By Maiysha Clairborne MD
It was 2004 straight out of residency that I started my first business. I didn’t know a thing about business, much less running a practice. However, I jumped in headfirst without a life vest. The journey that began in August of 2004 became one the scariest and most exhilarating journeys of my career. Now, almost 15 years later, I share the knowledge, expertise, and learnings that I’ve acquired about stepping into physician entrepreneurship and what it takes to start, grow, and successfully maintain a business without pulling your hair out with other doctors wanting to do the same. I speak with women physicians and other moms in medicine daily who are thinking about quitting medicine, but aren’t sure they have what it takes to start their own business. They have this grand view that starting a business is this impossible mountain. Here are some of the top 5 myths I hear about becoming a physician entrepreneur and starting a business. You have to have an MBA or have a business background I have known many physicians (and non-physicians) who have had MBA’s who are either not utilizing the degree (meaning they have not started their own business), or who are failing at starting, growing, or maintaining a successful business. On the contrary, I know even more physicians (and non-physicians) who have no such degree and have started and grown multiple businesses. The point is, while having an MBA or business background is not a bad thing, it’s certainly not an indicator of whether or not you can start or be successful as a business or practice owner.
You have to have business experience to start a business
This is like saying to a newly graduated college student that they have to have experience in a position before they can get a job. While, the former helps, it doesn’t predict one’s success in the field. Having prior exposure to running a business (through family or other ties) is an added benefit, but not a necessity to be able to successfully run a business. What is required is the willingness to educate oneself, learn from mentors or coaches, and grow into the expertise. I grew up in an entrepreneurial household. However, when I first started my practice, it failed because I knew nothing about business. I knew I wasn’t going to spend $40K and 2 years on a business degree, but what I did know is that I could attend workshops, conferences, and seminars. I bought programs, hired coaches, and participated in masterminds. This willingness to learn is what has made me successful in my businesses.
If you fail, you are obviously a bad business person
I am the poster child for not letting failure define me as a business person. Not only did my first practice fail, I’ve probably had more failures in business than successes. However, it’s the failures that have led me to those major successes, and it’s the mindset that failure is feedback that keeps me in the game. If you are going to be a physician entrepreneur and be in business, you have to get that failure is just part of the game. If you are not willing to fail, then you are really not willing to succeed. 14 years after my first business adventure, I continue to step into new territory. It is the life of an entrepreneur… always “leveling up”. I take the lessons I learned over the last more than decade, and not only re-apply them in new ventures, but also teach my physician entrepreneur mentees and students everything I’m learning along the way. The most important thing for physicians who want to embark upon starting a business to know is that it’s not so much a destination but a journey. When you choose business ownership you choose the mountain with no top. It can be a scary journey, but the biggest failure in business is to not try at all. Maiysha Clairborne is an integrative family physician, coach and trainer of Neurolinguistic Programming, Hypnosis, and NLP Coaching. To learn more about her programs visit www.drmaiysha.com Listen to her podcast The Black Mind Garden at www.theblackmindgarden.com
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By Michelle Mudge-Riley, DO
Scheduled to kick off on November 20th… The Physicians Helping Physicians Nonclinical NEXT conference is set to be one of the biggest events for doctors and it's VIRTUAL, yet *LIVE* PLUS you’ll join a community of physicians who openly share ideas and valuable networking opportunities…AND get CME.... See the schedule and register here: https://www.phphysicians.com/schedule-registration-nov-2021-what-to-consider-next/ Over a decade ago, I felt completely lost and unsure about my career path as a doctor. Although I got into med school on the first try and had succeeded in medical school - I actually LOVED medical school - along the way I had realized that traditional patient care wasn’t the right career path for me. I didn’t know what I was going to do or even what I wanted to do. I guess I should have seen some of the clues, but I didn’t. In medical school, SPAL (standardized performance assessment lab), where we simulate an H&P and go through the motions to practice a doctor-patient interaction, was my least favorite class. I didn’t know why at the time and I didn’t really think about it until rotations my third and fourth year, when I didn’t get excited enough about any direct patient care specialties to think about doing them for the next 40 years. While academically, things were great, I was horrified to realize I didn’t enjoy direct patient care. That scared me. It caused my classmates to question me. What was wrong with me? Turns out, there was nothing wrong with me, but it took me many years (and two more unnecessary degrees!) to realize it. Along the way I started writing about my struggle and when physicians of all specialities, out of residency and practicing for 3, 5, 10 even 20 years started reaching out to me to tell me THEY never liked patient care or were ready to do less of it, I realized I wasn’t a huge failure or a jerk. What helped me the most? Meeting and interacting with other physicians who had also decided to work in a nonclinical or nontraditional job. I realized I had options - lots of them! What are your options for a nonclinical career? You may have been considering a nonclinical career for years! In my experience coaching other doctors who want to transition to a nonclinical career, I’ve seen burnout can motivate a doctor to want to transition to another career. Boredom in a chosen specialty is another reason doctors may start looking at their options. For a certain subset of doctors, medicine may have been the wrong choice from the start. Through my journey and through helping other doctors, I learned that there are lots of nonclinical options for doctors. My first nonclinical job was working for a medical device company as a clinical liaison. I wanted to get into something that emphasized wellness and prevention and by luck, I stumbled on a job as director of wellness and medical management for a brokerage firm. That led to other consulting opportunities. Once I got into that first nonclinical job, my world started to open up as I learned about things I didn’t see or learn about in medical school. I also started to recognize opportunities to work in jobs where I could use my medical degree (and get paid as a doctor) within the business world. Pharmaceutical, public health and insurance companies are obvious places for most physicians who want a nonclinical job but there are also opportunities in finance, banking, writing, consulting, teaching, leadership, IT, marketing, public relations, entrepreneurship, nonprofit, government, international relations, nutrition, real estate, comedy, speaking...and more! Many of these are options for physicians who are not licensed or board certified. A nonclinical community Connecting with other physicians pursuing nonclinical paths really helped me map out what I wanted, identify opportunities, and understand that I wasn’t alone. Eager to help other physicians enjoy that same camaraderie, in 2008 I founded Physicians Helping Physicians, a community of like-minded physicians who coach and advise each other about nonclinical and nontraditional career opportunities. Every year we bring our community together for a conference to support each other. The conference is called Physicians Helping Physicians because that’s our mission. Some of the doctors in our community realized traditional patient care wasn’t for them early in their careers. Others came to the conclusion after practicing for five, 10 or even 20 years. Some suffered a health issue or needed more time at home with small children or aging parents. Others had a hard time getting out of bed each day because they didn’t look forward to their work anymore. Many of these doctors were clinically depressed. Some were suicidal. These doctors found hope in a nonclinical or nontraditional career.
