Leaving Medicine and Landing Your First Non-Clinical Job With Dr. Phil DiGiacomo

“Once you step out of the traditional clinical roles, you have to convince employers why a physician is a good fit for that role. It's not just implied that all the soft skills come along with taking care of patients. You have to explain them.”

Dr. Phil DiGiacomo is an emergency physician who made the tough choice to leave clinical practice after a decade. Today, he’s the National Medicare Medical Director at Humana, as well as an advocate for physicians in pursuit of non-clinical roles. He created an online course to help doctors make career transitions, which is available on his website.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker talks with Phil about why he decided to change jobs, how he found his new career three years ago, and the tradeoffs of leaving clinical medicine for a remote desk job. Phil also offers tactical advice about different aspects of the non-clinical job search, including getting past AI resume screenings, how to identify jobs that would be a good fit, and how to break through in a huge applicant pool. Here is Phil’s advice to any physician who’s considering leaving clinical medicine or making a significant career change:

The importance of recognizing burnout and making a change

“My burnout did not get fixed by going to a different emergency room. And I finally just had to sit back and ask myself. It's obviously not the location. It's not the employers or the coworkers. It's something with me and emergency medicine.”

During his decade as a practicing emergency physician, Phil changed jobs multiple times in an effort to feel happier and less disillusioned with his career. The first time, he thought switching off the night shift might fix the problem, but it didn’t. Neither did moving to a hospital near the beach, his “happy place.” Eventually, he realized he needed to make a much bigger change — and leave clinical medicine altogether.

The specific challenges doctors face as job applicants, and strategies for standing out

“You're not just a pediatrician who works at a community health department. You are an expert at identifying and managing rare diseases in a pediatric population. That's taking what you actually do and spinning it into a resume, kind of wordsmithing [it] to appeal to a job.”

More and more doctors are looking to leave medicine, making the talent pool for non-clinical roles increasingly competitive. Phil understands the barriers that physician job-seekers face just to get interviews — let alone job offers. He helps doctors get their resumes past AI screenings and in front of human eyes, and then convince hiring managers that they’re top candidates. Doctors already have the “soft skills” that employers are looking for, but they’re not often emphasized in their resumes. Using the right language can go a long way. Phil also talks about the value of networking, which he now embraces but used to shy away from because it felt unnatural.

What to think about before quitting medicine

“People have a lifestyle and they want to maintain it, or close to it. So they want to know, can I replace my clinical salary? And the answer that I give is it really depends on what your specialty is and what kind of job you're looking for.”

Phil fields a lot of questions from doctors considering new careers, but salary prospects and job options are two especially common topics: Will a new industry mean higher pay? What types of non-clinical jobs are available to physicians, and how do you find them? Phil created an online course that explores 18 common non-clinical occupations for doctors to help them understand what their second act could look like.

Exploring part-time jobs and side gigs

“The majority of the non-clinical jobs are full time, but not all of them.”

For people who aren’t sure about leaving medicine entirely, Phil says it might be worth looking into non-clinical part-time opportunities. One example is being an expert witness in trials, which involves remote tasks like reviewing medical records and typically requires only minimal time spent inside a courtroom. For those with research experience, part-time principal investigator roles in clinical trials might be another option.

If you’re interested in pursuing a side job, sign up for Offcall’s Side Jobs Tool which allows you to explore what other physicians in your specialty are doing outside of their primary job and how much additional money they are making with their Side Job.

Gaining an edge in a competitive market

“What I was missing were the actionable steps of how do I find these jobs? What do I need to do to get these jobs? And where do I find them? That's where I found the biggest gap.”

Is it easier for doctors to make career transitions than it was a few years ago? No. Phil thinks non-clinical roles have become more competitive because more doctors are vying for them. But there are also resources to help doctors identify jobs they’re well-suited for and network with companies that are hiring. For example, there’s an annual multi-day in-person conference about non-clinical jobs for physicians called SEAK. And Phil says it’s important to know the right job titles to search for, which is something he goes into in his online course.

The day to day – and perks and drawbacks – of Phil’s non-clinical job

“I work 100% from home. And I work banker's hours, so… I work 7am to 4pm, Monday through Friday. I work no nights, I work no weekends, we get all major holidays off, and then we get a pretty significant amount of paid time off.”

