questions, but thank you everyone for joining us today. We're going to be discussing non-clinical careers, and this is just a small sampling. I recognize that there's lots of different opportunities out there, but I'm in a clinical career, just as a disclaimer, and this is the easy part, just getting to introduce these speakers who can talk about their experiences and how they got to where they are. So we'll have more polling later. I'm currently at Vanderbilt Medical Center. I have no relevant disclosures. Again, I do have a clinical practice. I think there's three things that we were hoping to accomplish with this session today. So first, we wanted to at least just get an idea of what non-clinical careers are available, and I think just a lot of us may not know what's out there, and again, this is a small sampling here. I understand maybe some of the pros and cons that go along with that, as well as just discussing some of the decisions that may go into the next steps if you're considering something like that. So why this topic? I know there's lots of different sessions about burnout, and I think a lot of people start thinking about whether or not they want to continue a clinical practice. Part of the issue, too, for a lot of people is that a lot of the training that we've been given is heavily clinically focused. We really don't get much opportunities to know more about non-clinical careers in any type of training setting. We may not know what exists out there, and I think a lot of us maybe want more freedom outside of a traditional clinical-based practice, and so that's my hope for today is to hear some of their perspective and also opportunities and how they got to where they are. So again, for those who are still walking in, I know I've been showing this up on the screen. This is a way to join a poll and just try to keep it interactive. So we're going to introduce the speakers here. We'll go one by one. First is Maurice Cholas, and I love his picture. This probably just really characterizes who he is, and so I love he's going to jump for you when he gets up here. No, I'm just kidding. So he is going to come up, but I want to show you, I want you guys to guess the lie. So he submitted to me two truths and one lie, and what you have to do is judge him already and guess what the lie is about him. Yes, yeah, I can read it. So A is he was the king of Mardi Gras, B is he loves crafting, and C, he was the first peds rehab doctor in the state of Louisiana. So which is the lie, and that's what you're trying to pick out of these three. The issue with this screen is that once everyone chooses, if people are split, you can't tell which one there's more choices on, but it looks like you're judging him. He doesn't love crafting, I guess. You know, you're not much of a crafter, but I don't know. All right, so we're going to see what the answer is. Oh, guess not. Can you tell us about each one? Welcome to New Orleans. I am a lover of all things carnival, and as you all know, it's a carnival season that starts on King's Day or Epiphany, which is January 6th and goes until midnight going to Ash Wednesday. So it can be a number of days depending on the lunar calendar. So Mardi Gras is not a day or a week, it is a season, usually several weeks, and us hardcore New Orleanians party the entire time. I, as a lover of Mardi Gras, I'm a member of Zulu Social Aid and Pleasure Club, one of your most beloved carnival crews, but I have never been king of Mardi Gras. I do craft, I make my own throws, I make my own outfits, and I was, in fact, the first peds rehab doctor in the state of Louisiana. That means I still get mailings for cardiology because they didn't have a two-digit code for me, so they just gave me one at the beginning, and that was the cardiology code. We have a code now, and I've written the actual credentialing guidelines for Children's Hospital, which is adopted by Ochsner Hospital, which is now how peds rehab doctors are credentialed in the state. So I guess I'm sufficiently elderly and senior now that I've wrote things that people still use, but welcome, guys. This topic is really, really near and dear to me, and it's interesting. This has been one of the main things I've been asked to talk about over the last year or so, and it's a good introduction to the entire panel. A few disclosures. I do a couple things outside of this, and some people give me money. Hopefully that won't influence me. However, I do give talks about career pivots, so I guess maybe Is that a conflict of interest? I'm talking about something I... Well, in any event, we're talking about stuff that we actually know about and are going to do. So this is how people think about medical education. It's sort of like, you know, we develop from rostral to caudal. At the beginning, you have primary education, then you go to secondary education, then you move on to undergraduate, med school, and postgraduate training, and that's sort of how we become fully formed humans. Well, humans have lots of different aspects, and I borrowed from my website here in that I'm a healer. I actually provide clinical care, and I intend to be a clinician until the day I die in some way, shape, or form. I'm a speaker. I like talking. I never met a microphone I didn't like. Podcasts, I was like, wait a minute, I get to record me talking? Oh, God, yes. Writing, I wrote one of the interesting things that came out of this is the commentary we wrote about sending kids back to school post-COVID is the most influential article from the Journal of Pediatric Rehabilitation Medicine of all time. God, I found out, I was yesterday years old. So you write things all the time, and some of them actually stick. We're a consultant. When you talk to people about how to do things, that's all consulting is. When you talk to people about how to do things, that's consulting. So we all consult in informal ways. There's ways you can do it formally and actually get paid for it. And lastly, I'm an advocate. I am not satisfied with the world being the way it is. I want the world to be the way I want it to be. That advocacy can happen one-on-one. That advocacy can happen with me going to the mayor's office, which I go, and that advocacy can happen to me going to state government or federal government. Elected officials are the only people in the world paid to listen to you complain. That's their job. Whatever you want to talk about, however long you want to talk about it, that's what they have to do. So I really put that up there to say, being a physician should not mean muzzling all the other parts of you. And I think finding a career path that embraces that leads to less burnout and leads to better happiness. So what do I actually do? This is the money shot. This is how I spend my time. This is a mystery, too. My grandparents died not understanding why I did an M.D. and a Ph.D. Couldn't you do one or the other? And I feel like all of the people that trained me over my career are like, what exactly are you doing, Maurice? Are you starving? Are you somewhere? What's your title? I don't have a big title anymore. But you can see about 30% of my effort is patient care. Medical operations consulting is 10%. In plain speak, I help people start pediatric rehab programs from scratch. So hospital systems are really, really good at running what they have. They're terrible at startups. So they need someone to help them with startups. Medical legal consulting is about 20%, meaning I've monetized my expertise. So I get to tell people what I think, and it moves juries, and it sets awards and damages. So I don't testify on who was at fault. I testify on how disabled the child is and what it would require to care for them for the rest of their life. So it's monetizing my background as a Peds rehab doctor. Community and public health, making sure people get COVID vaccinations, making sure people understand complex medical topics. That's one of the things I do. Mentorship is a big part of it. I am so excited that I was the first black man board certified in Peds rehab, but now there are six of us. And all six of them I know or I recruited somebody that recruited them. So one person can make a difference, and that's part of your portfolio. 