If you’re considering a nonclinical career, I recommend that you start by taking the following three steps:
Create a resume. CVs are traditionally the norm in the scientific and medical fields, but resumes are becoming more common because they quickly describe a person’s experience and skills. Knowing how to translate a CV to a resume can help you communicate your value to employers. I didn’t receive training on creating a CV or resume in medical school, and my first resume was a mess of a document. If you want to create a resume, make sure you list your professional experience first, use bulletpoints to highlight how you bring value in your job (your results) and keep your resume to 1-2 pages. Be careful if you are considering hiring a professional resume writer. I’ve seen nice looking resumes that don’t help physicians because a non-physician resume writer may not understand how to effectively translate your clinical skills and experience into the right business terms or industry specific language. That will hurt your chances of getting into your ideal nonclinical job. Put together your one- to three-year personal development plan and an elevator pitch. To find the right job, knowing where you want to be a few years down the road is essential. Do you want to live and work at the beach? Why? Are you more interested in working internationally? How much money do you need? What’s your work-life balance goal? These are all important questions to know the answers to when you get to the point of evaluating job opportunities. Asking yourself questions like these will also help you create your 30-second elevator pitch to provide context about your skills and value to those you meet and interview with for jobs. Learn how to find jobs and effectively network. Knowing what your options are can help you narrow your focus and make your search more effective. You can learn more about options by reading books like Careers Beyond Clinical Medicine by Heidi Moawad or listening to Physicians In Transition podcasts. Finding specific jobs and getting interviews often involves the help of others. Networking is key to finding those people who can and are willing to help you. Networking through Linked In and scheduling phone calls with people works well. It takes purposeful action steps to figure out what you want to do and then do it. These steps will help you get started. The good news is that physicians who have transitioned to nonclinical careers are likely to remember their own transitions and be willing to help you. You have so much to offer so don’t lose confidence in yourself. You are still a doctor and you always will be. Every year, we bring our community of physicians in nonclinical careers together in a conference to help other doctors who are interested in learning more about or getting into a nonclinical or nonclinical career. The conference is called “What’s NEXT”, where NEXT stands for Nonclinical EXit Transition. Physicians who have successfully transitioned will share pros and cons of their new job and industry, answer questions about salary and lifestyle and help attendees with resources. If you are interested in learning more about a nonclinical career, please check out our conference. In 2021, the conference was virtual and CME approved. You can see the schedule and learn more about future conferences here here. 
How to Network
by Robert Priddy Networking is part of finding a non clinical career.
Making connections can be easy, and people often want to be helpful. It’s catching up with long lost relatives, attending business and organizational parties, and connecting with friends and associates you usually just pass in hallways or in elevators.
People will honestly ask about you and what you’re doing. Starting your conversations with, “I’m looking to make this a great year of change,” will certainly elicit responses of tell me more, and what kind of change. Then, “Well, as you know I…. , and I’ve been involved in doing a lot of…., so now I’m working on…,” stands a great chance of getting the attention you want. So, don’t think for a minute you should be hanging up your Nonclinical Career Transition resume, stump speech and business cards when you are networking.
Some years ago I administered the Birkman Behavioral Assessment® to a group of high level members of a national physician executive organization. What differentiated them most from my control group was their elevated interest in “persuasive behavior.” Note, the Birkman assessment interprets “persuasiveness” with an orientation towards direct, persuasive communications.
While interests may or may not translate into actual behaviors, those results showed a heightened awareness in the need to convince others of their message. Outside of practice, in pursuit of a nonclinical career transition as well as in nonclinical work, physicians, like everyone else, need to be selling their ideas, their recommendations and their results constantly. While starting your sentence with, “As a physician,” may turn heads and gain initial attention, it won’t guarantee you’ll get your way. Persuasiveness is a skill, and a skill that can be learned. Learn to make a case for your point and presently it knowledgeably, logically and cogently, and you’ll find many more opportunities for success await you.
I recently wrote about your Stump Speech as the best way to make the best first impression. However, it is more than that. Actually, the basic content of what I’ll call your expanded Stump Speech can be primary material for almost every question you’ll be asked during networking and interviewing sessions. Let me explain.
First, the elements of the expanded Stump Speech:
So, consider this as just one example of effective use of your Stump Speech in a networking environment. Let’s assume you’re attending a conference and you sit next to a lady and turn and smile:
The key to a good Stump Speech is to be brief and focused. It’s an introduction and it’s a way of setting conversational focus and boundaries. It is not your autobiography. With enough practice, it will become very easy to network with many people with a highly focused and managed content structure that clearly communicates important information about you while setting boundaries for the conversation.
If you'd like to learn more, don't hesitate to contact me for an initial Hallway Consult... Text or Call 720-339-3585 or email: rfp@thirdevo.com.
Heather Fork, MD, MCC is a master certified coach, blogger, and founder of The Doctor’s Crossing. Over the past 10 years she has helped hundreds of physicians find greater fulfillment both in medicine and in nonclinical careers. In addition to coaching, she also recruits for several nonclinical companies. Dr. Fork ran her own successful dermatology practice for 9 years in Austin, Texas.
