1 00:00:00,000 --> 00:00:05,860 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills 2 00:00:05,860 --> 00:00:11,260 to build their own research program, whether or not they have a mentor. 3 00:00:11,260 --> 00:00:17,340 As clinicians, we spend a decade or more as trainees learning to take care of patients. 4 00:00:17,340 --> 00:00:22,380 When we finally start our careers, we want to build research programs, but then we find 5 00:00:22,380 --> 00:00:27,780 that our years of clinical training did not adequately prepare us to lead our research 6 00:00:27,780 --> 00:00:29,180 program. 7 00:00:29,180 --> 00:00:35,480 Through no fault of our own, we struggle to find mentors, and when we can't, we quit. 8 00:00:35,480 --> 00:00:40,580 However, clinicians hold the keys to the greatest research breakthroughs. 9 00:00:40,580 --> 00:00:46,200 For this reason, the Clinician Researcher podcast exists to give academic clinicians 10 00:00:46,200 --> 00:00:51,800 the tools to build their own research program, whether or not they have a mentor. 11 00:00:51,800 --> 00:01:01,380 Now introducing your host, Toyosi Onwuemene. 12 00:01:01,380 --> 00:01:03,820 Welcome to the Clinician Researcher podcast. 13 00:01:03,820 --> 00:01:08,540 I'm your host Toyosi Onwuemene, and it is my absolute pleasure to be talking with you today. 14 00:01:08,540 --> 00:01:10,640 Thank you so much for tuning in. 15 00:01:10,640 --> 00:01:15,260 I'm excited to bring you today's episode called Seven Things You Should Understand, 16 00:01:15,260 --> 00:01:19,140 You Should Know, Before You Go Into Academic Medicine. 17 00:01:19,140 --> 00:01:22,980 Seven Things You Should Know Before You Go Into Academic Medicine. 18 00:01:22,980 --> 00:01:28,320 This comes from a coaching session that we had yesterday, and I thought I needed to come 19 00:01:28,320 --> 00:01:34,220 on and share with my audience and to share with those of you who missed the coaching 20 00:01:34,220 --> 00:01:38,820 session what you really, really should understand about going into academic medicine. 21 00:01:38,820 --> 00:01:44,500 I have to say that I think people were somewhat shocked, but it was a good shock because it's 22 00:01:44,500 --> 00:01:49,500 good to know, to have a clear understanding of the lay of the land, because then you're 23 00:01:49,500 --> 00:01:51,820 able to go in strategically. 24 00:01:51,820 --> 00:01:59,300 You're not like me, like a dare stuck in the headlights when you start your academic position. 25 00:01:59,300 --> 00:02:04,700 And just to recall, and for those of you who've been listening to me for some time, you'll 26 00:02:04,700 --> 00:02:10,420 remember that I started my academic job totally clueless. 27 00:02:10,420 --> 00:02:11,860 I said, I want to do research. 28 00:02:11,860 --> 00:02:12,860 I want to do research. 29 00:02:12,860 --> 00:02:14,700 That's why I'm here in academia. 30 00:02:14,700 --> 00:02:22,500 And I ended up with a full-time clinical job, totally confused as to how it was that I wanted 31 00:02:22,500 --> 00:02:25,500 to do research, and I ended up with a 100% clinical position. 32 00:02:25,500 --> 00:02:28,900 I'm sorry, it was 80%, even though I was seeing patients five days a week. 33 00:02:28,900 --> 00:02:30,740 It was technically 80%. 34 00:02:30,740 --> 00:02:32,140 How did that happen to me? 35 00:02:32,140 --> 00:02:37,660 And so I want to share with you what the challenges are and what some of the drivers are that 36 00:02:37,660 --> 00:02:43,340 may be driving decisions that are happening outside of your purview so that you can prepare 37 00:02:43,340 --> 00:02:47,780 yourself to be ready to take on an academic job whenever you choose. 38 00:02:47,780 --> 00:02:52,500 Or at the end of this episode, you might say, well, academia is probably not for me. 39 00:02:52,500 --> 00:02:53,500 Thank you. 40 00:02:53,500 --> 00:02:57,740 And that's okay too, because what you want to do is you want to have a realistic picture 41 00:02:57,740 --> 00:02:59,260 of how you're going to move forward. 42 00:02:59,260 --> 00:03:00,260 Okay? 43 00:03:00,260 --> 00:03:01,700 All right, here we go. 44 00:03:01,700 --> 00:03:08,220 So first of all, you need to recognize that academic medical centers operate a business. 45 00:03:08,220 --> 00:03:09,220 Okay? 46 00:03:09,220 --> 00:03:11,060 I want to say that again. 47 00:03:11,060 --> 00:03:14,020 Academic medical centers operate as a business. 48 00:03:14,020 --> 00:03:17,900 Now, I know that you are a wonderful person. 49 00:03:17,900 --> 00:03:19,500 You are altruistic. 50 00:03:19,500 --> 00:03:23,500 You really want to take care of patients, and actually you feel like patient care should 51 00:03:23,500 --> 00:03:24,660 be free. 52 00:03:24,660 --> 00:03:26,300 And I'm not disagreeing with you there. 53 00:03:26,300 --> 00:03:31,620 I'm just saying that in this year, right now, 2024, it's not. 54 00:03:31,620 --> 00:03:37,380 And for that reason, you're going to have to reckon with the fact that you take care 55 00:03:37,380 --> 00:03:40,180 of patients within a business model. 