From Medicine to McKinsey to Main St

This is post 2 in a series highlighting my journey from physician to consultant to entrepreneur

I write this in a period of reflection — when I try to figure out what’s next for me as I reflect on my career to date.  My calling is the fixing of our broken health system.  However, as but one individual, how to do so in a way that allows me to build something of immediate value while taking care of my family is a complex challenge.  My goal is writing this is to help highlight my somewhat strange career path, as I’ve been contacted by a number of physicians at all stages of their careers.

Having been admitted to medical school, I now was immersed deep into the more academic curriculum of the first two years.  I have to admit I was tremendously disappointed.

Don’t get me wrong, I loved the clinical piece of medicine.  Interacting with patients (even in our limited pre-clinical years) was an amazing process.  Donning the white coat opened up a whole new world of access into the deepest, most intimate details of a person’s life.  The tradeoff was the dimming of your own empathetic humanity…the role required that those deep details be used to drive medical diagnoses and services and a filter of “doctor” screen all normal human impulses and reactions.  This perspective would truly change my life and enforce the importance of time in generating enough of a rapport and relationship to really be able to help someone.

The academic/ science side was a different story.  What I thought would be an experience that built upon the dynamic understanding of physiology combined with how to achieve great results in real patients in the health system…instead was a flood of didactic memorization based on the deep (and largely irrelevant) details of our professors’ research.  There seemed to be a great focus on breadth in detail…providing a slurry of facts and figures without the focus on building a high-level framework that would serve as our foundation in medicine.  In an era where most of these details were available on my palm pilot, when they were relevant to anything I was doing, I found incredibly frustrating and largely a waste of time.  Where I wanted discussion and debate, I found a premium placed on memorizing what my elders told me…and substantial challenges at the points where I thought that the literature pointed to plausible alternatives to what I heard in class (e.g., my early suspicions that “mature” tissues like nerves and muscles could regenerate based on satellite cells and latent stem cells).  My love for science and probing mind had become a liability in the two year sprint through the basic sciences…and how I was frustrated by the intellectual challenges of science turning into brute memorization of things I didn’t quite believe.

What had happened was that the explosion of science had translated into a desire to cover all of life sciences, rather than to focus on the skills and evaluation frameworks that would ensure that we were lifelong scholars we could evaluate all of that research relevant to our patients.  As a happenstance of fate, our class of supposedly 150 at USC School of Medicine had somehow accepted our admits in a way well outside the bell curve.  We ended up with 180+ in our class, 2/3 men.  This meant that our lectures had to be videotaped and broadcast into a satellite room.  This provided me the opportunity to study instead of waste my time in class, read the textbooks and literature and go deep in areas of interest, while still being able to review lectures that I wanted to play back.  I became a virtual student…and memorized enough of what I was told to pass my pass/fail first couple of years.

What did I do with that extra time?  I focused on a few things…I spent a fair bit of time volunteering in the emergency room and I pursued a deeper understanding of how health care worked…not the scientific part but the people part.  This would be the element that would change my life and move me away from my initial calling in prevention-oriented pediatrics…but that will come in the next installment…

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