In this interview, Dr. Fork shares her insights about the financial aspects of transitioning to a non-clinical job including the anticipated salary and how to approach a contract negotiation. Dr. Fork explains that many physicians who want to pursue non-clinical jobs are often hesitant due to financial concerns. She says that it is important for physicians to consider their long-term salary expectations and how much they would be willing to accept through a transitional phase.
Many of her clients carry a heavy weight of financial responsibility as the primary breadwinners of the family. Dr. Fork says that some doctors feel trapped, but she wants physicians to be aware that they have more career flexibility than they realize. She says that most doctors are surprised to learn that primary care physicians can expect to earn a starting income in a non-clinical field that ranges between $160,000 and $300,000.
She also explains that specialists— who have a depth of knowledge when it comes to high cost services, such as in orthopedic surgery, neurology, or cardiology—may be offered salaries above $300,000 by pharmaceutical and insurance industry employers. Dr. Fork encourages doctors to consider all aspects of an anticipated salary, and explains that stock options, bonuses, and yearly pay increases, as well as eventual promotions are routine in the non-clinical healthcare industry. She tells doctors to calculate hourly compensation in clinical work by including time spent charting and responding to off hours calls to be able to make accurate apples to apples comparisons between jobs.
She suggests that doctors to do their homework and learn the industry standards when negotiating a first contract. Dr. Fork explains that she had a client who had more experience than a typical entry-level physician. Because Dr. Fork had other clients who worked for the same company, she was familiar with compensation range and her client was able to negotiate an increase in compensation before starting the job.
She also recommends that physicians consider the long-term career potential of a new position. Sometimes a physician may accept a lower salary than they are used to in order to have better work-life balance. This is not uncommon, especially for the higher earning specialists, such as radiology and oncology. Taking a pay cut in the interim can also be a way to develop expertise in a new area with the goal of rising in the ranks and regaining the salary. Dr. Fork says that in her experience, it is realistic for some physicians to continue to see patients a few days a week while working part time in a non-clinical role. This is often specialty dependent. In fact, she says that this arrangement can help prevent burnout and may keep a physician’s skills sharp, helping build skills in both jobs.
With her extensive experience guiding physicians through career transitions, Dr. Fork also reminds doctors that it is important to formulate financial goals and become comfortable with financial issues and investments. She points out that it helps to understand your relationship with money and to try to develop a healthy attitude about money. For example, Dr. Fork says that some doctors have a hard time knowing when they have enough money to take the foot off the gas. In reality, they have piles of money but they still feel compelled to keep working hard. They’re often aware of this compulsion, but still have difficulty slowing down. It’s also common for some physicians to be so focused on providing for everyone else —helping extended family members, saving up for the kids college, donating to worthy causes, etc. that they neglect their own self-care and well-being. They feel guilty spending money on a gym membership or a massage.
When making a career change, she advises that physicians get a good handle on their financial goals, their habits around money, have a good understanding of their true income potential in a variety of jobs and careers. 
By John Jurica MD
Instructor of online course Securing a Career as a Medical Science Liaison Shortly after finishing my residency, I worked in a small family medicine practice. I held inpatient privileges, and spent many hours in the local community hospital caring for my patients. As a result, I attended many medical staff committee meetings. I balanced work in the office, nursing homes, and the hospital for a long time. I enjoyed working in the hospital environment. Ten years later, I was hired as Vice President for Medical Affairs, the hospital’s first ever physician executive. I was later promoted to Senior Vice President / Chief Medical Officer (CMO), and I stopped all direct patient care. In the next few paragraphs, I’m going to explain how to make the transition from practicing clinician to hospital executive, based on my experiences and conversations with CMO colleagues. Characteristics of an Emerging Hospital CMO Physicians best suited to this career generally have the following characteristics or backgrounds:
About the Author: John V. Jurica, MD, MPH, is a certified physician executive, host of the Physician Nonclinical Careers Podcast and “admin” for the Physician Nonclinical Career Hunters Facebook Group. You can access a free guide to 3 Top Hospital Management Jobs, minicourses, and articles by going to vitalpe.net/nonclinicaldoctors.
By Nana Korsah MD
Have you ever felt overwhelmed with the transition from one job to another? The pressures that come with this life change is somewhat unavoidable, but there is something that is sure to ease the process, and that is tail insurance coverage. So, what is tail insurance? According to www.studentdoctor.net, “tail coverage is an extended reporting period endorsement, offered by a physician's current malpractice insurance carrier, which allows an insured physician the option to extend coverage after the cancellation or termination of a claims-made policy.” In this guide, I will get into how you can set up tail coverage with ease, if needed, and how to discover different types of malpractice insurance. This is information that I wish my coaching clients knew sooner, but my hope is that this will prevent the stress of tail malpractice insurance coverage.
In conclusion, when it comes to malpractice insurance, pick a job that has an occurrence-based policy. If you should decide to go for a claims-made policy, make sure you have established one of the following: your employer will cover tail insurance when you leave, you have a tail coverage fund, or your new employer will pay for your tail policy. I encourage you to use these simple, practical solutions at your disposal because no one should be imprisoned at a job because of tail insurance.
