Physician Disrupt Thyself

(Stepping away from health policy and business this week, a quick post on alternative careers in medicine).

Wrapping up a great week spent with emergency medicine friends attending this year’s American College of Emergency Physicians national meeting in Boston.  Over the course of a few receptions and dinners, more than one old friend has stopped to ask me about how I made the decision to step away from caring for patients in the emergency department and into a nonclinical role at a progressive startup healthcare company.  A few friends confessed that they love the idea of getting their hands dirty fixing a broken healthcare system– but don’t know where to begin.

I have a very limited perspective and I’m no expert on career pivots.  But I often look to an article I came across a few years ago, written by Whitney Johnson in the Harvard Business Review.  Her article is called Disrupt Yourself.


In the piece (and later in her book) Johnson argues that people can successfully transition into satisfying roles in new businesses but often need to “disrupt” themselves and their current careers.  This disruption is needed because moving to another job or field (even one adjacent to the one you’re in) is hard.  I think that this is particularly true in medicine where the time and money needed to become a doctor creates incumbents, inherently resistant to change.  Physicians are, by nature of our training and regulation, IBMs and Microsofts.  We are slow to change.  We can plateau.

She writes:

If as an individual you’ve reached a plateau or you suspect you won’t be happy at the top rung of the ladder you’re climbing, you should disrupt yourself for the same reasons that companies must.

Johnson references Clayton Christensen, who is the father of disruptive innovation, which is the theory that the most successful innovations create new markets and value networks.  She believes that the same principles hold true for positioning yourself in the career market:

I believe that disruption can also work on a personal level, not just for entrepreneurs who launch disruptive companies but for people who work within and move between organizations. Zigzagging career paths may be common now, but the people who zigzag best don’t do it randomly.

Johnson identifies four principles for folks looking to translate their skills into a new type of work.  She writes that they need to:

1. Target a need that can be met more effectively.
2. Identify their disruptive strengths.

Don’t think just about what you do well—think about what you do well that most others can’t. Those are your disruptive strengths.

3. Step back (or sideways) in order to grow

An individual’s well-being depends on learning and advancement. When organizations get too big, they stop exploring smaller, riskier but perhaps more lucrative markets because the resulting revenues won’t affect their bottom line enough.

4. Let their strategy emerge.

Because we’re not following traditional paths, we can’t always see the end from the beginning. As John D. Rockefeller wrote, “If you want to succeed, you should strike out on new paths, rather than travel worn paths of accepted success.”