Moving up corporate ladder with CMG/ medical director etc

[throckmortonDO]

Lurker since 07. Now first time poster. Lots of great infor learned over the years, now, I have a question.

PGY2 EM at mid-west program.

Looking to move to an area after residency which is essentially dominated by large CMG's, predominantly TH and EC. Since they are the dominant gigs in town, likely I'm looking at a job via that route. With my loans, as well as wife's, essentially no other option but community gig until debts paid down some.

How does one move up the ladder with these corporate entities ? Essentially I'd like to come out of residency well equipped to initially start taking on some admin responsibility and after say 2-5 years move up to Asst Med director or Med Director positions, possibly transition to Chief Med officer or similar say after 20-25 years of clinical practice.

My initial plan was --> try to make chief, get involved with QA/QI projects in residency, learn about observational medicine etc. I've heard this can help you with job search/helps to show that you are interested in QI and Admin responsibilities, display of leadership etc. Another option would be to get MBA, MHA, either during or after residency. Or possibly Admin fellowship, although it seems like one can acquire such skills without losing those 1-2 years of attending salary and instead complete a business degree on the side without going that route, although I could be wrong.

Heard varying opinions, one side saying those gigs are easy to get because not much interest in admin in general from EM physicians, other side says they are competitive especially with CMG's. I'll be looking to work a decent amount clinically coming out of residency, and then possibly scale back slightly the clinical duties, and move up the ladder so to speak. I'm also looking to make myself the most competitive for my first job since the area is a little bit competitive job wise. Does being chief get you more Hourly wage? adding a phd or mba? Clarification or opinions would be welcomed.

ThrockDO.

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[throckmortonDO]

anyone?

I guess I understand the process to become director etc, my question essentially is: is it the same with CMG's? I know everyone hates them, but likely those are my options.

 

[RustedFox]

Your lack of responses is likely the result of the local dislike of the CMG brass.

Your question may be being read as "how can i become a guy who isnt well liked by the rank-and-file docs?"

 

[docB]

You basically have it down. If you're interested in admin, which most EPs aren't, you can easily get into the lower level positions. I've seen set ups where the new guys are required to take assistant directorships because it's work with little upside.

Moving up to the regional medical directorships is much harder. Those positions are held by people who want to stay there. They tend to be there because of their business acumen and contacts. If you find a higher level spot with a lot of turnover it usually means it's a turkey position where no one can make the contracts profitable and the heads roll every year or so. Watch out for those.

As for becoming the CMO of one of the big CMGs that's just statistically unlikely. Think of all the docs who work for TH or EC and realize that there are only 2 CMOs for all of them.

In general "extras" like PhD, chief, MBA and even other board certifications don't equate to additional money although they can get you in the door (especially peds). Admin responsibilities do mean extra money but not what you'd make working those hours clinically. That's another reason so many EPs don't do admin.

 

[EctopicFetus]

Those regional directorships pay well. Best way is to be involved and get to know people. EM at that level is a relationship business. Get involved in EMRA, get to know people. Try to meet the big wigs of the hated CMGs at ACEP. Ask them... seriously..

Also, knowledge of quality measures, throughput, six sigma etc.. that will make you a star.

 

[Arcan57]

The turn-over for medical directorships is staggering and the best way to get your foot in the door is to simply talk about being interested in admin. I became assistant director about 6 months of out residency (when my first medical director quit), and would have been the medical director at my old shop within 3 years (when his replacement resigned) if I hadn't moved. As stated above, it's a very different level to be regional medical director and those positions involve years of networking, putting in staggering numbers of essentially uncompensated hours, and some luck. There's less turnover at that level but a reorganizing of divisions could see you tossed out relatively quickly. In general, hospital systems want quality without having to pay for quality and it's common for even well negotiated contracts to have unobtainable metrics built in. So the door is always open...

 

[realOC]

Some groups offer Admin fellowships, I was hoping someone can speak on this topic in regards what type of job you can expect coming out of a fellowship? Is it easier to become regional director through this route?

 

[pagemmapants]

Those of us who want to stab out our eyeballs with sporks when faced with admin stuff say thank you.

 

[deleted547339]

Those of us who want to stab out our eyeballs with sporks when faced with admin stuff say thank you.

Sporks? You sound like my patients who have a "suicide attempt" where they take 2 ibuprofen then call 911 or "slit their wrist" with a butter knife and get a drop of blood. Go big or go home.....

 

[pagemmapants]

Foon then?

 

[Arcan57]

Some groups offer Admin fellowships, I was hoping someone can speak on this topic in regards what type of job you can expect coming out of a fellowship? Is it easier to become regional director through this route?

I'm not really sure the point of administrative fellowship unless you're getting a second degree as part of it (either MBA or MPH in health admin) which may make you more attractive for admin positions. If you're trying to get into a group that has a pretty fixed hierarchy an admin fellowship may let you skip a couple of spots up the depth list. Otherwise I don't know that it buys you anything that saying "I'm interested in admin" doesn't already.

In terms of becoming an RMD, having an advanced degree may help but it's really going to be about how good you are as an FMD and being in a position where the current RMD is going to be leaving that position in the forseeable future. I don't see an admin fellowship letting you skip the FMD step and becoming FMD in a CMG is relatively trivial if you're interested +/- willing to move to a trouble shop.

 

[throckmortonDO]

Sounds good.

Seems like many aren't interested in anything admin for the most part, and understandably. I sit on some committees at the moment and find some of it to be macerating to the soul, however I hope that my involvement with these will demonstrate increasing history and exposure, as well as interest to med business. I'll get into the inquiries with some big wigs on next conference. I suppose in a nutshell, I'm looking for a way to taper off into the business side of things once my twilight years start twinkling.

btw RF, the area I'm looking to move to is near you I think, assuming your still in that area. Any advice would be appreciated.

On a side note, is there anything one can do in residency to make oneself more competitive for first job? assuming I have a chance to escape CMG and woo a democratic group? ie make chief?, research?, throughput stuff,? stay on with residency program for 6mos -1yr and get boarded prior to applying for other jobs?

Thanks again

 

[RustedFox]

PM me with specific questions. I'm in west florida.