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Today, I am excited to share with you an interview with one of my former clients who successfully transitioned into the field of Utilization Management. It just so happens that when I was preparing this blog, the company informed me that they are actively recruiting more physicians! So if you like what you hear from Dr. Susan Brister, you might be able to follow in her footsteps!

Susan Brister, MD, is a Board-Certified Internist who was working long hours seeing Medicare patients in the clinic setting when we met. She began a 6-month coaching program in March 2017 and landed her new job in Utilization Management right at the end of the 6 months.

Q: What made you decide to consider a non-clinical career?

Dr. Susan: Work had taken over my life. I realized I was not only neglecting myself but especially my aging parents. My father was ill and ended up dying before I transitioned. Any free time I had, I was traveling to be with him. There was no time for a healthy diet, rest, or exercise. Sometimes I was working up to 70 hours a week with all the charting.

Q: How did you decide what non-clinical career to transition into?

Dr. Susan: That was a very difficult decision. Being doctors, we want to know what we are getting into. The unknown is uncomfortable. It was unsettling to think about going into a new field and not knowing how much I would miss patients. At first, it was overwhelming. It helped me to read your blogs and see some of the options out there. Then when we did the coaching together, I gained more clarity on my preferences. Having the chance to speak with other clients of yours who had transitioned into different non-clinical areas was especially helpful.

Q: What kind of company are you working for?

Dr. Susan: The company is called an Independent Review Organization (IRO) and they do third-party reviews for health insurance plans. When claims are denied, they come to us for independent review. A lot of what we do is evaluate for medical necessity and whether or not the desired medication, treatment, or procedure meets appropriate criteria based on guidelines and current practices.

Q: Can you share some more specifics about your work?

Dr. Susan: Sure. I am on a team with a team lead and 3 other physicians. We get along very well and I like the camaraderie and support. My team lead is fabulous. When we start our day, we check our “queue” to pick up the most urgent cases. We also review the reviews from the external specialists, such as cardiologists and endocrinologists. These reviews can be quite complex. There is a good balance between cases that are very straight-forward and those that are complex. I am always learning about unusual diagnoses and new and novel treatments.

Q: What is your work schedule like?

Dr. Susan: I have the choice of either working five 8-hour days or four 10-hour days. I am doing a mix right now. Every month I cover a weekend shift and then have days off during the week.

Q: How is it working remotely?

Dr. Susan: The number one rule is to get up, exercise, take a shower and get dressed. No working in your pj’s! A lot of people warned me about that. It was really important for me to set up a home office. With all the time I spend on the computer, I wanted to have an ergonomic keyboard and chair. I actually use a kneeling chair. I have to be careful what I have in the fridge, as it is too easy to walk over and grab something.

Q: What else do you like about your job?

Dr. Susan: I like working for an IRO because there is no pressure to deny claims. We are not the insurer. I enjoy the variety of cases and using my clinical knowledge. I am always learning about unusual diagnoses and new and novel treatments. There is always some degree of challenge.

Q: How often do you do peer-to-peer calls?

Dr. Susan: I do anywhere from 1–8 peer-to-peer calls a day, with an average of 2 calls per day. 50-60% of the doctors I speak with are grateful. They are usually busy primary care physicians. They often don’t know how to get certain things approved and are grateful when I can help. Most of the others are at least polite. About 1% are irritated. I approach them by saying, “Here is the case. How can I help you?” I focus on the policies and specific criteria for approval. I can also ask my team lead for suggestions on a peer-to-peer call.

Q: Do you miss clinical practice? Can you imagine going back?

Dr. Susan: If I went back, it would be to do some occasional volunteer work. I am enjoying my life as it is.

Q: What kind of physician might enjoy this work?

Dr. Susan: Someone who is very detailed oriented and comfortable working on a computer. You must absolutely be self-motivated. Be ready to be a learner again. You also need to be transparent. If you stop to change the laundry for 10 minutes, you need to make up that time.

Q: Any tips for doctors considering this area of Utilization Management?

Dr. Susan: You can try some chart review as an independent contractor first to evaluate your interest level. Then find a company where the physicians are happy. See if the company is focusing on what the patient needs, versus what the insurer wants.

