Learning for earning: When it's time to consider an extra career

Physicians increasingly are taking classes to develop new skills outside their practices, to boost their professional satisfaction and supplement their incomes.

By Robert Kazel, amednews staff. April 21, 2003.

Chris Smythies, MD, started writing as a way of escaping the more dismal realities of practicing medicine. Then he discovered that someone could show him how to make a little money at it, too.

The Renton, Wash., neurosurgeon signed up for a course on medical fiction writing. He is one of a growing number of doctors trying to learn new skills to supplement traditional practices with nontraditional side jobs. Physicians are taking classes or m eeting with career counselors to develop skills that may or may not have anything to do with their profession: how to be a writer, or an independent medical examiner, or a financial planner.

Are you a career explorer at heart?

See related content

These physicians aren't seeking to leave medicine but to discover untapped aptitude for secondary jobs that could bolster professional satisfaction and income, says Francine Gaillour, MD, an internist who advises doctors through Creative Strategies in Physician Leadership, an executive coaching firm she founded in Seattle.

"They have so much more to give, they have so much more to offer, and they can't see an outlet for how to express it," she says. "It can be frustrating at times. I see them and think, 'What are you waiting for?' They are fearful of exploring and disrup ting the routine, no matter how miserable it may be."

For Dr. Smythies, disrupting the routine means traveling in September to Massachusetts' Cape Cod region to study the craft of medical fiction writing with best-selling physician authors, and to hash out ideas and make contacts with a half dozen literar y agents and editors who could help him get published.

Writing fiction, he says, "will never replace [medicine], but it'll supplement it." This will be the second summer that he has taken the $995 workshop, which this year is expected to attract hundreds of physicians.

Physician workshops for outside business opportunities have grown in popularity over the last few years.

Steven Babitsky, president of SEAK Inc., the Falmouth, Mass.-based company that offers the writing course, plus a variety of other seaside summertime business seminars for physicians, says that since his company started holding classes for doctors in t he early 1980s, more than 4,500 physicians have taken its courses, and attendance has been up 20% to 25% each year in the past few years.

"I think people see [writing and publishing] as an escape from their current mundane existence, which unfortunately so many of us have," says Dr. Smythies. "There's more stress these days than there ever has been."

There exists a veritable smorgasbord of nonclinical choices for doctors seeking nontraditional work for their spare time, and a variety of seminars, workshops and Internet-based instructional programs have cropped up to meet the demand.

Dr. Gaillour knows of doctors who have sought to become inventors, expert witnesses, medical examiners, professional speakers, financial planners, wellness and nutritional product entrepreneurs, "space planners" for medical office interiors, patient sa fety consultants, mediators, medical reporters at newspapers and TV stations, magazine writers, mass-market nonfiction authors and business instructors.

Enough doctors are considering challenging their vocational limits that business has been good for Dr. Gaillour, who offers one-on-one coaching to physicians who have made the "gut-wrenching decision" to learn skills for the pursuit of work outside the ir medical practices. She typically has 40-minute telephone conferences with each doctor three times a month, with a minimum commitment of four months. Though some doctors are just seeking more variety in their lives, others are interested in improving de clining incomes.

"If they are perfectly happy doing what they are doing, the world needs physicians who are completely focused on clinical practice," she says. "But the world also needs those who [wish to explore]. I help them discover hidden talents. I ask them, 'Does anything here hit your hot buttons or make you tingle?' "

For love or money

Some doctors try out vocational paths for the pure fun of it and discover later that they can make money, too, Dr. Gaillour says. Anil Maheshwari, MD, a family physician in Metuchen, N.J., has been getting advice from Dr. Gaillour for several months on how to turn his part-time passion -- standup comedy -- into a steady source of income.

Dr. Maheshwari, whose business card reads "The Standup Doctor," started taking himself seriously as a comic about five years ago, when he was a medical resident and won a Closet Comedian Competition at his hospital. As his prize, he was able to open fo r comedian Steven Wright at a community theater before several hundred people.

Dr. Maheshwari, who describes his brand of humor as a mix of Bill Cosby, Ray Romano and Woody Allen, has started making a small but growing amount of money working New York clubs, and performing comedy at medical conferences and medical school graduati ons.

