The IdeaLab: The Seven Year Switch

November 1, 2007

Michael J. McLaughlin, MD, on the hardest, and best, decision of his career: quitting clinical practice.


When I reflect upon leaving my surgical practice, I realize how good of an idea it was to become a doctor. That may not make sense to you. There was a time, after all, when it did not make sense to me.

Let me explain.

Seven years ago I felt trapped in my career, as though every hour since high school was spent training to become highly specialized for the wrong job. I considered getting out of practice but wondered: What else could I possibly do? My ability to replant severed fingers and reconstruct cancer defects had no apparent applications in the business world. How could I even find out what my options were? Would I really be happy in another career?

Fortunately I discovered in medical communications a career that combined two of my passions: medicine and writing. My career transition became an essential step in a natural evolution, rather than a desperate attempt to back out of a dead end. For the first time since I fell in love with medicine years ago, the spark was back in the relationship with my career. I enjoyed going to work, marveling at the mere possibility. Everyone asked “How could you throw away all those years of training?” They viewed the change as evidence of an earlier mistake, and my clinical experience as “wasted.” A mentor even accused me of wasting the time that he spent teaching me to operate. But to me, the only mistake would have been missing the opportunity in front of me.

Attitude adjustment

Career transition is a potential affront to a physician’s ego. One week I was standing in the middle of an operating room with assistants, nurses, and OR staff circling me, fulfilling my wishes, and the next, I was sitting in a conference room, just another member of a team working on an account, inexperienced and intimidated. I had searched for a new job for two years, sneaking networking calls between patient appointments and surfing the Internet at night, living a clandestine life like a prisoner planning an escape.

Finally I was out of the nonclinical “closet,” feeling exhilarated and unfettered. But what was waiting for me? Few people could relate to my desire to change jobs. There is a certain sense of empathy for a physician in practice, but not for one who leaves practice. Even close friends assume that you had a nervous breakdown or a bizarre midlife crisis. In leaving clinical practice, I sacrificed some of the prestige and mystique of being a doctor. Few jobs allow such intimate impact on other people’s lives. My work in medical communications will indirectly affect more lives than my clinical career ever would have, but there is no doubt that I have left something special behind.

Even my kids have noticed it. My youngest daughter, 5-year-old Carolyn, was born after I left my practice (I see her a lot more than I did her sisters Megan and Amelia when they were her age). She asked me to come into her pre-K class to tell them about my job. Of course I was delighted, but then she said, “Don’t tell them about your job now. Tell them what you used to do … when you were a doctor … and you helped kids.”

Most physicians have treated medical emergencies, but physicians leaving clinical practice need to face their own kind of “emergencies.” A last-minute request forces you to work late tonight. Someone cutting a tree in the rain with a chainsaw while holding onto the wrong end of the branch would have led to an emergency when I was on hand-surgery call. Other industries generate their emergencies through similarly poor planning. Physicians will do better in their new career if they can treat such business matters with an appropriate sense of urgency, resisting the tendency to dismiss them as unimportant because nobody’s life is at risk.

Practical tips

There are several practical considerations when transitioning from clinical practice to employment in another business. Clinicians typically do not have to worry about job security, but in other industries physicians are laid off like everyone else. That’s why maintaining hospital privileges, medical licensure, and board certification for as long as possible is well worth the extra expense; you may find you want or need those again, and you worked too hard to start at the beginning.

What about the money? Few physicians that I know entered medicine because of the money, but many turn away from alternative career options that require a pay cut. Making any career transition without an initial (and possibly permanent) salary decrease is quite difficult. My wife and I labored over financial spreadsheets and identified three salary thresholds - one identical to clinical practice, a lower “break-even” that matched our spending, and an even lower “acceptable net-loss” that we could sustain for two years while spending some of our savings. My first nonclinical salary ended up being even lower than our calculated “acceptable net-loss” threshold - a pay cut of 33 percent.

Acknowledging that I was leaving a senior position in one industry for an entry-level position in another, I treated my first few years in medical communications like a residency. Luckily there were no 72-hour shifts or third-night call schedules. I worked hard, learned as much as I could, and enjoyed the intellectual challenge. I was eager to take on additional responsibility, and worked my way to a management position. Within three years, I was a senior vice president of a Fortune 500 company overseeing a department of nearly 60 people.

Two years ago I started my own medical communications company, called Peloton Advantage, with a business partner, thus reaching the culmination of my career transition. I have never been this satisfied with my career, and now look back on my clinical experience in a different light. The progression makes sense. I was not so dumb back in high school. My career has been far more than a series of training programs to reach an end-point, and will continue to evolve. My time in clinical practice prepared me in so many ways for the challenges that I face today, and for those of years to come. I have left the practice of medicine, but my clinical background is still a part of me. Interestingly, few people now ask why I “threw away” all those years of training.

Get help


I am motivated to assist physicians who find themselves in the position where I was seven years ago. Physician Renaissance Network, which I started in 2004 with this goal in mind, is a comprehensive resource for doctors with nonclinical careers and interests. I mentor numerous physicians that I meet through the Web site, Peloton Advantage recruiting, and speaking engagements. These physicians have a challenge ahead of them, but one that is well worth the effort. I have recently gathered my answers to the questions they commonly ask into a book entitled “Do You Feel Like You Wasted All That Training?”

As I sat in a plane writing the first draft of this article, there was an announcement asking whether a physician was on board to evaluate a sick passenger. I saved the file containing my article about leaving clinical practice and pressed the flight attendant button. My kids looked puzzled. My oldest daughter Megan asked “What are you doing?”

 “A lady up there needs my help,” I answered.

Michael McLaughlin, MD, is cofounder of Peloton Advantage, a medical communications company. He founded Physician Renaissance Network for doctors with nonclinical careers and interests, and he advises physicians changing careers. A Senior Scholar in Thomas Jefferson University’s Department of Health Policy, he lives in Bethlehem, Penn. with his family.

This article originally appeared in the November 2007 issue of Physicians Practice.