Improving Medical Practices
5. Become a Healthcare Practice Management Consultant
Thousands of physicians have started practice management consultancy firms based on a skill they learned when they ran a practice, such as coding, claims processing, strategy, and practice efficiency.
"This is good for people who are self-starters," says Steve Babitsky. Babitsky is an attorney who runs SEAK Inc., a Falmouth, Massachusetts-based company that trains physicians, including those who want to switch careers.
David Zielske, MD, an interventional radiologist in Tennessee, founded a company that addressed the difficult coding requirements of his specialty. "The coding for interventional radiology is unusually complex and error-prone," he says, but he enjoyed the challenge. "I've always had a passion for coding."
In 2000, Dr Zielske took his coding skills and cofounded ZHealth in Brentwood, Tennessee, to help physicians and hospitals deal with interventional radiology coding. For a while, he operated out of his home and had to continue practicing for a few years to keep up his income.
The transition was "a very expensive, long-term process," he says. "You can't just quit and think you can be successful right away."
The company has prospered since then, branching out into coding for vascular and cardiac care, and Dr Zielske has also written books, hosted webinars, and given speeches and seminars on coding.
Some physicians who start consulting firms keep practicing medicine. For example, L. Neal Freeman, MD, a practicing ophthalmologist in Melbourne, Florida, is president of CPR Analysts, coding and physician reimbursement analysts.
The work can build on basic skills learned in clinical care. "Consulting is like the problem-solving you do in medicine," Dr Fork says. "You have to take a project from beginning to conclusion."
Pros: You can build on a skill you learned in running your practice.
Cons: It may take many years to establish your business.
6. Help Payers With Utilization Review
There's a growing demand for physicians to help payers with utilization review. "The health insurance industry has been booming," says Babitsky, citing changes still in effect under the Affordable Care Act.
Although some physicians may view this as working for the wrong side, it's "actually a chance to do good," Dr Fork says. "Your role has to do with stopping overuse of services within the healthcare system and helping to provide quality care for value."
The advantages are that you can use your diagnostic skills as a physician; you're often able to work out of your home; and, if you work full-time, it may be possible to make as much money as you did seeing patients, although many utilization review physicians work part-time.
Heidi Moawad, MD, a neurologist in Cleveland, served for several years as a utilization review physician, working part-time out of her home while raising her young children. Working with a radiology review company that contracted with several health insurers, she dealt with preauthorization requests for radiology from fellow neurologists.
Although she felt some trepidation before starting the job, she says she did not feel under pressure to deny payments and felt little resistance from the physicians whose requests she was reviewing. In fact, she says many of them would even ask for her guidance. "They would tell me, 'This is the story; what do you think?'" she recalls. "When I said the test was unnecessary, they were actually relieved." She says the job helped her get on the Practice Guidelines Committee of the American Academy of Neurology.
When her kids got older, Dr Moawad switched to a teaching job, but she looks back fondly on her utilization review career. She believes that utilization review physicians will be under increasing pressure to closely follow practice guidelines, rather than follow their own inclinations.
Amy E. Odgers, MD, an internist in Chicago, also switched from clinical practice to utilization review work. Initially she worked in a call center, handling physicians whose charges were being challenged. "At times, the work can be contentious," she said. "Doctors don't like to be questioned about why they're ordering tests."
After 9 years of reviewing claims, she now has a new position at the same company, studying ways to improve workflow. Working just 20 hours a week, she said she doesn't make as much money as clinical care physicians, but she isn't in debt either. Plus, she has time to pursue gardening and ceramics. "I love the balance I have between work and other things," she said from a cell phone while in her garden.
Pros: Reviewing claims pays relatively well, and in many cases, you can work part-time from your home.
Cons: The work is becoming more and more regimented.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Leigh Page. Tired of Medicine? 20 Nonclinical Career Options - Medscape - Mar 14, 2018.