In his job at Humana, one thing Phil does is review electronic medical records that go with coverage approval requests. He’s not making as much as he was in medicine, but unlike in his previous career in the emergency room, Phil now has time for things he enjoys, like exercise, and things he needs, like sleep.

To connect further with Phil, connect with him on LinkedIn here or on his website.

To make sure you don’t miss an episode of How I Doctor, subscribe to the show wherever you listen to podcasts. You can also read the full transcript of the episode below.

Offcall exists to help restore balance in medicine and improve the wealth and wellbeing of physicians. Sign up for Offcall here to bring about more physician compensation transparency and join our physician movement.

Transcript

Phil DiGiacomo:

Once you step out of the traditional clinical roles, you have to convince employers why a physician is a good fit for that role. It's not just implied that all the soft skills come along with taking care of patients, you have to explain them.

Graham Walker:

Welcome to How I Doctor, where we're bringing joy back to medicine. Today I'm joined by Dr. Phil DiGiacomo, who made the difficult decision to leave clinical practice a few years ago and is now an outspoken advocate for physicians on the often difficult path of trying to find non-clinical roles. He's now the National Medicare Medical Director at Humana and went from working days and nights and weekends like me in the ER to banker's hours behind a computer. We're going to talk about some of the trade-offs in medicine, how he decided to change jobs and how he found his new career three years later. Welcome to the show, Phil. Thanks for being here.

PD:

Oh, thanks Graham. Thank you so much for having me and that warm welcome.

The Journey from Clinical to Non-Clinical Medicine

GW:

Phil, I want to get really tactical with you so our listeners can walk away with real clear action items if they're thinking about leaving clinical medicine or they're just curious about what else is out there. I thought I'd maybe just read some of your amazing LinkedIn about section. "I stopped taking care of patients in 2021. It was one of the easiest and hardest decisions I've ever made. I was burnt out, angry all the time and pretty much miserable to be around. Deciding to leave clinical ER practice was hard, but finding a non-clinical job was almost as difficult." So Phil, I think that really speaks volumes. I mean, just reading that aloud, I know that burnt out feeling. Maybe give our listeners a little bit of background on the clinical work that you did, how much you were working and what made you ultimately start thinking about doing something else.

PD:

I practiced clinically for 10 years. After residency, I worked a couple years in Raleigh, North Carolina. I did nights only, anyone who knows me knows that I hate nights, but it seemed like a good job with a good group of people, so I decided to do that. For about a year and a half is how long I made it and then I was like, "You know what? I'm getting a little burned out." I thought it was just the nights, I'm going to take another job. So I actually moved to Maryland and surprisingly the burn out did not get better, so then I'm like, all right, what am I going to do now?

Lots of conversations with my wife and she's from Illinois, the Chicago area, so we said, "Hey, let's try that." Hey, no surprise, my burn out did not get fixed by going to a different emergency room. And I finally just had to sit back and just ask myself, it's obviously not the locations, it's not the employers or the coworkers, it's something with me and emergency medicine. So made a big decision to leave clinical medicine altogether. It was not easy. We still had to make some big life changes to make it happen, but that's what I had to do.

GW:

Well, Phil, I mean your story's really touching. I think it actually speaks to your character that not only were you able to acknowledge that, but that you're willing to talk so openly and honestly about that. It's, I would imagine, really hard to let go, maybe it actually is not the right place for me.

PD:

Yeah, I think my answer to that was denial. "Oh, I don't think of myself as a doctor. My identity is not attached to being an ER doctor." And that was the lie that I told myself and when people ask me, what do I do now? I'm like, "Oh, I work for a health insurance company." As opposed to, "Oh, I work in the ER. I'm an ER doc." And everyone's like, "That's so cool." Now that I have kids, I feel like being an ER doctor is actually even a bigger part of my identity because the community and my neighborhood thinks of me as the ER doc. Their son falls and cuts his chin, they still come to our house to see if he needs stitches.

GW:

That's a common theme that thinking of yourself as something other than a physician or a doctor, it takes some time to get to that mental space to accept like, hey, it's okay if I actually have a different role than doctor.

