A rational approach to career change

Recently, the number of physicians who have been interested in alternative careers has vastly increased. Many physicians express dissatisfaction with clinical practice, but they are uncertain about which nonclinical options are appropriate for them. Pursuing a different career after many years of studying and practicing medicine can seem like an overwhelming task. In this article, the author briefly outlines a decision-making process that can be used in analyzing career options and suggests some careers that have provided challenging opportunities for physicians.     

Preparing to tack: when physicians change careers

Because of the progressive health care revolution that gives all the power to the managed care insurance companies, the usurpation of physician autonomy, and the replacement of the physician-patient relationship with HMO policies, doctors are looking at other career choices. Many doctors have never considered life after medicine and have made no plans for that time in their future. Despite their ample education, some doctors say, "I don't know how to do anything else. I am trapped in this system, and I can't get out. If I knew what else I could do, I would definitely change careers." Many doctors feel that it is too late in their lives to make such a change. However, it is becoming more and more acceptable to switch or modify a medical career. A number of physicians have switched careers successfully without disgrace and have discovered that there is indeed a life after the first career choice. It isn't always easy, but it can be done.     

In transit from physician to manager--Part I

Physicians are finding themselves in increasing numbers in significant management roles. Physician managers interviewed about their experiences in changing careers identified six critical transitions, three involving psychological adjustments and three requiring development of new skills. A framework is developed in this two-part article that relates career events that trigger transitions, the transitions themselves, and the obstacles that can hinder or block success. The challenges that physicians encounter in management are similar to those faced by other professional groups, and the chances of successful transition can be improved by individual and organizational actions.     

The medical practice as business organization

Medical practices historically have not been examined in terms of their organizational structures and of the appropriateness of their structures for survival as business entities. In this paper, we propose a model for the typical medical practice and discuss its fit with current organizational theory. It is apparent that the medical practice organization does not fit with the demands of a rapidly changing and complex environment. To survive and grow, the medical practice organization must align itself with others that have an interest and stake in the health care system, develop teamwork among physicians, bridge the gap between physicians and others in the organization, and recognize that the work done in the organization depends on other components of the organization.     

Corporate expatriate career development

Western business expatriates assigned to Hong Kong responded to a mail survey regarding availability and usage of corporate career development activities. Despite the strategic need for expatriation, it was found that corporate development activities had a low availability indicating little interest on the part of parent organizations to assist in the development of expatriate careers. Large-size parent organizations, with substantial interests in international business operations, generally provide more expatriate career development assistance as opposed to small and medium-sized enterprises with fewer resources and little experience to cater to such needs. Experienced expatriate managers generally use more career development activities than less experienced managers, which could pose a problem for the procurement and advancement of new generations of expatriate managers. Implications of these findings for managers and their employers are discussed in detail.     

Deus ex machina? Career progress and the contingent benefits of knowledge management systems

Knowledge management (KM) systems are increasingly common in firms which promote self-managed careers and autonomy, such as professional service firms. Yet, whether or not KM systems provide real benefits is underexplored. Our focus is on the impact of KM use on the career progress of service professionals. We use recorded logs of employee KM system use and career progress data over a two-year period within a strategy consultancy to study the effect of KM use on career advancement speed. We present a contingency-based model to KM use effectiveness, showing that, although KM use generally boosts career progress speed, (a) benefits vary by seniority (more junior employees benefit more), (b) benefits vary by knowledge type (encyclopedic vs. social), with social knowledge use mattering more to career progress, and (c) those service professionals who tap a wider range of knowledge sources progress faster in their careers. We also find mediating effects, specifically that KM system use operates partly by accelerating the development of task-related skills. We draw the conclusion that KM systems contain neither a magical Deus ex machine for boosting employee performance and progress but nor do they warrant excessive skepticism, rather their impact on careers is contingent on employee needs.     

