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The path to physician reinvention

March 12th, 2014

by Kenneth H. Cohn

It always gives me a good feeling when physicians say to me after a seminar, "You gave me hope."

Physicians are facing a number of losses, from clinical autonomy to financial security, as noted in the Archives of Family Medicine. In general, physicians have done everything asked of them from college through fellowship training.

Yet, something is missing from the lives of many doctors I have worked with across 43 states.


As Joe Tye wrote in "A New Clinical Finding:"

In the sterile quiet of the exam room
doctor ponders the unusual x-ray
What do you prescribe for chest pain
caused by a dying dream
trapped inside the heart?

Unlike the progression from college to medical school to residency and fellowship training, the path for physician leaders is unclear because, unlike training, no one tells us what to do. With many ways to expend scarce resources without any guarantee of success, the outcome is in doubt, which triggers expense concerns. Moreover, failure is not an option for physicians.

Consider what a practicing general surgeon told me about getting promoted to section chief: "We're not stupid--we just need to be trained."

The path toward physician reinvention includes:

  • Tune into trends outside your field: Gary Yates, M.D, looked to nuclear power and commercial aviation as models to develop a high-reliability safety culture at Sentara Healthcare in southeastern Virginia.
  • Find unmet needs and solve the problems: Charles Rinker, M.D., a rural surgeon, found a way to learn sentinel node biopsy and train other rural surgeons so patients did not need to travel long distances for breast care.
  • Find your niche by asking, "What do I do really well, what benefits do I provide that people will pay me to deliver, and what gets me so excited that I lose track of time?"
  • Expect any new idea to be perceived as an antigen, which triggers an antibody response. As Machiavelli noted more than 500 years ago: "There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things."

Another general surgeon commented, "Think of your current career as a springboard to your next one, not as a prison to escape from." Any healthcare professional who wants to pursue reinvention can begin the journey.

Ken is a general surgeon/MBA and CEO of, who works with organizations to engage disgruntled doctors to improve clinical and financial performance.


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