The Art of the Pivot: aka How to Tell Your Department Chair You're Starting a Real Estate Empire

⚡The Art of the Pivot: aka How to Tell Your Department Chair You're Starting a Real Estate Empire

First of all, my path has always been clear - Just kidding - I wasn't even sure that I wanted to do academic medicine. I just thought that I would not go back to academic medicine if I started in private practice, so I started my career in academic medicine. And, while I really loved teaching, and I grew to realize that research was my favorite thing, it was all focused on clinical care. I was an outcomes researcher. You couldn't do this without having outcomes…. and that required me to take care of patients. 

Over time I started to really enjoy the research more than the clinical care, at least in the system in which I was working, and so I pivoted to being the director of a medical/surgical program and spending my time split between clinical time and research - and I was happy. But after some shifts in my personal life (divorce, dating in my 40s…) and my professional life, I was no longer as happy. 

I still wanted to help patients and so I pivoted to population health. I served as the Associate Director of the Physician Hospital Association (PHO) and helped to build a Utilization Management program from scratch and get it accredited.  I really enjoyed this process, but I missed interacting with patients. And the number of patients served by our UM group did not meet projections as Medicaid expansion was reversed and I was laid off. 

So I went back to clinical care and tried to decide who I wanted to be going forward. 

I was still on grants and writing papers and giving national and international talks. But I found that mentorship and coaching really were the things that made me the happiest. I got trained and certified and started my coaching business and love to see the success that the people I work with create for themselves. And I found real estate investing… as the independent owner of 12 doors. I realized that I wanted to bring investing to other physicians in ways that I wish had been presented to me earlier in my career, and I started assessing real estate deals to see if they were good investments. I passed on a lot of them, but have found a few that I feel deserve my time and energy (and money) and love being able to present these to other physicians on their journey to passive income and choice in how they spend their time and energy. 

And finally, after turning several locums opportunities into more profitable prn opportunities, I am working part-time at 2 hospitals, loving my coaching and real estate businesses, and serving as a Market CMO for a not-for-profit Medicaid insurance company. 

So I have spent some time thinking about pivots…. 

Like many of you, at midcareer,  I felt confident in my clinical expertise but began to consider new directions. It is common to think about whether to pursue leadership roles, reduce clinical hours, deepen our research impact, or even explore ventures outside of clinical medicine. If you're contemplating a career pivot, you're not alone. 

Here I present 4 steps to identifying opportunities, realigning your professional goals, and ensuring a smooth transition to your next act without losing momentum in your career.

1. Assess and Redefine Your Professional Goals

• Reevaluate Your Long-Term Vision: 
• What do you envision for the next phase of your career? 
• Ask yourself where your passions currently lie and where you can bring the most value. 
• This may include questions about work-life integration, the desire for leadership, or interest in new fields.
• Tip: 
• Try scheduling a quarterly “vision review” for your career. 
• Reflect on the past few months and assess whether you’re moving toward or away from your ideal future.

2. Gradual Clinical Load Adjustment for New Roles

• Reduce Clinical Hours Slowly: If you're thinking about moving into administration, research, or other non-clinical avenues, a gradual reduction in clinical hours can help you balance responsibilities and test the waters without a full commitment.
• Example: I shifted to a 50% clinical role while growing my research career and administrative expertise. This allowed me to maintain my clinical skills and connections while exploring other interests and expanding my influence in outcomes research.
• Tip: 
• Consider approach this change incrementally
• Reduce clinical hours by 10-20% at a time to give yourself time to adapt 
• Or if you are taking on a big role, retain 20% of your time in the clinical realm so that  you can retain your skills
• Make sure the change aligns with your goals.

3. Building Versatile Skills and Expanding Your Professional Network

• Seek Cross-Functional Skills: 
• Midcareer pivots are smoother when you build skills relevant to both clinical and administrative roles, such as data analysis, public speaking, and project management.
• These skills not only enhance your leadership capabilities but also improve your marketability for diverse roles.
• Example: My pivot into full-time administration taught me valuable organizational and leadership skills, which later helped me transition to a Chief Medical Officer role.
• Tip: 
• Look for short courses, workshops, or certifications in management, data science, or finance. 
• Build these hard skills while you are introduced to a new professional network.

4. Diversify Your Portfolio: Explore Side Ventures or Passive Income Streams

• Think Beyond Medicine: 
• Many midcareer physicians diversify through teaching, consulting, or entrepreneurial activities. 
• Whether it’s investing in real estate, launching a side business, or offering coaching services, these ventures provide financial security and personal growth.
• Tip: 
• Start small—whether with a single real estate property, a few consulting projects, or by mentoring a colleague. 
• This gives you a taste of entrepreneurship without overwhelming your primary commitments.

Summary

There is no bad time to make a pivot, but mid-career is often a time of immense potential for physicians in academic medicine. By reevaluating your goals, adjusting your clinical load thoughtfully, building versatile skills, and diversifying income streams, you can make a rewarding career pivot that aligns with your professional and personal aspirations. 

Remember, each step in your pivot journey adds value to your skill set and broadens your options, allowing you to create a fulfilling and resilient career path. Whether you’re moving into leadership, exploring academic research, or launching a side business, your journey can be both transformative and satisfying with the right strategy and mindset.