5% is other. That's probably me doing cartwheels, crafting, or whatever random stuff that I do along. So I am a recovering academic. I'm an alcoholic. I'm still there. And so I put this up here to say, what is the expectation versus the reality? So my expectation as a Harvard MD, PhD guys, I was going to be dean of something or chair of something or something important and something relevant. I was going to be in leadership. I was going to do clinical research. I was going to have academic publications, and I was going to be a full professor. I am none of those things. I am an entrepreneur. I consult. I have publications. I collaborate. I have flexibility, and I have a balance of my focus. So these are the non-clinical options. This is a good Venn diagram, and I'm going to lay it out for you really quickly. And this is going to talk about how some of my other colleagues are. So you have administrative self. So as a physician, you can be a hospital executive, a medical society executive, a nonprofit executive. Each of, like, we have the foundation of PM&R. That's a nonprofit that's connected to the work that physiatrists do. There's industry, pharma, medical device, firms, biotech firms. There's venture capital now. Why do they need physicians? Those people don't speak to a physician. They didn't go to medical school. Somebody has to be there to translate. Next, consultative stuff, life care planning, legal stuff, expert things. That's an aspect there. And finally, research, be it applied science, basic science at all. So if you look at all these different areas, they have different ways that they overlap. So somebody working for a regulatory agency. It's a mix of administrative stuff and industry stuff, because you have to help industry understand how to be compliant. You have to make sure that the rules actually apply fairly, and people are doing what they're supposed to do. An example of something that's researchy and consultative is foundation leadership. One of my good, good friends is in charge of the Thrombosis Society, which is basically the hematologist foundation. So she really works with industry, she works with clinicians, and she works with the public to help understand how to move the needle on things related to a subject area she loves. A team lead is a good example of industry and sort of a consultative overlap. And then lastly, retail entities. So we talk about Google, Walmart, all of these industries are now getting chief medical officers. 3M, which makes all the supplies that go in the operating rooms and tapes and plastics and all kinds of things, they have a chief medical officer. That is a physician. And they have several physicians under him over the various branches and relevations. And finally, venture capital. The money guys have come. They are buying hospitals, they're buying clinics, and they want to understand how to maximize return on investment. You can't do that if you don't understand the business model. So I really put these up here to really talk about there's lots and lots and lots of ways you can find overlap and find a place and a space for your skills as a former clinician, a part-time clinician, as a clinician with other outside interests. So I say this is sort of like relationships. You don't have to get married. You can just date. You can date seriously. You can date casually. You can one night stand it. There's lots and lots of different ways to make use of yourself. So if you don't remember anything else about this talk, this is really the framework that lays out what we're going to be doing and talking about here. So it takes courage to walk a custom path rather than walk a traditional one. You don't know where you're going to end up. It might be Shangri-La and perfect. You might be four miles out of the way and lost with no food. I am, I don't exist alone. And when you go out on your own to try and put together something that's non-clinical, it's important you bring a team with you. That's the one thing that academics has right. They have a department that helps you with PR. I had to make one, Bambi. They have a department that actually tells you where you're supposed to be and who you're supposed to say yes to. That's Lisa Marie. Good Lord, if something happened to Lisa Marie, I wouldn't even know where to use the restroom. I just blindly look at my phone and whatever she put in there, that's what I go to next. I have protocol managers. I have operations assistants. You have to put together your infrastructure so that you can use your brain power to move the ship forward. So with that, thank you, guys. And we have a great panel that's going to really lay it out for you all nicely today. Thank you, Maurice. Great. So we're going to move on to our next speaker. So this is going to be Dr. Hofstein, and he is currently the associate dean at the, at University of Missouri School of Medicine. So again, we've been doing this with our speakers for those who also joined us. We are doing a poll, and your job is to spot which one is the lie and which one, sorry, you're supposed to just spot which one is the lie because two of them are true, one is the lie. And I'm just going to read them out for you. So A, David was voted most friendly in high school. B, I have my student pilot license. And C, as his first career, was a high school science teacher. I know we're making snap judgments. He does look like a really nice guy. So it looks like A is running away with the vote. Great. Well, David, I want you to tell us which one is the right one, and you can take it from there. Thank you. So I do not have my student pilot license. I don't, I love to work, and I love to read and travel, but doing like piloting would be terrifying to me. So yeah, that's my lie. So, and unlike Maurice, I've never met a microphone that I did like, and so that just maybe proves that leadership maybe comes in all shapes and sizes. So I'll tell you a little bit about my career and the medical school dean's office. So first of all, I'd like to say thank you to several people in the room and not in the room. I feel like during my transition from clinical care to non-clinical care about five years ago, as I was going through that turmoil, there were a lot of people at AAPMNR that I leaned upon for advice and wisdom, and so this is a great group of people to reach out to when things aren't always sunny and you're not sure of the road ahead. So I entered the dean's office because I was longing for a career that had meaningful work that I enjoy. I also wanted a very flexible career where I own my time rather than having 40 hours a week of patient care, and I also wanted to grow myself personally and professionally, and working in the dean's office for me checks all three of those boxes. I realized I took my first job in the VA thinking I wanted to be in academia, but I quickly realized that I love business and entrepreneurship, and VA was not a good fit, and so I started looking for ways to encourage those things that I was really passionate about and good at. So I have found that working in the medical school has been the perfect blend for me of business and medical education. So I love a healthy organization. I've had great bosses in the past, and I've had terrible bosses in the past, and so creating a healthy soil for all staff members and faculty members is really important to me. So giving that organizational structure to our little medical school campus and working with the next generation of doctors is really a noble place for me, and I just love it. I never knew that I could love a job so much, but I just really enjoy it. I oversee a small medical campus of 50 students and 350 faculty members. I have a staff of about 10, and I employ about 14 doctors as clerkship directors to oversee the clerkships. To describe the dean's office, I'd like to kind of tell you about the anatomy of it. It kind of looks like a PM&R inpatient experience where you have a physiatrist at the head of an inpatient experience who's kind of the coach or the leader of it, and then you've got PT, OT, speech, psych, a variety of disciplines. Well, the same thing in the dean's office. The dean is the face of the medical school, and he or she is the custodian of the vision of the medical school, but then underneath that dean, you have a variety of folks. Their titles may be senior associate