PD:

Yes. So it's like we had imposter syndrome when we were doctors, now we're having imposter syndrome about being something other than a doctor.

GW:

Oh, that's fascinating. I never thought of that. Phil, did you have any sense of this in residency training?

PD:

Yes, it definitely started in residency. And I clearly remember it was right about halfway through my second year of residency and we had a three-year residency. I had met my now wife who, I think she was my fiance at that time, and we had some serious conversations where I mentioned to her that I really was disillusioned by what the reality of emergency medicine practice. So I really heavily considered doing a critical care fellowship because critical care is my favorite part of emergency medicine, always was. And ultimately despite having a lot of conversations, I couldn't stomach the thought of doing two more years of training and having a fellow salary when I was staring down the barrel of those ballooning med student debt. And my wife and I had also eventually gotten more debt for our infertility treatments because our insurance company didn't cover it.

So I just felt like I had to take the big paycheck. I will admit that I made some other mistakes along the way, so that burden I discussed about what the debt led me to push myself and work more than the minimum clinical hours. I worked at some places where you only had to work 120 hours a month minimum. I was pushing myself to do 160, 180, I think I topped out at 220 a month. So I was burning myself out by working so hard to afford the vacations and pay off that debt sooner. And that came from nowhere but me.

GW:

There's something to be said for the emergency medicine mantra of just make it work, work harder, go faster, sleep less. I think that it's part of our culture, it can be a good thing and a very bad thing as well. I think that's also another common thing that we hear a lot is, "Hey, while you're young, bang out some extra clinical hours, work really hard, you'll be able to pay down your debt faster and be able to..." It's almost like another step. It's like, "Okay, you just finished board certification now the next step is work your butt off so you can pay down your student loans."

PD:

Yes. And then the next step after that is saving for college for your children. I remember working with a guy, this is my first job out, so I was 20 whatever, 24, 25. He just paid off his student loans and now all that money was going to go into a college fund for his kids. So like you said, it's the next step, so keep working that hard because there's always somebody that's going to take that money from you.

Challenges and Advice for Transitioning Physicians

GW:

Take us back to your decision to start looking for those other jobs. Looking back at Phil from three years ago, are there mistakes that that Phil made or shortcuts that you advise new applicants to make in the future?

PD:

I think that one of the biggest ones was not spending proper time creating a resume. And I'm not talking about CV, a lot of times they're interchangeable. Clinical medicine, we're very familiar with CVs. Once you step out of the clinical realm though a resume is way more common. A CV includes literally everything you've done in your entire professional life. The resume, it is a one to two page succinct document that only lists the relevant experience and degrees and certifications for the specific job you're applying for. We're used to saying, "This is my one CV for every job." And you submit it. That's not how it's going to work in the non-clinical world. You have to tailor your resume for each every single job description and every job you apply for. Because if you apply for my job, I work as a medical director for a health insurance company.

They don't care how much research or pharma experience you have. They want to know what is your medical experience, your inpatient experience? Are you board certified? And have you done any prior utilization management work? So I thought resumes to CVs were the same, but CVs are way more succinct. And my belief is that that's because when you apply for a clinical job, they may get a few applicants because it's your specific specialty, in a specific location, at a specific hospital. These jobs, a lot of these are remote, so you're competing against physicians of all backgrounds, across the whole US. They could be getting thousands of applications, which means they spend five to seven seconds on average looking at your application. Once you step out of the traditional clinical roles, you have to convince employers why a physician is a good fit for that role.

It's not just implied that all the soft skills come along with taking care of patients. You have to explain them. Here's a perfect example. You're not just a pediatrician who works at a community health department. You are an expert at identifying and managing rare diseases in a pediatric population. That's taking what you actually do and spinning it into resume kind of wordsmithing to appeal to a job and help you get past that technology, whether AI or applicant tracking system, because they're looking for those specific words. Although the technology is smart, it's not a human, I can't interpret, oh, he takes care of people, he knows how to communicate. You've got to put it on there.

GW:

Interesting. Are there other mistakes or advice you give to people looking in the space besides CV versus resume?