About the author: Nana Korsah, MD is a former Nephrologist turned locum Hospitalist. Board certified in Internal Medicine. She has side gigs as a Telemedicine Physician, Neora skincare/wellness company brand partner, a certified life, and financial coach for physicians who want to pay off debt and live wealthy lives quicker. She helps physicians who want to enjoy the lives they sacrificed so much to create, but they don't know where to start. She helps them build wealth and say yes to the lives they want using the magic of personal finance and multiple streams of income. You can contact Nana Korsah, MD through her website www.mdworklifebalance.com or via email at Doctorkorsah@gmail.com 
An interview with Physician on FIRE's Leif Dahleen, MD
Leif Dahleen, MD is a part-time anesthesiologist on the brink of early retirement from medicine at the age of 43. When he realized that work had become optional in his life, he started a website, Physician on FIRE (Financial Independence Retire Early) to help educate and enlighten others on personal finance topics. He can be found via his website, Twitter, Facebook, and Instagram. Do you think doctors approach money differently than other groups? Why? Well, money is money and the money we doctors earn is no different than the money that everyone else gets. Nevertheless, there are some unique aspects to our career trajectories that necessitate an approach to money that addresses them. We get a late start, are often saddled with large student loan debt, and are taught next to nothing about money management throughout our education and training.
Do you think physicians have any financial advantages?
Physicians earn a lot of money. Any published list of the top-earning professions will be dominated by medical specialties. The high salaries are an advantage in that they allow us to potentially save a lot. However, it's not unusual for a doctor and his family to spend the vast majority of that income. Gratification has been delayed for so long that it's hard not to splurge once you finally see a real payday. We also benefit from relatively good job security. I actually lost my first "permanent" job as an anesthesiologist when a hospital was going bankrupt, but that's relatively rare and I had plenty of opportunities at that time to work elsewhere. Our skills are portable, too. Locum tenens work can be a great way to supplement our incomes without having to learn a "side hustle."
Do you think physicians have any financial disadvantages?
They start earning late, the massive debts, and the lack of financial literacy. That last piece makes us sheep facing a financial services industry with far too many wolves. Physicians also too often mistakenly assume that because they've been successful in their careers, they will also be successful in other endeavors. Unfortunately, understanding the complexities of the nephron does not translate well to the business world. I've known physicians to go bankrupt after putting too many eggs in one faulty basket with business and real estate ventures. How would you recommend that a physician get started learning about managing money and investments? Start with a good book or two. My first money book was The Only Investment Guide You'll Ever Need, which I read as a medical student. I read The Millionaire Next Door shortly after finishing residency. Since then, a few good books have been written by physicians, including books from The White Coat Investor and The Physician Philosopher. With a good foundation from a well-organized book, delve into topics of interest via blogs and podcasts.
What blogs, websites, books or podcasts do you recommend?
I've written a pretty thorough guide to DIY investing that's chock full of resources. I've also got a two-part series on Investing Basics for busy professionals. But my site is just one little sliver in the personal finance world, and the number of physicians participating has increased more than tenfold since I started in 2016. I'm a part of the White Coat Investor Network which also includes WCI, Passive Income MD, and The Physician Philosopher. All are excellent. Helpful podcasts include Dr. Nii Darko's Docs Outside the Box, Dr. David Draghinas' Doctors Unbound, and Dr. Carrie Reynolds' Hippocratic Hustle. These are insightful podcasts with guests doing unusual and extraordinary within and in addition to medicine. There are dozens of other great resources out there, and I can't possibly mention them all. I do my best to keep a blogroll that's reasonably up-to-date, but the landscape changes rapidly in the online world.
Do you think there is a magic number in terms of how many hours/week a physician should spend on managing money?
The number isn't magic, but for the vast majority of physicians, that number should be less than one. I think people ought to spend a few hours a week learning about personal finance, but money management is generally best when it's automated and not tinkered with much at all. Invest in a three fund portfolio or variant and earn the market returns. Most who try to do better fail, including very well-paid investment managers with vast resources in terms of data, connections, and quantitative analysis. Simple and effective money management shouldn't take much more than an hour a month once you've set things up the way you want them.
Always Act Like You've Been There Before
by Robert Priddy I try to refrain from sports analogies, but this is one of my favorites. I'm from Ohio, so, yes, I'm a buckeye at heart, and one from the Woody Hayes era of The Ohio State University football. So, the legend goes, a young Ohio State player scored his first touchdown for the Scarlet and Gray. He then performed some celebration in the end-zone before returning to the sidelines, whereupon Coach Hayes reportedly grabbed him by the front of the jersey and pulling him in close growled, "Son, when you play for THE Ohio State University, you act like you've been there before."
An interview with physician coach Karen Leitner MD.
How did you get into coaching?
There was a point before I started to transition away from clinical medicine where I was burned out and lost, trying to juggle a busy practice and a growing family. I genuinely thought the problem was not having enough time. I felt pulled in a million directions and therefore inadequate at doctoring and mom-ing (despite outside evidence to the contrary). I would look around at my colleagues who seemed like they were all managing OK and I wondered what was wrong with me that it felt so overwhelming and out of control. I felt like I was letting everyone down and there was a lot of shame. It was only after I completely changed everything (new job so I could work from home, set my own schedule, be around my kids, make more money) and still felt unfulfilled that I realized the problem was not the external factors. A big part of my dissatisfaction was my mindset and the unrealistic expectations I was setting for myself. If I didn’t change that, it didn’t matter what I did; I still wound up feeling like I was not enough. So (to make a long story long!) through a life coaching podcast, I was exposed to the thought model that I now use with my coaching clients, and it was like a light went on for me. I realized a lot of my thinking was hurting me. I did a lot of work on myself and my mindset with the tools of coaching and being coached, and it made all the difference! Now I can handle whatever life throws at me. I am more balanced, independent, self assured of my value both at work and at home and I’m excited to live my life on my terms. Do you have a niche in coaching? I exclusively coach women physicians. It has been a fascinating journey and I am compelled to help other women physicians learn the skills of coaching, earlier, before they reach burnout like I did. I love to coach them to help increase their confidence and fulfillment in their careers and relationships.
What surprises have you have about your client's professional lives and needs since you started?
