Thinking outside the box

6 ways to be a physician without practicing clinical medicine

Christopher Behringer, DO, says a mix of clinical and nonclinical work is his professional sweet spot. He shares the benefits of this approach and tips for others who are interested in it.

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In recent years, the term “burnout” has not just been a mere word, but rather an omnipresent phenomenon in conversations revolving around the health care profession. Despite numerous proposed solutions—from mindfulness practices to workload management—the rates of burnout remain persistently high, and the current situation threatens to further exacerbate the impending shortage of health care professionals.

Many of us look at ways to avoid burnout and think to ourselves, “Where will I find the time?” or “That doesn’t pay enough.” I would encourage all of us to challenge those notions as arising from the inertia of burnout. While it may seem like a challenge and big lift for many of us, we are doctors and we have proven ourselves capable of overcoming challenges in the name of our passions and profession.

I would like to share a thought-provoking question and answer inspired by a mentor of mine, Philip Miller, DO: “Whose wellbeing is more crucial? The doctor’s or the patient’s? The answer is the doctor’s, because if the doctor is burnt out, there are no patients, only victims.” This statement underscores the critical importance of a doctor’s wellbeing for the health of their patients, and, by extension, the community.

This current predicament clearly calls for an innovative approach and a radical solution. And that solution may sound counterintuitive: Engage in more activities. Hold on, I’m not advocating for an increase in workload, but rather, a diversity in the nature of the work.

Allow me to elaborate.

Beyond simply caregiving

The medical profession has always been a magnet for individuals whose aspirations are not limited to clinical patient care. Historically, physicians have played roles that extend beyond being caretakers—they have been the pillars of their communities, the voices for the voiceless and champions of social change. They have always been driven by a compelling need to make a significant difference in society, to advocate for the rights of marginalized populations and to contribute to the betterment of the world.

However, the current system, with its relentless focus on productivity and efficiency, has unfortunately reduced many physicians to employees who perceive their noble profession as just another day job.

What could possibly be the antidote to the pervasive disillusionment and burnout in our profession? In my opinion, many physicians would be served well by pursuing projects and work that align with their passions. This could look like getting involved with the next generation of healers through teaching, conducting research or other options explored below. It could involve taking a break from patient care for a time to engage in one of the many nonclinical work options for physicians.

My schedule

In my own life I’ve tried to do this. I work a four-day work week at a clinic as a family physician. On my off day (Wednesday), I’ll work on my other ventures, which include my faculty position at a medical school, research articles, remote work at a medical education company and mentoring premeds.

I find this schedule and mix of pursuits to be extremely fulfilling. My faculty position and remote work have allowed me to increase my income without having to work as many hours as I would if I was just seeing patients.  

Ways to pursue your passions

Can you think of six ways to be a physician without practicing clinical medicine? This exercise is beneficial not just for physicians, but also for residents, medical students and even premeds. It gets our minds thinking outside the box of the “day job” mentality.

Below are some ideas:

  • Teaching: We were all taught at one point, and we’ve all had physicians serve as mentors to us during our training. Doctors can make significant contributions to education by becoming adjunct professors, delivering inspirational lectures to the next generation of medical professionals, or guiding students during their clinical rotations. Maybe you want to do something that involves local health care outreach as well. You could offer Basic Life Support (BLS) classes at your local Department of Motor Vehicles to prepare new drivers for possible emergencies.
  • Research: Physicians can contribute to the advancement of the medical field through research. Pave the way and prepare materials and practice styles that can reach beyond yourself and make a lasting impact on the world.
  • Advocacy: Physicians have critically important expertise that legislators need to make informed decisions when they create policies. Identify a population in need and advocate for them at the local, regional or national levels. Help guide legislation with your hands-on, patient-facing focus.
  • Public speaking: Again, physicians have expertise that is worth sharing with many different populations. If this is an area of interest, the opportunities can include motivational speaking, advising other health care professionals, and educating your community.
  • Consulting: Many fields and businesses seek out physicians for their specialized knowledge. Physicians can be brought on to give feedback on a new medical device or pharmaceutical. We can talk to our peers on how to engage with patients better or transition to a new EMR. Maybe a company would like to bring a physician in to help develop an employee health and wellness program.
  • Writing: Writing is an excellent avenue for physicians to pursue. We can enshrine our knowledge as a reference for others by creating written material. Ideas for this include writing opinion pieces and submitting them to journals. Tell a story about your own journey in medicine to help inspire another generation. Question writing and technical writing are good options for those who are more academically minded.

Express yourself

All of these activities—teaching, advocating, research, etc.—are amazing opportunities for physicians who are clinicians. Many of them can also be engaged in by those earlier in their medical journey. Premeds, medical students and residents can get engaged with community outreach, aid in research and provide mentoring to others seeking the medical professional path.