PD:

Networking. If you talked to me three years ago, I don't think you and I would be on this podcast today. And it's not because I didn't like you. I've actually followed your stuff for a long time. It's that I wasn't open to the benefit of networking and it's not just what can you give me? It's a shared experience. But you can reach out to somebody who either works for the company that you want to apply for and have a conversation with them, learn about the role, make sure you're a good fit, make sure they're happy there. Because they may hate it, they may be looking for a job themselves. And then if you establish a meaningful relationship with them, they may be able to give you an internal referral to their recruiters and say, "Hey, look, this guy's applying. He is a great fit." And that kind of recommendation means so much more than a random application, even if your resume is great and your cover letter is wonderful.

GW:

There is a corollary with medical hiring. By far I find the most value out of asking a fellow ER doctor about somebody that I'm thinking about hiring like, "Hey, we're all two degrees of separation." Often it's like, "Oh, I know somebody that works at your hospital," or somebody who knows somebody who knows. I would imagine it's a bit more intimidating to put yourself out there as a physician in a realm that's more corporate, less clinical, looking for networking opportunities in that space too.

PD:

That's why I didn't do it. It didn't feel natural. However, part of the reason why I'm doing what I'm doing now is I've had multiple people reach out to me out of nowhere on LinkedIn and just say, "Hey, look, I'm either considering utilization management or I've applied to your company and I just want to know, can you tell me about your job or about the company or can you help me get an interview?" They're trying to gather this information and do the process that I should have been doing three years ago. So I'm more than happy to have these conversations. And there's one guy in particular who we really connected and I'm like, "You've got a great background. You're a great fit for this company." I told the recruiter and he ended up getting hired.

GW:

Oh, that's great.

PD:

And I think that really helped. Yeah.

GW:

Yeah. Well, yeah, the internal referral probably allows you to bypass a lot of the AI applicant tracking system.

PD:

In fact, I had this idea earlier today, I would love to create a network like this of physicians just for non-clinical jobs to facilitate these types of conversations and referrals. Because there's statistics out there that say 80% of all job offers come from networking anyway. And 70% of jobs aren't even advertised on the main job boards that you use.

GW:

And that's exactly what we're trying to do with Offcall is build a place where people can find non-clinical jobs, just being able to find what is out there for a physician to do. But we aren't considering all the opportunities out there, all the soft skills that we have as well that make us a good employee no matter what kind of work we're doing.

Phil, if someone's thinking about leaving practice like you were three, three and a half years ago, what are some questions they should ask themselves before they commit to that?

PD:

The main questions that people bring to me usually is, how much money can I make? So they want to know, can I replace my clinical salary? And the answer that I give is it really depends on what your specialty is and what kind of job you're looking for. Because if you are a pediatrician, you may have a pay raise by working for an insurance company. But if you're a neurosurgeon, you're almost undoubtedly going to take a pay cut. But pay is one of them. And then two, what options are out there? What are the non-clinical jobs that physicians can and have worked in? And that's why I created the course on my website to discuss 18 of these most common occupations, just to explain to people like, "Hey, this is what's out there." And I can tell you what you may need for it. What are the pros and cons? What are the salaries? And then most importantly what I was looking for is where can I find these jobs?

GW:

Are there jobs that tend to have specialty requirements or are these jobs generally open to all or most specialties?

PD:

There are some that are specialty specific. So the ones that come to mind would be a lot of the pharma jobs. The biggest areas of specialties are oncology. That's a big one. Neurology. So they want you to have and be board certified in those specialties. Another one is the medical device development. So for instance, Medtronic, if they're going to hire a physician to help with their medical device, they're going to want an interventional cardiologist, that they're not really going to take any other physician specialties or look for them. But then there are others that it doesn't really matter what your background is. Like utilization management, on our current team right now, we've got a pediatrician, OB-GYN, emergency medicine, general surgery, anesthesia. So we all have different areas that we specialize in and expertise.

Exploring Part-Time Non-Clinical Roles

GW:

Are these non-clinical jobs something that someone can dip their toes into? I mean, could I reduce my clinical practice down to 50% and do this part-time as well? Or are most of the things that you're seeing really expecting the physician to stop their clinical practice or maybe they're doing a little bit of clinical practice in their free time, but the job really expects or demands your full time and commitment to it?

