The physician's alternative career transition model: a stepwise approach

Physician Executive, March, 1995 by Stan Bernard, Donnical L. Moore

Character traits of successful physician executives are numerous and varied. A common denominator is the ability to make effective transitions from the medical profession to their chosen business careers. Based upon informal interviews with hundreds of physicians who have made successful transitions into the business arena, we have developed the Physician Alternative Career Transition (PACT) model, which is built on four critical steps to making successful transitions: an internal self-evaluation process; an external environmental evaluation process; seeking the best "career match"; and, finally, securing the career match.[10]

Internal Evaluation

The first critical step to success is a systematic, thorough, internal self-evaluation. The internal evaluation process has three major components: the personal needs assessment, the personal interests assessment, and the personal skills assessment. These represent three basic questions physicians rarely ask themselves:

* What do I need?

* What do I really like?

* What am I really good at (besides medicine)?

To answer the first question, both tangible and intangible factors must be considered. While these factors may seem simplistic, it is often difficult for physicians, who have been trained to focus on the needs of others, to consider their own needs, particularly as these have typically been put aside, often at tremendous self- and family sacrifice. While issues such as compensation and geographic location seem straightforward, they can become complex once such issues as life-style and family concerns are addressed.

There are numerous intangible factors to consider. However, there are three common issues that physicians usually confront.[11,12] A major challenge for most physicians who make these transitions is the issue of going from an independent role as a clinician to a subordinate employee position, especially if reporting to a nonphysician boss. Second, going from command and control in a clinical setting, where "doctors' orders" rule, to a consensus-oriented decision-making process in business can often be difficult for many physicians. Physicians are generally very comfortable making independent decisions. In business settings, the decision-making process can often move relatively slowly; this can be frustrating. A third consideration is maintaining one's self-esteem while moving from one's established, certified competence in medicine to relative naivete and inexperience in business. The most important question for physicians to ask themselves related to this realm is "Why am I looking beyond clinical medicine"? Answering this question not only is central to the internal evaluation process, but also is essential for using the PACT model successfully.

While the second question also seems basic, many physicians have difficulty answering it thoroughly. For example, throughout residency training, and even in the early years of practice, physicians generally put former personal interests, skills, and hobbies aside, often to the point where those neglected attributes are forgotten. These are important experiences to resurrect in order to focus on special skills and interests. A particularly important question for physicians to consider in this category is the extent to which to maintain a connection to clinical or academic medicine. Various combinations of part-time practice and part-time business activities are feasible, as are limited connections such as maintaining adjunct clinical or academic faculty responsibilities. Maintaining this connection through active participation in continuing medical education programs, medical organizations, and specialty societies is another option, as is pursuing a business opportunity related to scientific or medical research. The aim of this question is to determine ultimately what combination of business opportunity and ancillary activities will produce the most professional and personal satisfaction. It is important to recognize that the percentages of time dedicated to each component can--and probably will--change over time.