The impact of international business education on career success—Evidence from Europe

In today's globalized world, career paths are becoming increasingly international, and so managers need respective cross-cultural strengths in order to act effectively in various cultural environments. Even though education—especially business education—is progressively becoming more international to meet these organizational demands, little is known about whether the extent of international business education influences careers, and in particular career success. In addressing this research deficit, we explore whether and how international business education affects career success. As the major contribution of this paper we suggest a conceptual framework which posits global identity and international experience as mediators of this relationship. The assumptions of this framework are confirmed by an investigation amongst 450 alumni of a European business school. Additional contributions include that we extend the limited body of research on the construct of international business education and its measurement, by providing an all-encompassing definition and much-needed operationalization. Furthermore, we contribute a European perspective on international business education through our empirical evidence.     

Locum tenens solve staffing problems.

The use of locum tenens physicians (physicians who work temporary assignments) began decades ago when primary care physicians arranged coverage for their private practices while on vacation. Today, the placement of locum tenens physicians has evolved into a national business. The reason for the increase in the use of locum tenens physicians is because of the benefits they can offer. They can prevent a hospital, HMO, clinic, or physician practice from losing market share due to a gap in medical coverage.     

Physician leadership. Learning to be a leader

As the business role of health care delivery expands and complex reform is imposed, physicians must assume leadership roles and imprint medical expertise on business dynamics. Before the end of this century, health care and its delivery will likely become unrecognizable to those who ended their practices only a decade ago. Traditional management will wither away to be replaced by self-managed, self-trained, and self-motivated workers, no longer employed in jobs but working through processes, projects, and assignments in integrative health care delivery systems. Becoming a leader is an active and arduous process that can no longer be approached haphazardly. To be effective, the physician must plot a course with clear and calculated intent and effort, which requires acquiring organizational tools and administrative skills to innovatively alter medical care for the good of all.     

Career patterns of top managers in Europe: Signs of further globalisation?

Investigating career patterns of top managers has been a prominent topic in European Management Journal (EMJ) since the 1990s. Our article contributes to ongoing debates about national differences in top managers' career patterns between European countries. An open question is whether globalisation processes may have challenged the existence of specific career patterns and whether they may have transformed the profiles of business elites in Europe. Our article uses recent data from four European countries (France, Germany, Switzerland and the UK), collected in a way similar to an EMJ article published in 2013, with the objective to assess potential developments that have taken place over the last decade. Some of the major changes relate to the growing relevance of business school degrees or certificates (such as MBA degrees), a higher proportion of non-nationals and women on boards, more managers with international experience and an increasing number of top managers with a prior career with auditing or consulting firms. The article provides not only new empirical insights, but also a review of the key characteristics of top managers’ careers, some methodological reflections on cross-national comparison and new research avenues at the cross-roads of career literature and upper echelons literature. By shedding light on the career patterns of key decision-makers in large European firms, the article offers new insights for researchers, educators and managers alike.     

Get real: what will draw physicians to the Web?

What are physicians waiting for? What will it take to stimulate widespread adoption of Internet medical systems? How can health care leaders and physicians help the technology innovators and the executives of technology firms understand the components necessary to assure physician acceptance and utilization of new tools? (1) Don't underestimate the personal nature of a physician's practice. It really isn't a "business." (2) Most physicians are not Luddites; they are just extremely pragmatic and practical. (3) For the majority of physicians to adopt a new technology in their private office practice, it must address three major issues: money, hassle, and patient care. There are many obstacles to adopting the new technologies that are the result of physician training and expectations and the current models of payment and revenue generation. Some technological innovations are presented to physicians without sufficient respect for their knowledge of how medical practices really work. The benefits promised often don't match with the needs structure of the physicians. As a consequence, the cycle of diffusion of these new systems is extended and delayed.     

