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A New Direction For My Medical Consulting Work

Building My Medical Consulting Skills

When I started my consulting gig with one particular telemedicine company, I assumed that I would help the fledgling startup shape its software to better serve its target patients. Over the past year, the role evolved more into being a physician seeing patients on a virtual platform – not really what I set out to accomplish.

I made a few half-assed attempts to focus my work back into the initial direction. I wanted to work on the software, I wanted to bridge the gap of clinical input and software output. It was in vain, I failed to be clear enough about my goals and intentions with the company’s leadership.

I have written about how important it is to have clearly written out goals, to know what you want, to know where you want to end up and how you want to get there. Even if you don’t know the details, you should know what general path you want to take and what things you absolutely refuse to do.


My Intentions For My Medical Consulting Work

I value the skills which I’ve obtained during my short medical career, however, my passion isn’t in serving up clinical medicine. It seems more worthwhile to develop my consulting skills regardless of where it might take me – having less need for the income puts me in a favorable negotiating position.

Just like any highly specialized field, medicine is quite dynamic and there is plenty of room for improvement. Whatever skills I can dig up within myself and learn along the way, should serve me well as a consultant.

What Is ‘Consulting’

Consulting is trading my knowledge, expertise, opinion, and organizational skills in order to profit an entity. This appeals to me because I enjoy getting into projects and setting goals, taking apart problems and coming up with innovative solutions.

I am arrogant enough to believe I have something to bring to the consulting world within the field of medicine. Can I back it up? Time will tell. Writing it about medicine on my blog and talking to people far more intelligent than myself is a great start. Realistically, it will be years, possibly decades before I have the adequate skill set to profit such groups. Thankfully, I’m a long-term investor and therefore not in a rush.


Employee Or Consultant?

As employees, it’s common to find ourselves in precarious situations, unsure of where our responsibilities might take us. In the role of an employee, there often isn’t too much wiggle room – physicians do as they are told except for retaining the majority of the clinical decision-making authority.

As I mentioned, I wasn’t able to make myself clear to the leadership of this startup company which led to me doing more manual clinical labor. And I was sure they had no ill intention but were perhaps just as perplexed as to why I wasn’t reveling in my assumed position.

I sat down last week and wrote a succinct email outlining that I no longer was interested in pursuing clinical work on their site and wanted to slowly bring our interaction to a close. I said this very kindly and included all the praise you can imagine for a company which treated me fairly and kindly all along the way.

I needed to be brief, succinct, and clear. I believe I achieved that. I outlined that I had already put in my dues with clinical medicine and that I wasn’t looking to do more of that. With more desire to have autonomy over my free time rather than earn a high income, I respectfully declined their offer for a full-time gig at a $200,000 annual salary.

I am finding myself in some excitingly, turbulent, uncharted times in my life. I don’t know exactly what I want but I know what I value and what I want less of. There are certain health related topics that really inspire me which I can see myself getting involved in but if I don’t know what they are, I won’t keep spinning my wheels trying to figure it out.

It must be tough for the leadership of a startup to get an email like that. What the hell are they supposed to do with that? So…. does this doctor wanna leave? Is he unhappy? Does not feel inspired by the work? Is he a cry-baby? Should we let him go and get a replacement? Or is there something else we could use him for?


Let The Company Figure It Out

I agree that if you know exactly what you want, things will be much more straightforward. Confusion will be avoided and you can carve a path out for yourself towards achieving your goals.

However, if you don’t know what you want, don’t just get stuck doing it because it earns money – especially if it earns easy money, that’s the most dangerous kind of money. That kind of work and income can keep you hostage, worse than your job’s golden handcuffs.

Especially for those physicians who are in the fortunate position of not needing the income as much and wanting to focus their efforts on doing something meaningful, it’s perhaps better to put the responsibility on the company’s leadership. If you are an employee/consultant of value and you aren’t fulfilled in what you’re doing then your talents likely aren’t utilized appropriately by the company.

If you are a worthwhile asset and the company has a sound business model, they will work hard to keep you. If your value is questionable then you’ll either have to be an incredible marketer or you’ll have to work at creating that value in the future.


Are You A Worthwhile Asset?

Doctors are among the best at being humble. My surgeon friends make it seem as though what they do is pretty simple – “once you get the training…” – what crap! It requires so much dedication, repetition, learning from mistakes, mastery, developing the eye for incremental improvement.

When you’re out there strutting your stuff in the lonely world of consulting, it can be hard to know whether you really are an asset to your client or just going through the motion to make a dollar. I don’t think this is a healthy mentality and perhaps I’ll spend some future words discussing how to best assess your value as a consultant. In the meantime, know that if the company sees value in you then you are a worthwhile asset.

Instead of doubting yourself, spend time figuring out what it is that they see in you. It could be your charm, it could be your attention to detail, it could be how easily you can relate to the layperson, it could be your ease of communication with the engineering team or your ability to see the next problem lurking ahead.


Their Counter offer

I offered to stay on for a reasonable amount of time to make sure they could find a suitable replacement. It’s tougher with startups because they don’t have the personnel to go hiring anyone, anywhere, whenever they want. They spend months looking for the right kind of candidate and put a lot of value in their initial employees.

That company recognized that I was a valuable enough employee that they wanted to keep me on. They agreed to slowly cut back on my clinical responsibilities and mentioned a new project which they were undertaking. For their strategic advantage, I won’t mention what the project is but it is exactly the sort of thing that I would love to be a part of.

I am humbled by the fact that they didn’t just agree to cut my hours slowly and have me leave. They instead offered me a new opportunity that’s perhaps more suitable to me.


My Own Reluctance

At first, I thought it would be better to just lay off this company altogether and thank them for the opportunity but let it pass me by. Did I really want to dedicate many hours a week to this new proposed project? It would likely mean having to fly back and forth to San Francisco in order to meet with their team. I would have to delegate tasks, work with another team of physicians, write protocols, work closely with software engineers, etc.

My reluctance came slightly from laziness and slightly from being in a place of comfort. After all, I don’t need the income, I am perfectly content spending my days climbing in the gym, writing, reading and going for walks or bike rides. And I absolutely don’t think there is anything wrong with that – ‘productivity’ is insanely overrated.

But this happens to be a project which I’m actually excited about. Sure, I’d have to put in some effort and get off my ass but how can I just dismiss it because of the time commitment and ignore the money it will earn me simply because I don’t need the income. Not pursuing something which I’m passionate about would be idiotic, right?

Not only am I excited about this project but I want to own the shit out of it. I look forward to it challenging me in ways I haven’t been challenged before and I want to see how well it (I) can do. The money it earns will be money which I can devote to my many side projects


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