June 26, 2017

Is Guilt Putting a Monkey Wrench in Your Career Transformation?

There are many kinds of guilt, Catholic Guilt, Jewish Mother Guilt, Generic Parental Guilt, Couch Potato Guilt, Not Feeling Guilty Enough Guilt, and so on. Guilt is such a pervasive emotion it will likely never be on the endangered species list, and as painful as it can be, it is not something we should try to completely eradicate like small pox. Guilt serves a worthy purpose to keep us in line, however, it can also unnecessarily hold us back. As I see it, guilt can be divided into two types:

Guilt Trip
Appropriate guilt: when you’ve done something wrong (or not done something you should have) and you rightly feel regret and hopefully make amends.

Inappropriate guilt: when you feel guilty about feeling a certain way, or wanting or needing something, yet these feelings and desires are healthy and valid.

Inappropriate guilt often arises when you’re feeling conflicted about what you want to do versus what you feel you should do.

Of course there are many instances when we need to put our shoulds over our wants. We may not want to answer a page at 1 am, but we know we should, so we do.

What I often see happening with my physician clients is they feel inappropriately guilty when it comes to making their needs and wants more of a priority, and the SHOULDS win out because guilt is a very uncomfortable and PAINFUL emotion. They end up make decisions based on avoiding the feeling of guilt, and these are not necessarily the best decisions.

Common GUILTY THOUGHTS that can get in the way

“I feel guilty taking my kids to daycare on my day off.”

“I feel guilty taking a job where my income is less; my family shouldn’t have to sacrifice because I’m  unhappy.”

“When I think about leaving my patients, I feel guilty.”

“If I don’t stay in medicine I feel guilty wasting my training.”

“If I work part-time, I feel guilty knowing others are working more.”

“I feel guilty wanting to do something by myself when I don’t get enough time with my family. Sometimes I wish I were single, not really but….”

“I feel guilty for wanting to be happy. Shouldn’t I just suck it up? How many people like their work anyway?”

Guilt is tricky. It’s good we can feel the emotion of guilt, so we have some starch to go with our moral compass. But too often we set unreasonable expectations, putting ourselves at risk for rubber-stamping “Guilty” on our psyche like a bored government worker. We don’t take the time to really understand why the charge of guilty. The gavel comes down and Bam! We’re Guilty! Case closed. No further discussion.

We keep doing what guilt tells us we should be doing, all the while building up resentment and frustration. Nothing really changes except change seems even harder.
Q – What is the way out of inappropriate guilt?

A – Take the time to understand what’s underneath the conflict you’re feeling and reassess your situation without judgment.

A “How To Guide” for Putting An End to Inappropriate Guilt

 To make this more concrete, I have included an example of a physician who wants more time for him/herself,  but feels guilty taking time from family.

Identify what you’re feeling conflicted about that’s creating guilt.

I’m not finding time to do the things I need and want for myself. Work already takes up too much of my time. I feel guilty taking more time away from family.

Write down your underlying feelings, needs, and wants in this situation (It’s key to write these down, get them out of your HEAD, and see them on paper).

All day long I am giving to patients. When I come home, I am giving to my family. After the kids are in bed, I finish my charting and I’m exhausted. I get up the next day and do the same thing over again. I don’t have hardly any time for myself. At the very least I want to exercise more regularly, and eat healthier and get more sleep. It would be great to be able to work on improving my career and just do something for myself, anything!

Look for where you are judging yourself or comparing yourself to others in this situation.

I feel it’s selfish to take time away from my family.  I made the decision to have these children and they should come first. Dr. So and So seems to find time to work and be the perfect parent. I waste what little time I have procrastinating and internet surfing.

Write down the potential benefits if you meet this need.

If I take more time for myself, I will:

Be able to exercise more and feel healthier and less stressed
Be more patient and present for my loved ones
Feel better about myself
Have better relationships (avoid jeopardizing my marriage and job)
Be able to work on my career and make progress
Be healthier and happier for the long run
Not build up underlying resentment
Realize how important my happiness is, and make it a priority

 Write down the potential negatives of meeting this need.

 If I take more time for myself:

My family could feel neglected
My spouse could feel I’m not doing my share of the household duties
I might cut my work hours and see a drop in income
My family might have to see some budget cuts
I could discover I HAVE TO make some changes and that’s scary
Others may see me as being selfish

Write down the cost to you and others if you continue to deny this need or want.

I continue to be unhappy
I become more grumpy, irritable, and resentful
I damage my relationships at work and home
My health suffers; I develop some illness or disease
I grow to hate getting up every day and feeling overwhelmed
I feel like I am wasting my life
I end up not doing anything well

Step back and look at the whole situation. Ask yourself what choices will lead in the direction of optimum mental, physical and emotional well-being and health – for you. Then make any changes you can that will support this overall move towards, not away from, healthy and joyful living. Nothing has to change overnight. Making even small steps over time in the right direction can profoundly change the course of your life. And remember – innocent until proven guilty!


