Nisha Mehta, MD, is a practicing radiologist and founder of Physician Side Gigs. She joined us to talk about personal and professional development for physicians, getting clinicians more involved in healthcare operations, and how doing that can make careers in medicine more sustainable while also contributing solutions to some of healthcare’s greatest problems.
What is the underlying premise of your (side) work?
Fundamentally I want to encourage physicians to think about themselves as more than just physicians in a clinical environment. I want them to think about themselves as individuals, as people, as well as powerful members of the healthcare landscape. After so many years of training, it becomes natural to sort of follow the pathway that’s been set for us. But as things change in the healthcare landscape, so many of us are not content with what that pathway has become for a number of reasons. And so in my work, I really try to encourage physicians to think about first what they went from their personal lives and their careers and then shape the life in medicine that they want. And that doesn’t mean that they’re putting themselves before their patients, but rather that they’re really just trying to find the best way to deliver care in a way that allows them to stay happy and healthy.
What is driving the change in expectations around clinical careers?
If you look at physician demographics and you look at millennials entering the field and you look at 50 percent of physicians in the pipeline being female, it’s clear that what people want out of their careers is very different than what that traditional model was. And really what I’m trying to do is get that system to change, to reflect those demographics rather than trying to force all of these people to change themselves to fit this traditional demographic which may not be ideal for healthcare as it is today.
Explain the disconnect between physicians and the healthcare system
Traditionally, physicians have focused primarily on patient care and not gotten too involved in all of the other things outside of the physician-patient interaction. And nowadays there’s just so much emphasis on trying to do more with less resources overall, and so what happens is that it seems like physicians can’t really focus on the physician-patient relationship. There’s this overarching sense of loss of autonomy and lack of control over external factors because the people who are making decisions in healthcare these days are not the physicians and their patients. So […] if you step back and think about that, that’s terrifying because the people who know the system best aren’t the ones making the decisions [… ]I think there’s a role for everyone and I think that everyone needs to work together to create the best system possible, but I think it’s easy to see how problems arise when the two parties that are involved at the heart of healthcare don’t have a seat at the table.
How does the current trend of consolidation affect this issue?
It’s a mixed bag. On one hand, physicians have been really happy to give away some of the things that they don’t want to get involved in, whether it’s billing or whether it’s the business side of medicine, because they really do want to be able to focus on their patients. But I think in doing that they have given away a lot of their ability to be integral members of that decision-making process.
I talk to a lot of people about burnout these days, and really more than the number of hours worked, more than the stress of the job, the thing that people really keep coming back to is this feeling that they don’t have control over their destiny or their careers in medicine.
When I give these burnout talks, when people come up to me afterwards, [the concerns are] number one, this sense that they don’t have the ability to make decisions that impact them on a daily basis. And number two, this fear of what’s going to happen in the future.
What’s your take on the issue of specialization? Any concern over clinicians taking time away from clinical practice to develop other skillsets?
If [physicians] go into these other spaces and they come up with real, actionable solutions, they can number one, be more effective at work and number two, not burn out and be able to participate in the healthcare system for a longer period of time. I think that understanding the healthcare system, business and technology is really important for physicians and it was never something that was stressed to them during their training.
We’re living and breathing medicine. We’ve gone through over a decade of training, so I don’t necessarily think that we need more degrees […] Generally, physicians are pretty clever and resourceful and as long as they’re willing to think outside the box, they could do a lot more learning on their own.
What does it look like for healthcare systems to view clinicians as valuable contributors to innovation
I see so much stuff out there that are nice ideas, are they really moving the needle forward? And so I think systems coming together with clinicians and saying, is this something that’s actually going to help?
Right now there are great administrators out there, don’t get me wrong, but they come into the healthcare system with a different perception than physicians do. And what seems like a good idea on paper may not translate into reality. And every time I hear a hospital put out a new initiative – even if it’s really, really well-intentioned – I hear from the physician’s side about unintended consequences.
So like I said, I’m a believer in the long game and what maximizes profits in the short term isn’t necessarily what’s best for our system in the long-term. So really encouraging healthcare systems and clinicians to work together.
Talk about how physicians can think about getting more involved outside the clinic
I tell people [to] look at the things they’re interacting with on a daily basis. We all have things that as we go through the system we’re always thinking, “this is a real pain point that needs to be addressed.” And instead of just saying those things, go to whichever product that you’re using or whatever system that is frustrating you […] and say, “well, how do we do this better?” And if you’re looking to do this more on a professional level, consider becoming a consultant for these companies and getting involved in things from the ground up and saying, “Instead of having this work one way where we’re constantly looking at what’s wrong and then trying on the back end to fix it, let’s get involved in that innovation process from the outset.” And then we can prevent that from ever becoming an issue and save a ton of money in the process and a ton of time in the process.
So I think that that’s why healthcare systems should be working with clinicians and why clinicians should be working with healthcare systems. Because it benefits all of us to have these systems run as efficiently as possible and have them be things that really people want to use and are going to use.
Tell us about Physician Side Gigs
We’ve got over 15,000 physicians who are thinking about their careers from a different perspective. So it’s a really targeted audience from which to recruit people who are willing to serve as consultants or who are willing to participate in research. We actually have a database of over a thousand physicians who want to get into consulting across various specialties.
One thing that I’ve worked on with companies are people who are saying, well, you know, we need to get a certain number of cardiologists, for example, to test out this idea we’re putting forward. And conventionally they’ve gone too places like LinkedIn[…] but that’s a lot of time and not necessarily always effective. And so instead, if they can come to me and say, “do you have 10 cardiologists who’d be willing to give us input on this particular product,” that’s a partnership in my mind that has a lot of value.