of Physicians Practice.