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Many doctors naively believe that once they start
earning lots of money and have a long line of
patients waiting for them, they will have it made.
Once they reach this point, many are quite happy
to cruise on their reputation and skills for the
rest of their lives. However, to judge the health
of your career, it’s not enough to just
look at your income statement – you need
to assess your personal balance sheet as well.
You are a professional and your major assets are
your medical knowledge and skills. You need to
keep on building these if you want to remain successful.
The Japanese call this kaizen, which means constant
improvement. If you do not actively work at it,
your career prospects will decline, even when
(or perhaps especially when) you are making lots
of money. In fact, the more “successful”
you are in later years, the greater the temptation
to exploit existing skills - and the harder you
need to work to make sure that you don’t
just rest on your laurels. You have to find ways
to continue to develop the knowledge that your
patients value. Doctors get paid for their time,
but that's not what we sell. We sell our medical
knowledge and skill, and left untended, these
depreciate in value surprisingly quickly ! This
is especially true in medicine, where the knowledge
base expands exponentially every year, and new
discoveries are being made all the time. We all
need a personal strategic plan for our careers,
and the sooner you formulate this, the easier
it will be for you to progress.
Most doctor’s careers have the following
five stages:
- Entry, when you are starting out;
- Establishment, when you have created a name for yourself;
- Exploration, when you look for new fields to conquer;
- Specialization , when you settle down in your niche; and
- Mastery, when you establish yourself as the Expert in
your area of interest.
Whether you are 25 or 55, you always need to think about where
your career is headed. The one constant in life
is change – and as medical technology , governmental
regulations, insurance reimbursement policies and
patient expectations change, you will need to change
with them.
As you think about your
career, here are some questions to ponder:
- In what way are you personally more valuable to your patients
than last year ?
- What specific new skills do you plan to acquire or enhance
in the next year?
- What is it that you want to be famous for ?
Traditionally, doctors have adapted themselves to
their jobs – and most have uncomplainingly
and blindly done what the rest of their colleagues
are doing. However, many are increasingly finding
that this is a difficult burden to bear. This is
why, rather than change yourself, it is better to
create a job which is especially designed for you.
A niche is “ any position specially adapted
to its occupant” , and if can find your niche
where you can practice effectively , this will help
to make your career in medicine enormously rewarding.
After all, we all have different interests and talents.
Why not use these to stand out and shine - you need
to play from your strengths ! Find your special
interest as soon as possible. What turns you on
? What do you enjoy most ? What part of your work
would you be happy to do daily without pay ? The
secret for success is to find something you love
doing and very good at – and then to attract
patients who will pay you to do this for them !
A niche does not need to be some new thing imposed
on you (unless you want it to be) nor does it need
to be a whole new aspect of your life (again, unless
you want it to be).
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If you want to make yourself a truly valuable asset, then you
have to focus your attention on building a highly specific set
of knowledge and skills – you have to carve out a niche
for yourself. With ever increasing sophistication in medicine,
patients value specialization, and you have to consider what
your patients define as value. For your patients, your asset
is valuable only if you have technical skill as well as the
ability to apply it in a customized way to their situation.
It is important to make a distinction between knowledge and
skill. Knowledge is relatively easy to accumulate, but it depreciates.
Skills are harder to win, but keep their value a little longer.
For most doctors, technical skill alone is rarely enough. To
be a valuable doctor in the eyes of patients, you need to learn
a wide variety of interpersonal skills as well, which allow
you to communicate effectively with your patients.
Each patient encounter can teach you – if you are willing
to learn. Many good surgeons will take time at the end of an
operation, for example, to ask themselves, “What went
well, and why? What didn’t go so well, and why not ? ”
. This self-imposed discipline allows them to critically analyse
their performance, so they can come up with ideas that will
help them get better the next time. Keeping notes will also
help you remember and apply the lessons next time. Take every
opportunity to discuss your work with colleagues, so you derive
value when they ask “Why did you do it this way? What
would have happened if you did that?”
Although creating a niche for yourself can be a lot of hard
work, there are ways to make the job easier. For instance, if
you want to be known as an expert in a specific area of medicine,
it helps if you give professional talks on the subject. Start
locally and expand your horizons as word of your expertise travels.
If you are inclined to write, publishing articles in peer-reviewed
journals or the lay press will help to further establish your
credibility as an expert. Join professional organizations that
can provide valuable information in many forms, including publications,
seminars and formal coursework. For example, if you are interested
in writing on medical topics, you can check out the American
Medical Writers’ Association (AMWA). If you are interested
in becoming a hospital administrator, you can contact the American
College of Physician Executives (ACPE). Having a niche allows
you to differentiate yourself from other doctors, so that you
can attract more work . Being different can be very helpful
in becoming the leader, so don’t waste time trying to
be everything to everyone and ending up becoming nothing to
no one !
