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For Physicians Seeking Change
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My number one recommendation is — DON’T try to do 6 different things like I did.
Make a careful plan, assess your finances, and FOCUS.
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This is the hard part!
Are you ready to be on your own, responsible for generating business?
Ready to give up medicine completely, or do you just need different hours or a different venue?
Are you ready to make a clean break with your current employer?
Are you ready to work more hours if you start your own enterprise?
Have you done a complete financial analysis?

This is the easy part.
Decide whether to set up a limited liability company (LLC) or work as a sole proprietor.
Register with your state
Get a business license (county)
Start with a checking account and debit card, later can add credit card
For my bank, I needed a corporate plan. I subsequently changed it; Not sure if you need this for sole proprietor

A major change to your career plans requires not only careful introspection, but also careful inspection of your finances.
What you decide will depend on your stage in life, who depends on you for financial support, and your current assets and future assets.
Are you in the accumulation phase or the preservation phase of life?
A careful evaluation of your current and future income will help you avoid any severe financial mistakes.
Some of my thoughts on investing: I’ve been an investor for 35 years. Having done my share of buying high and selling low and having my share of all kinds of luck, I have a recommendations, none of which are terribly novel:
1- Quick and dirty reference for a new cash influx: 1% of 40,000 =400 /2 = $200 per month (with a 6% yield)

You will want some computer programs or websites to help with your endeavors. Depending on what direction you go, but their will always be some basic needs:
Communication Scheduling Tracking income and expenses Keeping track of ideas References Making a web site

Locums work can be very rewarding and can be a back-up in case you launch into a non-clinical career, only to find you don’t love it, it doesn’t pay as well as you expected, the demand is not there, or you need to maintain clinical contact, such as for expert witness work.
The travel can be tiring and it can be a strain to leave your family often.

File review involves reading medical records, searching the medical literature, reviewing medical insurance contracts, answering questions, and writing reports.
The work is paid for by insurance companies and independent review organizations, the third party middlemen who review proposed treatment for medical necessity.
If you think you might like to do expert witness work, file review can be a good place to start. You can gain experience reviewing records on nights and weekends while getting paid and keeping your full time job.

Tackling expert witness work is not for everyone. Most of my colleagues say, “how can you do that?” I think they are afraid of having to claim that another doctor made a mistake and needs to pay a penalty.

Wow! I am impressed! I want to write a book too.
Non-fiction for me. Maybe fiction for you.
It takes discipline and time.
There is so much to research and so much to learn about publishing and self publishing, etc.
Income could be low or non-existent.

You can teach yourself how to design a good website, and there are many helpful programs available online.
You can do this work nights and weekends.
You need a good idea that others haven’t thought of or have not executed well.

me for websites3.jpg
R. B. Mitchell

Medicine residency 3 years Fellowship in hematology/oncology 4 years Academic hematology/oncology 7 years
Private practice hematology / oncology 24 years and counting
Locum tenens 4 years Chart review 4 years Expert witness 5 years+
My clinical practice runs 4 days per week (no Fridays); no night, weekend, or holiday call

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