It has surprised me how much fun we have in coaching and how many friends I have developed in my clients and the coaching community. Group coaching has been deeply meaningful to me, both as a participant and also in the group coaching programs that I run. There is such commonality among women physicians and what we struggle with. What I mean is that we are a brilliant, hardworking, dedicated, capable, powerful, compassionate group. Yet on the whole we lack self compassion, we put others’ needs ahead of our own, and many of us feel inadequate much of the time since we are trained in a system that relies on external validation. We don’t recognize our intrinsic worth and when things go wrong with patients or our families, we are extremely harsh and unforgiving with ourselves. We also negotiate for ourselves on the whole quite badly. I love helping physician women grow into the best version of themselves and realize how much value they contribute and how worthy they are of their own love and compassion. What one piece of advice do you have for physicians who are not satisfied with their careers? Before you switch jobs, clean up your thinking. A lot of us think if we can just switch jobs, partners, institutions, % FTE, etc we will be happier and more fulfilled. If we do that without looking at the thoughts that are contributing to our dissatisfaction, we risk recreating the same situation wherever we wind up. If you are a people pleaser, hate saying no and take on too much work without setting boundaries in one job, chances are you will do the same in your next job if you don't work to change. Through coaching I help clients take radical responsibility for their lives. As long as it is up to your boss or partner or kids to change in order for you to feel happy and fulfilled, you don’t have much control. Recognizing that how you think about EVERYTHING Is what really creates your life is a huge game changer.
How can a doctor know when it's time to call a coach?
I love this question! Everyone can benefit from coaching. A common misconception is that coaching is only if you are having trouble or are unhappy. I am very happy and successful and I still commit to investing in coaching for myself because it helps me set new goals and pushes me to attain them, as well as work on the parts of me that I’d like to improve. Think about athletes: Poor performing athletes need coaches. Michael Jordan needed a coach. Being a human is both wonderful and also incredibly challenging, especially as a physician and as a woman. The culture of medicine does not focus on taking care of us and we in turn do not do a very job of caring for ourselves. We pay a price for that, just look at the rates of mental health problems, addiction and suicide in medicine. We need help and there is a stigma around pursuing it. Coaching should be part of medical education so we learn the tools of resilience and self preservation. I could go on and on. What is your favorite thing about coaching? My clients! Meeting them, getting to know them, seeing their strengths and watching them transform and grow and reach their goals. They are incredible, each and every one. You still maintain work with Teladoc- what are the benefits of doing that? I enjoy it because of the members I am able to help. Currently I work exclusively with Transgender folks in a longitudinal virtual care program. They are an incredible and gifted community of folks who have unique challenges in navigating the healthcare system. I love getting to know them and helping to make it easier for them. These relationships enrich my life. You can contact Dr. Leitner, karenleitnermd coaching at www.karenleitnermd.com 
By Jessica Lubahn, MD
When I went to medical school, I never imagined that I would become a Urologist, much less start an underwear company. As rigorous as medical training is, there is something very comfortable about having a step-wise path that leads to a mostly stable endpoint. Entrepreneurship has been anything but comfortable, with no discernible blueprint to follow. The merging of these dichotomies started soon after I began my first private practice job after residency. In my line of work, I directly bear witness to the impact incontinence has on my patients, as well as my close friends and family members. Incontinence can drive isolation and depression. I treat women and men with medications, nerve stimulators, botox, and even surgery. The distress may be great even when the leakage is “mild” from a medical standpoint due to the shame experienced by the patient. The idea for leakproof underwear developed while I was on maternity leave, and I thought about extrapolating cloth diapering technology into stylish, adult underwear.
5 Common characteristics of an entrepreneur
Navigating the ins and outs of the fashion industry has been --- interesting. For a person with a scientific background, negotiating the lack of standardization at every level was eye opening. For instance, there is no encyclopedia of general fabric properties. Juxtaposed to the urgency of medicine, steps in business seemed to move at a snail’s pace. To enjoy this environment, certain characteristics apply:
Steps to starting a clothing brand
I wish I knew what I know now, and I think that I could have created this brand through a much more efficient route. However, mistakes helped me really learn about the production process.
In the end, this company has been quite complementary to my medical practice. It has brought me more joy to my own practice, as it has made me a better listener to the pain points of my patients. It has challenged me, not only from a treatment standpoint, but also to think of more inventive ways to look at their problems. About the Author: Dr. Jessica Lubahn, MD is a medical doctor and urologist. She is a health writer and consultant and is the creator of ONDRwear (ondrwear.com) which are plant-based leak proof underwear for preventing leaks. Facebook: https://www.facebook.com/ondrwear/ Instagram: ONDRwear (@ondrwear) • Instagram photos and videos  I recently had the opportunity to talk with Eric Bork of Pattern Insurance. Pattern is an independent insurance brokerage that caters specifically to physicians. Eric shared some great insights about physician disability and life insurance that every doctor needs to consider when selecting an insurance policy—and when reviewing already existing policies to see if any updates are needed. When should physicians start thinking about disability insurance? For disability insurance, the answer is yesterday! Nobody can predict what illness or accidents you may face in your life when they might occur. You will never be younger and healthier than you are now, so that is the ideal time to purchase disability insurance. This will allow you to get coverage with fewer health restrictions, if any, and the cheapest rates possible. Protecting your future income after all those years in training is crucial for any doctor at any point in their career. What about life insurance? What about doctors who have never been married and don't have children? Life insurance is a little different and depends on each individual's circumstances. If you have any dependents or are married, you need life insurance right away. If you are single with no dependents, it can still be a good idea to get life insurance as it is cheaper while you are young. However, your needs should be discussed with a financial professional