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The Ex-Doctor's Diary: Embracing Uncertainty


Michelle Mudge-Riley, DO, learns to accept - heck, embrace - uncertainty.

I was calmly eating my strawberry cheesecake, surrounded by executives from local hospitals at a student-group dinner I recently attended, when a middle-aged woman leaned toward me, picked up her water glass, and asked, "What do you really want to do?"

It's a good question - one I've been asking myself lately.

Sometimes I think I'd like to pursue my passion for long-distance running as an Olympic athlete. My marathon time is actually not that far from a qualifying time. My husband has encouraged me to try. Alas, the structured diet of an Olympic training program probably wouldn't have much room in it for Edy's rocky road ice cream.

At other times I think I want to be a stay-at-home mom. Although I don't have children yet, when I do, I want to see every aspect of their growth and development in those first years.

Then again, I am also driven to have a role in medicine. But what role?

I'll be getting a master's degree in health administration - my second stab at a career in healthcare after deciding that clinical medicine wasn't for me. But how I'm going to incorporate my medical degree and experience into my administrative career is something I've been asked repeatedly since I've begun my MHA program.

I haven't figured it out yet. Not that I haven't been trying.

I've had a number of jobs between leaving clinical medicine and enrolling in graduate school. For a while I worked for a medical device company. In addition to my clinical responsibilities during that time, I learned about different aspects of marketing, sales, and managing people. The enormous, deep-pocketed corporation that employed me offered opportunities for growth but also showed me how easily different departments could coexist with little to no communication. I also worked part-time for a government health-planning agency where I dealt a lot with regulation-versus-promarket approaches to healthcare cost containment.

I understand my medical degree and past clinical experience give me unique abilities to enhance communication between physicians and business administration. I enjoy reading medical journals and literature, and I can understand and communicate with specialist physicians. At the same time, learning about healthcare administration is giving me the skills and knowledge to understand healthcare from a business perspective.

In particular, I'm interested in health communication and disease prevention through behavior modification. I would like to build, add, or market existing health prevention and disease-management programs to businesses, managed-care companies, or hospitals.

Meanwhile, I'm hoping I can figure out a way to incorporate a successful career and a happy, stable family life with my husband and our future children. Being honest with myself about my interests, values, and how I want to live my life is a good step toward this goal. Perhaps it's not a very interesting answer to the what-do-you-want-to-do question. But it's exactly what I want, and whether it includes the title of CEO or something else remains to be seen.

Only a few years ago I was depressed and fraught with worry because I didn't see how I could build a future career for myself when I discovered I didn't enjoy patient care. I went straight through medical school in my pursuit of a degree wearing blinders about the realities of practicing clinical medicine. It wasn't until I removed those blinders that I saw the opportunities to be a doctor without practicing clinically.

Michelle Mudge-Riley, DO, is currently a student in the Masters of Health Administration program at Virginia Commonwealth University in Richmond, Virginia. She graduated from Des Moines University Osteopathic Medical School in 2003. She can be reached at or via

This article originally appeared in the April 2006 issue of Physicians Practice.

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