Physicians in transition

The study of physicians as managed care executives has been relatively recent. Much of what was written in the past focused primarily on doctors who had taken hospital-based administrative positions, especially as medical directors or vice presidents of medical affairs.1 But the '80s brought rising health care costs and the emergence of the "O's"--HMOs, PPOs, UROs, EPOs, PHOs, H2Os, and Uh-Ohs--in response. It also brought a growing number of physicians who traded their white coats and their particular "ologies" for the blue suits of executive management. I am convinced that it is important now, and will be increasingly important in the future, to better understand that transition. That belief led me to undertake, with the help and support of ACPE, the survey that is reported in this article. A questionnaire was sent in 1994 to a random sample of 300 managed care physician executive members of ACPE. Responses were returned by 225 members, a response rate of better than 80 percent. Twenty-five of the responses were not applicable, having been returned by physicians who had never made a transition from clinical careers. The remaining 230 responses form the basis for this report.     

A blueprint for career change when you don't know what you want to do

Follow the paths of a gynecologist turned investment banker and an internist who became a medical writer. Both used a proven process to change their careers and determine what they wanted to do.     

The medical director as educator: an interview with Elizabeth M. Gallup, MD, JD, MBA. Interview by Richard L. Reece

Richard L. Reece, MD, interviewed Elizabeth M. Gallup, MD, JD, MBA, on July 9, 1999, to talk about the evolving role of the physician executive. Dr. Gallup discusses how medical directors have evolved from a purely clinical role to participating in the business side of medicine as well. The traditional medical director, a Dr. No who denies treatment and watches clinical performance, is now becoming an educator helping physicians to manage their behavior and change their practices based on comparative data. Her book, How Physicians Can Avoid Surrender and Lead Change: Gaining Real Influence in Your Own Health Care Organization Before It's Too Late, (American College of Physician Executives, 1996) promotes acting together as a group if physicians want to stay independent and not become employed. Independent physicians can form IPAs and act together as a group, avoiding some antitrust laws. Unless physicians get together and act as a group, she says, they are doomed to further and further erosion of their economic interests as well as their clinical autonomy.     

Zwischen Autonomie und Unsicherheit

The author describes, why the need for career counseling has increased what are the reasons behind it and which “type of client” asks for career counseling. She highlights some relevant developments in society and corporations and how this development influences careers. Examples of client biographies make visible, that job-changes are intertwined with changes in personal life and that these transition phases have their own pace and rhythms. She describes her process of counseling and how her process has – due to needs of her clients – changed in the last years.     

Physician leadership. How do physician executives view themselves?

Most physician executives today have acquired substantial management training and experience, and many have worked with and relied on the expertise of mentors for their career guidance and development. Physician executives are actually becoming executives who happen to be physicians. They view themselves first as leaders, then as physicians, and finally as managers. That is a remarkable transformation in perception. To chronicle this process, Witt/Kieffer, Ford, Hadelman & Lloyd conducted a national survey this spring among senior physician executives in both payer and provider organizations. The data provide a "snapshot" of their role, and may also suggest some future scenarios for the industry. The primary reasons for choosing to pursue a management role noted by most participants include a desire to be part of the health care solution and an interest in management and leadership challenges.     

Is leadership born or made?

Is leadership born or made? By profiling three colleagues who made the transition from clinician to top-flight executive in a health care organization, the author provides case studies from which to discuss leadership issues. An evolutionary pattern has developed with respect to physicians changing careers: The first model was the medical director, followed by the vice president for medical affairs, and finally the move to managing the health care system, group practice, or managed care organization. Are physician executives fundamentally different from clinicians in terms of leadership characteristics? What are the essential qualities needed to lead health care organizations? These questions are explored in-depth.     

Characteristics of good mentors.

Physician executives who have advanced in their careers have had people who helped them. Six successful physician executives were interviewed about how mentors encouraged, taught, and helped them grow. Most agreed the term role model was more comfortable to them than the word mentor and that they only recognized these people as mentors when they looked back on their career paths--not at the time the interactions were happening. Sometimes they were role models and sometimes they were just the right person with the right information at the right time. Most were located in the person's city and organization and seen daily, but some were in another part of the country and seen on occasional visits but regularly talked to each other on the phone. Generally they were friends who created safe environments for learning, were protectors, gave specific feedback, viewed problems from a different angle, and stretched the thinking of those who sought their advice.