The Good And The Bad Of Being A Medical Director

In this post I want to talk about the pro’s and con’s of taking on leadership at your job. I’ll talk a little about my own personal experience, definitely the financial benefit, the level of work involved and what might be expected of you. I’ll summarize by saying that, though reluctant to take it on, I am very glad I did because I learned skills that I assumed I could simply learn from a book or seminar.

Dabbling In Leadership End Of Residency

After 3 years of residency I wasn’t quite ready to take on a full-time gig so I decided to stay on as a chief resident. In Family Medicine Residencies few programs have 4th year chief residents, at least in California. I dabbled in sharing the chief-load as a 3rd year, like it, so I decided to suggest to my wonderful program director that she really needed a 4th year resident… she actually agreed. This goes to show you, when desperate, it’s worth it to reach for the stars.

My Hail Mary suggestion paid off. She knew I was gonna put in the necessary work, but she also realized that I loved moonlighting (mostly for the money), which is how we agreed on me working only 3 days a week as the chief resident. That would be my first dabble in leadership. Who says you gotta play by the rules? If your services are needed bad enough others will compromise.

Doing The Leadership Work But Not Getting Paid For It

My next pseudo-dabble in leadership came when I worked in San Diego as an urgent care doctor, acting as the go-to person for a lot of the urgent care issues, perhaps due to the small size of the department. I wasn’t getting paid anything extra for orienting residents & the new-hires or working on schedules with the Chief of the department. I was too inexperienced to realize that I needed to ask/push to be compensated.

My First Leadership Role Fell Into My Lap – I Almost Passed It Up

Beginning of 2015 I started working in a similar medical group in Portland, Oregon, in a much larger urgent care department which was still expanding. I moved mostly because I wanted a change in scenery, Southern California never impressed me… a bit of a hype. Portland was and is an absolute perfect city for me and with an expanding urgent care department, the new Chief asked me if I would be interested in becoming a Medical Director for 2 clinics.

It took me a while to make the decision… funny, thinking back now I remember how certain I was that I didn’t want it. Being the awesome chief that he was/is he helped me through the transition and it has been overall very smooth sailing. I divide my time a bit unevenly between the two clinics, one in Washington and the other in Oregon, both accessible by bike from my home. My chief and I hang out, talk shop over beers and pizza, not only have I gained a great friendship but an invaluable experience in leadership.

Being the clinic director means that you work directly under the Chief. He/She is tied up in a lot of meetings and handles the big decisions, guides the direction of the department and takes whatever shit from on top and hands it down to the MedD, who is responsible for implementing the changes. Our department is large… we have more than 6 urgent care sites, 3 Medical Directors in total. Each clinic has a Department Administrator who works under the MedD and represents the staff (LVN’s, RN’s, MA’s etc). Together, the DA and myself try to make each urgent care run efficiently, deal with sick-calls, staffing issues, and of course keeping up with whatever changes that get passed down.

An Extra $25-30k/yr, But It Comes With A Lot Of Work – Easy Work

So… what’s my day like? Today was my off-day, my first day off on my 7-on-7-off schedule. I spent the entire morning until 1pm sending off emails, making phone calls and planning out the rest of the month. At one of my clinics I am stuck with this fuck-tard of a DA who is as useful as a window on a submarine… minus the view. This means I am left with a lot of pooper-scooper duty. My average day starts out with multiple text messages going out handling last-minute staffing changes. Throughout the day there are about 10-20 vital emails to handle… 30 emails that can be deleted without viewing. I am interrupted by about 5-6 people on the average workday coming up to me asking urgent care related questions… which I don’t mind, I’m glad they find me friendly enough to chat with me.

There are numerous phone meetings, in-person meetings and pseudo-meetings to attend nearly every week, even on my off days. There are also plenty of work events that involve alcohol, food, dessert or coffee… it’s Portland. Almost always those dinners are paid for by my medical group.

My pay… right, that’s the juicy part. For my administration role I get paid a whole day’s pay (10-hours) at around $100/hr every paycheck (2x per month). On top of that I get paid administration time at the same hourly rate for another 10 hours per paycheck. There are certain lengthy mandatory meetings which I have to attend every week… also paid for at my hourly rate. In total, I get paid a gross of $25-30k extra per year for this role.

The less tangible benefits of this position… I get to attend leadership classes, paid for by my medical group, organized and taught by really successful leaders in their field. If one is vigilant enough it’s also a good way to make some decent connections. Getting to know the head of interventional cosmetic proctopathology has its benefits. In a smaller city like Portland we also get to rub elbows with some big-name local entrepreneurs who are involved when my medical group wants to expand into whatever market. I will also add personal growth and the satisfaction one gets from instilling positive changes… yea, I know, cheesy, hope you’re not lactose intolerant.

What Sucks About Being In Leadership

Now, the shitty sweaty-balls-parts of the job. Duuuuuumb-ass doctors, with medical degrees, from very respectable institutions who are so clueless that you just want to push them off of a cliff. It’s much better dealing with a medical assistant who is still trying to figure out left from right… you sort of spell everything out, stupid questions are expected and actually welcome because at least he/she asked which way the thermometer should be inserted in the infant’s rectum before doing so. An MD or DO however… that’s … that’s something else. When they come to you wining, when they call out sick because they had a tough shift the night prior, when they complain about ‘sick’ patients, let their licenses lapse, when they just had to smoke weed before coming into work, when they have their crazy ex show up at work threatening the staff… them’s the special moments when you wanna bust out the Jameson and finish the bottle.

My Long-term Plans

It has’t even been a full year yet and I’ve hit a rough patch which I would like to ride out. I enjoy the money that comes with this position and I am still learning quite a bit. Like most things in life, I will leave it if a better opportunity comes along.

I don’t intend to move further up in leadership. The next level would be becoming the chief of the department. That position will be available in the next 2-3 years and I am fairly certain I could have it as long as I don’t fuck things up. Doing less clinical work and more admin stuff doesn’t interest me. If I am going to ‘manage’ anything then I would do so running my own business.

Have you considered taking on a leadership role in your medical group?

Do you think the extra income justifies the extra work on your off days? I would love to hear your comments regarding this.