dean or vice dean or associate dean that are running the different programs. So those different programs look like admissions or academic affairs or student affairs, faculty affairs, clinical affairs. So there's these kind of like miniature departments that are in charge of the day-to-day running of the medical school. And if you're wondering where you may fit within that lineup, academic affairs deals a lot with educational program objectives and curriculum mapping. So if you have that as a passion, I do not. Go that way. If you are interested in admissions, they are primarily tasked with holistic review of applications. Student affairs deals with career advising, requests for accommodations, mental ease of absence, and student health. And then faculty affairs, my institution deals a lot with promotion and tenure, discipline and bylaws. If I could speak to some of the physiatrists who have made the switch into the dean's office, I think that might be instructive. So these are the ones that I know of. There may be more out there. So to speak of an interim dean or the head person at an institution, at Florida Atlantic University, Dr. Curtis Whitehair serves as the interim dean of that medical school. At the vice dean level at Ohio State, you have Dr. Dan Clinchot, who oversees the education as the vice dean of education. And at Baylor, you have Dr. James McDevitt, who is the dean of clinical affairs, so overseeing the clinical enterprise. Also in that clinical enterprise space, at University of Colorado is Dr. Scott Laker, who is the associate dean for clinical affairs. And then at University of Louisville, Dr. Matt Adampkin is the assistant dean for student affairs. So there's a variety of physiatrists who have infiltrated the dean's office. And I'd like to maybe tell you why you could fit well in a dean's office as a physiatrist. You are ideal in several ways. So one, physiatrists are generally really nice people who are good educators and they know how to work on teams. Number two, one weakness or aspect of physiatry that sometimes we struggle with as a group is we don't own an organ system, but that's also our strength. We are not siloed into any one organ system. We are known to be neutral and helpful physicians, no matter what you got going on. And so that can be a strength within the dean's office. We're also very comfortable interacting with both medical and surgical colleagues. And that's kind of unique within the dean's office. And number three, I think that as physiatrists, we know that health education could take place on a continuum, anywhere from the acute injury or acute illness through the hospitalization, through rehabilitation or survivorship, and chronic care. So we're familiar with that spectrum, and we probably can see ways our students could integrate across that spectrum of care. So I thought I would tell you what my typical day looks like, just to give you perspective. So I looked at my schedule for Monday. And Monday, I have a 7.30 a.m. meeting with a student who failed a clerkship. Then at 8.15, I meet with a couple of my direct reports. So serving at a regional medical campus, I feel like a miniature medical school dean where I've got student affairs issues and educational issues and faculty issues. So I meet with my core leaders at that time to run through what's happened in the past week and what fires are out there. At 9 o'clock, I meet with all the associate deans for the School of Medicine, and we are working on a 2,000-page document to show our accrediting body that we are a well-situated medical school. At 10 o'clock, I'm touring a new autism center in town with some local physician psychologist leaders. At noon, I'm setting up advising meetings for our M3 students. At the M3 level or a third-year level, they are wondering if they're going to be competitive for vascular surgery, or maybe they're split between derm and plastics, or they're thinking about PM&R but also thinking about a family medicine, sports medicine route. And we can sit down with them and say, okay, here's your grades. Here's your extracurriculars. Here's how many research publications you've done. Here's what the average applicant to those residencies looks like. How could we strengthen your application before the residency season starts? At 1 o'clock, I will meet with our advancement team regarding donors in our area. At 2 o'clock, I'll meet with the chief medical officers of both health systems in town, and I'll have an awkward conversation about needle stick injuries in students and the awkward routing that happens, and that's probably inefficient. At 3 o'clock, I have another tour of a facility in town, and then at 4 o'clock, I'll meet with the third- and fourth-year class presidents to ask them, okay, what's going well and what do you need improved? And so that's an average day, and I love it, that variety of interacting maybe with HR at one hour and legal the next hour or a student following that or a faculty member. I just love that diversity. One thing I do love about this life is that it does feel like meaningful work with inspiring young people and also working with volunteer physicians who are volunteering their time. These are like the greatest people in the world, and so it's a real honor to be in their presence. I love a flexible environment, so one thing that I found troubling when I was with the VA is I couldn't get away for my kids' activities, you know, whether it was a school program occurring during the day or an early track meet, needing to schedule that three months in advance to block a clinic was pretty disheartening to me, and I want flexible days where, you know what, tonight I'm going to work until 6 or 7 because I have meetings, but tomorrow I'm coming in at noon, and I'm going to rock through a variety of meetings at that time. One other thing I love about med ed is I have this big, beautiful sunlit office and a staff of 9 to 10 people working with me, and I love having an executive assistant. I feel like that makes me so productive to work in such a nice, pleasant environment. Cons to working in the dean's office, so dean's office positions feel like they don't come open very frequently, and so sometimes you've got to kind of wait in the wings as the second in command, waiting for that opportunity to advance. Typically that would look like moving from, oh, an involved faculty member up into a course director role, up into an assistant dean role, associate dean, senior associate dean and dean role, and so that may happen locally for you, but if you had some geographic flexibility, there are openings all across the nation in the dean's office, and it's really rewarding work. One other con is you serve at the pleasure of the dean, which means things could change. I feel like, you know, probably as a clinician, I could tolerate more missteps or because no one else wanted to do EMG clinic for the next three months if they fired me, whereas in the dean's office, it feels like transitions could happen relatively fast, just like when the president moves out and a whole new cabinet moves out and needs to move in. So to combat that, I do have a consulting business where I do life care planning and other activities, and so I've got that in my back pocket that should this dream job that I'm in not work out someday, well, I've got coverage and no problems there. So in conclusion, if you are a good teacher and have a passion for medical education, consider a career in the dean's office. Best job I've ever had. It is meaningful, flexible, and rewarding work for which a physiatrist is well suited. Thank you. Thanks, Mark. So we're going to move on to our next speaker, Dr. Huang, and so he is going to talk about informatics, and he is currently at Shirley Ryan, and again, we're going to continue with this game, and you're going to spot his lie, and the three options are A, he is an avid Penn State football fan, B, he was invited to the White House for a reception in high school, and C, he was born in Taiwan and moved to the United States when he was two. So if you want to join the poll, again, it's you text Aaron Yang 927 to 37607. The question is, is he still a Penn State football fan? Well, I live in Chicago, so, you know, there's a lot of heartbreak in Chicago for sports, but since