Doctor thinking of exit opportunities
Dear all,
I am new to this community but not new to contemplating my exit from clinical medicine. I have been weighing pursing consulting or equity research in biotech/pharma/healthcare. I crave learning about innovative solutions in healthcare and medicine, creativity, being surrounded by more like-minded folk (patients and other doctors can be quite soul-sucking), and more critical and analytical thinking. I've seen physicians (even some former colleagues) cross over into equity research or managemetn consulting so I'm wondering what would sway one more to one side versus the other. I'm also contemplating my MBA and/or certifications so I can legitimize my interest.
FYI: my academic pedigree is pretty respectable, I work hard and love challenge, I have freedom to relocate, I am completing subspecialty fellowship so I am far along in medicine and I have good research (basic and clinical) experience.
My family members and friends are entirely in the medical field, a few have done these exits: - pharma route and joined an innovation lab within this institution (I was told they have really interesting projects) - MBA and then subsequently consulting (MBB type) within healthcare/bio - one former MD is now within the health practice at Wolters Kluwer (but he hates the culture and the team though)
Can't say anything about ER for ex-medical staff or funds that would hire s.o. - Have not seen it personally (but that doesn't mean it is not possible, of course).
no way. Pay is higher in medical PLUS you get a title. Finance is too tough. Stay put. Who'd want to leave that life anyhow. You can be Ferrari driving by your 40s.
I'm in the same boat as thinking doctor. Ferrari driving in your 40's? Most doctors coming out today are in debt until age 65. Ivey league medical centers pay most internists, psychiatrists, pediatricians, family doctors, neurologists, and pathologists less than 180K per year and you are worked HARD. If your nurse makes a mistake guess who it falls on even when your on your well deserved lunch break. If the clerk doesn't hand the patient your scripts guess who it falls on? If your on vacation and something happens to a patient in the hospital due to another doctors mistake, you are also named on the law suit and it follows you for life. Imagine how uneasy it would be to work with others who don't care or aren't competent. Lets not even get into how flawed healthcare is. Nurse Practitoners are now taking jobs from doctors and getting paid 120K per year instead of the 180K per year doctors get for doing the same robotic mechanical work. With the world crying how expensive healthcare is, who do you think they will hire?
I'm with you thinkingdoctor, as I am a doctor that left medicine also and being a by product of two doctors as parents trust me I've seen it all.
Thanks for the reply, alyeshermni. I dont even care about the money anymore. I agree with everything you said. Can I ask what you are currently doing now outside of medicine?
Then what about those Doctors driving Ferraris and Porsches ? Are they images of the old world ? I always despised a doc who had 3+ Ferraris and 2 Lamborghinis. Is it not possible to be him anymore ?
Is it possible? Sure if you have several private practices established a long time ago. Getting into private practice now is walking off a cliff unless your in select fields with certain educational backgrounds or networks established through family ties.
Heres why: I walk into a major hospital urgent care clinic. I leave with a follow up with one of their hospital doctors on the outpatient side. If i had a private practice endocrinologist for my diabetes, well now they changed it to their affiliated endocrinologist. Major hospital systems are taking over smaller groups and are earning a % of their pie. Did you see CVS and Aetna? There are many healthcare mergers going on that are shrinking the mom and pop practice. It is happening every where and its in effort to maintain profitability.
Let me give you an example. You own Walmart. You have 30% of the customers coming in taking what they want and leaving without paying. Thats the emergency medicine system. Over 30% have no insurance and each patient runs a tab over $1,000 on average. The hospital bites that bullet. A doctor working there may start at 180K, he will never see 200K because his worth is not going up, its staying the same, yet the hospital has the tightest margins. So they will acquire group practices, urgent cares all as feeders to their system to maintain adequate patients with insurance to dilute those who don't have insurance. In doing so, the nurse practitioner and PA become very favorable to them.