56 00:03:40,180 --> 00:03:44,580 And for many physicians, especially my group of coaching clients who don't really care 57 00:03:44,580 --> 00:03:51,000 very much about money and don't necessarily want money to be front and center of the conversations 58 00:03:51,000 --> 00:03:54,860 that they're having, especially around patient care, I want you to know that even though 59 00:03:54,860 --> 00:04:00,560 it's not front and center for you, it is front and center for the people who run the business. 60 00:04:00,560 --> 00:04:03,680 Academic medical centers are businesses. 61 00:04:03,680 --> 00:04:05,820 Academic medicine is a business enterprise. 62 00:04:05,820 --> 00:04:06,820 Okay. 63 00:04:06,820 --> 00:04:09,200 Why is it important for you to know that? 64 00:04:09,200 --> 00:04:12,340 Businesses exist only when they profit. 65 00:04:12,340 --> 00:04:13,540 Okay. 66 00:04:13,540 --> 00:04:20,780 If a business is only able to meet its operating costs, that means that it is not able to really 67 00:04:20,780 --> 00:04:24,260 provide the services that it needs to. 68 00:04:24,260 --> 00:04:28,420 Businesses that operate at a profit are able to keep going. 69 00:04:28,420 --> 00:04:36,500 For that reason, the security of your job lies in the profit-making ability of your 70 00:04:36,500 --> 00:04:38,020 business enterprise. 71 00:04:38,020 --> 00:04:39,020 Okay. 72 00:04:39,020 --> 00:04:43,740 Again, this is not front and center for you, but when it comes to the powers that be at 73 00:04:43,740 --> 00:04:50,700 any academic medical center, the administrative team is thinking very seriously about the 74 00:04:50,700 --> 00:04:52,580 business enterprise. 75 00:04:52,580 --> 00:04:58,980 And whether you like it or not, you play an important role in the success of the business 76 00:04:58,980 --> 00:04:59,980 enterprise. 77 00:04:59,980 --> 00:05:02,700 Now, I'm talking about physicians as a group, right? 78 00:05:02,700 --> 00:05:04,820 I'm talking about you individually. 79 00:05:04,820 --> 00:05:09,860 You may not think your contribution is very much, but when it all comes together, you 80 00:05:09,860 --> 00:05:15,980 play a significant role in the success of the academic medicine business enterprise. 81 00:05:15,980 --> 00:05:22,220 I would like you, if you would please indulge me, would you just say after me, I play an 82 00:05:22,220 --> 00:05:27,380 important role in the success of my academic business enterprise. 83 00:05:27,380 --> 00:05:28,380 Okay. 84 00:05:28,380 --> 00:05:32,180 Now, I'm saying that to people clearly who are already in academic medicine. 85 00:05:32,180 --> 00:05:36,380 I am hoping that people who are not yet in academic medicine, at least committed as faculty 86 00:05:36,380 --> 00:05:42,060 members, are listening to me so that perhaps when you repeat after me, you're saying, I 87 00:05:42,060 --> 00:05:49,100 am going to play a role in the revenue generating capacity of the business enterprise. 88 00:05:49,100 --> 00:05:50,100 Okay. 89 00:05:50,100 --> 00:05:51,860 I forgot what I said the first time, so now I switched it up. 90 00:05:51,860 --> 00:05:53,260 But you know what I'm saying. 91 00:05:53,260 --> 00:05:57,620 The money that comes into the institution happens because of the work that you do. 92 00:05:57,620 --> 00:06:01,180 Thank you for keeping our academic medical centers funded. 93 00:06:01,180 --> 00:06:05,660 Thank you for doing the work that moves money into the academic medical center. 94 00:06:05,660 --> 00:06:07,380 You may be like, well, I'm a fellow. 95 00:06:07,380 --> 00:06:08,380 Yes. 96 00:06:08,380 --> 00:06:12,660 Thank you so much for the work you do that brings money into the academic medical centers. 97 00:06:12,660 --> 00:06:13,660 Thank you. 98 00:06:13,660 --> 00:06:14,660 Okay. 99 00:06:14,660 --> 00:06:18,340 This is important to recognize that academic medicine is a business. 100 00:06:18,340 --> 00:06:22,820 Here's a problem with the academic medical enterprise as a business. 101 00:06:22,820 --> 00:06:28,640 It's that things are shifting and businesses have to be able to pivot to stay afloat. 102 00:06:28,640 --> 00:06:32,300 So you can't just be like, this was my business model 20 years ago and it's a business model 103 00:06:32,300 --> 00:06:34,220 that we're still using. 104 00:06:34,220 --> 00:06:35,940 Businesses have to evolve. 105 00:06:35,940 --> 00:06:36,940 Okay. 106 00:06:36,940 --> 00:06:41,700 I'm going to stop at that for number one, which is recognize that academic medicine 107 00:06:41,700 --> 00:06:42,700 is a business. 108 00:06:42,700 --> 00:06:47,600 Now I'm going to move on to number two, which is to understand how academic medical centers 109 00:06:47,600 --> 00:06:48,900 make money. 110 00:06:48,900 --> 00:06:49,900 Okay. 111 00:06:49,900 --> 00:06:55,260 So think about all the things I said in number one, but now I want you to recognize how academic 112 00:06:55,260 --> 00:06:56,820 medical centers make money. 113 00:06:56,820 --> 00:07:00,900 Now the stuff that's really easy is like, of course, clinical dollars. 114 00:07:00,900 --> 00:07:01,900 Yes. 115 00:07:01,900 --> 00:07:02,900 Clinical services. 