Physician Careers – The New Rules

Posted by Dike Drummond MD

Physician Careers – The New Rules

Happy 40th, 50th, 55th Birthday !

You wake up one morning.  It’s your (45th, 50th, 55th) birthday.  You look back over the last five years and feel pretty good about what you’ve achieved so far in your Physician Career.  You’ve done well AND you have worked darn hard to get here.  Your physician career has provided well for yourself, your family and your loved ones.

You have become a shining example of a successful doctor in your community. You become comfortable in your practice.  You have enough “water under your bridge” that the day-to-day practice of medicine is rarely a significant challenge.  The bigger challenge is what’s happening in health care in general.

  • The changing laws and rules
  • The falling reimbursement rates
  • The control that competing organizations exert over your interactions with your patients
  • The changing political landscape as groups and hospitals merge

It’s as if the rules for a fulfilling physician career are changing all the time.

I want you to know that this feeling is spot on. To expect anything else in this modern day is to believe in the old rules of medicine. Those rules were built on a two phase model.

Physician Career Phase 1:

This phase covers the time and energy to take you from your decision to become a doctor to your initial board certification.

This entire phase occurred within the educational system.  The rules and regulations were clear.  Your performance was strictly monitored and you were given quick, graded feedback.

Phase 1 involves the least amount of freedom, creativity and financial rewards.  We are also in a phase of “delayed gratification” and typically early in the growth of our family.  This is also a time when our parents are young and healthy as well.

Physician Career Phase 2:

This is your practice building phase.  This is where the common perception is that you “hang out your shingle” and they will come.

For decades this was actually true.  In most markets growing your medical practice to the point where you were “busy” took nothing more than time.  My how things have changed!

And “back in the day” the only measurement of success was to be “Busy”. The cliché was the doctor too busy for his/her family and most all of us lived into that cliché to some extent.

Phase 2 is another phase completely controlled by the rules of your medical group, insurance providers, hospital system.  However, in this phase, you rarely get feedback on your performance unless something goes wrong. You develop a number of additional roles and responsibilities that compete for your time, your energy and your affections. Most of us are raising families.  All of us have to work harder as time passes to stay physically fit and keep our relationships nourished.  Over time, as our parents age, we often must take increasing responsibility for them as well.

Then there’s the whole “Lifestyle” issue

Another factor that requires attention and “care and feeding” is our lifestyle.  I remember when I was the Chairman of the Executive Committee of our 40 doctor multi-specialty group back in the first wave of Managed Care in the 1990’s. A surgeon colleague of mine became inconsolably upset when asked to take a temporary $20,000 per year pay cut — from his $250,000 per year salary. At the time I was living high on the hog on $120,000 per year and found his protestations difficult to swallow.

And your lifestyle is something that grows over time. It is a version of the Peter Principle. Your lifestyle expands to occupy your income. It can become a hungry beast you may feel like you have to work hard just to continue to feed.

With all these competing segments of your life it is almost impossible for a practicing physician not to get out of balance. At the same time, you may also feel like you are at the mercy of outside forces with little control over your work and day to day life.

It’s a perfect storm of conditions for Burnout, Stress and Exhaustion. And this is a Calling to a new Phase of your Career.

The Phase Three Calling

This is why I believe our modern practice of healthcare demands a third practice phase.

Busy isn’t enough anymore. Busy only gets you more busy and these days busier  gives you very little more money, fulfillment or satisfaction.  No longer is it just about doing more and more of the same things.

Reality Check:

If you have any wishes for a practice or a life different than you have now

What got you here won’t get you there


Here’s another way to understand this simple and very powerful concept:

If you always do what you’ve always done,
you’ll always get what you’ve always got.


You are being called to Phase 3 of your medical career.

In Phase 3 you create your own, personal definition of success. Then you design and create a career adn life that fulfills that definition. It’s all about you at this phase. Only you can create this for yourself.

Let’s look a little more closely at my proposed phase 3 of your physician career.

Physician Career Phase 3:

In this phase the focus is on meaning, fulfillment, life balance and creating a legacy with your family.  This is about carefully crafting your own personal, unique definition of success in ALL areas of your life … then consciously creating it for yourself and your family.

This is not about working harder
What is being called for is a SHIFT

A Shift in

  • Your awareness
  • Your intentions
  • Your level of involvement in the creation of your day to day, month to month experience of life

It is not about swinging in the breeze at the whim of the next regulation change or merger to come down the pike. In fact, Stage Three contains the transition from being a victim to outside circumstance to taking full responsibility for your career and level of satisfaction from this point forward.