Considering Pharma? Check out the DIA 2017!

pharma reseracherLast year was a big year for pharma at the Doctor’s Crossing. Four of my clients landed great jobs in pharma and I attended the inspiring world-renowned pharmaceutical conference – The DIA Global (DIA – Drug Information Association).

One of my four clients had no prior pharma experience and she is now working happily as a Drug Safety Officer for a large pharmaceutical company. She is proof that you can get into pharma without having experience in clinical trials or research. 

In my on-going efforts to learn more about pharma, scout for opportunities for clients, and get a better feel for the community, I attended the DIA’s annual conference in Philadelphia last year. I was one of 6,454 participants and I loved every minute. There was an electricity in the air which I attributed to being amongst so many bright individuals who are passionate about improving the health of patients in profound ways. Before I share specifics about the conference, I want to give you an idea of positions open to physicians in pharma.

  1. Drug Safety Officer  (Pharmacovigilance)– involved with reported side effects from drugs, labeling, SAE’s (serious adverse events). Can include involvement in preclinical studies. clinical trials and post-market stages. Public education.
  1. Medical Monitor – advises on clinical trials, planning, and implementation. Monitors patients enrolled in trials for safety, side effects and suitability for study enrollment and completion.
  1. Clinical Trial Researcher – participates in and oversees clinical trial design and implementation. Actively involved in running trials and design.
  1. Medical Affairs Director– bridge between drug development, marketing, and public education. Involved with medical information, communication, launch and post-market strategies.
  1. Medical Science Liaison –a knowledge expert in a therapeutic area, develops relationships with KOL’s (Key Opinion Leaders) externally, resource for physicians in practice; educational and communications role. Frequent travel.
  1. Medical Writer– prepares regulatory documents, slide decks, scientific articles, white papers, covers scientific and medical conferences, etc.
  1. Regulatory Affairs Director – knowledgeable about FDA regulations, prepares and submits regulatory documents, negotiates for market authorization for drugs and devices, keeps informed regarding legislative changes.
  1. Health Economics and Outcomes Researcher (HEOR) – concerned with the cost-effectiveness of drugs and devices, value, as well as the impact of treatments on patients.

 For a more complete description of these positions for physicians, please click HERE. (Note – the job opening links are no longer active).

Click HERE specifically for the Medial Science Liaison.

Sameer Thapar (PharmD), Director of Global Pharmacovigilance for Oracle, and one of the speakers at the DIA, shared a simple way to think about the complex array of jobs in pharma. He said, “There are the Makers, the Sellers, and the Defenders.”  The Medical Affairs and Medical Science Liaison positions help to bridge these three areas (my addition).

When considering a transition to pharma, you may wonder whether or not you would miss patient care and if you’d feel like you were making a difference in a meaningful way.

Dr. Kelly Curtis, my former client who now works remotely as a Medical Director and Medical Monitor for INC Research said this about his transition, “I find non-clinical work very rewarding and feel like I make more of an impact on the future of oncology in this role than when I was in academia.” 

I personally know a pediatrician who works remotely for pharma and he does a few pedi-urgent care shifts a month to keep his clinical connection to patients.  Although maintaining some degree of patient care while working in pharma is not the norm, some doctors find ways to do this through volunteering, medical trips abroad, or attending in a teaching setting.

The satisfaction from helping an individual patient can shift to helping entire populations of patients. Dr. Larry Brilliant, who gave the DIA 2016 Keynote address, recounted his fascinating involvement in eradicating smallpox and his on-going efforts to prevent and treat blindness in millions of individuals in developing countries. You can read about his amazing life’s work intertwined with his spiritual journey in his hard-to-put-down new book, Sometimes Brilliant

Here are some of the Hot Topics on tap for DIA 2017:

  • Data/Big Data/eHealth – informatics, data integration, bioethics
  • Disruptive Innovation – innovative science, technology and therapies: stem cells, regenerative therapies, gene therapies
  • Medical Affairs – MSL (medical science liaison), medical writing, medical affairs roles throughout product lifecycle
  • Patient Engagement – patient-centric practices, advocacy, culture, tools
  • Safety – best practices, post-market safety considerations, monitoring
  • Regulatory – advertising and promotional laws, regulatory writing, document management, compliance
  • Special Populations – Rare diseases, pediatrics, women’s health, aging
  • Preclinical and Clinical Development – discovery, clinical research, recruitment, clinical trial data disclosure, outcomes, statistics
  • Value and Access – drug pricing, reimbursement, access, real world outcomes

For additional information on the Hot Topics for DIA 2017 please click HERE.