116 00:07:02,900 --> 00:07:03,900 Okay. 117 00:07:03,900 --> 00:07:06,440 And part of the clinical services are physician payments. 118 00:07:06,440 --> 00:07:11,900 So yes, you as a physician, whether you're in training or a faculty member, you help 119 00:07:11,900 --> 00:07:16,300 to make clinical revenue for the academic institution, right? 120 00:07:16,300 --> 00:07:18,740 Because you see patients, you generate bills. 121 00:07:18,740 --> 00:07:21,500 Ooh, you send patients off to get procedures. 122 00:07:21,500 --> 00:07:22,500 Okay. 123 00:07:22,500 --> 00:07:28,100 There are clinical services that may not necessarily require or depend on the physician, but the 124 00:07:28,100 --> 00:07:30,960 physician is helping to generate these clinical services. 125 00:07:30,960 --> 00:07:33,020 You send someone off to get PFTs. 126 00:07:33,020 --> 00:07:35,220 You send someone off to get different studies. 127 00:07:35,220 --> 00:07:37,380 Gosh, they're all escaping me now. 128 00:07:37,380 --> 00:07:43,260 You're generating revenue because now the clinical services are able to generate revenue. 129 00:07:43,260 --> 00:07:44,500 You send people to get lab draws. 130 00:07:44,500 --> 00:07:46,340 The lab services are generating revenue. 131 00:07:46,340 --> 00:07:52,020 So clinical services are a huge part of how academic medical centers make money. 132 00:07:52,020 --> 00:07:54,420 Now are clinical services the only way? 133 00:07:54,420 --> 00:07:55,420 No. 134 00:07:55,420 --> 00:07:57,500 Academic medical centers are academic. 135 00:07:57,500 --> 00:08:00,260 And so they are providing an academic service. 136 00:08:00,260 --> 00:08:06,500 And so yes, there are students, there are trainees within that academic framework. 137 00:08:06,500 --> 00:08:08,540 So medical students pay fees. 138 00:08:08,540 --> 00:08:11,240 So that also is part of the income. 139 00:08:11,240 --> 00:08:16,220 And also, GME is funded largely by Medicare. 140 00:08:16,220 --> 00:08:19,340 And so the government funds education as well. 141 00:08:19,340 --> 00:08:25,860 And so educational dollars are coming into the institution either through fees or through 142 00:08:25,860 --> 00:08:31,180 payments by the people who are invested in this education, or maybe even the VA as you're 143 00:08:31,180 --> 00:08:34,460 training some fellows who work at the VA. 144 00:08:34,460 --> 00:08:38,620 But dollars are coming in to support the education mission. 145 00:08:38,620 --> 00:08:42,180 Another way that academic medical centers make money is through philanthropy. 146 00:08:42,180 --> 00:08:47,900 Now philanthropy for some institutions is a big chunk of that, never bigger than clinical 147 00:08:47,900 --> 00:08:50,540 dollars, but still a significant portion. 148 00:08:50,540 --> 00:08:54,700 However, there are some institutions that don't really necessarily make a lot of philanthropy 149 00:08:54,700 --> 00:08:55,700 dollars. 150 00:08:55,700 --> 00:08:59,420 That's another strategy in which, and that's another way in which money comes into the 151 00:08:59,420 --> 00:09:01,060 academic medical center. 152 00:09:01,060 --> 00:09:02,420 And I want to talk about one more way. 153 00:09:02,420 --> 00:09:04,820 There are a couple of other ways, but I want to talk about one other way. 154 00:09:04,820 --> 00:09:10,380 One other way is providing operational services to hospitals that are part of the system. 155 00:09:10,380 --> 00:09:16,100 So if I'm going to use MD Anderson as an example, there's MD Anderson in Houston, which is the 156 00:09:16,100 --> 00:09:20,580 original MD Anderson, but there are MD Anderson's now all over the country. 157 00:09:20,580 --> 00:09:25,480 And there is a price, a cost to using the MD Anderson name. 158 00:09:25,480 --> 00:09:28,980 There is benefit, and there's also a cost to the people who are using the name. 159 00:09:28,980 --> 00:09:31,700 And that's another way that revenue can be generated. 160 00:09:31,700 --> 00:09:36,540 So there are a number of ways that academic medical centers generate revenue, but by far, 161 00:09:36,540 --> 00:09:42,140 the most important, the most critical to an academic medical center's business enterprise 162 00:09:42,140 --> 00:09:44,100 is clinical dollars. 163 00:09:44,100 --> 00:09:49,140 And you as a physician are very important part of that revenue generation process. 164 00:09:49,140 --> 00:09:53,020 Now here's what's happening in the landscape of academic medicine and the landscape of 165 00:09:53,020 --> 00:09:58,940 medicine in general, is that there are declining reimbursements for the same services. 166 00:09:58,940 --> 00:10:02,780 And so people are still sick, we're still doing the things that we've been doing to 167 00:10:02,780 --> 00:10:06,140 them for ages, and we're getting more sophisticated. 168 00:10:06,140 --> 00:10:09,020 Our treatments are becoming more expensive. 169 00:10:09,020 --> 00:10:13,960 Everything is becoming more expensive, but guess what's happening in the government circles? 170 00:10:13,960 --> 00:10:17,300 Reimbursements are declining for government paid services. 