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Gigi Hirsch, M.D., a career consultant in the Boston area, found her creative spirit withering away when she practiced emergency medicine in the Boston area a decade ago. "I had no outlet for my creative energy. People would tell me to stop having new ideas and go treat patients."
She concluded that she and many of her colleagues had a lot of untapped potential for professional learning, growth, and creativity.
After completing a residency in psychiatry in 1992, Hirsch found her career niche helping physicians develop their potential and more satisfying careers.
Over 500 physicians and numerous organizations including the AMA and the American College of Physician Executives have used her services since she founded the Center for Physician Development in 1992 backed by Beth Israel Hospital in Brookline. Hirsch has since discovered that "there is not a lot of room for shaping organizations because they are in a survival mode."
This past year she formed an independent consulting firm Gigi Hirsch, M.D., & Associates and launched a Web site "MD CareerNet" (www.mdcareer.net), using the insights she has gained from her consulting experience.
"My main goal is to help people realize they have options without feeling judged. The most unhealthy situation is when doctors feel trapped. I see people who have stayed too long in a job become enraged, frustrated, and depressed. They begin to think they are deficient when, in fact, the job is a bad fit.
"Some physicians knew they picked the wrong specialty but tolerated it until managed care tipped the balance."
Psychiatrists may feel they are spending too much time on psychopharmacology or are unable to tolerate the misalignment of values in a managed care environment.
"Physicians with exceptionally high standards regarding quality and patient accountability are not well supported. They may even love their specialty but can't practice in a satisfying way," said Hirsch.
"The only option some may be able to see is to lower their standards of quality. That doesn't mean behaving unethically but choosing not to work longer hours or going the extra mile," she explained.
"I try to help them consider the implications of this for their long-term professional satisfaction, and also to see a broader range of options."
Hirsch observed that the medical community tends to stigmatize physicians who leave medicine, especially when they move into industry-related positions. "There seems to be a wall between medicine and business, which may be due to concerns about potential conflicts of interest."
Most physicians who seek Hirsch's services, however, want to diversify their practice. They may have mastered a high level of skill in psychiatry and want a new intellectual challenge.
"This may involve developing a new interest or specialty. I advise them on how to package their skills and market themselves," she said.
Hirsch encourages physicians to develop a set of nonclinical skills in the health care industry. "This proactive strategy creates variety in a person's work life, which can prevent long-term burnout. It also provides a safety net of transferable skills in the event of health care workforce shifts or unanticipated health problems. I see a lot of physicians with no transferable skills who have to start from ground zero."
She noted that there has been a 60 percent increase in the incidence of physician disability claims for some insurance companies between 1990 and 1997. "This trend is driven in large part by the increased workplace stress and professional dissatisfaction of physicians."
Nonclinical areas open to psychiatrists include occupational and organizational consulting. This can involve, for example, helping departments understand how interpersonal stresses affect productivity and turnover, said Hirsch.
She also recommended psychiatrists get involved in clinical trials, explore fellowships in pharmaceutical companies, and take a few epidemiology courses.
Hirsch's Web site also has information about nonclinical career opportunities. She plans to post job placements for 12 sectors starting with the biotechnology industry. Resources and expert strategies to help physicians manage their careers and reduce stress also will be available. Hirsch welcomes comments from readers. Her e-mail address is ghirsch@mdcareer.net.