This is a highly creative phase where you set your own rules and give yourself your own grades.  For the majority of doctors it involves continuing to practice clinical medicine with the clear understanding of your vision and mission and the “why” behind your career.

And for a small number of doctors it will mean starting a new career in a non-clinical position.  This could be either inside the healthcare system or outside healthcare altogether. It may even take the form of becoming a Physician Entrepreneur.

The Path to Phase 3

My intention is to teach you the tools and share the shifts in awareness and perception that will allow YOU to create your own Phase Three career … allow you to create your own “right livelihood” from this point forward.
This transformation will be a HUGE benefit to your spouse/significant other, your children, your staff, your patients and most of all … to you and your own private sense of fulfillment, joy and satisfaction.

My Story:

I graduated from Mayo Medical School in Rochester, Minnesota in 1984 and from my Family Practice Residency in 1987 in Redding, California. I spent a year as a “MASH Unit” Emergency Room physician in Clearlake, California right out of my residency. I call it a MASH Unit E.R. because we had no on-site general surgeon. We had to keep everyone alive until the Helicopters got there to take them to the Bay Area. I am proud to say that no one died in my Emergency Room that year even though several folks REALLY tried.

I moved to Mount Vernon, Washington (about an hour north of Seattle) to settle down, raise our family and build my own family practice. I was a full-time, full spectrum family doc. I eventually delivered over 500 babies … most at 3 in the morning. Two years out of my residency program I was elected chairman of the Executive Committee in our 40-person multispecialty group practice. I played a leadership role in that organization from that point forward. For six years I was their Managed Care Medical Director. This was back in the days of the initial wave of “Managed Care”. I was the person who approved, or disapproved, referrals outside of our medical group.

Throughout my medical career, I harbored a secret.  Every year I had wanted to quit.

Becoming a doctor had never been my dream. It was the dream of my mother and her mother before that and I was born to live into that dream.  I played the role really well and became the epitome of a successful small-town family practice doctor.  I was busy, had a beautiful and young family, was one of the top producers in our Family Practice Department and a member of the leadership team.  And every year I want to quit and didn’t know how.

There seemed to be no one who could understand and no resources available… no one at all to talk to.  Eventually, because I saw no other options available, I did shave my head and walk away from my medical career.  This course of action cost me millions of dollars and years of heartache despite the fact that I went on to become a successful entrepreneur and at one point was earning four times my physician salary in my own businesses.

I have started and developed two training companies.  One teaches leadership to LEAN/ Six Sigma practitioners in the military and the other teaches commercial real estate investing.

I’ve been a Life and Business Coach to hundreds of entrepreneurs both inside and outside of medicine over the last eight years.

I’ve done a lot of things outside of medicine but I’ve never been able to stop being a doctor. Once you have been trained to diagnose and treat … those thought processes never completely leave.

That’s the thing about our medical training.  We share a heritage and an experience of coming up through medical school and residency that no one else can really understand.  We’ve seen things and done things that sometimes we even find hard to believe.  It’s true… yes?

We learn how to delay gratification.  We learn how to constantly look for problems and cover our backside.  We learn to handle multiple moving parts and priorities at once.  We learn to be constantly focused outwards and to become so busy that we deny our own biological instincts at times. And I know you know exactly what I’m talking about

AND I have never stopped caring about anyone in medicine who might feel like I did back when I was 40 and saw no alternative but to quit my practice. Now I know there were lots of alternatives. What I was feeling was just a sign of my shift to a Level 3 career wanting to happen.

I felt there was no one who could understand or help back then. Now I know the person I was looking for as a resource, coach and mentor … and it’s who I have become today.

If you are feeling this pull to shift into your own definition of success, well then ….

It’s your time to create your own Level 3 Physician Career

You know what you love about your practice of medicine and your relationship with your medical career.

You know what impact your career has on your

  • Finances
  • Family
  • and your larger life and other interests

You can see the tradeoffs.

And, if you were like me at all back in my days of dissatisfaction, you are wondering what other options are available. What can you do to build more meaning, fulfillment, balance and happiness into your life and career.

What I know from experience is this …

Once you get clear on what you really want … you can work a process to get it. Honest. And you and your family will be so pleased when you get there.

Ready to get started?

Watch this important video to learn how to discover the path to your Level 3 Life.

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Tags: discovery session, level 3 physician career, my, practice, your definition of success


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