171 00:10:17,300 --> 00:10:24,140 So Medicare is a huge portion of any academic medical center's practice in terms of who 172 00:10:24,140 --> 00:10:30,980 are the insurance providers that are paying for people to be seen, and over time, less 173 00:10:30,980 --> 00:10:36,620 and less money is coming in, and we're seeing more and more people come in who are Medicare 174 00:10:36,620 --> 00:10:39,740 population, the part of Medicare population. 175 00:10:39,740 --> 00:10:40,880 What does that mean? 176 00:10:40,880 --> 00:10:49,220 It means with declining reimbursements, you need to do more with less to be able to keep 177 00:10:49,220 --> 00:10:50,220 the business afloat. 178 00:10:50,220 --> 00:10:56,020 Remember, number one, academic medical centers are a business and they've got to stay profitable. 179 00:10:56,020 --> 00:11:02,540 So what happens if you are getting less money for the same services, then the squeeze starts 180 00:11:02,540 --> 00:11:03,740 to happen, right? 181 00:11:03,740 --> 00:11:06,860 People are asked to do more, they're asked to do more with less. 182 00:11:06,860 --> 00:11:10,580 People start to feel the pressure, they feel the pressure of the business, they feel like, 183 00:11:10,580 --> 00:11:15,020 oh my gosh, I thought I was here to care for patients, I hate this feeling. 184 00:11:15,020 --> 00:11:17,740 People are calling you all the time, close charts. 185 00:11:17,740 --> 00:11:23,060 Yes, you are feeling the squeeze because in healthcare generally, everyone is feeling 186 00:11:23,060 --> 00:11:27,740 the squeeze of declining reimbursements with increasing cost of care. 187 00:11:27,740 --> 00:11:32,320 It's one thing if the reimbursements are declining and the cost of care is the same, the cost 188 00:11:32,320 --> 00:11:37,820 of care is increasing and the reimbursements for care continue to decrease. 189 00:11:37,820 --> 00:11:41,260 Okay, now, why does this matter to you? 190 00:11:41,260 --> 00:11:43,780 Why does this matter to you? 191 00:11:43,780 --> 00:11:48,500 Number three is for you to recognize your role in the business, recognize your role 192 00:11:48,500 --> 00:11:49,780 in the business. 193 00:11:49,780 --> 00:11:54,540 If academic medical centers are a business that can only profit, that profit to be able 194 00:11:54,540 --> 00:12:02,220 to stay afloat and their biggest revenue generation is clinical services and you are a provider 195 00:12:02,220 --> 00:12:06,740 of clinical services, then recognize that you are an important piece of the revenue 196 00:12:06,740 --> 00:12:08,480 generation framework. 197 00:12:08,480 --> 00:12:12,860 When it comes to your institution, when it comes to your academic medical center, you 198 00:12:12,860 --> 00:12:19,620 are a critical piece of the revenue generation framework and the more your specialty brings 199 00:12:19,620 --> 00:12:22,860 in dollars, the more you are critical. 200 00:12:22,860 --> 00:12:27,380 Even if your specialty does not bring in a lot of dollars, wow, you still got to be able 201 00:12:27,380 --> 00:12:30,340 to make that revenue. 202 00:12:30,340 --> 00:12:38,540 The reality of the pressure you feel to see more patients with less resources is real. 203 00:12:38,540 --> 00:12:40,500 It is a real thing. 204 00:12:40,500 --> 00:12:45,220 That is what's happening at academic medical centers across the country. 205 00:12:45,220 --> 00:12:48,740 It's been a trend that's been shifting over time. 206 00:12:48,740 --> 00:12:52,500 We're going to continue to feel it more and more and more. 207 00:12:52,500 --> 00:12:57,260 Okay, I want to share that, you know, for many people, I hear people say, oh, yeah, 208 00:12:57,260 --> 00:13:01,220 yeah, yeah, I really am just here for, I mean, I really want to take care of patients. 209 00:13:01,220 --> 00:13:02,420 So it's a win, right? 210 00:13:02,420 --> 00:13:06,220 It's a win because you take care of patients, you love to care for patients and the academic 211 00:13:06,220 --> 00:13:11,060 medical center wants you to take care of patients because it's generating some revenue. 212 00:13:11,060 --> 00:13:12,820 And so it's a win-win. 213 00:13:12,820 --> 00:13:18,380 But here's the thing though, you didn't come to academic medical center to only see patients, 214 00:13:18,380 --> 00:13:19,380 right? 215 00:13:19,380 --> 00:13:25,100 Yesterday, I had the privilege of being with a fantastic group of early career people who 216 00:13:25,100 --> 00:13:29,500 were really thinking critically about how they contribute to the academic mission. 217 00:13:29,500 --> 00:13:34,100 And when they talked about the things that they really love about academic medicine, 218 00:13:34,100 --> 00:13:38,060 they talked about things like, you know, the ability to really think about the patient 219 00:13:38,060 --> 00:13:40,460 problem and really help somebody. 220 00:13:40,460 --> 00:13:45,100 They talked about the ability to teach and really pass on to the next generation. 221 00:13:45,100 --> 00:13:49,160 They talked about the ability to do research and generate new knowledge. 222 00:13:49,160 --> 00:13:53,220 And they love that academic medicine gives you all these things that you can do. 223 00:13:53,220 --> 00:13:55,740 And oh my gosh, it was so beautiful listening to them. 224 00:13:55,740 --> 00:13:58,860 I was like, academic medicine is so beautiful. 