What does it take to move towards changing physician careers?
Over the next few months, I plan to share a series of email interviews I will be doing with a number of physicians who have successfully made the transition to a non-clinical career, or have started working on changing physician careers.
Gretchen Bosacker MD – Life Insurance Physician Consultant
Q: What prompted you to change or evolve your physician career?
I worked in Family Medicine clinic from 2005 to 2008 in a rural area, 25 minutes from St. Paul, Minnesota. I was the newest physician there for about six months. Therefore, my first few months were filled with patients who had experienced negative visits with other doctors and wanted to “try the new doctor.” Most of these folks requested narcotics or wanted me to endorse naturopathic methods or disabilities. When I refused, they were dissatisfied again.
I eventually cultivated a practice of women and elderly men. The women thought that because I was female, I would be super-sympathetic to their concerns, mostly obesity, fatigue and lack of sex drive, and the elderly men liked my veteran status and straight talk. They knew they’d been hard on their bodies for decades and wanted me to help them survive a bit longer.
Truth is, I loved my elderly patients. I loved their stories and addressing their concerns. I loved comforting them and helping them die peacefully.
I uncovered a brain tumor in an adolescent and unstable angina in a diabetic woman. Other than that, it was vanilla. I was seeing 30-35 patients a day and I was bored. I worked as a hospitalist for two years after that. Same area. I loved the acuity. Twice, I jumped on the ambulance with the EMS because I could not, in good conscience, send an ICU patient with a paramedic to a tertiary center. Both survived. Once, I helped a 42-year-old man with terminal pancreatic cancer and mesenteric carcinomatosis to his car and injected him with IV dilaudid from the back seat while the hospice nurse drove so he could get home. I prayed we wouldn’t get pulled over! I had told him I thought he would did that day. He lived three more weeks, was able to see his son play football, fished one more time and sat on his deck.
When changes came about requiring physicians to document “Acute Systolic Heart Failure” instead of “CHF” I offered to put together a presentation for the medical staff about the new rules and how to best follow them. I offered to make placards with tips and tricks to improve reimbursement and post them above the toilets where they would be seen. The administration declined my offer.
I had been host of weekly medical radio program for the care system for three years by this point. I had honed my presentation skills and was being sought out by two local network affiliates to do television appearances. I wanted to explain medicine. I wanted to teach in words everyone could understand and remove the mystique around medicine. I had used a sharpie marker in residency to draw suns and moons on pill bottles for my low-vision and illiterate patients having difficulty with their medications. I wanted it all to make sense so they could make healthy choices!
In my first three months doing medical media projects, I made the same income I had in the entire year prior. I flew first-class to Manhattan, L.A. and Miami, stayed at the Beverly Hills Hotel, ate incredible food and had makeup artists and limos… And I hated it. I hated being away from my family. I hated the plastic nature of it. I hated how scripted it all was. I was a novice paying dues in the industry, but I’d paid dues already in medicine and the military! I was done with dues!
One day, I received a cold call from a recruiter who had seen my LinkedIn profile asking if I would be interested in a job in insurance medicine. I said I would and interviewed. The hiring process took six months, but I was hired. During that time, I read “What Color Is Your Parachute” (A) and did all of the exercises inside. Turns out, I’m an introvert! The radio and TV (and occasional karaoke appearances) were outlets for energy, but my true regeneration happens when I’m alone. I also outlined the conditions I worked best in and the team I wanted to have. It was all incredibly enlightening.
Q: What steps did you take to make these changes happen?
I allowed myself time off to figure this out and worked Urgent Care to make ends meet. Taking time off without an injury or infant was very difficult. I had no hobbies or friends that were available during the day. Without my job title, not “doctor” really, but “employed clinician,” I didn’t have much of an identity. I searched online and emailed colleagues from the Navy and residency asking about positions and read blogs about medicine, travel, motherhood and change management. It was all quite regimented.
Q: What has brought you the greatest joy in your non-clinical physician role?
In my role as insurance medical director, I have taught underwriters, insurance company employees and claims examiners about medicine and health. I made the difficult topics easier to understand and created reference materials for them to use when the medical directors weren’t available.
As a lifestyle, being able to come in after having breakfast with my kids, work alone in my office with an administrative staff taking care of phone calls, bills, calendars and paperwork and rearrange my schedule as necessary to be available for my family has been fantastic. I do not work at night or on weekends. I’ve continued learning and have stayed proficient clinically by precepting residents at the University of Minnesota one-half day per week. I was voted Community Preceptor of the Year in 2016 and I cherish that honor. I not only teach medicine, but I demand that the residents negotiate their salaries and contracts and evaluate their needs before signing anything. I help them negotiate disability insurance and bonuses. More than once, a resident has told me she has gotten $10k more than was offered because of what I taught her. That is wonderful.
On the flip side, office politics and corporate nonsense are not taught in medical school. When I ascended from medical director to Chief medical director, I learned about budgets, meetings, evaluations, boards and corporate-speak. I hated every bit of it. Every moment. I loved the job of chart review, but loathed wearing a suit and attending meetings. It was this political busywork that ultimately drove me away from being Chief. Fortunately, there are many jobs in insurance medicine that involve chart review without managerial duties. I’ve learned that my lifelong drive to achieve, Achieve, ACHIEVE was doing me a disservice and that to best sleep at night, I needed to change my focus to love, play, parent and work on the side, because, in the end, the memes are true – my job is only my means to pay bills. My ultimate joy in life comes from being my kids’ mom. With medical director work and a board certification in insurance medicine, I can work remotely, see and love my kids, pay the bills and enjoy the whole bit.
Q: What if any regrets do you have about changing physician careers?
I run a damn good code. When things are hitting the fan, I am the doc you want there. I put a central line in a seizing ICU patient on heparin for angina (alcohol withdrawal) and orchestrated a whole team that ultimately saved a man with a catastrophic GI bleed. It was like dancing. Often, though, this happened in the late afternoon and ate up my evening with my family. So, while I miss these, I’m very glad to not deal with this anymore.
Q: What is the one success secret you have for changing physician careers?
Be introspective about WHY you want to make a change. What do you NEED? What do you WANT?
Sit still. Think.
Give yourself more time than you think you need or can stand with NOTHING to do before you make any big decisions.
Read the Parachute book and MAYBE one other. Not more. Don’t overdo it.
Be honest with yourself about money. Having a $300k salary is nice. It’s ok to say that. It’s ok to demand it. You are worth it.
Thanks to Dr. Gretchen Bosacker of Grant Medical, LLC for sharing with us the story of her journey to changing physician careers!
PS: If you didn’t pick up on this takeaway, having a dynamic updated LinkedIn profile is a BIG PLUS!!