Income Expectations in Non-Clinical Physician Careers

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.

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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.