Prioritization

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The first step in deciding on a new career path is to prioritize your goals for a new career. This may sound simple, and you may think you know exactly what’s important to you, but if you actually take the time to sit down with a pencil and paper and write out the list, you’ll probably surprise yourself. If there a “significant other” in your life, you might as well get them involved in this step to review your list. They may surprise you as well, and it’s better to discuss these priorities together now.

Before diving into a future career, take a look at your current career. List what you like about your job, and then what you don’t like. The lists will probably get pretty long quickly. Then force-rank each list.

My “like” list had the following items:

  • Intellectually challenging

  • Technically challenging
  • Generally highly respected career
  • Good current salary
  • Very high earning potential
  • Doing good for people
  • Short commute

My “dislikes” list included:

  • Long hours
  • Insurance company restrictions
  • Patient demands
  • Pressure of the consequences of a bad result
  • Malpractice and other overhead
  • Concern about malpractice threat
  • Only keep a fraction of profit (non-partner in a group practice)

When I really thought about these and got more specific, it helped further assess my job. For example, “long hours” really broke out into several items that provided much more insight as to why I wanted to leave medicine:

  • Unpredictability of work hours
  • Getting called back into the office during dinner
  • Being on call
  • Lack of sleep
  • Lack of sufficient coverage to leave town
  • Interruptions (and concern about interruptions) of time with my family

These started to add up to lack of control over my work time, which impacted on the quality of my “free time.”

Do your best to complete these lists, and don’t be surprised if you miss a few. Revisit the lists as you move forward with your exploration of alternative career options. In looking back now, I realize that I completely missed one of the best aspects of a clinical career – job security. I never had to worry about the possibility of being laid off. The thought probably doesn’t even arise in the mind of most physicians; in most cases it probably feels like their job is secure 24 hours a day, 7 days a week, including holidays. I have since seen physicians fired and laid off; the impact of such an event can’t be overstated. Now, without a potential job in mind, take those two lists and use them to create a new list of the attributes that you desire in a new career. With enough detail, you’ll probably end up with 10-20 attributes. That’s the easy part. Now we get to the topic of this chapter: prioritization. Force them. No ties. No generalizations. Just a numbered list.

This is a time to be honest with yourself. It might be nice to tell people that the reason you sent into medicine was to help people, and that might be true, but imagine reducing your salary – by 10%, by 25%, by 50%. We will revisit salary in a later chapter. For now you need to decide which general attributes are most important to you. What must you have? What could you do without, if necessary? Of course all of these items are relative, but draw a horizontal line to divide the “must-haves” from the “could-do-withouts.”

Keep this list. In the end, the process of going through this exercise may help assure you that your current job, while not perfect, achieves more of your top objectives than any alternative that you are considering. Then you can refocus on your current career with extra peace of mind.

Now you’re ready to start looking into options.

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