225 00:13:58,860 --> 00:13:59,860 Yeah. 226 00:13:59,860 --> 00:14:03,140 But here's the challenge now. 227 00:14:03,140 --> 00:14:09,900 There is increasing pressure to generate clinical revenue with declining reimbursements. 228 00:14:09,900 --> 00:14:12,780 And so over time, people are going to be asked to do more. 229 00:14:12,780 --> 00:14:17,500 But over time too, the question is, well, how can we continue to provide care in a way 230 00:14:17,500 --> 00:14:19,180 that's not so expensive? 231 00:14:19,180 --> 00:14:24,180 And to some extent, physicians, though they're the most, you know, one of the biggest revenue 232 00:14:24,180 --> 00:14:28,740 generators in an academic medical center, also tend to cost a lot, right? 233 00:14:28,740 --> 00:14:31,300 Because the biggest cost to any environment is payroll. 234 00:14:31,300 --> 00:14:33,180 And to any business environment is payroll. 235 00:14:33,180 --> 00:14:35,940 You got to pay the people who are working for you. 236 00:14:35,940 --> 00:14:40,980 And so here's why it now becomes important. 237 00:14:40,980 --> 00:14:47,180 Number four is understand how your academic pursuits fit within the revenue generation 238 00:14:47,180 --> 00:14:48,180 model. 239 00:14:48,180 --> 00:14:49,180 OK. 240 00:14:49,180 --> 00:14:53,980 So now when I talked about how academic medical centers make money, I talk about the importance 241 00:14:53,980 --> 00:14:54,980 of GME. 242 00:14:54,980 --> 00:14:59,720 I talked about, you know, fees from medical schools and things like that. 243 00:14:59,720 --> 00:15:03,020 But remember, I told you that the most important is clinical. 244 00:15:03,020 --> 00:15:04,020 OK. 245 00:15:04,020 --> 00:15:07,740 Now, you come into an academic medical environment and you're like, well, you know, I want to 246 00:15:07,740 --> 00:15:10,140 see patients, but I don't want that to be all that I do. 247 00:15:10,140 --> 00:15:13,660 I want to be able to teach and I want to be able to do research. 248 00:15:13,660 --> 00:15:18,780 And then you've got to say, well, how is what I'm doing making money relative to my ability 249 00:15:18,780 --> 00:15:22,220 to generate revenue from seeing patients? 250 00:15:22,220 --> 00:15:26,540 That's an important consideration that while you may not be thinking about the math, somebody's 251 00:15:26,540 --> 00:15:28,000 thinking about the math. 252 00:15:28,000 --> 00:15:32,420 And they're looking at you saying, hmm, so this person is able to generate significant 253 00:15:32,420 --> 00:15:36,300 clinical revenue with their specialized degree. 254 00:15:36,300 --> 00:15:42,660 And they want instead to forego that revenue generation so they can do some academic stuff. 255 00:15:42,660 --> 00:15:43,660 OK. 256 00:15:43,660 --> 00:15:44,660 OK. 257 00:15:44,660 --> 00:15:45,660 All right. 258 00:15:45,660 --> 00:15:46,660 OK. 259 00:15:46,660 --> 00:15:48,300 Let's let's make the math work here. 260 00:15:48,300 --> 00:15:53,380 Who is going to have to work extra so that this person can be covered in the academic 261 00:15:53,380 --> 00:15:54,380 pursuits? 262 00:15:54,380 --> 00:15:58,700 I think it's a well, I'm going to bring in grant funding like, OK, OK, when are you going 263 00:15:58,700 --> 00:16:03,220 to bring in the grant funding that allows you to contribute to the profitability of 264 00:16:03,220 --> 00:16:05,740 the of the of the of the enterprise? 265 00:16:05,740 --> 00:16:07,620 When are you going to do that? 266 00:16:07,620 --> 00:16:14,540 When you think about it, it takes years, especially for a physician to be able to grow in their 267 00:16:14,540 --> 00:16:15,540 research skills. 268 00:16:15,540 --> 00:16:19,760 So in prior episodes, I've talked about the fact that your clinical training, as amazing 269 00:16:19,760 --> 00:16:21,620 as it is, is really clinical training. 270 00:16:21,620 --> 00:16:23,240 It's not research training. 271 00:16:23,240 --> 00:16:26,740 And if you as a physician say, well, I want to do research, it's like great. 272 00:16:26,740 --> 00:16:28,140 But you have no research skills. 273 00:16:28,140 --> 00:16:30,740 You don't have a significant amount of research skills. 274 00:16:30,740 --> 00:16:36,900 So now you're going to forego your clinical dollars to get the skill that, you know, to 275 00:16:36,900 --> 00:16:40,180 be honest, my PhD researchers already have. 276 00:16:40,180 --> 00:16:41,420 Right. 277 00:16:41,420 --> 00:16:48,220 And so when you are a physician saying I want protected time, and I'm on to number five, 278 00:16:48,220 --> 00:16:51,220 to understand what it means to request protected time. 279 00:16:51,220 --> 00:16:57,180 So when you as a physician say, I want protected time, it's like, oh, you too. 280 00:16:57,180 --> 00:17:00,380 How is it going to be funded? 281 00:17:00,380 --> 00:17:02,620 That's the question that people are asking. 282 00:17:02,620 --> 00:17:04,100 How is it going to be funded? 