The secret for planning your career is to pick a
clear focused personal professional goal. As physicians,
we aren't used to choosing our own professional
goals because they were usually chosen for us. Throughout
our training, we were told what we were going to
do, and when and how we were going to do it. But
by not setting our own career goals, we have no
direction—which is why, after 10 or 15 years
of practice, some physicians end up saying, "Is
this really what I wanted to do? Did I train 16
years to do this?" When you set a goal, and
every day do some work toward reaching that goal,
you begin to take control of your professional life.
That's why choosing a professional goal is the most
important single thing you can do—it starts
to put you back in control of your career. Each
year, perhaps on a specific date such as your birthday,
you might want to reflect on the path your career
is taking. Think about what things you can do in
the coming year to further define your niche. As
time goes on, you will develop new interests. At
some point, you may even want to move in a completely
different direction. Taking the time to reassess
what you are doing on a regular basis allows you
to incorporate these new interests into your life
, and to get rid of things that you really don’t
want to continue pursuing. Discovering your true
mission in life, and then allowing that to frame
a career that is specially designed for you, can
help to make you a true healer. Both you and the
people whose lives you touch will reap the rewards
of the careful thought and planning that go into
creating your own personal place in the world—your
niche.
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The most important factor in your career design
is to shape your practice around your abilities.
In doing your self-assessment,
five areas are key:
- Values: What motivates you? What would make you feel
you were devoting your time and talents to something extremely
worthwhile?
- Skills: What's your strong suit? Which strengths do you
have that complement your medical skills? Are you skilled
at something you don't enjoy doing? If so, you'll want to
de-emphasize it so you don't gravitate toward something
you won't like.
- Behavioral style: How do you approach problems, people,
rules, and procedures? What kind of pace do you like to
keep?
- Cultural preferences: Do you like the intimacy of small
medical groups or the anonymity afforded by a larger organization?
Are you a traditionalist, or an innovator who prefers a
fast-moving, entrepreneurial culture?
- Lifestyle: Are you a family- and community-oriented person?
An outdoor enthusiast who needs the right setting to pursue
other passions? A travel bug who needs to take vacations
on your own schedule?
Thus, if you are an orthopedic surgeon and find you are technically
clumsy in the operation theatre, it’s better to stay out
of the OR and not botch up surgical operations. Instead, you
could choose to specialize in medical legal work, by providing
advise to lawyers in medical compensation cases - a very remunerative
field. If you enjoy what you are doing, you will do a much better
job at it !
You don’t have to limit yourself to medicine
either ! Many doctors have successfully pursued
careers in many other fields, such as information
technology, writing, law and business management.
Some start coaching classes to teach medical students,
while others serve as consultants to the pharmaceutical
industry. In today’s world, your options are
limited only by your imagination. Other doctors
have been even more enterprising and have a portfolio
of careers – after all, there is no rule which
says that you have to slavishly do one job all your
life ! Having a career portfolio can add colour
to your lives , because it ensures you have multiple
interests to pursue, which keeps you on your toes;
and also allows you to create a financial buffer,
in case one career is not doing well at a given
time.
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Remember that you are your most important asset . You can think
of yourself as a small company – You, Inc, which you need
to nurture. It’s no longer enough to just become a doctor
and work hard anymore. You must do something you love, have
outside interests, participate in your community and continue
learning throughout your life. These are investments in your
future, which help you lead a life full of purpose and meaning.
Unfortunately, too many doctors (especially those with successful
careers) have forgotten that there is more to life than just
earning money. Finding a second source of income, which comes
from something you love to do, will make life much more interesting
– after all, medicine can become very monotonous if you
don’t explore new options. As you get senior, it’s
the quality of your patients which counts, and you are not going
to be very excited about doing your 500th appendectomy.
Finding a mentor who can give you the benefit of his experience
can also help you achieve your goals. This is why every athlete
has a coach – to drive them, to make suggestions, to help
encourage them to better their best. Coaches know exactly how
to get their "stars" to work a little harder, to stretch
their horizons, to try things that they ordinarily wouldn’t
have tried left on their own. Many doctors hate the business
side of practice, but that is exactly where profits are made
or lost! So, what’s a doctor to do? Simple - put a knowledgeable
coach on your success team, and maybe you’ll win the Olympics
of success in practice ! How do you find such a coach ? If you
have a friend or relative who is a successful businessman, ask
him for help. Many successful people are very happy to share
their secrets of success with others. Another useful source
is your patients. Pick your most successful patient, and ask
for help. Most patients are more than happy to help their doctors
!
In his book, Finding Your Niche, author Laurence
Pino suggests trying this exercise. “Visualize
your own funeral. There will be four speakers at
the service: a family member, a friend, a colleague
, and an associate from your community. What would
you like these speakers to say about you and your
life?” This might seem a morbid thought to
some, but it’s worth considering Pino’s
point. What exactly is it that you hope to accomplish
in your lifetime? You then need to plan your life
so that you can achieve these goals. Planning backwards
works much better than stepping forward into the
unknown. If you plan well, you can lead a life which
you can look back upon with pride and joy.
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