Connecting The Dots of Healthcare

I spoke to a very close friend last week about his contemplation of a major professional change. Bill has been a lawyer for almost twenty years and has grown beyond his job. He isn’t necessarily unhappy with his job, but he yearns for a change of pace and of location. His approach/avoidance problem is that he is very good at what he does, makes a great living, but has seen a glimmer of what could await him. The same glimmer is also terrifying. To leave a good job, friends and family behind and to explore the unknown is daunting. But the price of staying on are long years of predictable sameness mired in the mundane.

I understand what he’s facing because I wrestled with the same dilemma in 2001 when I left my established clinical practice to the vagaries and uncertainty of launching my own healthcare consulting business. I spent many years in school and then in training to become a surgeon. A similar time commitment Bill spent becoming a lawyer. And then, while supporting a family, I chose to leave the certainty of steady income and a great practice for something totally new and different.

I offered Bill an encounter I had in a recovery room. Having completed a now forgotten surgery, I was writing post-op orders at a counterspace desk in our recovery room. All the OR staff knew about “THE BOOK” I had written and the increasing frequency of my trips out of town to speak. Caroline, an RN in the recovery room was waiting for me to finish my orders.

“So how’s the speaking circuit going? Are you enjoying it?” she asked.

Everyone always asks how the “speaking circuit” is. I guess if I was a NY Times bestseller, a publisher might arrange a series of appearances, “a circuit,” but in my reality, there is no “circuit” for a keynote speaker.

”It’s keeping me busy.” I neutrally replied.

“So, you think you might leave surgery to do that full time?” she responded.

Well, no one had openly broached this particular subject before and it caught me off guard. I had been contemplating this very question for weeks, but hadn’t shared this with anyone other than my wife. I knew Caroline as a genuine, warm person who spoke her mind plainly and freely. She asked this question in such an off-hand, matter-of-fact way, I simply answered her.

“Well, I’ve actually given it some thought, but it’s a hard decision. I still like what I do as a surgeon, but I used to love it. Medicine has change so much now. I’m torn between leaving an economically great steady day job but excited about new opportunities I think I’ll find that will also pay the bills. I’m intrigued by this other potential career, but am finding it hard to give up something I’m pretty good at. Especially something I’ve spent so many years working to get to where I am,” I told her, somewhat surprising myself at my candor.

“Hmmm,” she murmured thoughtfully, then added, “So, how long have you been doing surgery?”

I figured it out using all my fingers and toes plus a bit. “Twenty one years, including residency,” I answered,

”Well,” she told me, taking my now completed post-op orders, “that’s long enough — you can change now, if you want to.”

She turned away and walked back to my patient, reading the orders. I simply sat at the desk and repeated to myself what she said. “That’s long enough; you can change now, if you want to.”

What if I’d said “twenty years?” Would that have been long enough? How about seventeen years? Eleven and a half years? What’s “long enough” and how, exactly, is “long enough” determined?

I’ll never know. She didn’t elaborate. The next time I had the occasion to speak with Caroline, I had made my decision and she had already heard. But I don’t know if she ever knew how much of an impact she had on me when she gave me permission to change before I gave myself permission to change.

So I asked Bill how long he had practiced law. And then I told him “Well, that’s long enough. You can change now, if you want to.” I added, “You have my permission to change.”

Today, especially when I speak to physicians, I often have frustrated successful people linger off to the side after a program and when the crowd has dissipated, they approach and ask me, “How did you manage to leave medicine? How did you start a new career?” We talk for a bit and then I give them permission to explore other avenues, and if they find something that reminds them of how they once felt about medicine or whatever their passion had been, they have permission to change too.

Our greatest assets are our minds. The same mind that can become a physician, or a lawyer, or any profession or occupation requiring reason, judgment, commitment and prudent choice can become anything that requires these basic traits of intelligence and accountability. The inertia of status quo is formidable and resists change but when overcome can lead to adventures, new discoveries and an amazing freedom.

And the truth is you don’t need anyone’s permission to change, only your own.