Career Options
"Don't ration your passion." ~ some wise person
There are so many different ways outside of the traditional hospital, clinic or private practice options that physicians can pursue to both utilize their expertise and work towards a position of time/financial freedom.
See below for some ideas to spark your own unique path forward and creating a fulfilling career that is just as varied as you are.
Entrepreneurial Paths:
Telehealth Entrepreneur: With the rise of telemedicine, physicians can establish their own telehealth practices in most any specialty you can think of including surgical ones as many patients will pay for second opinions and consultations even if a proceduralist isn't doing procedures. This allows for more location independence and scheduling flexibility.
Medical Device Creation: If you have an innovative idea for a medical device, you can pursue its development and creation. This may involve collaborating with engineers, designers, and business partners to get an MVP (minimum viable product) off the ground.
Industry:
Physician for Pharmaceutical Companies: Work in research and development, clinical trials, or as a medical science liaison for pharmaceutical companies. These roles involve using your medical expertise to develop new drugs, evaluate their safety and efficacy in trials, or act as a medical expert liaising with healthcare providers.
Physician for Medical Device Companies: Similar to pharmaceutical companies, you can work in research and development, clinical trials, or as a medical science liaison for medical device companies.
Insurance Companies: while this can be a sensitive option to consider given the pervasive feeling of "how come they earn billions each year and won't help out our patients or make our lives easier?" it is important to have compassionate clinicians working for insurance companies to ensure waste isn't happening, patients are receiving the best standard of care and that at least one person in the company is caring about more than the bottom line 😉
Leadership and Consulting:
Healthcare Consultant: Consult for hospitals, clinics, healthcare organizations, or insurance companies on various issues like improving healthcare delivery, optimizing operations, or developing quality improvement programs.
Medical Director for a Large Company: Become a medical director for a large corporation and oversee the healthcare needs of its employees. Responsibilities may include managing on-site clinics, wellness programs, and occupational health initiatives.
Medical Malpractice Expert Witness: A lucrative and potentially rewarding option can be filling the role of an expert witness. You can do this for either the prosecution or the defense. Some physicians will only work for the defense to ensure their colleagues aren't being persecuted by frivolous lawsuits.
Telehealth Medical Director: Telehealth companies are looking for physician leaders to oversee the quality and standards of care provided through telehealth platforms.
Startups:
Join or Advise for a Healthcare Startup: Many healthcare startups are looking for physicians with a background in medicine and a passion for innovation. These startups may be developing new technologies, apps, or other solutions to improve healthcare delivery.
Teaching:
Develop Online Medical Courses: Develop and sell online medical courses for other physicians, medical students, or patients. Platforms like Udemy and Coursera allow you to create and sell your own educational content.
Medical Expert for Online Learning Platforms: Become a medical expert for online learning platforms that provide medical education to healthcare professionals or patients.
Other Atypical Settings:
Cruise Ship Physician: Provide medical care to passengers and crew members on cruise ships. This can be a great opportunity to travel the world and live in a unique environment. They frequently will hire EM, FM or IM physicians.
Disaster Response Physician: Join a disaster response organization like Doctors Without Borders (MSF) or the Red Cross and provide medical care in areas affected by natural disasters or humanitarian crises.
Expedition Physician: Become a physician for expeditions to remote locations. Responsibilities include providing medical care to expedition members and ensuring their safety.
Archeology Dig Physician: Provide medical care to archaeologists and staff working on archeological digs. This may involve working in remote locations and dealing with unique medical challenges.
If interested in any of these options it can be helpful to brush up on your wilderness medicine skills (think Dr. MacGyver). The Wilderness Medical Society (WMS) has a great fellowship which can be done remotely and provide lots of education to prepare you for austere settings. I did this fellowship and would strongly recommend it to others. Hit me up with any questions you might have.
Focus Areas within Telemedicine:
Teleintensivist: Provide critical care consults to intensive care unit (ICU) patients remotely via telemedicine technology. This is more often done at critical access or smaller hospitals who have some ICU capabilities but want intensivisits managing vent settings and providing some guidance to the hospitalists on hand.
Teleneurologist: Provide neurological consultations to patients remotely via telemedicine.
Telehospitalist: Care for hospitalized patients remotely using telemedicine technology. They also have this option for patients at skilled nursing facilities (SNFist).
Telepsychiatrist: Diagnose and treat mental health conditions remotely through video-based telemedicine platforms. This can be for routine outpatient visits or inpatient rounding.
Additional Notes:
Family Medicine in Non-Traditional Settings: While family medicine is most commonly practiced in clinics (+/- OB), family physicians can also work in dermatology clinics (cheaper than a dermatologist but still a physician leading to derm hours, high wages and all the biopsies you want), skilled nursing facilities (SNFs), hospice, disability exams (for general public or through VA for vets) and correctional facilities (some of the CA facilities I've seen paying up to $240/hr for 7-8 patients per day).
Fellowships vs. Additional Training/Certification: Many of these non-traditional physician jobs don't require lengthy fellowship training. I strongly recommend avoiding low paid fellowship training unless absolutely necessary to practice in the area you have your heart set on. You can often list an area such as heart health, sports med, endocrinology as an area of interest and expertise and craft your practice to managing those patients as long as it's within your scope of practice. A 2-3 year fellowship has a huge opportunity cost associated with it. Some of the options listed above may require additional certifications or training courses specific to the area of practice that can be done through CME training.
This is not an exhaustive list, but it gives you a starting point for exploring the many exciting and fulfilling career paths available to physicians outside of the traditional hospital setting. Let me know if you come across other interesting and atypical routes I should add to the list.