I came from the East Coast, you know, being a Penn State fan, you guys still be a fan, I guess, but we'll see. Anyway, so which is the lie? So the lie is actually the last one. That was my brother who was born in Taiwan and moved here when he was two, so it wasn't me. So I was actually born in Baltimore. So we're going to talk today about clinical informatics. Let me see if I can move it on here. So, okay. So, you know, informatics is a very interesting topic. I'll just say my disclosure, kind of, sort of, is like I'm the incoming data registry chair, just FYI for that. I don't know if it's a conflict, but just to be aware of that. So I want to talk about clinical informatics, the role of physiatry potentially in that, really, and then really talking about how do you, what are the career options to do in informatics and sort of how to get started. So, you know, what is informatics? A lot of words on the screen, right? So if we kind of look at this, it's the science of processing data for storage and retrieval. So it sounds complicated, right? If you look in the second bullet point, I'm not going to read it, but you guys can look at it. I've got the handout. It's really a lot of information processing, cognitive science, human interface design, decision support databases, a lot of things to digest there. So it's a very broad field, but when you think about what is clinical informatics, it's really the application of informatics to deliver health care services, and, you know, we saw a lot of interesting lectures today between the two plenaries, it's kind of perfect, right? We were talking about technology in the first plenary, which the speaker was going 100 miles an hour over lots of different technology applications, which he really touted all the good stuff, right? And then we got the reality talk from our plenary speaker yesterday talking about some of the scary stuff out there with what people are doing with their data and all your ghost Facebook accounts for all you guys are trying to stay off the grid, it's hopeless. So it's kind of thinking about, well, then applying information, technology, AI, all the other good stuff to what we do in health care, because we all, you know, how many people out there, like, I love my EHR, it does everything I want to do, you know, raise your hand, right? So everybody's got some unhappiness out there. It's kind of scary, right? Like, I got my phone, I can, you know, look at my accounts at the bank, I can, you know, whatever, I can go order my Starbucks coffee or Dunkin' Donuts for me, but, you know, it's pretty seamless, right? This stuff happens pretty easily. Why is it that we can't do that in health care, right? So it's all this frustration, but I think, you know, what's great is that technology is getting better. People can be part of the process to help that along the ways, and here are just some concepts in terms of clinical information that you might or might not know daily basis. We talk about clinical decision support, things like, you know, pop-up windows, directed pop-up windows, things to help guide you in terms of making decisions, you know, ability to see visual images, you know, it's really cool now that you can pull up x-rays on your mobile device for a lot of EHRs, you know, documentation in the bane of our existence right now, you know, how much time that we spend in documenting and how hopefully AI can potentially change that, provider order entry systems, you know, how you can enter orders and system design and implementation. So these are all sort of concepts that are tried and true really in informatics and what I sort of handle on a lot of basis is in terms of dealing with a lot of these concepts. And then obviously one of the impact areas, you know, AI is the hottest topic, AI has been around for a while, it's just now it's, you know, it's just coming to the surface and people realizing that chatbots was really the first part of AI, the really idiotic things that you like when you like try and talk to Xfinity support and they just give you the wrong answer every time. So it's like things like that, so it's, you know, those are like sort of early versions of AI, but it is AI, but app development, you know, apps have been around for a long time in terms of, you know, applications for use in the healthcare space. A lot of it's, you know, things that are on our devices and intrinsic, now it's a matter of connecting that to the EHR, connecting it to your healthcare provider. And then really talking about patient reported outcomes seems to be the big buzzword across the industry, both in the governmental space, regulatory space, as well as just wanting to do what patients are reporting, what is it, what are their goals, really, not just our goals for them, but what are their goals and getting buy-in from that standpoint. So really trying to address those kinds of issues. So why physiatrists and informatics? Well, we're really good at leading teams in communication and just like we, you know, we talked about earlier in the dean's office, you know, a physiatrist is really good at being able to communicate with teams and understanding that. So you have an intrinsic ability to collaborate. So that's really important that you have that kind of team focus. This can be very helpful in terms of bridging the gap between sort of an analyst, software analyst on the information system side who doesn't quite get what the clinical workflow is like. And then the clinician on the other side who might be pulling their hair out because of why am I doing six clicks and why does this screen look different in two different ways, you know. So these are all kind of things that you as a physiatrist can help bridge that gap much more effectively than many other specialties. And so, you know, us being able to focus on function and outcome, it's like there's function and outcome in clinical informatics and trying to utilize that. So you guys already have tools to be able to be effective communicators and working with clinical informatics. These are some additional skills that sometimes people forget about, but there's a lot of management, leadership skills involved as a clinical informaticist. And so, you know, workflow analysis is probably one of the most important, kind of understanding what is the current process for how things are getting done. Because you can't really make a change or improvement until you have a good understanding of what is going on right now. You know, what is the process to get this order in the system or what is the process to open up an x-ray? You know, walking through those steps and seeing where are the potential barriers, areas of duplication. Quality improvement is the next piece, obviously doing a lot of quality improvement in informatics, trying to improve outcomes and, you know, be able to use the system better, get better outcomes for your patients and improved use of the system or satisfaction by end users. And then project management, you know, if you're doing big projects such as new upgrades, installing new technology, but you don't understand how to go through a project from start to finish. Not necessarily saying that you are going to be a project manager, there's usually going to be a project manager associated with the IT department or something like that. But in smaller organizations, you may be the go-to person as sort of leaning a project, you know. So especially if it's like a smaller practice and you're sort of the go-to person in a smaller practice for sort of helping out with technology implementation, understanding a project from start to finish, you know, what are you supposed to do in that space? So what are some of the career options? There's a lot out there. I mean, first off is just being the go-to guy in your practice or gal in your practice in terms of regards to utilizing technology. Then there's, you know, more sort of administrative roles of large organizations, informatics medical director or a medical director of some sort of area in informatics. You can also become then sort of a chief medical information officer, which is more in the C-suite realm in terms of just going and getting higher up in terms of just the ability. But even also chief information, chief technology officers that some folks have even