Career Transitions: Why I Pivoted and How I Did it

For the last few years, I have had the privilege of sitting on a panel at the American Society of Plastic Surgeons Senior Residents Conference discussing career transitions. The panelists have been plastic surgeons who have changed from academic to private, private to academic, group to solo, and even from fully clinical to part-time practice. Central to the decision-making of these surgeons was a desire to achieve self-actualization: the human desire for individuals to maximize the return on their potential.

One of the most attractive things about the aesthetic industry (an industry based, after all, on attractiveness) is the flexibility that we have to explore a variety of professional endeavors that draw upon our core competencies while providing possible outlets from the daily grind. We have the ability to treat patients of all ages, throughout the body, with each patient's unique features and goals presenting a novel canvas. The spectrum of procedures we offer within our practices is staggering. And yet, for many, this is not enough to sustain a completely fulfilling career. This may be due to conflicting financial pressures; medicolegal risks; unfamiliarity with newer, more marketable procedures; difficulty keeping up with competitive positioning and marketing in the digital era; frustration at the pursuit of perfection ingrained in our psyche and reinforced by the demands of ever more difficult patients; life-changing events that call into question what will make us happy; or even boredom.

Changing Course

Physician burnout is at an all-time high and growing numbers of us are seeking tangential career paths that only skim the surface of our medical expertise. Others are exiting clinical medicine altogether. There are ways to parlay your extensive expertise without taking yourself out of practice entirely, and in so doing, provide sustaining variety and newness in your career. This is known in business as “pivoting,” or making a switch within or outside of your career comfort zone. There are many reasons to pivot.

In my case, I encountered a significant setback in my personal life, which, coupled with my observations of the challenges of a group practice that at times struggled under the weight of its success and a clash of egos (commonplace in our industry, where each physician is a brand unto himself/herself), led me to seek opportunities to reinvent myself as more than a plastic surgeon. A physician innovator is what I wanted to be (I call it being a “wantapreneur”) but felt only moderately qualified in the language of business and strategy. I sought to join an Executive MBA program, partly to learn the vocabulary of finance and business, partly to establish bona fides not commonly possessed by doctors, and partly to network outside the healthcare profession. Simultaneously, I was approached by a referring physician who had founded a new EMR company. He asked if I was interested in building a product for plastic surgeons, and I jumped at the opportunity.

This led to a transition out of my group practice and into a role of an independent contractor, working with aesthetic centers, dermatology practices, and a technology company, cobbling together an income stream that was previously more easily constructed as a full-time practice employee. This gave me the flexibility to schedule other activities into my professional time—expert witness work for patent infringement, consulting to the venture capital and investment banking industries, doodling ideas for medical devices, even moving cross-country to help lead a startup in the genomics and precision medicine space. It also meant leaving a market where I was a known entity, having to make transitions with referring doctors and facilities, and deciding how to position my personal brand going forward.

Pivoting Road Rules

If you are interested in these kinds of extra-curricular activities, know the following, partly gleaned from business experience and partly learned from rock and roll lyrics:

• You can't always get what you want.Income, free time, schedule predictability, variety, autonomy, security … there are trade-offs among these objectives, and the rare physician actually accomplishes all of them. Prioritize and execute accordingly. Having a supportive partner and home environment is critical if others will be impacted by your decision making.
• If you want it, you've got to believe. There are enough obstacles to your success without self-doubt. The same resilience that got you through plastic surgery or dermatology residency should help accomplish non-traditional goals if you dedicate enough time and resources.
• Nothing compares 2 U. We are unique in our combination of aesthetic vision, manual skills, social networks, intellectual capabilities, and time capacity. Figure out your “value proposal”; throw time and capital behind optimizing it.

There was (and remains) certain risk to one's career momentum that accompanies such a transition, but I have never been more fulfilled.

Tim A. Sayed, MD, is a double board-certified plastic surgeon in California and Florida. He works in the healthcare technology space as a developer, consultant, and investor.