August 1997
Volume 61 |
Number 8
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| Practice Options:
Transitioning Anesthesiologists Into Nonclinical Areas |
Candace E. Keller, M.D.
In this and following issues, the ASA NEWSLETTER will
be publishing articles about some of the various practice options
available to anesthesiologists today -- inside the operating room
and in other venues.
The realities of today's radically changing health care environment
have created an opportunity to expand the traditional clinical
role of the anesthesiologist in the operating room into a variety
of nonclinical areas. Embarking upon such an endeavor, however,
must be considered carefully. Although our rigorous residency
training programs provide us with the clinical skills to practice
our specialty, entering the nonclinical arena necessitates a personal
assessment and possible acquisition of new skills. Presented here
are some initial points of reflection to begin such a journey.
The decision to enter the less traditional nonclinical area should
be a conscious one made after serious reflection and research
of many issues. Career goals, both short- and long-term, must
be examined and clarified. Thought must be given to the types
of tasks and work that will provide both personal and professional
satisfaction.
- How important is the satisfaction achieved from direct contact
with and care of the patient?
- Will the type of satisfaction derived in nonclinical work,
from which no immediate rewards may be seen, be sufficient?
- Will the development and management of systems and processes
to provide care for patients supply a level of achievement and
enjoyment commensurate with one's personal needs and career
goals?
- Will working with individuals from disciplines and professional
backgrounds far different from the world of anesthesiology bring
a new and adequate sense of success, or will it be an added
source of frustration?
- Can and will nonclinical work be approached with pride and
enthusiasm rather than regret and disappointment because one's
career has taken a tact different from that envisioned upon
entering the medical profession?
Combining Professional and Personal Goals
These are the types of fundamental questions one must address
by inward searching and in conversation with others. Consideration
must be given to a number of personal issues as well. These include
an examination of lifestyle desires and needs. The time requirements
of a potential career move as well as the time needed to acquire
additional continuing education, degrees or experience are also
crucial factors. Family needs and responsibilities are an integral
part of any decision, particularly when assessing one's potential
ability to relocate, financial obligations and job security. In
spite of the relative insecurity in today's clinical anesthesia
market, job insecurity in the arena of organizational politics
could be potentially greater.
The current stage of a physician's career in combination with
the myriad of personal factors will play a strong role in his
or her choices particularly when determining the type and amount
of additional training to be pursued. Some physicians in the mid
to latter stages of their careers have been quite successful in
transferring the management and people skills gained through experience
to new roles as medical directors, clinic managers, operating
room directors and administrative positions as hospital vice presidents
of medical affairs.
Physicians entering the nonclinical arena at earlier stages of
their careers may choose to obtain either more formal education
such as an M.B.A., M.H.A or M.P.H. degree, or extensive medical
management courses. Such training may be obtained through a variety
of options ranging from full-time degree programs to part-time
executive programs to weeklong seminars. Career stage may also
influence the decision to engage solely in nonclinical career
activities versus in combination with or as part of clinical anesthesia
practice.
Important Skills for Now and in the Future
No doubt there are numerous skills of importance when transitioning
into a nonclinical area that will vary depending upon the job
to be done, but several skills cited by current physician executives
are likely to be of value both now and in the future. Communication
skills and problem-solving skills will be critical to success.
A working knowledge of information systems and quality improvement
are vital. Negotiating skills and an understanding of organizational
dynamics will become a valuable asset. Personal integrity and
good time management abilities are important strengths to successful
job performance in any area. Leadership skills that emphasize
team development, consensus building and empowerment of others
will be highly sought after in today's shift away from authoritarianism.
Today our specialty of anesthesiology has a golden opportunity
to improve, expand and increase the scope of our profession. Whether
we choose to transition into nonclinical areas partly or totally
or to remain primarily in clinical practice settings, we can all
be leaders of the type envisioned by Chinese philosopher Lao Tzu,
who said:
"Leaders are best when people barely know they exist,
not so good when people obey and acclaim them,
worse when people despise them.
But of good leaders, who talk little,
when their work is finished, their aim fulfilled,
the others will say, 'We did it ourselves.'"
Candace E. Keller, M.D., M.P.H., is an
anesthesiologist in private practice in Hattiesburg, Mississippi,
and is Clinical Coordinator of the Foundation for Medical Care
of Mississippi, Jackson, Mississippi.
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