advanced to those levels. And then finally, like, you know, sort of in the consulting space, you know, being a consultant with other organizations, you know, you could be a consultant for the vendors that are out there, consultant for a provider. You can even be a consultant for an administrative, excuse me, for governmental space as well, or regulatory. So there are opportunities in terms of helping in a consulting role. Now so what are the settings of employment? So really a variety of different settings. It could be done in the healthcare space and for the provider space, whether it be in a physician's practice, it could be in a hospital setting, academic institution, but also with industry developer, vendor, it should elicit governmental space actually out there too. And then of course the consulting role. So there's a lot of different avenues that you can go in terms of being involved in informatics. And then, you know, there's even sort of board certification in informatics that's out there. Some people may not be aware, but there is a clinical informatics subspecialty that is honored through two boards. One is the American Board of Preventative Medicine and the other's American Board of Pathology. So relatively new. So the first diplomats were 2013, so it's not that, you think about it, that's pretty recent, right? So as far as that, and certificates are in 2014, so as far as an officially recognized board specialty we're talking about, this is year 10. So that's pretty impressive that there's a new specialty for clinical informatics, and clearly it's a very broad field in terms of what it can cover and what it can encompass. Now, do you need board certification right away? No, and actually there are some steps along the way to get to that. I can review that later, but this is very interesting. So this is from AMIA, so the American Medical Informatics Association. This is one of the associations that looks at clinical informatics. And they did this board certification sort of rundown in terms of the number of board certified physicians from 2013 to 2019. So actually, I was pretty impressed. So rehab is actually about 10th on the list. So we got 17 diplomats in PM&R, just behind OBGYN and ophthalmology just behind us. But what are the vast majority? Obviously, internal medicine, but pediatrics is pretty strong. Up there are 300 plus pediatricians. Pathology is always very interesting. Pathology has its own board. Even though there's its own separate board certification, there's only about 111. But pathology was really one of the starts of clinical informatics just because of pathology lab. Lab was one of the first pieces to really get automated and digitized, so to speak. And so that's where that came from. But you can see a pretty broad amount of specialists on there, which rehab we have 17, which I thought was pretty good. So we have actually a pretty good representation in terms of that board certification. And then what does the demographics comprise in terms of clinical informatics? Unfortunately, some of the stereotypes sort of still exist. So predominantly male, predominantly Caucasian, and then second is Asian. So there is, but trying to get more diversity in the space of clinical informatics is coming and hopefully will continue along that path. But so how do you get started? So really start at the base level, having an interest in sort of technology applications and working with your electronic health record or other related information system style issues that may be out there. And then at that point in time, working either with your practice manager, your chair or whoever is your department or division head in a large organization and starting to ask for some role in that space. And then really starting to develop relations with your peers and information systems to sort of get that, garner that support and collaboration. Because you kind of need, you're gonna need that if you're gonna make information changes. And just kind of gradually increasing your information system role or presence. And then really the other key piece is as you garner some sort of momentum in terms of that space and start to get known for the go-to person, so to speak, then really starting to garner support from leadership for maybe more funded roles with some FTE support, and then even moving up the chain of command or even starting to look at if you want to pursue something like board certification in that space. And then of course, actually some people, if you guys are still residents or medical students and are thinking about informatics as a career, that is a fellowship. So you can do fellowship training after your residency. So it's two years for the fellowship. And that would then allow you to then be able to sit for the clinical informatics boards. There is another way that is actually sun setting in about two years, which is doing a non-fellowship route as far as just getting involved from a clinical informatics standpoint. So sort of some lessons learned for me along the way as I've gone through this journey is clinician involvement and now patient involvement is really important and engagement is really key. So you really have to listen to the end users. Myself as a CMIO, half of my time is clinical. It's really 40% of my time is clinical, 50% is informatics, 10% is administrative, but it feels like 140%, right? But understanding what clinicians are doing on a day-to-day basis is super important. You don't wanna lose track of like, what is it really like in the trenches to put orders in and to do documentation and to see patients? Because if you're just up there and just kinda sitting up there but not having a clinical background or having someone close to that level to tell you what's going on, you really don't know what's happening when you implement changes to the system. What are the unanticipated consequences? What's the reaction? Or how are providers using it in their workflow? How are patients getting benefit from the changes? And then leadership buying is really critical. So in order to move anything forward in your organization, it's really, you kinda have to do a pitch to leadership because if leadership is not backing what you're doing, it is doomed. So in the realm of trying to adopt new processes, new technologies, things like that, it's really important to get leadership buy-in. And you can't do it all by yourself. So getting help from analysts, from trainers, from other support staff, you're what we call super users, meaning people that may report to the informatics person so that they can then continue to spread the word regarding changes or processes or new technologies or education. And then the other thing that I alluded to was workflow, workflow. You gotta be able to understand what is the workflow and what are you trying to achieve and what are you going to change? And then change your project management. Those are the other two really critical things to actually understand when you're going through this process of making system changes and implementing new ideas or resources. And then this is just the resources we have. The American Medical Informatics Association, they have a great meeting that they usually hold every year. Actually twice a year, different ones. AMDIS is the Association of Medical Directors of Informatics, which actually has annual meetings. That's actually very good. HIMSS is a very large healthcare organization, Health Information Management System Society. This is like all sorts of vendors. There's usually a HIMSS chapter in almost every state where clinicians can get involved. We have one in Illinois. So it's great that it works out for us to be able to meet and collaborate with other CMIOs, other informatics individuals. I did do a supplement in 2017, so it's a little dated, six years, but the concepts are kind of the same. But this is sort of a good primer in terms of just some concepts that, for the most part, haven't changed that much. So that clinical informatics special supplement is actually nice in the Journal of PM&R. That actually kind of goes over a couple different articles or topics that actually sort of review informatics in a little more depth. At that point, some of those things are, still a lot of those concepts and articles are still