283 00:17:04,100 --> 00:17:06,600 Who's going to give you money for this protected time? 284 00:17:06,600 --> 00:17:11,280 Because here I thought you were coming in to use your specialized surgical skills to 285 00:17:11,280 --> 00:17:15,220 build my organization to help keep us profitable. 286 00:17:15,220 --> 00:17:19,100 Because hey, payroll every month is as high. 287 00:17:19,100 --> 00:17:23,500 Of course, certain salary is kind of, it's a little bit higher than we like to pay. 288 00:17:23,500 --> 00:17:27,380 But you're telling me that you're not going to generate the revenue that pays that salary. 289 00:17:27,380 --> 00:17:28,860 You want to do what? 290 00:17:28,860 --> 00:17:32,740 You're like, I won't protect the time because I want to do research. 291 00:17:32,740 --> 00:17:33,940 Like, okay. 292 00:17:33,940 --> 00:17:36,660 And how are you qualified to lead research? 293 00:17:36,660 --> 00:17:40,860 Like, well, you know, I did a fellowship, I did a year and a half of research. 294 00:17:40,860 --> 00:17:41,860 Okay. 295 00:17:41,860 --> 00:17:43,260 So I was asking how, right? 296 00:17:43,260 --> 00:17:48,200 Do you understand the conversations that are going on around physicians wanting to lead 297 00:17:48,200 --> 00:17:49,860 research, right? 298 00:17:49,860 --> 00:17:53,540 So when you say I want to request protected time, you're saying for the next three years 299 00:17:53,540 --> 00:17:57,220 or more, I want to focus just on the research. 300 00:17:57,220 --> 00:18:02,260 I don't want to generate this clinical revenue that actually really easily funds my position 301 00:18:02,260 --> 00:18:07,580 or actually becoming less easy to fund my position, but it's still funding my position. 302 00:18:07,580 --> 00:18:09,380 I would like to forgo all of that. 303 00:18:09,380 --> 00:18:13,660 And I would like to focus on research and oh, I don't really have research training. 304 00:18:13,660 --> 00:18:16,380 So I'd like to invest my time doing the research training. 305 00:18:16,380 --> 00:18:20,500 I'm not going to be able to bring in any significant research dollars for the first five, six, 306 00:18:20,500 --> 00:18:22,180 seven, maybe 10 years. 307 00:18:22,180 --> 00:18:24,960 I hope that's okay with you. 308 00:18:24,960 --> 00:18:30,340 So I want you to understand the challenge and it's a big deal. 309 00:18:30,340 --> 00:18:33,860 And once upon a time, you know, you could say, well, you know, to be honest, we're making 310 00:18:33,860 --> 00:18:36,220 a lot of money from this clinical revenue. 311 00:18:36,220 --> 00:18:39,260 Let's just use some of that money to fund the academic mission. 312 00:18:39,260 --> 00:18:41,740 And to a great extent, that's still what's happening. 313 00:18:41,740 --> 00:18:46,180 But again, remember I told you that the reimbursements are declining, the cost of care is going up. 314 00:18:46,180 --> 00:18:53,020 And so there is less and less margin for any medical dollars or clinical dollars to fund 315 00:18:53,020 --> 00:18:54,660 the academic mission. 316 00:18:54,660 --> 00:19:00,100 And so the person who comes in and now says, I want protected time, there has to be a good 317 00:19:00,100 --> 00:19:06,940 justification of how this person merits the protected time and is going to use that time 318 00:19:06,940 --> 00:19:08,700 and be successful. 319 00:19:08,700 --> 00:19:13,500 Because what you're asking your institution to do is to make an investment and they want 320 00:19:13,500 --> 00:19:15,180 to see a return on that investment. 321 00:19:15,180 --> 00:19:18,620 It's like, okay, okay, we're going to make the investment, right? 322 00:19:18,620 --> 00:19:21,860 Because when you come in and you're like, I want protected time, you're not just asking 323 00:19:21,860 --> 00:19:23,740 for protected time, you're asking for resources. 324 00:19:23,740 --> 00:19:25,740 You're asking for a startup package. 325 00:19:25,740 --> 00:19:28,460 And it's like, okay, I'm going to make this investment. 326 00:19:28,460 --> 00:19:31,860 I'm going to lose out on your clinical dollars because you are in this space where you're 327 00:19:31,860 --> 00:19:36,780 trying to do research and I want to recoup my investment. 328 00:19:36,780 --> 00:19:42,500 When they look over time and clinicians in general who haven't had a lot of research 329 00:19:42,500 --> 00:19:47,460 training are not able to start bringing in significant research dollars very quickly, 330 00:19:47,460 --> 00:19:48,460 right? 331 00:19:48,460 --> 00:19:52,700 It takes you time to grow in skill and you're a masterful person. 332 00:19:52,700 --> 00:19:56,900 You're going to grow in skill, but it'll take you time because it takes time to grow in 333 00:19:56,900 --> 00:19:57,980 skill. 334 00:19:57,980 --> 00:20:01,460 And all this while people are like, we're not seeing those dollars coming in for research 335 00:20:01,460 --> 00:20:02,460 funding. 336 00:20:02,460 --> 00:20:06,020 We're not seeing those dollars coming in for research funding, but what we're seeing is 337 00:20:06,020 --> 00:20:10,340 loss of clinical revenue because you're not in the clinical space. 338 00:20:10,340 --> 00:20:16,780 So I say all that to let you know that there are some real pressures happening in the background. 