before deciding what is best for your situation. Overall, term life insurance is very cheap and can fit in every doctor’s budget. Do the costs and benefits differ by specialty? What if a doctor has a completely non-clinical role like chart review? The cost of disability insurance does vary by specialty, along with many other factors including your state, income, and age. Certain specialties are deemed as more risky for potential disability, so they are all separated in what are known as occupation classes by the insurance company. Insurance companies also look specifically at your duties when applying for coverage to assign the right occupation class. However, the great thing about getting a true own-occupation policy, is that if your duties change over the course of your career, you would be covered according to your specific duties prior to the time of disability. This can work to your advantage if you get a disability insurance policy in training while less specialized with a cheaper occupation class. Even as you add specialization or additional duties over your career, your policy will now cover you even at the cheaper rate. How about doctors who have an inconsistent salary and can't even estimate their salary in advance? Such as doing locums clinical work or expert witness, which are both sporadic projects? This can vary a little with each insurance company. Insurance companies will typically look at some income documentation to determine how much coverage you are eligible for. This could include paystubs, tax returns or even employment contracts. If you have inconsistent pay, the insurance company will most likely look back at your entire prior year taxable income to come up with an appropriate benefit amount. Do physician moms who work part time or step away from work for a while still need to get life and disability insurance? Life insurance is absolutely a must if you have young children. Anyone who makes an income that is relied upon by themselves or other family members should get disability insurance. In other words, if you or anyone else would have financial difficulty if you became disabled and couldn't earn your income, you should protect that income with disability insurance. How does specialty specific insurance come into play when a doctor becomes disabled and could do something that isn't physically demanding—like telemedicine? What if there are jobs but the doctor can't seem to find a job or the new job pays less than the in-person job? Can he or she collect some disability payment long term or temporarily? This is the exact reason why you want to get a specialty specific or true own-occupation disability insurance policy. If you cannot perform the specific duties of your specialty, you can collect a disability payment, even if you can work in another job. This would include telemedicine, teaching, etc. You could get the full benefit from your disability policy as well as the entire income from your new job. The other great thing about a true own-occupation policy is that if you can’t find a job or choose not to work in a different job, you do not have to. You can still collect a full benefit as long as you cannot perform the material and substantial duties of your specialty at the time of disability. How does divorce affect rates? Should doctors adjust the policy when this happens? Divorce is not one of the factors that affects the rates of disability insurance. However, it can affect how much coverage you need. For instance, if you are married and living in a two income family where your income makes up 50% or less of the total family income, you could opt for less coverage than if you were divorced and single and solely reliant upon your own income and without the support of your spouse's income. How can you keep an open mind when assessing different policies? The first thing to do is to educate yourself and determine what you absolutely must have in a policy and what you absolutely do not want in a policy. Once you know these things, you can begin to narrow down the options. One thing to avoid is talking to any insurance agent who represents one insurance company. Even if they say they are unbiased but are employed by a single insurance company, they will have a conflict of interest and most likely be incentivized to sell that company's policy. Find an independent broker who works with all of the major companies and who has a long track-record of working with doctors and being trusted by doctors. Between educating yourself and finding a trusted, unbiased broker to work with, you will be able to discern what is really best for you and avoid getting "sold" something that's not in your best interest. If you are ready to talk to an unbiased, independent broker who specializes in own-occupation disability insurance, visit www.patternlife.com. 
By Mark J. McCandless, CPA, CFP®, MTax
I love reading the Wall Street Journal. I learn interesting tidbits about sports that are not covered on sports websites. I learned about the importance of getting enough protein in my diet. I like the movie reviews that I can totally ignore because they don’t understand why I prefer action movies. I look forward to the full page ads from some company that just screwed up pledging that they are devoted to fixing whatever it is that everyone hates them for right now. I even read the financial news! However what I don’t like to read is that a regulatory body just indicted or sanctioned or otherwise punished a financial advisory firm. It reminds everyone why they have a negative view of the financial services industry. That is why I was struck by an article in the Wall Street Journal about the Securities and Exchange Commission (SEC) charging 79 financial firms with misleading their clients about the fees and other costs of the products they promote. Oddly, the Wall Street Journal did not list all of the firms but focused on perpetual bad - behavior poster child Wells Fargo. To find the firms involved I had to go to the SEC website. I was shocked at the number of well-known firms along with some smaller firms that were involved. The news release from the SEC as well a link is found here- check it to see if a firm you know is involved.
By Naval Asija MD
A computer is a machine that works very fast and makes things easy. How fast, depends mostly on the hardware, and how easy mostly depends on the software. Software or applications are fancy terms for the computer program. A computer program determines how well the computer is told to do things. “Machines are excellent workers, but poor leaders”. It can’t be truer than the case of computer programs. If you don’t tell the computer to do its task in a proper manner, it will never do it properly. Computer programs are based on stacks of information known as databases. And then, the written instructions tell the computer whether to run or not run elements of the database. This process of giving instructions to the computer is based on logic statements using binary results in the form of TRUE or FALSE and the use of “Operators” like IF and THEN, AND-OR, GREATER THAN-LESS THAN. The actual instructions to the computer are however provided through use of special programming languages like HTML, C++, and Python which are known by software engineers. They convert the above logic statements into “Code” and this process is called coding.
What If The Physician Can’t Alter The Database? What Skills Does The Physician Require?