very relevant in today's healthcare market. And I'm gonna stop there, so we can move on to our next speaker. Thank you. Thanks, Mark. So we have our last speaker here, Dr. Stark. And so you're going to spot a lie here. And the options are A, I played the snare drum in high school. B, she's adopted six rescue pets. Or C, her favorite rock and roll band is Aerosmith. Dr. Stark was practicing pediatric rehabilitation and she was actually the first program director at Vanderbilt, which is where I practice. And now is in a sort of non-clinical career. So we'll give her a chance to talk about that after we get a consensus. Well, hi everyone. My name's Stacey Stark. As Dr. Yang said, I practiced clinical medicine. Well, not clinical medicine, academic medicine for about 17 years before I transitioned to a different career. So first about me is I am an animal rescuer. I have rescued six pets, mainly cats and dogs. And I work with my friend back home. I did not play the snare drum. I actually played the electric guitar and was a lead vocalist in high school. And my favorite band is Aerosmith. And I was blessed to see Aerosmith's last concert before he went out with his injury. Anyways, I was thinking, I don't have any slides. What can I offer you to talk about the variety of positions that you could hold in medicine? Because I have held residency director. I have been medical director of pediatric rehab. I have been chief of pediatric rehab in my career. And I loved every minute of it. I loved every minute of academic medicine. I got to meet wonderful people. I worked with wonderful residents. Some of you lovely people are out in the audience today. And why would I ever change from something that I deeply loved? And I think that's maybe what I could add to this program. Because I think when I made that decision, I got asked that question so many times. So first of all, I'm a mother. I have two beautiful daughters. My daughters, when I made this transition to a different or alternative career, were young. So my oldest was going into high school and she looked at me and she said, mom, you have never been on any field trip with me. You have FaceTimed in to all of my performances because my daughter performs. She's actually the snare drum player. And she was right. She's absolutely 100% right. My mom got cancer. I'm an only child. I had that responsibility of taking care of her. And then my very best friend, the day after my mom passed, called me and said, Stacy, I have stage four cancer and I don't know what to do because I have a six and an eight-year-old child. These are things that we never prepare for. These are things that affect us. And as an academic, I wanted to be 100%, 250% to everyone, but I knew I couldn't be that to the people in my life. So I made the decision to change my path. Now, at first, I did not go into non-clinical medicine. I actually did something really cool. So I went into the homes of patients and worked for a company and provided PM&R consults within their homes. And that was so cool. And you get to see people in their home and their element and kind of decide what they needed. So I kind of held on to that clinical aspect. And as Dr. Sholis says, there's a lot of different things that you could be and you could do and you can make money and you could survive and you could survive well. So I think that maybe I have done consulting. I've done PEDS PM&R consulting. I've done life care planning. I've done, you know, private practice. I've done utilization management. And, you know, I've been in an executive role for a few years with a corporate company. So overall, I think that when you make that decision to transition into maybe the non-clinical arena or a different arena, it's scary when you have been an academic for your entire life and that's all you know. It was very frightening to me. I was thinking, is this really what I want? Is this, you know, how's this gonna look? Am I gonna miss what I'm doing? Well, for the last few years, I have remained on the ACGME Residency Review Committee and I have kept up my academics that way. I'm an oral board examiner, which I'm sure a lot of you are too for the AB PM&Rs. So I also do that in part of academics and that makes me happy and that brings me joy. But on the other hand, with my life right now, I have the flexibility to care for those that I need to care for. I have the flexibility to go to those holiday performances to be deeply involved with my children because they grow up, children move on, you become empty nesters and then you're looking at each other wondering what you're gonna do. And I'm here to tell you that you can always go back to clinical medicine or as Dr. Shola says, date clinical medicine, date non-clinical medicine and have really a joyous career that you get to decide what you do and what you do on your time. And for me, that has been the best compliment is to have my children say, I'm glad you were there. To be part of the band, because I'm a big part of the band at school and to have them say, hey, Mrs. Stark, you know what I'm doing? I'm now conductor of a high school band down the road or whatever, or have a resident come up to you and thank you for training them or seeing the colleagues succeed. So you could always have that. Moving into this arena and to moving into these different jobs doesn't mean that you have to give up anything. You just have to be okay with yourself and know that you have achieved what you wanted to do in life. My whole life, I wanted to be a residency director and I achieved that. And I loved every minute of it. And I worked with that wonderful man up there for many years doing it. And I was okay to move on at that point. And I think that that's what needs to happen is just to be okay with your career and then understand what you need or what you want to achieve. And that's it. I'm here for questions if you have any. Thank you. Thank you. Thank you, Dr. Stark. That really came from the heart. I felt that. So thank you. So this will be a time where we can just, you can ask questions. You can come up to the microphone. If you want to just type it into this box here through that poll that we had, you can also put questions in there. One thing is that it does cut off. So if you could just keep the question a little short because sometimes we can't read as it goes off the screen. So, but yes, we can start off here in the front. Hi, my name is Angela Carboni. Thank you for this talk. It's very timely. And I relate so much to you, Stacey. Right, I've been in practice for 26 years. I have four children. I'm an empty nester now. And I find myself needing to leave clinical practice because my mother is ill. Where I'm stuck, and that's the right word, is where to start my search for non-clinical. And because I love everything that you guys have talked about, and I just find myself stuck. So if you have any practical advice from any one of you on how you started to do your discernment and search for something that will continue to bring you joy. I'm not afraid that I will not find joy. I know I will. It's just a question about where should I put my energies. And I know what I need. I need to have a flexible job. I need to be able to do it like a hybrid, remote and in-person. Because I'm going to be traveling from Indianapolis to New York very frequently to take care of my mom. Thank you. Go ahead, yeah. So, my transition arc was 10 years. And I say that because everybody sort of looks at things the way they are now and think that's the way they always looked. So my first thing to you is to say, this is going to be a process and not a diagnosis and treatment in the traditional clinical sense. Second, I really liked, there was a comment earlier in the meeting where people said they make a value statement for themselves. It's like your own personal motto, your own personal greed. And they update it annually. When you do things like that, it really helps you focus on all the stuff. Could you put that diagram I have of all the different areas? Because there's all that stuff up there and really figuring out which one works for you is going to be a blend of what are you good at versus what you can get paid for versus what you have the capacity to deal with the BS of. Like that's the Venn diagram for that