My dream for most of the early part of my life was to be a doctor. While playing football in high school, I thought it would be really neat to be a sports doc and an orthopedic surgery spot at a place like Kerlan Jobe seemed a dream.
As I developed a bit more of life in college, I realized that shaping the lives and experiences of young people really was my calling– I spent time as a SAT tutor, athletic tutor, teaching assistant and spent my free time volunteering at camps for kids who had faced significant challenges– mainly at Camp Ronald McDonald for Good Times, but a little at Unicamp, Diabetes camp, and a heart camp. It was here I realized a few things: how much I got back from giving just a little, and how much I was driven by activities that taught and created sustainable change, not just a break or short-term intervention.
My college pursuits taught me well. I was more a physiologist and psychologist than a M.D.– I saw the provision of health services as a system and it wasn’t just enough to try hard and do my best.
I was going to follow my passions and become a pediatrician and help start young people off on the right foot– until I started doing my electives in pediatrics. I had a few rounds of SCFE kids (a slipped capital femoral epiphysis occurs often when a child is so fat that their weight causes the growth plate in their hip to fracture) and one tonsil removal that broke my heart– she was 5 years old, 110 pounds, and getting her tonsils out to clear more room in her airway so she could breathe. It turns out in getting her history that her parents thought Coke was better for her than water— so thats all they gave her.
Seeing a system where my patients would be broken far before they came to me– and far too in need of many services for me to make a dent with a 15 minute office visit. I decided I had to find out why medicine was this way– and how changing the business model to focus on prevention would actually work.
Financial considerations were also a factor– I considered why I would take my $200K in med school loans, work slave wages for another 3 years, and then hope to get a spot making $90K to start, when friends of mine that had gone off to banks or business were already making more than that today. I found it ironic that my friends going off to residency were paying to take their interviews for $40K a year jobs, while I had the same degree and training and was getting paid to go out to interview with business firms for 6 figure jobs.
I decided that management consulting would be the best option for me and looked at firms like McKinsey and BCG, who were receptive to MDs coming out of school. McKinsey had the best training for non-MBAs, a 3 week training course called Mini-MBA.
I’ve since found that others have taken many different routes (and that there are a number of folks that have linked together through the Doctors Dropout Club that have gone to investment banks, pharmaceutical industry, not-for-profits, research and think tanks, equity research, and specialty information companies (Gerson Lehrman is a favorite).
Its been a path that suited me well. While my colleagues were learning much more tactical things about how the human body works and how to stick people with things, I did a residency in learning how the health system works– why things function as they do, and where there are opportunities to change it for the better.
As I’ve left McKinsey to create new avenues to deliver quality health information, services, and products to consumers, I take with me the beliefs I had as a young medical student– that the doctor patient relationship is paramount to good care, that patients have every right to find a provider that will treat them the way they think is best for their health, and that innovative providers deserve to be paid for superior service.
For those medical students, residents, or physicians that stumble across this in their search for something else, please feel free to reach out– I’d be happy to help you think through your options.
Addendum– Dr. Reece has a great article on why managed care will lead to a primary care physician shortage