I'm sure many of you walk into a doctors office, see the dr for 2 minutes. Btw, I gaurentee that doctor missed a number of things on your physical exam, labs, follow up preventative care, etc because they really can't handle all of your issues in the amt of time they have. They have become cheap labor just watching over other mid level clinicians stated above.
So in short, who are the doctors driving the ferrari's? I've seen them and you have too. I think a number of them would be driving ferrari's even if they weren't doctors. A lot of them are old money, or people who were able to command significant income long ago when real estate was cheap, invested the right way, and bought a used ferrari or
They are the plastic surgeon that everyone knows about in town commanding 10k for a 4 hr boob job. That guy went to a great med school with great performances on his boards. He was able to nab a great residency, sits tall, handsome, and can charm his patients. Or
He's the spine specialist , dermatologist (making $400 per botox) which now everyone including a dentist can do and will drive down prices, interventional radiologist or cardiologist commanding 500K-1M per year. Want those fields? You better be damn near perfect in a top medical school. 98% of doctors aren't touching a ferrari ever. I know tons of doctors living in neighbhorhoods that are occupied by middle class teachers living a similar lifestyle. As expenses in society increase, their salary does not. They really should pray it doesn't go down as reimbursements have across the board.
Yeah, internal medicine/pediatrics/general care aren't compensated nearly as well as people think. Specialists are a different story, though. I personally know urologists, cardiologists, and orthopedic surgeons who stepped immediately from their residency/fellowship and into $350-450K per year posts in both private practice and within hospitals. The pay discrepancy between docs is pretty huge.
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never seen someone make the same "your" vs "you're" mistake so many times in a single rant.
out of all the options listed, ER would be my last pick. VC, pharma research, etc., all have longer futures ahead of them
even buy side ER has a short future?
Why is ER future short, especially in buy side pharma? Biosimilars, gene therapy are taking off as far I know. Would like to get some more info on this from your perspective.
buy side not so much, moreso sell side
you're right, biosimilars, immunotherapy, gene therapy, etc., are all taking off. if I were you, I'd try to get into the drug development side rather than finance, you won't have to start from scratch.
I'm noticing a trend of doctors fantasying about ER. ER is a dying industry unfortunately.
From ER, where can someone branch off to?
I think you'll be VERY successful going the MBA -> MBB route.
If you're dead set on AM / Equity Research, you can get your CFA and still make bank as a doctor without incurring big opportunity costs. In the meantime, read the full 2016 10k's of various biotechs & pharma co's. Build detailed revenue and cost models and see how they compare with 2017 results. Research skills are transferable across professions. Good modeling isn't. You'll need practice. When you finally think you've got the hang, show it to WSO. Chances are, it will need major work.
While making the transition, get a few books about fundamental analysis, valuation and banking. If you understand the value and transaction sides, you'll be off to a good start. Reading Seth Klarman's Margin of Safety (google for PDF) and Joshua Rosenbaum Investment Banking (buy 2nd edition with excel models) will give you a balanced perspective and technical know-how. GL.
thinkingdoctor
Thanks for the advice @HazelJ. I am trying to weigh the MBA heavily now because I tried to get into MBB, failed at M but have not tried the others. I got a hit from OptumLifeScience a few years ago and did not proceed bc I took an academic promotion (MISTAKE) instead. I am trying to read up more on finance and investing right now and seeing if that is another option. Fingers crossed for the future...if all else fails medicine is not the worst planB by any means.
I don't see how you could go direct to an MBB. You're clearly smart, but a good portion of consulting is operational/market analytics and speaking the "language" of business. I don't know if Medical school prepares you for that.
MBA could be a good route to change over. I know a doctor that went that route and now works at an operating partner at a healthcare based PE fund.
which school for an MBA did he go to? I hear its either top 10 or bust.
Top 25 MBA. But pretty unreal experience in the medical profession prior.
Google "drop out club", it's a great resource for physicians that are considering other careers.
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