Q: Any last thoughts?

Dr. Susan: Last Christmas, after starting my new job, I was with my extended family at our vacation home and I noticed my brother was missing. Then I discovered he had disappeared to work on his computer. And it hit me; I don’t have to do that anymore!

If you are interested in being a Medical Director for this company like Dr. Susan, the basic requirements are:
Board Certification
Active State Licensure
5 years of clinical practice experience (residency counts)

Preferred specialties:  Internal Medicine and subspecialties, Family Practice, Psychiatry, and Sleep Medicine.

Update as of 7/3/18 – The company is no longer taking applicants due to significant interest. When they are hiring again I will update the post.

My sincere thanks to Dr. Susan Brister for granting this interview!

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8 Comments

  1. Meena N. on June 16, 2018 at 2:08 am

    Great read, thank you!
    I am a practicing doctor in Malaysia, with a diploma in Dermatology and some research experience. May I know if there are any opportunities for freelance medical writing at Doctor’s Crossing? Otherwise, I will be grateful to receive your suggestions.

    Looking forward to hearing from you.

    Regards,
    Meena

    • Heather Fork on June 16, 2018 at 2:45 am

      Hello Meena, I am glad you enjoyed the blog. Thank you very much. Nice to know we had a reader in Malaysia. I appreciate your interest in doing freelance medical writing at The Doctor’s Crossing, however we don’t have any opportunities in this area. You might look into the American Medical Writer’s Association as a possible resource for freelance writers. https://www.amwa.org/ If you become a member you can create a profile for promoting yourself as a freelance writer. I am not sure whether or not you need to be in the US to do this, but I would check with the organization. Wishing you all the best.

  2. Heather Warchocki on June 18, 2018 at 1:38 pm

    Thank you for interesting interview. Do you come across positions for licensed clinical psychologists?

    Best,
    Heather Warchocki, Ph.D.

    • Heather Fork on June 18, 2018 at 9:17 pm

      Hello Heather, thank you for reading! I do not personally come across jobs for clinical psychologists, but you might want to check out Dr. Todd Finnerty’s site. He is a clinical psychologist and he has a website focused on non-clinical review and IME work for psychologists and physicians.
      http://www.toddfinnerty.com/

      I hope this helps!

  3. Adonis Saremi on June 20, 2018 at 3:06 am

    Hi Heather,

    Thank you for another extremely informative post. I appreciate hearing about Dr. Brister’s personal experiences and can relate in many ways. I’m glad to hear things are working out for her!

    All the best,

    Adonis Saremi, MD

    • Heather Fork on June 20, 2018 at 2:54 pm

      You are most welcome Adonis! Thank you for reading and commenting.

  4. Sameena on May 5, 2019 at 3:31 pm

    Good Day Heather !

    Dr. Brister’s post was Quiet informative and detailed post. I couldn’t practice due to my personal reasons, I want to get considered for Insurance company jobs. I am a Medical doctor by profession.Can I be guided accordingly,

    Thanks

    • Heather Fork on May 5, 2019 at 7:05 pm

      Good day to you too Sameena! Thank you very much for reading the post with Dr. Brister’s interview. To work as a physicians for insurance company jobs, the basic requirements are an active unrestricted license in at least on state in the US and recent active practice. Most companies also require board certification as well as a minimum of 3 – 5 years clinical practice after residency. There a few companies that will hire without the board certification, and with less clinical practice, but they are the minority. Does this help answer your question?

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Tim O

The coaching I have had with you has been life changing."

You helped me find the courage to seek out leadership positions and become a medical director as well as a physician advisor. I am grateful we crossed paths and am a different person because of it. You have inspired me to "believe" in spite of my inner skeptic. I consider you one of my most important mentors and am proud to also call you a friend. This says a lot given the apprehension I felt when I took a chance with our first coaching session. Even though I have already made a successful transition, I still value your ongoing mentorship and can enthusiastically attest that the value of your services is tremendous!

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“I was at a crossroads in my medical career. I asked myself, "Do I stay or do I go?" 

