Many readers of this blog are convinced that there is a better way to work and live as a physician. Practicincg medicine should be enjoyable because you can make good money and you can help people. That is why many of you are contemplating a career change.
But timing your career change matters. You can’t let your career dissatisfaction blind you to the economic conditions of 2019. Not trying to make any economic predictions here, but I want to highlight the importance of income stability and timing of your career change.
Who needs a stable income? You need a stable income if you have dependents and a lot of overhead. If you haven’t shaved your overhead by now, it might not be the right time to make a dent in it in late 2019.
Stable income in medicine usually comes from being employed. But remember that 40% of physicians are still in private practice, despite popular media claiming otherwise.
But starting a private practice at the height of a market, at the height of the biggest economic expansion in modern history might be a bit too adventurous.
But it might be a good time to consider jumping ship from your mega health corp over to a sustainable private medical practice as an employee.
A Career Change
A career change could be getting out of medicine or it could be transitioning from a full-time Urgent Care doctor to a part-time telemedicine physician.
Maybe you want to leave your clinical role and take on a teaching position. Or maybe you want to pursue writing as a career.
Or, even more likely, you have no fucking idea what you want to do. You just know that you don’t want to keep suffering doing what you’re doing. This means you’ll have to dabble in a lot of different things until you find the right opportunity.
But you need to first secure a solid base. A solid income.
Peak Economic Time
It’s the end of 2019 and we are in the midst of the longest economic expansion according to some experts. The peak is usually followed by a trough.
It’s late 2019 and we have low unemployment rates, easy access to credit, investors willing to gamble on innovation, a stable political climate, and low inflation.
Bonds are doing pretty well and stock prices are high. Real estate is once again at an all-time high. Companies are hiring left and right. This is as good as it can get, given all the conditions mentioned above.
Peak economic times usually mean that some correction is in order. It’s the nature of economy to expand and contract in order to maintain a healthy balance. Who knows what will set it off – a plague, inflation, a war, political instability, or policy changes.
Opportunity During Recessions
Since the early 1900’s, there have been maybe 12 major economic recessions. Each lasting about 12 months.
Opportunity dries up for most of us during an economic recession. It’s harder to get a loan. It’s harder to get applications approved. It’s harder to hire good help and it’s harder to get hired by good companies.
Physicians who are interested in getting into telemedicine won’t have as many opportunities during a recession. Those interested in opening their own private practice will not have the rich patient pool to choose from.
Moonlighting Through 2008
I first got my medical license in October 2006 – I had just started my second year of Family Medicine residency at UCLA. I wanted to get out there and moonlight as soon as possible.
By 2007 I was already working at 5 different clinics. I was moonlighting in the ER’s and Urgent Cares and in Family Medicine clinics.
I was making around $80/hour and then 2008 hit – the first recession of my working life. I had a hard time getting as new gigs. The medical groups wanted to only hire full-time workers and didn’t want to have as many per diem doctors.
One major company wrote a letter to their per diem docs and said that because of shitty economic times they had to cut their rates down to $65/hr.
UCLA and Kaiser Permanente laid off hundreds of nurses during that economic contraction. The whole atmosphere of work and opportunity changed. People were more fearful, they became more greedy, and attendings were freaking out about their retirement.
Timing Your Career Change
1. Maintain a Stable Income
If you have a solid source of income then this is the time to hold on to it. This isn’t the time to risk it for a career change – not yet. It doesn’t mean that you can’t pursue something else on the side, but probably best to keep that main IV.
There is always a level of uncertainty as to which sector gets hit the hardest during a economic downturns. Last time it was real estate but it also compromised money lending. Who knows, next time it might be the healthcare sector or the transportation industry or it might be mostly inflationary.
2. Secure a Main Gig
If you are working several gigs, try to lock in one of them as your main gig. Spend the rest of your time moonlighting so that you can keep those doors open.
You might be let go by one employer or the nature of the business might change. You want options but at the same time employers will look to keep the most loyal employees.
3. Secure Some Money
If you are thinking of starting your own practice, this is the time to start saving money. It’s a good time to secure a business loan and get rid of as much overhead as possible.
A HELOC is a good thing to have on hand. But a business loan is also great, especially when you have the stable income from full-time employment.
4. Explore Consulting Work
If you’re interested in being a little less location dependent and want to pursue some of the digital nomad work that I’m doing, this is the time to start looking for those gigs. This is the time to get some consults under your belt to build your resume.
5. Get Credentialed for Telemedicine
If you think telemedicine is a good option for you, this is the time to get credentialed and start seeing patients. Who knows when telemedicine companies might run out of funding. Maybe they’ll only take physicians with prior telemedicine experience.