For the Agenda for the DIA 2017 please click HERE.

I particularly enjoyed a panel presentation on “Big Data” with oncologist Dr. Brad Hirsch, CEO at SignalPath Research. Dr. Hirsch continues to see patients as well as work in pharma in the areas of informatics, innovation and gene-based therapies. You can tell he loves caring for his patients, and also being at the cutting edge of finding cures for the cancers that threaten their lives.

If you’re considering pharma, attending the DIA will give you a deep dive into this area, as well as the chance to make helpful networking connections. And your attendance would be an undeniable indication to any hiring authority of your genuine interest in this career direction. This is just one of a number of ways to increase your chances to land a pharma job.

Even though my time at the DIA was beyond busy, especially since I made a point to network at all of the exhibitor booths (pens anyone?), I left energized and uplifted. Call me pollyanna, but I felt that I was among a large group of people who really care about giving patients the chance for healthier and longer lives.  As physicians, and as individuals with loved ones, we know personally how devastating having an untreatable condition is, or having a poor quality of life due to illness. Pharmaceuticals are, of course, only part of the answer to good health, but when nothing else works, the right drug is truly a miracle.

The DIA 2017 will be in Chicago, June 18 – 22. 






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Using Your Internal GPS for Career Change

Is your internal GPS telling you it’s time to change your career direction? Is it saying “Recalculate! Recalculate!” but leaving you stranded at the crossroads, failing to provide any further instruction?

If so, it can feel overwhelming, daunting, and confusing.



Uncertainty is uncomfortable. It’s natural to wish for some kind of roadmap to guide us through a process of change.

It makes sense that we feel this way. To become a physician, we had every step mapped out for us. Yes, it was quite a climb, but even Everest has a summit and there is one way up. If you don’t give up and make it to the top, you win. There is guaranteed employment, a career with status, and a paycheck.




There is a sense of security in such a well-trodden path where the finish line is visible before you even start. However, as our high physician burnout rates reveal, there is no guarantee of happiness. There is no certainty that the rules of engagement won’t change or that expectations will be met.

The shifting sand at the top of the seemingly sturdy staircase has left many considering other options. Instead of using the staircase that guided us, we now have to create our own path.

If we were wired like Lewis and Clark, we wouldn’t have gone into medicine. We’d be bushwhacking with Sacajawea by our side, discovering new lands – not practicing evidence based medicine.

But in spite of our predilections, we may find ourselves staring into a great expanse of non-clinical career terrain, wondering where even to take the first step?

Since we don’t have the prefab staircase outside of traditional practice, we have to use a different approach. Siri had the right idea. We need to use our internal GPS. We need to be able to listen to ourselves and hear our own guidance.

The connections may be a bit rusty if we’ve had to push down that inner voice in service of our career. It may take time to start hearing our true inner voice and what we need and want. When we start to listen, we might be confused by the presence of two voices, one coming from fear-based thinking (The False Self) and the other coming from trust-based thinking (The True Self). Here are some identifying characteristics to distinguish the two:

The False Self – fear-based and self-doubting

  • Sees problems rather than possibility
  • Jumps to the “What if’s” – what could go wrong
  • Is accompanied by anxiety
  • Sells your abilities short
  • Has to see all the steps before starting

The True Self – confident and trusting

  • Focuses on possibilities rather than problems
  • Is able to imagine success
  • Creates a sense of calm internally
  • Does not over or underestimate your abilities
  • Is comfortable taking steps without having all the answers

How do we turn up the volume on the True Self and mute the False self?

1. Start noticing anxious, fear-based thoughts. Write these down and note the frequency.
2. Look at the fears objectively and see if they make rational sense.
3. Take stock of all you have already accomplished and the challenges you have met.
4. Give yourself permission to accept whatever feelings you are having. Get curious about their origin, rather than judging them.
5. Practice mindfulness or meditation techniques to help quiet and train the mind so it is not so reactive.
6. Do things you enjoy and love. This will awaken the heart, which is part of the internal GPS
7. Believe in the value of your individual uniqueness. Embrace your path and don’t worry if it doesn’t look like anyone else’s.

Our Internal GPS = an awakened heart + rational, non fear-based thinking

To get started on your career transformation, you don’t need to enter a specific destination into your GPS. You can start with a commitment you make to yourself. It can be a simple statement such as:

“I want to enjoy my work.”

“I want my work to be fulfilling.”

“I want to have quality family time.”

“I want to make a difference in a way that is meaningful.”

“I want to use my creativity.”

“I want to use my brain more and be challenged.”

Your internal GPS will start to work on the initial steps, and as you gain more clarity, keep refining the destination. Staircase or no staircase, it’s OK to “recalculate” so you end up in the right place – for you.