PD:

That's another one that I get a lot because some people don't want to fully commit. And it's a big, big decision to leave 100%. So it certainly makes sense. So the answer is the majority of the non-clinical jobs are full-time, but not all of them. So some part-time examples would be being an expert witness for a lawyer or a law firm. You can do that part-time. In fact, it's really hard to have that be a full-time job. But you can act as an expert witness for the plaintiff or the defendant. You can review medical records. Sometimes you have to do recorded depositions and then pretty rarely would you have to go into the courtroom, only about less than 5% of the time. But that is a perfect side gig while you still do clinical work. There's even some principal investigator roles that are part-time if it doesn't require full-time hours. So if you have some research experience or if you've ever been a sub-investigator on a clinical trial, you could be a principal investigator and that could be a part-time role as well.

GW:

Generally, most of the jobs are going to want your 9:00 to 5:00, weekday time because you're probably interacting with other people too. Is that fair to say?

PD:

Yes. In fact, my part-time utilization and management job, we had to work Monday through Friday, so our 20 hours had to be Monday through Friday and it had to be between 8:00 AM and 5:00 PM Eastern Time. For that reason, that's when everybody else was there working. Certainly expert witness work, yes, you could do that on your own time as long as it wasn't being in the courtroom or having to be filmed like a deposition. There's also disability reviews where you do chart reviews to determine if somebody meets the criteria to be disabled. And that is purely chart reviews, you usually have a short timeframe, like 48 to 72 hours to review them, but you can do it whenever.

Transitioning Back to Clinical Medicine

GW:

Phil, let me ask you just how permanent the decision to go into a non-clinical route or a clinically adjacent route. You're still doing utilization review work, so still using your medical brain. Is that a one-way door or do people decide, actually I'm happier with clinical work and do people go back to working clinically?

PD:

I would say in my experience, most people leave clinical medicine and they don't go back. But that's also because that's a bit of a self-selected population. Most of the people on my team practiced for 20 years, 25 years. They were peri-retirement clinically anyway, so this was a great transition. That being said, we had a younger physician, he was a hospitalist and he was on our team for maybe about a year or so. And he was not happy with the work that we were doing just in terms of it being meaningful compared to clinical work. So he went back to being a hospitalist and he'd only been away for about a year or so.

There's definitely a way back to clinical medicine. The longer you're out, there may be more hurdles, specifically if it's been over two years, two years is kind of the cutoff or hospital bylaws may say you have to have some type of formal re-entrance. Like if you come back, somebody has to supervise the patients that you're seeing or you have to discuss them with them, almost like being like a resident again. But less than two years, I think it's a relatively easy transition provided you still are board certified, have an active medical license, you've been new and relevant CME as well.

Navigating the Job Market and Career Advice

GW:

Are there particular experiences that might make somebody a more qualified candidate or more exciting candidate or bubble them up to the top of the list that they could list on their resume that would be particularly attractive to you?

PD:

Some of the things that I think about would be people being involved in hospital committees, particularly for a utilization management job. And then maybe somewhat related would be leadership. So maybe you are the head or the chairperson for those committees. Maybe you're the medical director for your department or the chairperson for your department or a residency director. Those are all leadership positions and involve people management and conflict resolution and get all those buzzwords that they want to see. If people have done side gig work that perhaps they forgot about or didn't highlight or maybe you've done some consulting, even if it's contract, if it was just part-time, doing that shows that you have more skills than, and I don't want to say just taking care of patients because there's so much that goes into that, but additional skills other applicants may not have.

GW:

Was it hardest to get your very first, that part-time UM job, and then it became easier because, like you said, you started to build your network. I mean, is it the hardest to get your foot in the door and then from there it starts to get easier?

PD:

I always think of pharma jobs. If you look at pretty much any pharma job, regardless of the title, they're going to tell you, "You need three to five years of experience for this job." And you're like, "Okay." And then you keep looking and then you realize that none of them are entry level jobs or at least advertised that way. But it's not impossible. We hire people for my team who've never done this before, straight out of clinical practice.

GW:

How did you get your first UM part-time job? Was it just a ton of work? Was it through a network, through a mutual friend? Or how did you land that first job?