339 00:20:16,780 --> 00:20:19,820 They may not be going on in your mind, but there are people crunching the numbers who 340 00:20:19,820 --> 00:20:25,600 are saying, where is this funding going to come from for this person who wants to spend 341 00:20:25,600 --> 00:20:28,980 a significant portion of time not generating clinical revenue? 342 00:20:28,980 --> 00:20:31,860 And you might be like, oh, I'm going to teach the fellows. 343 00:20:31,860 --> 00:20:37,120 There's a fixed pot of money that's coming in from GME and that pot of money does not 344 00:20:37,120 --> 00:20:38,820 make up for your clinical dollars. 345 00:20:38,820 --> 00:20:44,020 And so there is a real pressure and a real conflict of interest to support physicians 346 00:20:44,020 --> 00:20:49,180 in leading research programs, especially when they come in and they don't have the training. 347 00:20:49,180 --> 00:20:51,820 So I want it to be very explicit to you. 348 00:20:51,820 --> 00:20:57,980 So you recognize the currents that you are swimming against when you enter into the academic 349 00:20:57,980 --> 00:21:04,440 medical enterprise, or you recognize that it makes less and less sense for a physician 350 00:21:04,440 --> 00:21:10,660 who can generate significant clinical revenue to come in and spend all that time doing something 351 00:21:10,660 --> 00:21:16,860 that's largely unfunded by that person, at least for a fixed period of time. 352 00:21:16,860 --> 00:21:17,860 Okay. 353 00:21:17,860 --> 00:21:22,620 That brings me to number six, because I think all of that before now, to some extent, it's 354 00:21:22,620 --> 00:21:25,580 the good and the bad news because you want to know. 355 00:21:25,580 --> 00:21:27,740 You don't want to be naive like I was. 356 00:21:27,740 --> 00:21:31,140 This is why I'm here, because I don't want you to be like me and I don't want you to 357 00:21:31,140 --> 00:21:35,300 show up and be shocked when people were so shocked yesterday, which is why I was like, 358 00:21:35,300 --> 00:21:38,660 this has got to be an episode that I share with the rest of the community that wasn't 359 00:21:38,660 --> 00:21:39,660 there yesterday. 360 00:21:39,660 --> 00:21:44,980 And with you, my audience who I hope, well, maybe now you already know, or maybe if you 361 00:21:44,980 --> 00:21:52,140 didn't know, you know now, but it's important to recognize the reality of what's happening 362 00:21:52,140 --> 00:21:55,140 in academic medical centers. 363 00:21:55,140 --> 00:21:59,140 So the good news is that now you have this information. 364 00:21:59,140 --> 00:22:00,720 Number six is pertinent to you. 365 00:22:00,720 --> 00:22:03,020 Don't start an academic job until you're ready. 366 00:22:03,020 --> 00:22:04,020 Don't. 367 00:22:04,020 --> 00:22:06,180 Now here's the pressure that a lot of people feel. 368 00:22:06,180 --> 00:22:09,460 They're like, did you understand how much I owe in student loans? 369 00:22:09,460 --> 00:22:11,420 Do you understand how much I owe? 370 00:22:11,420 --> 00:22:12,420 And I get it. 371 00:22:12,420 --> 00:22:15,020 What you're saying is that you're feeling financial pressure. 372 00:22:15,020 --> 00:22:20,020 I want you to think about separating your financial pressure from your academic career. 373 00:22:20,020 --> 00:22:21,020 Separate the two. 374 00:22:21,020 --> 00:22:22,020 What do I mean by that? 375 00:22:22,020 --> 00:22:26,980 I'm saying, well, if your problem is revenue, then go do locums or something. 376 00:22:26,980 --> 00:22:28,800 Go moonlight. 377 00:22:28,800 --> 00:22:33,740 Go do something that generates the revenue for you, but that still leaves you time to 378 00:22:33,740 --> 00:22:36,540 really build an academic portfolio. 379 00:22:36,540 --> 00:22:38,660 Don't say I'm desperate for clinical dollars. 380 00:22:38,660 --> 00:22:40,220 I'm desperate for money. 381 00:22:40,220 --> 00:22:42,500 So I'm just going to take a job and just whatever. 382 00:22:42,500 --> 00:22:47,180 We'll just let whatever will be will be because it doesn't have to be that way. 383 00:22:47,180 --> 00:22:51,020 Again, I'm not saying that you shouldn't take the academic job, but I'm saying that if you 384 00:22:51,020 --> 00:22:55,380 understand the pressures of an academic medical institution, you recognize that if you're 385 00:22:55,380 --> 00:23:00,140 going to come to the table in your negotiations and you're going to say, I want protected 386 00:23:00,140 --> 00:23:06,060 time, you've got to show up as a candidate who is ready for that investment. 387 00:23:06,060 --> 00:23:09,480 You can't be like, well, I'm going to figure it out in three years because institutions 388 00:23:09,480 --> 00:23:11,420 don't have three years for you to figure it out. 389 00:23:11,420 --> 00:23:16,020 And at the end of it, you're kind of like right back where you were at the beginning, 390 00:23:16,020 --> 00:23:21,220 only now they've invested a couple of hundred thousand dollars to figure that out. 391 00:23:21,220 --> 00:23:25,500 So understand that people now are very selective in who they're investing in. 392 00:23:25,500 --> 00:23:27,540 Yes, there's disparities in that process. 