kind of thing. But if you don't think through it that way, you sort of end up in these random places and you don't know how you got there. So it's a process. It takes a little time. And move through it in a way that supports your mission statement. I could add. I'd like to. Okay. So when you are looking for a remote position, it is really highly competitive. So remote position would be chart review. We're great at chart reviews, utilization management as being, you know, PM&R docs, really understanding what patients need, what's that next level of care, things like that. So there is actually a conference out there called SEEK that is for remote positions. It's a little bit expensive, but you get to network with a lot of remote companies in different areas, pharma, utilization management, all sorts of things like that, consulting. The other thing that I could suggest, because you have to put in a lot of what do you call it, applications and your CVs and things like that. Start looking at the big corporations. Start looking at the major insurance companies. They usually have different utilization management positions available on their websites. And just start applying there. So if you went to Humana, you could look and see what is available. And it's not necessarily, you know, post-acute care or whatever. You could look at different areas and apply for those also. Some musculoskeletal imaging or whatever. And that remote position will allow you to have that versatility when you need to be in New York and when you need to be in Indiana. And you can work from both places. So that may be a very good option. But usually you have to apply for an exponential amount before you get those interviews. So I say just start looking, start applying. You're going to get a couple hits. And go from there. But it is a rewarding job. I think a lot of people question if it will be. You still feel like you're doing something for the patients that you evaluate. Quick piggyback on that. How about preparing your CV? You know, what are they looking for, for any of them, any job? Actually that's a big deal. That is a big deal. It's not a CV and they don't want that. It's a resume. It's a resume. And if you don't know the difference between a CV and a resume, see me after this because that is step one. CVs talk about accomplishments. Resumes talk about skill sets. And so part of what we need to do as physicians is explain ourselves in terms of skill sets and not accomplishments. And that is really fundamental to people actually saying yes when you apply this stuff. Because if you do accomplishments, people don't know what that means out of context. Right. A lot of these positions, you know, I could say I was medical director, I was chief. They have no concept. Well, I feel like, well, were you in charge of anything? Did you do any process improvement? Was there people that you led, you know? So it's interesting the questions you get. But Dr. Sholis is 100% correct. Start looking on websites. There are a lot available out there that will give you example resumes. So I had an academic CV. I mean, I'm sure all of us did before we went into the corporate world. And I mean, and it read like an academic CV. And that was the first feedback I got was, what is this? So I had to change it into that resume and the skill set. So organizational quality improvement, processes, you know, things like that. Yep. Great. Yeah, we'll take the next question here. Thank you, everyone. This is very inspiring, but sad at the same time. So I do have an informatics and data passion. I feel like it remains siloed as only as side projects. So for example, I built my own generative AI Q&A LLMs connected to medical textbooks. I've also built conversational AI to retrieve clinical data and generate encounter summaries, automating medical tech summarization, differential diagnosis, and treatment suggestions. And I can't tell people about this. Because when I tell leadership, they don't really care. They say that I should probably see more patients. So and even at the job fair and the vendor expositions this week, I did not see any opportunities. Even with the portable EMR and mobile space, they are just trying to sell us their products. And yes, it's a little bit frustrating. Do you have any advice on what folks in my situation should be doing? And if there's any way we can find mentors? Yeah, I mean, so that was, you know, this kind of dovetails in the first question, like, how do you get started? How do you make the transition? To me, also, it's a matter of first finding what you like to do that's outside of the clinical realm. And so if you're really love that sort of programming or deeper dive and sort of AI or whatever is the non-clinical focus, that's your first need is what is it that you're going to like to do that's not clinical, right? Then the second to me is, and I'm betting all these guys have this too up here, these people, is that at some point, there's an opportunity that might exist, right? Within an organization, within a networking, you know, you're meeting somebody, it could be completely random, and it's a networking and it's or maybe not so random. And then, and really, it's a matter of you being able to identify what your need and passion is and how does that fit with that organization, with that company's, you know, needs. So it's identifying their needs. What do they need and what can you offer? And so those things can kind of mesh, you know, then that's pretty good. So but I think, you know, some of these companies, they're not ready yet for somebody to program AI for them or to do whatever EHR stuff and all these worries about the data security, right, of these models. And so it's a matter of really what even yesterday's speaker talked about, even if it's a unplugged LLM, you know, the learning language model, which is like a chat GPT, and taking that unplugged but keeping it local, right? So it's a matter of how could you harness that for whether organization or universe say, look, you know, we can, I can build our own internal chat GPT for whatever, creating progress notes, right, or writing discharge summaries, prior authorizations, please. So you know, things like that to kind of help with that and help with clinician burnout. So really it's a matter of, hey, I can do this. Now it's a matter for you, you know, questions that are going to come up with every single organization's data security, HIPAA compliance, right? So how are you meeting those security requirements, the HIPAA compliance, like in your specific case, because that's the first question they're going to ask, right? And then you got the devils in the details later, like, well, how do people access this tool? You know, what's going to prevent it from having some other people access this tool? So there's a lot of other questions along the way, but really it's, again, to me, it's a matter of your passion, and then the host needs of your target audience, whoever that is, industry, government, hospital, practice, you have to meet their need, because if you're not meeting their need, they don't need you. So it's really, and if it's an unfulfilled need and no one else has that skill set, even better, right? So it's a matter of you trying to leverage that. And then the other piece that's the hardest piece is identifying who is the right person to talk to, right, in that organization, because you could be talking to someone that has no decision-making capacity. So a little bit of snooping work, right, in terms of, I always find it kind of interesting, like, this is like just aside, but like, you know, people that I interview for whatever the position is, right, it could be for a job or for a residency position, right, if they're asking specific questions about what you do and your fit in the organization, they've obviously done the research, right? They know where you are and what you do, and it's important to understand that target audience, so even under, you know, learning more about the person you're interviewing with, the organization you're going to, you know, target to work with. So these are all important things to kind of help with your process. So, and, you know, I think that as physicians, we are taught there's a undergrad, medical school, internship, residency, fellowship, ladder