PD:

So the first one, I think it was an act of God or something. Because I did not network. I would say volume game was the only thing that worked in my favor because I didn't have this knowledge or skills. And I wonder too if, this was pre-COVID, we had to do two weeks of in-person training. I wonder if that turned off a lot of people. Because I had to go to Florida for two weeks to do this training and that was a hardship on my family.

GW:

And how long were you at that part-time role before you switched to your current role at Humana?

PD:

It was about nine or 10 months and I was working full-time in the ER. So again, yeah, I contributed to my own burn. Out because what I told myself, and you said it perfectly, let me dip my toes in the water of non-clinical to see if I'm really ready to leave. And as I just burned myself out, working two jobs, one and a half time basically. So I stopped that, went back clinically, I didn't get anything, I didn't feel any better, I still was burnt out, so I finally decided, all right, I'm going to go full-time. Because I didn't hate my part-time UM job, I really didn't. I just hated balancing a full-time clinical schedule with it and having really long days.

GW:

Do you get a sense that it is easier at all since you started this? Or do you feel like it's probably still as challenging as it was when you were looking?

PD:

I think that it is more acceptable, but I think it is harder now than particularly when I first got that part-time job or even my Humana job three years ago. And I think it's harder because there's more people leaving, so it's more competitive. I mean, nearly everyone on my team now has an MBA. I don't have an MBA. I'm working on getting one only because my company covers the cost of it. And you don't need an MBA to do my job, don't get me wrong, and you don't need it for UM jobs, I'm just talking about how competitive it is. It's like getting into college is harder these days and med school. What I was missing was the actionable steps of how do I find these jobs? What do I need to do to get these jobs? And where do I find them? That's where I found was the biggest gap.

GW:

I'll punt it back to you. Where do people look for these jobs? Is it LinkedIn? Is it any job board? Is it through networking?

PD:

There are definitely websites out there. There is a big in-person conference, which I think actually just happened in Chicago called SEAK, S-E-A-K.

GW:

Oh, I've heard of that. Yeah.

PD:

It's all about non-clinical jobs for physicians, it's usually, I think it's two or three days. And then yes, job boards. You can go to LinkedIn or Indeed, those are my two favorite because I feel like they can actually provide you relevant job openings for physicians looking for non-clinical jobs. But you will find it is super hard to even know what specific search terms to look for for these jobs. Medical director's one of the most common ones, but you'll get utilization management jobs, you'll get pharma jobs, you'll get in-person plasma lab jobs.

But I think that's one of the most valuable things that I put in my course was if you are looking for a job in pharma, these are the five job titles you want to type in to these job boards to help hone in on it. Because it took me forever to get to that point. Maybe you just type in the company or you go to the company's website, but even then you could type in physician on a pharmaceutical website and no jobs may come up because you didn't put in vice president of medical affairs. And sometimes it's neither. It's another term like senior clinical scientist, that's another non-clinical physician job that I'm like, I never would've gotten there.

GW:

Maybe I can just ask you specifically about your job. What do you do? What does your work entail?

PD:

I work for a health insurance company called Humana. I work 100% from home and I work bankers hours. So I'm in the Central Time Zone, so I work 7:00 AM to 4:00 PM, Monday through Friday. So that translates to 8:00 to 5:00 Eastern. I work no nights, I work no weekends, we get all major holidays off and then we get a pretty significant amount of paid time off, paid CME, CME reimbursement. So I'm in front of a computer eight hours a day. 80% to 85% of the time, I'm reviewing electronic medical records that go along with a request. For whatever reason, it couldn't be auto approved by our computer or our nurse reviewers because something was missing.

So then those are the times it comes to a physician medical director and we review it. We use Medicare guidelines because I do only Medicare Advantage reviews. But we see if it meets criteria because as a Medicare Advantage plan, you have to follow Medicare guidelines. If I can't approve it, then we deny it, but we give an option for the treating provider to accept a peer-to-peer phone call. So that means 15% to 20% of my time, I'm making a phone call, talking to the treating provider, telling them the information I received and what was missing and why I couldn't approve it. And although everybody cringes when we say peer-to-peer.

GW:

I was going to say, are you the peer?