Many people limit their view of a doctor to someone who renders patient care. That’s how we ended up here in the first place, right? Burnt out and trapped in a clinical mindset. People can think they can’t contribute or do good in the world through their passions without becoming a certified physician first. But you don’t need a medical license to start mentoring, conduct research or speak up for disadvantaged populations. You can express yourself now.

By exploring these diverse avenues, health care professionals can reignite their passions and discover numerous ways they can contribute to the world, irrespective of the path they choose to tread. In the end, this exercise isn’t just about finding ways to be a doctor outside of a clinical setting; it’s about reclaiming the sense of joy, satisfaction and fulfillment that comes from serving others. It’s about re-establishing our connection with the Art of Medicine.

There are many resources and doctors out there who are willing to help others find openings and opportunities, craft a schedule and navigate financial concerns. One example is physiciansidegigs.com, an excellent community built by doctors for doctors looking to explore their different passions.

‘Reigniting the passion that led us here’

I urge my colleagues to think outside the box when it comes to their careers as physicians. Let’s remember why we walk this path and reignite the passion that led us here. And in doing so, let’s do what I’m sure all of us thought we could do while we were becoming physicians: Let’s go make the world a better place.

Editor’s note: The views expressed in this article are the author’s own and do not necessarily represent the views of The DO or the AOA.

Related reading:

Confronting burnout and moral injury in medicine

3 things to try when you have advocacy burnout

10 comments

  1. Ana Paula Ferreira

    Thank you for the Thinking Outside the Box article. Engaging in nonclinical work enriches life experience and clinical work as well.

  2. Ronald C MillerDO FAOCD

    A fulfilling life is focused on the journey, not it’s destination.Computization took this away from our passion,and love for patient care.Most of what I was told about computization was delivered through deception.

  3. Robert Goldman MD

    Dear Dr Berhinger
    Very thoughtful article.
    One other persuit — Entrepreneurship. There are a few of is out there. Our idea a wearable pressure and force sensor for rehabilitation and wound care. My goal involves my training in Medicine and engineering. It’s totally engrossing and I certainly hope financially successful. Success takes many forms and just getting to the point of making a workable unit was tremendously satisfying.
    I hope all our colleagues can find an idea in which they can totally immerse themselves.

  4. John Rothrock

    Literally for decades my career in academic medicine offered an attractive and rewarding blend of clinical work, research, consulting educating, writing, and editing. Gradually that blend evaporated in parallel with the Rise of the Administrators, the demise of the physician chair as leader, mentor and cultivator and the conversion of an intellectually and emotionally rewarding workplace environment into an RVU-generating widget factory replete with templated EMRs heavy on volume and light on medical utility. Toss in healthy doses of DEI, legions of HR administrators and many hrs spent answering endless messages from pts requesting one to wage uncompensated and tedious battle with their insurers, and you have a recipe for…erosion of individual and collaborative creativity, professional collegiality/QoL and, ultimately, the joy and pleasure of working together with your peers for the common good.
    I have been a departmental chair twice. Would I do it again in this Not-So-Brave New World? No, thanks.

    1. ANNETTE CIOTTI

      “many hrs spent answering endless messages from pts requesting one to wage uncompensated and tedious battle with their insurers, and you have a recipe for…” making the physician a human shield between the patient and the insurance Co. The 2010 ACA and the rush to adopt EHRs made this skyrocket. In the 90s, we did prior auths often enough. Now that insurance Co’s are stingier with coverage, more expensive in premiums and deductibles, and docs are chained to “the inbox” (even during time off), there is an expectation that physician jump immediately and get the issue solved. This attitude fails to realize something: there is no perfect humaniform robot. That only exists in Asimov novels. The reality/irony is not lost on young people opting for STEM or business careers.

  5. Matthew Werner, M. D.

    Nice, but not emphasizing the fact that all we have came due to gifts of others: shelter, food, clothing, education….
    Best outside activity: VOLUNTEER, even if nonmedical. I like packing food boxes at my local food bank, as well as reading ultrasounds for pregnancy centers. Matthew Werner MD

    1. Jean l Cadet

      I love your way of thinking. There is much joy in giving back and sharing our gifts.
      Mentoring pre-meds has given me much joy.

  6. Anne Louise Phelan

    Your article is full of wisdom and practical advice. However, I take strong issue with the quote from your mentor, Philip Miller, who said, “…if the doctor is burnt out, there are no patients, only victims.” This statement victimizes the very physicians who are under stress trying to provide the best medical care possible in spite of the forces working against them. There is NO evidence that burnout is a danger to patients. It’s mostly a danger to physicians themselves that results in anxiety, depression, demoralization and, sometimes, tragically, suicide. Don’t demonize doctors that way.

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