Doctors Beware: Potential Pitfalls of Non-Clinical Jobs

JULY 06, 2017
Heidi Moawad, MD

Non-clinical medical jobs have become a very popular focus for physicians who believe that working in the non-patient care side of medicine could be a good option. Yet, while almost all physicians in the United States have researched non-clinical careers, few make the switch. And there are many reasons that non-clinical work is not the right move for most physicians. 
 
Unpredictable Job Security 
Most doctors need to work without gaps in employment. Non-clinical jobs for physicians are not usually secure. Administrators, in particular, are highly susceptible to job turnover when the health system performs poorly. The possibility of sudden termination makes non-clinical work a frightening endeavor for most physicians. 
 
Evaluation Based on Short-Term Goals
Doctors who take care of patients are often frustrated by evaluation criteria that may seem short sighted or irrelevant. Yet, physicians who take non-clinical jobs can suddenly find themselves in a situation in which job viability is based on short-term goals, such as profit generated by expensive equipment within a given time period, or even seemingly less important targets. When others set benchmarks, many non-clinical physicians may feel that they are spending time on work that is not important for fear of being fired. 
 
Not Really Trained For the Job
Medical school instills the information needed to pass tests and to get ready for residency, while residency teaches young doctors how to take care of patients. Medical school does not include training on how to run a hospital, how to lead a health insurance company or how to decide what new devices warrant research funds. There are public health programs and MBA programs that can help give you some direction on how to succeed at in non-clinical work, but they do not provide direct instruction the way residency teaches you how to care for patients. 
 
You Have to Learn Something New 
You step out of residency ready to practice. In the non-clinical world, you need to learn something new, and often you need to learn how to learn it. Non-clinical work in the health care field requires skills and knowledge that will take time to develop. This is generally the most discouraging aspect of non-clinical jobs for physicians, because when you need to learn, you often cannot hit the ground running.
 
Few (if any) Role Models 
If you are a physician seeking a job outside of patient care, you are usually stuck making your own career path, without a senior physician ahead of you on the career ladder to look up to. Perhaps you know of another doctor who is doing what you wish to do, but you don't personally know anyone who is doing what you want to do. Without a clear sequence of professional levels, it is hard to know what you can expect as you pursue a non-clinical career. 

In a non-clinical job, you may not be sure about the next step and you might not know how to qualify for the next step. You may have your eye on a position, but don't know why the person ahead of you (usually not a doctor) is where they are, and whether or not you, as a physician can get there. 
 
Family Anxiety
The family you are supporting may be apprehensive about your ability to maintain the same lifestyle. Many doctors who leave patient care are burdened by extreme anxiety from family members who are concerned about the opinion of the community, or the opinion of relatives. Extended family, particularly parents of a doctor in transition, may express concern if they don't know how to define your job or feel the need to repeatedly prove your status and earning power if you are no longer defined as a surgeon or a pediatrician.
 
Rejection 
Some doctors who leave patient care are faced with peers who may express resentment or show disrespect or rejection. Many doctors who remain in patient care feel that physicians who leave are taking the easy way out. As you might want to keep the details of your own salary private, others may imagine that you are either making a killing financially or accepting a very low salary, which can lead other physicians to hold a grudge.
 
You May Feel Like a Sell Out 
If you really dreaded going to work when you practiced clinical medicine, but look forward to your new job, you may feel guilty that you aren't in the trenches or wonder if you are getting a free pass. If your clinical job involved hostility or fear of making a mistake, and your new job is more pleasant, you may also begin to feel like a sell out.
 
Decisions About Maintaining License and MOC
As you ease into a non-clinical position, you will always be aware of the unpredictable job security. Many non-clinical physicians remain uncertain when it comes to maintaining all certifications. It is challenging to decide how much time and effort you should put in to maintaining your certifications once you no longer officially need them. 
 
Non-clinical work is not right for every doctor. Most people will be more comfortable with you if you stay in patient care. The question is whether these disadvantages are worth it for you as you make the decision about how you want to spend your own hours every day.
 
Related: The Latest from Heidi Moawad, MD
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