I met Heather at the SEAK conference. She and I revisited this question.  Did I want to quit being medicine completely? She helped me to identify my needs, wants, and my vision for my FUTURE, not just in medicine, but in life!!!

She was able to listen to my "ramblings" about becoming a stand-up comic, lounge singer and voice-over actor and translate them into action steps.  I chose to become a composite of all of these. Now I am a more confident, healthier, happier person. I credit this in its entirety to the tutelage I have received and continue to receive from Heather.  She cares. She listens. She was there for ME.  She will be there for YOU!

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Heather helped me understand that I am more than just a doctor and that my experiences in clinical medicine are valuable in so many arenas.  As a result I realized that there are other ways to use my background, still be able to help people and continue to challenge myself and grow.  To that end I discovered coaching - specifically health coaching.  I am on my journey becoming a health coach and truly loving it!

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“Thank you, Heather, for helping me transform my career, my faith and my life."

What started out as an initial thirty-minute consultation call turned into an amazing four-year journey that transformed my life, personally, spiritually and professionally. 

Heather helped me to discover my passions...by doing so, I discovered I still had a calling for medicine but it now came from a place of truth...

Today...my wife and I are opening our first concierge medicine clinic in a community we love. I’m actually excited to have the opportunity to practice medicine the way I believe it’s meant to be, with a focus on the doctor-patient relationship and an emphasis on faith. I know if I had not reached out to Dr. Fork, my life would not be where it is at today.

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“Heather gave me the confidence to create a new livelihood by following my heart."

She is incredibly knowledgeable about the range of careers available to physicians and provided me with advice and connections which I would not have found on my own.  From the start she encouraged me to step out of my comfort zone and try different things.  I was laid off unexpectedly in early 2017, and Heather gave me the confidence to create a new livelihood by following my heart and making decisions based on trust, not fear.  Now I am enjoying working part-time in a clinical setting in addition to teaching and writing.

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Devki Patel

After months of struggling to find a non-clinical career that matched my values and passion, I stumbled upon Heather's website which truly changed my life."

Heather's insightful and personalized approach to career coaching made me think outside the box since she took the time to evaluate my personality, values, interests, and preferred lifestyle.

Through her encouragement, practical advice, and professional connections, I was able to find a non-clinical position at a state Medicaid agency that aligned with my passion for population health and serving low-income communities. In addition to her coaching sessions, Heather has built a community of like-minded physicians through her blog, and I feel honored to recommend her to friends and colleagues who seek to make positive changes in their professional and personal lives.

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Working with Heather ultimately helped me leave my job in corporate healthcare and find a path that was much more fulfilling."

My career was going reasonably well but I couldn’t shake this nagging feeling I could do better; or at least find a better long-term career fit.  

I was able to find a surgery job that better aligned with my goals and professional interests.  Additionally, Heather helped me start a consulting business which has allowed me to pursue a true passion: helping medical students, residents, and attendings surgeons navigate the challenges of high-stakes standardized exams.    

If you are reading this as a “Type A” surgeon who doesn’t think coaching is for you, I would encourage you to give Heather a shot.  I’m very glad I did!

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Through our work, I learned to trust myself to make good decisions for my own future – something I hadn’t realized I was struggling with because as an emergency physician, I make life-changing decisions with patients every day. 

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When I first started working with Heather, I was downtrodden...I’d been practicing medicine for 20+ years and yet had never quite found my place.  During the first year I worked with Heather, I left the practice I’d been working at, and recreated an entirely new professional purpose.

I’m now an executive and leadership coach, a university professor, and a Brené Brown Daring Way facilitator, and I have never looked back.  I love what I am doing more than at any other time in my professional life and I credit Heather with seeing in me what I was never able to see in myself, until now.

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I remember when she said ‘do your resume before our next meeting’, I was about to push back but she gently nudged me along and I’m glad I did exactly what she wanted me to do. We also did interview prep via Zoom and I was offered a great job in UM. She has continued to follow up even after I was offered this job, helping me with pointers about negotiating. I will totally recommend the Doctors Crossing and Heather to anyone feeling stuck like me and looking for a great coach! Thank you Heather!

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