Some doctors are studying for side jobs that are clearly less glamorous, yet which have potential for bringing in extra income. SEAK, for example, also holds yearly conferences for physicians on how to be an independent medical examiner. Like the writi ng courses, the workshop has risen in popularity recently as more doctors are scouting for sources of spare income, says Chris Brigham, MD, an occupational medicine specialist in Portland, Maine, who serves as the course instructor.

Independent medical examination has the potential to be quite lucrative for many of the doctors who learn how to do it well, and opportunities to break into the field abound, Dr. Brigham says. "There are great market needs for people who can do an unbi ased assessment."

Doctors who do IME work evaluate patients in workers' compensation, auto crashes, personal injury and disability cases and usually write reports for insurers, employers or attorneys. The fees vary widely, Dr. Brigham says, ranging from $200 for a simpl e case to several thousands of dollars for the most complex. He says his average case pays around $1,500 to $2,000 and requires five hours to review records, take a history and examine the patient, and write a report of 20 to 30 pages.

The market is ripe because even though more physicians are dabbling in such work, many of the reports they produce are substandard -- and in some cases "appalling" -- because the doctors never learned the necessary skills, Dr. Brigham says. Doctors who do the exams must not only have strong clinical skills but also be excellent interviewers and be able to gear their reports for an audience of nonphysician readers. Dr. Brigham's two-day, $695 course promises to teach doctors everything from "the excelle nt IME report" to Internet and computer technology to marketing and risk management strategy.

Writing books, fiction or nonfiction, is another field attracting wide physician interest. In SEAK's fiction writing workshop alone, 200 doctors attended in 2002 -- double the turnout of the previous year.

The write stuff

To doctors who believe their literary muse can make them rich, well-known physician-authors express caution. Richard Selzer, MD, a retired surgeon who has published 10 books of essays, short stories and memoirs over 30 years, including Letters To a Young Doctor, thinks it's unlikely that many of the doctors in writing classes will ever see income from publishing.

"For a doctor to spend his time trying to develop [popular] writing skills is crazy," says Dr. Selzer, who adds that his books, though critically acclaimed, never earned him much. "He should learn how to do pottery or something more useful than writing . Pottery, you can put something in. Even lemons you can put in a bowl."

But Michael Palmer, MD, a leading author of medical suspense novels and a teacher in SEAK's upcoming Cape Cod workshop, walks a fine line when lecturing doctors about writing potential. He encourages physicians to devote time to the craft if they truly are enthusiastic. But he is careful to convey that raking in cash via the best-seller chart is not easy, and that counting on leaving medicine through publishing may be unrealistic.

Even Dr. Palmer himself, a former emergency physician who had best sellers such as Extreme Measures turned into major-studio movies, has never left medicine. He now splits his time between writing novels and working in a program in Massachusetts that treats doctors with substance abuse disorders or psychiatric illnesses.

"What we make clear to [new physician authors] is that this is not something that they can just throw their oars in and start rowing," he says. "It takes hard work and talent. We can't give them talent."

But he says he understands why the number of doctors showing up with book ideas and manuscripts in progress is rising every year. "There's certainly a lot of disillusionment that largely stems from the shortcomings of managed care," he says. "Doctors a re tired of being told what to do and how much they can make and how independent they can be in their professional life." Dr. Palmer is getting a measure of sweet revenge himself with regard to payers. His current project, expected to be published next ye ar, is "a thriller about a serial killer who is knocking off the directors of managed care companies."

Dr. Smythies, for his part, is diligently applying what he learned in last year's writing class, from "opening hooks" to creating conflict, to developing suspense, crisis and resolution. He's bringing his 180,000-word novel -- composed on a laptop betw een patients -- to this year's class.

One of the key points made at the Cape Cod course was that doctors should write about what they know, and he has heeded those words. His book, though fiction, is about a heroic, well-regarded neurosurgeon who is being sued for malpractice groundlessly as part of a conspiracy to ruin him. It's based in part on his successful, but mentally draining, fight against a liability suit.

"I'm doing this for my own self-satisfaction," says Dr. Smythies, disclaiming any pretension to fame. Still, he adds it would be nice to become a little famous. His manuscript goes out to agents this month.

RELATED CONTENT
» Physicians are working more, enjoying it less June 3, 2002