PD:

So I am. So believe it or not, Medicare does not require you to be the same specialty as the treating provider. So yes, I do meet Medicare guidelines for being a peer. Most of the calls, overwhelming majority, they go well because people are coming to realize it's not Phil DiGiacomo's individual decision, it's that Medicare says X, Y, or Z and something was missing. Every once in a while though you do get those people that are not happy with you. And I've been berated while somebody's in the OR in front of their entire OR staff about how dumb I am and I'm not an orthopedic surgeon. So most people are like, "I would never want to do that." But most of the time they go smoothly. Kind of like when we're calling consults in the ER, you might get yelled at from time to time, but most of the time they go smoothly.

GW:

Phil, without getting into any specifics, is your pay competitive for either breaking it down in either total or hours worked? I mean, was it a level that was like, oh, okay, I can make this work?

PD:

Not coming directly from a full-time ER salary. So I would say it's not quite a 50% pay cut, but my per hour is probably around 50% less. However, I was an independent contractor for the last five years of my career, so I didn't have health insurance paid or retirement match.

GW:

In your ER job?

PD:

Correct.

GW:

The last five years of your ER job? Yeah. Okay.

PD:

Yes. Thank you for clarifying. Yes, the last five years of my ER job, I didn't get any of those benefits. So your salary doesn't go as far because I was paying like $1,500 a month for my family's health insurance and then putting away for retirement on my own and then there was no employer match to go along with that. So once I started doing that math, it actually is much closer than just the base salaries would come across as. But yes, it was a pay cut. And in fact, in order for me to take this job full-time, my wife and I sold our house, took that profit, paid off the remainder of our student loans. So we got rid of that debt payment each month and we downsized our house and then now we can comfortably afford our life.

GW:

And I like the way you think of it. That's how we're trying to put it together in Offcall as well is total comp, total hours worked to really have everybody have a full understanding of how much work, how much free time am I putting into my particular job? And what are the benefits? What's the compensation package look like as well?

PD:

Yeah, I was even thinking too about how many hours you lose sleeping after a night shift. We don't factor that in, but that's four plus hours depending on how lucky you are, how much sleep you can get after a night shift.

GW:

I mean ER doctor to ER doctor, I consider the pre-night and then the post-night day, those are a wash, they're gone. I have maybe a couple hours of useful time, then I'll pre-sleep before I start nights and then after I switch off of night shifts, I'll usually wake up around noon or one, I caffeinate, I'm kind of a zombie all day, I'm a pretty worthless partner and I just try to get through the day so I can get to evening time so I can fall asleep and reset. Those are not compensated hours that are just gone from my life. Phil, let ask you just one more question. Would anything bring you back to clinical medicine?

PD:

Up until, I don't know, maybe three or four months ago, I think I would've said nothing. Really nothing. But I think that what I've been doing on LinkedIn and posting has been almost like therapeutic journaling for me where I'm letting it all out and reconnecting with emergency medicine. So my answer would be I would need to find a highly lucrative job that would allow me to work four 24-hour shifts in a month only and I'd be able to comfortably live off of that. And it would have to be a very favorable state in terms of medical malpractice because the threat of that coming back into my life is very daunting. And I never was sued, but I was involved peripherally in some lawsuits and it was awful, as we all know.

GW:

Phil, I just want to thank you for your time. It speaks a lot to your character that you're willing to talk about this so openly when I think it's probably it'd be a really hard topic for many physicians to acknowledge and come to terms with. So thank you for that. Where can listeners find you and support the work that you do to help other physicians?

PD:

Oh sure. Two best spots to find me are LinkedIn and then I do have a website, it's straightforward, all one word, thenonclinicalguy.com. That's it. It's on the nose, but I was happy when I saw the website domain was available. My email is the same, it's thenonclinicalguy@gmail.com. So send me an email, come to my website, friend me on LinkedIn, I'm happy to connect. And I really appreciate you having me on the show.

GW:

Thanks for joining me today. For more strategies on managing burn out in healthcare, visit offcall.com/podcast. Make an account on Offcall to confidentially share your details about your work and sign up for our newsletter where you can hear more about the latest trends we're seeing in physician pay. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts, we'll have new episodes weekly. This has been and continues to be Dr. Graham Walker. Stay well, stay inspired and practice with purpose.