process. It doesn't work that way for innovation. It really works in terms of connections, it works in the way of abstract thinking, it works in the way of understanding how people move. So if you explain what you had to explain to a non-technical person and use those words, they would be like, he seems really lovely, but I have no idea what he said. And they might be the very person that needs to actually talk with you. So I really like what Mark said about finding your people, and you have to go find your people by going to stuff. It may be you find your people at the American Academy of Physician Leadership, or you found your people on LinkedIn, or you found your people at none of the above, and you had a random conversation at the coffeehouse one time, but there is no formula for how to get discovered. And I think that's where our buddies that did entertainment in college had it over us. They understood that their mixtape, they just had to go out there and show it to everybody that had ears, and eventually they'd figure out, oh my gosh, you're going to be the next Sean Combs. Well, you don't want to be him today. Long timing. You got another person behind you. Do you want to ask after? Yeah. Thank you. Thank you very much. Phil Marion, Washington, D.C. First of all, as has been said just earlier, this has been an excellent panel, and you guys have done a great job. I would just say, if you were going to do it again, you can do this as a whole day as a pre-conference, easily, similar to what Seek does, as you had mentioned earlier, which does something like this. I guess I'd want to hear from the panel, for someone who has done a combination of non-clinical career and stayed in practice, early on in my career, I thought I'd taken a position, maybe I was five years out, for an insurance company, and while they didn't quite say it, they pretty much demanded that you give up your clinical practice. And that would have been a huge mistake for me, because I have found now, later in my career, and I'm still in practice, I've stayed in practice the whole time, the longer you stay away from clinical practice, the harder it is to get back in. It really is, board certifications, CMEs, electronic medical records, et cetera. And what I also found was, and I would like you all to speak to this as well, is that many of the things I do that are non-clinical, whether it's file reviews, life care planning, clinical legal work, that for street credibility, many of these entities really want you to have a clinical practice. Again, I just did a trial recently in the first quarter, doctor, where do you practice? When was the last time you saw a patient? So I guess, for all of you, what was this decision regarding maintaining or not maintaining your clinical practice, and thoughts about that after you've done that? So I agree. Within the medical school, I feel like, personally, I could give up clinical medicine, but it helps me maintain street cred with my faculty members, and yeah, helps me be embedded in that EHR. If things were to not work out in the dean's office, I have that to go back to and to lean upon. So I do feel like there's a lot of value in keeping a toe in clinical medicine. So I will tell you from the dean's office perspective, when you work in the dean's office, your time is, like an assistant dean may have a 20% to 40% time spent in their dean's office role. Associate deans and senior associate deans, it may look more like 60% to 90% of administration, but having that MD and having that clinical experience is still extremely important. Any other thoughts there from the panel? I think with clinical practice and some of the remote work that you mentioned, so the utilization management, in that instance, you would file a conflict of interest, and it's probably dependent upon who you're working for, if that's accepted or not. In my experience, they welcome the clinical practice. It's just some restrictions that would apply, but they do allow you to practice clinical medicine and also do utilization management. You know, there's another opportunity that I just thought of. A lot of hospital systems are looking for physician advisors and utilization management within their own hospital systems. So that's also an opportunity that you could look for in your local area. So you're employed by the hospital, but doing that for the hospital. Correct. And there's also another board certification that you could get. I made a sound. Okay. And that's abcorp, A-B-Q-A-U-R-P. So that's for quality management and things like that, and that's also for people specifically for utilization management physicians, that you could have that certification on your resume. Great. Yes. Yeah. Bill DeMayo. I have a question regarding direction. I'm kind of reinventing myself in a non-clinical role, at least part-time. But in any case, I wonder what you all think about career coaching. To me, I had a good friend who does this in leadership circles, and put me through, I'm sure there's a lot of tools out there, but he put me through something called the M Code or Motivational Code, and we know what we like and what we don't like, but I was really surprised to look at this report, and it's kind of like sometimes we don't see what our real talents are, because we take them for granted. And so when I looked at this and I saw what really motivates me, I'm now using that as kind of my litmus test, rather than getting into something that, yeah, I like that, but that's not really where my passion is. So I found that really helpful, and I'm wondering what you all think about that. So you need a career coach and a therapist, and they do different things, that's a whole nother talk, friends, therapists, advocates, all of the above. And the reason I think this is important is that there are some development programs you can do. So like everybody here at an institution, the dean's office, and I know Shirley Ryan has this, they have physician leadership programs that'll do some of this. You can get fellowships from places like Robert Wood Johnson or the Kresge Foundation that will do specific development, that'll do things like that. But what the real gap is, is that you need someone to help you process what the actual data is. Because you all can go and take all these insights and these orientation tests yourself, but it's the secret sauce is actually interpreting what it means and applying it to what you actually want to do. And I mean, the best, best, best use of time that you could do when you're making this transition is working with a career coach. They helped me with something, and I'll tell you a funny story about this. When I first started to make the pivot to work on my own, the first thing I was told to do was hire an assistant. And I do like all good Southern boys, and I shared that with my parents. My mother said to me, well, that sounds lovely, what are you and the assistant going to do, watch television together? Because I don't think you're doing any business. It's a loving mom. My mother loves me. But that was an example of I shared too much too soon, and I didn't have an answer for her. And what that assistant did for me was they let me maintain my certification so nothing expired while I was figuring out what my life was supposed to be like. And not having anything else mess up while you're figuring out what's next is so valuable, and if it costs you $15 to $20 an hour, please God, pay it. Because getting those things back that you messed up while you're figuring it out is probably $500 to $1,000 a pop. So I say that to you to say someone out there can help you walk through this, and you don't have to do it by yourself, and someone can help you organize your thoughts and help you know what to share, when to share it, so you don't have your mom telling you stuff that makes you go, oh my God. And I'm literally one week into the process. Well thank you guys. I know we didn't get to the last two questions, but please come up, speak to the panel. I think they all did a great job. If you could give them a round of applause. Thank you all.

non-clinical careers

medical field

panel discussion

career paths

dean's office

clinical informatics

research

networking

data security

resume writing

self-assessment tools