Documentation and Writing
13. Be a Physician Advisor at Your Hospital
Of the physician jobs in hospital administration, one that has seen a lot of growth in recent years is the physician advisor. It involves working closely with doctors to improve documentation of hospital charges, and making sure they adhere to quality and safety regulations. You may also interface with Medicare's recovery audit contractors and other regulators.
This job was once a part-time position for physicians nearing retirement, but now it's usually a full-time position for doctors in mid-career.
Only about one quarter of hospitals currently have the position, but Dr Fork, the career coach, expects a great deal of growth here, owing to the need for physician alignment, the shift to value-based care, and increasing use of performance data.
Physician advisors are usually chosen from within the hospital staff. They have earned their colleagues' respect and understand evidence-based medicine. "The physician advisor is a clinical educator, diplomat, and tightrope walker," Dr Fork says. "This role is only for a certain type of physician who is able to handle conflict and deal with different personality types."
Bernard H. Ravitz, MD, has been physician advisor at the 300-bed MedStar Good Samaritan Hospital in Baltimore for 13 years. Beforehand, he had served as an emergency physician at the hospital for 15 years.
A key part of his job is to monitor admissions. "If even one hospital day is denied, that means we're still caring for the beneficiary but not getting paid for the care we're providing," he says. Working closely with physicians, he sees himself as an educator, helping with documentation and offering feedback to reduce denials and improve care.
"You have to be able to get along with the medical staff," Dr Ravitz says. "You have to have people skills."
Dr Ravitz is a founding member of the American College of Physician Advisors, which was launched in May. He said there are roughly 50-100 founding members out of hundreds of physicians in the field. The college plans to provide assistance to doctors interested in this career.
Pros: This is challenging work for those interested in evidence-based medicine.
Cons: You'll have to deal with pushback from physicians.
14. Become a Clinical or Healthcare Writer
If you have a talent for writing, there are countless clinical writing and editing opportunities with pharmaceutical companies, marketing agencies, CME contractors, quality and performance improvement initiatives, and medical publications. In most cases, the work is done on a freelance basis, which means you have to build up your business.
Once you have an established set of clients, however, it's possible that your income can reach $70,000-$130,000 a year, and the starting salary for in-house clinical writers ranges from $75,000 to $180,000. The higher end of the range is usually reserved for those with an advanced medical degree. However, many freelance writers, even physicians, do not earn that much.
"If you have the skills, it's not a big transitional hurdle," Dr Fork adds. Characteristics of good medical writing include thorough research, accuracy, logical organization, clear thinking, and readability, according to the American Medical Writers Association.
This has been a growing field. The medical writing market more than doubled in value last decade, increasing to almost $700 million, according to a report by CenterWatch, which studies the pharma industry.
Diane W. Shannon, MD, MPH, a freelance healthcare writer in Brookline, Massachusetts, writes on performance improvement in healthcare as well as other topics. Her exit from general internal medicine in the early 1990s was an act of "self-preservation," she recalls. "I was less immune than others to the stresses of practicing medicine."
First, she worked as editor and staff writer for a medical communications company for 3 years. As a freelancer, she's making more money than when she was working in clinics. "Leaving a relatively low-paying job probably made it easier to walk away from clinical medicine," she says, adding that she uses a variety of medical skills in writing, such as interviewing patients, having to be well-organized, and breaking down very complicated material.
Mandy Armitage, MD, also moved from medicine to writing. In an article on Dr Fork's website, Doctor's Crossing, she wrote that she stopped practicing sports medicine and rehabilitation after a year, and "I haven't missed it a bit."
She initially enrolled in a 6-week online writing course and then started a freelance company, collecting such assignments as conference coverage, medical news, and feature stories.
"What I love most about freelance medical writing is that I cover fields outside of my own specialty, so I'm always learning something new," she wrote. "Plus, I can set my own schedule, and this work is much less stressful."
Pros: Physicians who can write well have good prospects in this field.
Cons: It may take some time to get established, and for specialists especially, income is relatively low.
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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.