The physician can intervene at the workflow part of the application while also forming the logic rules for running the parts of database. Programming rules that facilitate integration with the clinician’s workflow and enable quality information entry and increase usability of the application should be the physician’s top priority targets of intervention. The physician could use intelligence and clinical experience to make the user experience seamless, smooth and enjoyable. Some of the examples in this regard could be:
About the author: Dr. Naval Asija is from India and has a postgraduate qualification in health administration. He has worked for four years in Synodex, Innodata as a Med-Tech Physician. He currently writes about various health issues. You may also like reading his blog post A Typical Workday Of The Physician In A Healthcare IT Company that was posted on his personal blog.  What Is Wound Care? Wound care is the subspecialty that provides expertise in the management of acute and chronic wounds. Specialists in wound care focus on evaluating and managing wounds using appropriate interventions and control of co-morbid conditions. These specialists use both surgical and medical skills to the manage wounds. The etiology of these wounds include pressure, arterial, venous, lymphatic, diabetic, traumatic, burns, autoimmune and several other causes. It is estimated that over 6 million people in the United States are afflicted with a chronic wound. As the population ages and the incidence of diabetes increases the demand for physicians skilled in wound care continues to rise. Wound care specialists are trained in managing complex wounds and in leading multidisciplinary teams to deliver comprehensive care. A successful wound care physician is as adept with a scalpel as she is in understanding the mechanisms of a medication that inhibits wound healing. Join Vohra Wound Physicians today. Click here to apply. There are several paths to becoming an expert in wound care and physicians can become a specialist in this area after two years of residency training. Wound care is not yet a recognized board specialty and there are just a handful of fellowships in existence. Many physicians from the backgrounds of general surgery, vascular surgery, internal medicine, plastic surgery, emergency medicine, and family practice become specialized in wound care. Neither the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) yet recognize wound care as a specialty or subspecialty.
This offers an opportunity for those who have not graduated from residency to serve as experts in a needed area of medicine and one day become part of a new board-certified specialty. If you are interested in:
See availability in your area. 
By: Brian Wilson, DO & Kyle Ulveling, MD & Robert F. Priddy
Loss of license is a devastating event for a physician. It's not just the absence of a license and a mechanism for making a living, but the act or issues that led to the revocation of the license. Whether it's malpractice, substance abuse, some alleged egregious administrative act or other, it's a challenge to your professionalism, to your identity and to who and what you've worked your entire life to be. It may seem like the end, but it's not. One of the unfortunate realities of medical practice and the medical profession is that everyone you've encountered, from your first day of medical school to you last day of residency or fellowship, and even on into the "doctors lounge," has expected you to practice medicine until you can no longer work.
Many physicians expect their state medical board members to review their data much like they would a medical record. Objective information is paramount and understanding intent by reading a bit between the lines is only fair, right? Wrong. You’re not being asked to represent yourself and present information, you’re there to defend yourself. An allegation of wrong doing has been made, and it was serious enough for the board to take action to defend its responsibilities, which is protecting the public, and the medical profession against physicians who commit wrong doing, intentional or not, malfeasance or mistake… doesn’t matter. So presenting a defense is very different from an objective presentation of the facts… the facts as you see them and as your supporting documentation may present.
Presenting your defense is based on several factors. The facts represent one factor, but also the context of the facts, and how your facts are delivered to the board represent multiple other factors. Your facts may go beyond the specific event. Past patient interactions may be helpful in creating a fuller, more accurate picture. Supporting staff observations and knowledge of the patient and the situation could be useful. And finally, how you physically present yourself in front of the board is extremely important. How you look, what you say, and how you say it will set the tone for all important first in-person impressions of you. Remember, the real “first impression” was made of you in the complaint. You’re playing catch up from the very beginning. As physician state medical board members, we’ve seen this play out hundreds of time. Some physicians do themselves more harm than good when they show up for a hearing. They may decide they know more than the board members, see their attorney’s instructions as overly controlling and are simply insulted to be called. Others are overly defensive and yet others may be too deferential to adequate defend themselves. We’ve seen guilty physicians convey an air of innocence and the innocent appear guilty. And both guilt and innocence are usually measured in degrees.
If you find a letter from your state medical board in your inbox, don’t panic - prepare. You need to look at your situation critically and consider this a process that demands your serious attention and your ability to take positive steps that involve not only you, but appropriate advisors as well. You need to:
You further as a practicing physician depends greatly on both what you say and how you say it when appearing at a state medical board hearing. Experienced legal counsel is an imperative, but professional support to help you shape your presence and your words can be equally important. Never think that your opinion that you did the right thing and the “right” will win out will be your best defense.
About the author: I provide my clients with what I call a CareerDiagnosis™. It's two days focused on learning about desirable and appropriate career paths to follow. I follow a SOAP note to collect that information. So, you can see, transitioning is a process, but it should be a structured and orderly process that takes you to a positive and rewarding career.
If you'd like to learn more, don't hesitate to contact me for an initial, no-charge, no-obligation Hallway Consult... call/text 720-339-3585or email rfp@thirdevo.com. More advice by Robert Priddy-The Resume Recruiters and HR People Hate, Physician Career Change, Never Overestimate the Knowledge of Your Audience, and Self Protection Is Self Defeating 
By Dr. Naval Asija
India’s healthcare has witnessed several transitions in last two decades with a trend towards Privatization, Commercialization and Globalization. This has opened newer avenues for physicians in several industries. Non-clinical positions for physicians now come in different shapes and sizes, with most of them being linked to specific career paths. The traditional types of non-clinical opportunities were more organized and secure; whereas the newer ones offer the promise of faster growth and higher financial rewards, sometimes at the costs of job insecurity and competition from non-physician candidates. Traditional Non-Clinical Opportunities Chief Medical Officer: The CMO is a public servant and is sometimes known as the Civil-Surgeon/Health-Officer. These officers are not directly recruited, but instead, get promoted from the medical officers employed with the government, who are primarily involved in clinical duties in initial few years of their service. Medical Scientist: The medical scientist works with the Indian Council of Medical Research (ICMR) and its affiliated institutes. Since its inception, with a network over 25 research institutes, ICMR has employed scores of medical scientists in bio-medical research. Medical Teacher: Medical teachers are the faculty members in medical colleges that produce fresh medical graduates of modern medicine. They teach basic sciences subjects to medical students, before they get ready for clinical medicine. Besides the medical colleges, medical teachers are also employed by the dental colleges, nursing colleges, and paramedical colleges.
Pharmaceuticals: India is known as the pharmacy of the developing world due to its successful pharma companies. The marketing/sales departments of domestic arms of these companies require services of a medical affairs physician. Similarly, their compliance departments require the services of a regulatory affairs physician.
