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Tuesday Jun 11, 2019

FPs Should Lead: Thoughts on an Executive Career Path

I've been involved in administrative medicine as a physician executive for a significant part of my career since graduating residency in 2001. This blog post is meant to serve as a gentle prod for anyone considering this career path, which I'm considering separately from academic medicine here.

[businessman standing at opportunity door]

Why make the leap into administrative medicine? I argue that there are several administrative jobs that require physicians, and if primary care physicians do not fill these roles, then subspecialists will. Although any physician could and should keep patients as the focus in these roles, many will bring biases from their own practices -- or specialties -- to a new position.

The types of jobs I'm talking about are varied: chief medical officer, chief medical informatics officer, department chair, chief of staff and medical director, to name a few. They differ in several ways, including the amount of clinical time allowed and the breadth of responsibility. For example, some roles may have oversight of family medicine or primary care, while others could include additional or even all specialties. Some jobs may involve supervising only other physicians, while others could also include other types of practitioners. Some roles, like CMIO, may require additional degrees or fellowship training.

If you are interested in pursuing an executive position, I recommend you start by finding a mentor. Talk to physicians in your organization who are already doing the job you're interested in or reach out to fellow AAFP members who are serving in leadership roles. (Some of your current Academy Board members are in physician executive positions.) Also notice what the requirements are in posted job openings and identify any gaps you may have.

Next you will want to beef up your resume or CV to specifically highlight the executive experience and training you already have (and perhaps pursue additional training). Create a LinkedIn(www.linkedin.com) profile if you don't have one already and be sure it indicates you're interested in administrative medicine positions. And I highly recommend reading FPM regularly because information in the articles may help during your job interviews.

I also highly recommend defining your clinical care expectations and desires up front -- in the second interview or, at the latest, during salary negotiation. Many physician executives have planned to add clinic in after they understand the administrative job better but never do. Carving out half a day or a full day just never seems to happen later.

Here are a few questions to ask yourself early to prevent yourself from feeling overwhelmed and failing to do either the clinical or administrative work well:

  • What scope of practice do I want to maintain, and what clinical support will I have to assist with things like following up on lab results and patient queries?
  • Will I need to travel to get from an administrative office to a clinic? If so, is traffic an issue in my area?
  • How much time will I spend in clinic, and what will that schedule look like?
  • Will the administrative job require decisions within hours, days or weeks? Can I build time into my clinic schedule to deal with urgent matters without taking away from patient care?

Finally, here's a little pearl I've learned: When someone tries to schedule a meeting during my clinic time, I ask, "Is this important enough that you want me to cancel patient appointments?" In health care, that mentality goes a long way.

James Ellzy, M.D., is a member of the AAFP Board of Directors.

Posted at 02:56PM Jun 11, 2019 by James Ellzy, M.D.

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