GeneralHr Library

How to Stay Excited and in Love with a Career in Medicine

Source |  |  BY:Pat Salber, MD, MBA, Founder & CEO, The Doctor Weighs In

Decades ago, when healthcare career choices for physicians were more limited (small private practice or large academic, primarily research, settings), physicians in training could focus on acquiring vast amounts of clinical knowledge as well as technical skills—mainly surgical. If they wanted to go into research, there was always the option of choosing an MD-PhD path; if public health, an MD-MPH. But the advent of managed care in the 80s opened up a slew of new career opportunities on the business side of medicine. Suddenly, doctors could be health plan medical directors, experts in utilization management, or Chief Medical Officers. They could run large practice groups or run hospitals.

Soon after the managed care revolution, the country went through serial efforts to reform our increasingly dysfunctional healthcare system (remember the Clinton plan?) offering doctors opportunities for careers in health policy and health services research. More recently, the explosion of digital health has teed up entrepreneurial opportunities unimaginable to prior generations of physicians. It is an exciting time for physicians, but it is also a confusing time. How can doctors prepare themselves both for the present and the future? What types of skills, beyond clinical, should they be acquiring? When should they acquire them? And, how?

Careers last a lifetime

I like to answer these questions by reminding people that careers last a lifetime. You don’t have to do everything all at once, you don’t have to do anything forever, you can take left turns, and you can reinvent yourself. You can do this in a planned or in an opportunistic way. I know because that was the serendipitous and convoluted path that I have followed.

I trained in academic endocrinology at the University of California San Francisco, working with some of the giants in the field (Peter Forsham, John Karam, Claude Arnaud), but I was moonlighting in the ER at Kaiser San Francisco to bring in some extra cash. It was the early days of emergency medicine—there was not even a residency in San Francisco at the time. So by day, I was working up complex endocrinology cases. And at night, I was intubating asthmatics and treating desperately ill patients in heart failure. One day, after getting back ambiguous results after a year-long workup for a rare endocrine tumor, a giant light bulb went off in my head. Emergency medicine thrilled me, endocrinology did not. So I left UCSF and became a Permanente Medical Group emergency physician, a position I held for the next 15 years. During that time, I became involved in the issue of domestic violence and ended up founding a non-profit, Physicians for a Violence-free Society. I also got involved in my specialty society, eventually becoming the first woman President of the American College of Emergency Physicians in California. This opened up a chance for me to do a 2-year Pew Fellowship in Health Policy at UCSF’s Institute for Health Policy Studies under Phil Lee who went on to serve as Undersecretary of Health in the Clinton administration.


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