Information Technology: India has witnessed an IT/BPO services boom over last two decades. The exponential growth of India’s healthcare IT-BPO market and its globalized nature has led to emergence of the role of a med-tech physician who aids in new product development, training of executives and project management. Insurance: India has also seen rapid expansion of private health insurance, and more recently with advent of government provided health coverage schemes the number of insurance beneficiaries and claims have multiplied manifold in last two decades. The physicians employed by the industry take care of the underwriting, authorization and claims processes.
by Robert Priddy
I’m always meeting with clients who are quick to say, just call me Jane or John…., and I always say to them, don’t give up “doctor.” There is a simple reason for that, it’s called credibility. Regardless of how you may feel today when it comes to the respect you receive from staff, colleagues or even patients, Physician is still the top or nearly at the top of any list of the most respected professions in America. So, if you have the ability to walk into nearly any meeting with the expectation of “trust me” already on your side, why would you not? Presenting and selling ideas in business is challenging for everyone. Establishing credibility is a tough job. Becoming a physician is also a tough job, so you’ve earned everything you have. Don’t be afraid or too timid or wishing to just be a part of the gang, to use the trust and the power you’ve earned. In time, once the boundaries have been established, you can drop the “doctor,” if you wish. But initially, use the respect you’ve earned.
If you’d like to learn more, don’t hesitate to contact me for an initial Hallway Consult... Call or Text 720-339-3585 or email rfp@thirdevo.com.
More advice by Robert Priddy-The Resume Recruiters and HR People Hate, Physician Career Change, Never Overestimate the Knowledge of Your Audience, and Self Protection Is Self Defeating 
by Andrew Wilner, MD, FACP, FAAN
Have you heard about locum tenens? Locums physicians act as "placeholders" in clinics and hospitals that need temporary help. Doctors may work locum tenens in addition to a regular job (moonlighting) or move from one assignment to another, traveling to different destinations and experiencing a variety of practice environments. If you've considered joining the approximately 50,000 locum tenens physicians in the US, here are five tips to get you started. 1. Why? Why work locum tenens? This decision depends on your stage of career. For example, newly graduated residents may travel to a part of the country they have never seen or experiment with different types of practices. Mid-career docs often need extra income or want to test the waters for a practice change. Pre-retirement physicians may wish to cut back a little, but their full-time job won't permit a part-time option. As a locum tenens physician, how often you work is up to you.
2. Find a good staffing agent.
A staffing agent can offer invaluable assistance, particularly if this is your first foray into the world of locum tenens. When you chat with an agent, ask questions and communicate your needs. Agents focus on certain medical specialties, and it's their job to know the market. Agents work on commission, so there's no cost to you. Select a staffing agency that belongs to the National Association of Locum Tenens Organization (NALTO), which sets standards and sound business practices for locum tenens companies. Two NALTO members that I have contracted with are CompHealth and Staffcare. See the NALTO website for an updated list of NALTO staffing agencies. 3. Where and when? Decide where you want to travel and your timeframe. Once your agent knows where and when you wish to work, he or she will search for an appropriate opportunity that fits your schedule and offers the best compensation.
About the author: Andrew Wilner, MD, FACP, FAAN is the author of The Locum Life: A Physician's Guide to Locum Tenens Dr. Wilner can be reached at www.andrewwilner.com
By Eric Brown
USMLE Course Consultant After spending two years in the classroom, now it’s time to begin your third-year with clinical rotations. During clinical rotations, you get to immerse yourself in patient care, know more about the different specialties and put your bookish knowledge to good use. Although clinical rotation is exciting, this transition can be a stressful time. It may fill you with tons of anxiety. Therefore, it is important that you enter into clinical rotations with a growth mindset. They may seem daunting, but you get only one shot at it. So, make it count. With that said, here are 5 tips to succeed in clinical rotations. 1. Choose your rotations wisely Clinical rotations help medical students in figuring out what medical residencies are best for them. During the rotations, the students shadow physicians in variety of medical disciplines. This helps them in making an educated decision about what specialty they want to join and later practice. To choose the right clinical rotations that is aligned with your future plans is not easy. Some tips to choose the right clinical rotations:
4. Be attentive to what your patients are saying
Listen carefully. It is one important clinical skill that will help you be a better doctor. Each patient encounter will give you an opportunity to learn something new, if you pay close attention to what your patients are saying. 5. Be friends with your fourth-year peers A friend who is in the fourth year can be an excellent mentor to you. You’ll get invaluable advice from students who have been through what you are going through now. Talking with them will keep you informed and updated about the forthcoming challenge. 6. Ask questions You have got into the third year without much hands-on experience of examining real patients and dealing in logistics of the hospital. Now you are in the real world, seeing real patients; you’ve got a lot to learn. The only way you can learn better is by asking questions. Let no doubts remain in your mind; ask questions, however silly they may seem. While it may be perfectly alright to ask genuine questions, do not ask questions that could reflect poorly on you. Don’t ask questions that you can easily look up.
About the author:
Eric Brown is a standardized patient (SP) who lives in New York and advises NYCSPREP with their Clinical Skills course. He has a BA from a liberal arts college in the Northeast, where he majored in the theatrical arts and business (he credits the first for his ability to simulate real patients). He’s amassed years of experience as an SP and keeps up to date with CS exam expectations, trends and developments. When the Phillies are in town, Eric considers it his duty to support his home team. He won’t be seen without his trusty catcher’s mitt on these occasions, and prides himself on having caught more than one foul ball with it. If you have any questions about standardized CS exams or courses at NYCSPREP, email Eric at eric.brown@nycsprep.com or visit http://www.nycsprep.com. More advice from Eric Brown: How International Medical School Graduates Can Obtain US Clinical Experience
by Robert Priddy
Put another way, most markets have plenty of room for expansion and growth, and that includes you as a new entrant.
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