393 00:23:27,540 --> 00:23:29,740 There's bias in that process. 394 00:23:29,740 --> 00:23:34,940 But if you're going to be the candidate that shows up at the door saying, I want protected 395 00:23:34,940 --> 00:23:38,540 time because I want to lead a research program, then you got to show up ready. 396 00:23:38,540 --> 00:23:39,740 And what does that mean? 397 00:23:39,740 --> 00:23:42,340 You've got to show up with publications. 398 00:23:42,340 --> 00:23:47,140 And publications now are the currency of academic medicine. 399 00:23:47,140 --> 00:23:50,020 And it's not really publications or the sign really. 400 00:23:50,020 --> 00:23:57,180 They're just the evidence of the value you've created in research or in scholarship in general. 401 00:23:57,180 --> 00:24:00,660 Sometimes people spend three years doing a research project that doesn't result in a 402 00:24:00,660 --> 00:24:01,660 publication. 403 00:24:01,660 --> 00:24:03,820 Does it mean that you didn't learn or that that time was wasted? 404 00:24:03,820 --> 00:24:04,820 It doesn't. 405 00:24:04,820 --> 00:24:07,500 But publications are one way of saying, I did it. 406 00:24:07,500 --> 00:24:08,500 I did it. 407 00:24:08,500 --> 00:24:10,500 And here's the evidence. 408 00:24:10,500 --> 00:24:12,320 And then grant funding too. 409 00:24:12,320 --> 00:24:19,060 It's like, oh, I'm not just coming and saying, hey, give me money or I'm hopeful or wishful 410 00:24:19,060 --> 00:24:21,860 that in the future I'll be able to get grants. 411 00:24:21,860 --> 00:24:25,640 When you come in and you've already had experience applying for grants and maybe even have one 412 00:24:25,640 --> 00:24:28,300 or two grants, you can say, I know how to do this. 413 00:24:28,300 --> 00:24:30,100 I've done this before. 414 00:24:30,100 --> 00:24:33,740 And I'm going to continue to grow in skill, but I already know what it takes. 415 00:24:33,740 --> 00:24:38,700 So what you want to do is you want to come to the table. 416 00:24:38,700 --> 00:24:40,820 You want to come strategically. 417 00:24:40,820 --> 00:24:42,220 So that's number seven. 418 00:24:42,220 --> 00:24:44,580 Prepare yourself strategically. 419 00:24:44,580 --> 00:24:47,180 Don't just show up at the door like I did. 420 00:24:47,180 --> 00:24:52,220 And this is, again, I think I'm so grateful for my younger self and for how naive she 421 00:24:52,220 --> 00:24:58,580 was because here I am now sharing with you so that you don't have to be naive like me. 422 00:24:58,580 --> 00:25:02,780 Don't just show up at the door and say, hey, I want the protected time. 423 00:25:02,780 --> 00:25:06,420 People who are counting the money in the background, they can start laughing. 424 00:25:06,420 --> 00:25:09,820 They're like, ha, ha, ha, ha, ha, ha, ha. 425 00:25:09,820 --> 00:25:10,820 No. 426 00:25:10,820 --> 00:25:16,980 And then the people who really want you to succeed as a researcher or succeed as a scholar, 427 00:25:16,980 --> 00:25:18,760 they want to make a case for you. 428 00:25:18,760 --> 00:25:25,260 But then they are like, well, you know, this person only has a clinical background. 429 00:25:25,260 --> 00:25:28,700 This person has demonstrated prowess in clinical things. 430 00:25:28,700 --> 00:25:31,580 I see no evidence that this person has scholarship. 431 00:25:31,580 --> 00:25:34,260 There's no real track record of scholarship. 432 00:25:34,260 --> 00:25:40,180 How do you ask that person to go make a case for you with the bean counters as to how you're 433 00:25:40,180 --> 00:25:46,820 going to succeed as a scholar if they don't have anything to go by? 434 00:25:46,820 --> 00:25:48,900 And if they ask you like, OK, so what do you want to do? 435 00:25:48,900 --> 00:25:50,940 And you're like, I just want to do research. 436 00:25:50,940 --> 00:25:51,940 What do you want to do? 437 00:25:51,940 --> 00:25:52,940 I just want to do research. 438 00:25:52,940 --> 00:25:53,940 What's your goal? 439 00:25:53,940 --> 00:25:54,940 And you're not specific. 440 00:25:54,940 --> 00:25:56,620 You have no clarity. 441 00:25:56,620 --> 00:26:00,660 You can't show a record of having done the work over time. 442 00:26:00,660 --> 00:26:03,900 It just makes your case not very strong. 443 00:26:03,900 --> 00:26:05,740 And what does a strong case look like? 444 00:26:05,740 --> 00:26:10,700 So now I interview faculty who come through our division and people will just show up 445 00:26:10,700 --> 00:26:12,300 and say, yeah, I want to do research. 446 00:26:12,300 --> 00:26:15,820 OK, how much of your time do you envision doing research? 447 00:26:15,820 --> 00:26:21,180 And somebody who's barely had any research training said, you know, I like research, 448 00:26:21,180 --> 00:26:22,660 but I like patient care. 449 00:26:22,660 --> 00:26:26,860 So I was thinking maybe 25% of my time, maybe 50%. 450 00:26:26,860 --> 00:26:30,220 And those of us who know are like, this person doesn't know. 451 00:26:30,220 --> 00:26:33,420 Because 25% patient care is kind of like 50%. 452 00:26:33,420 --> 00:26:37,060 50% patient care is kind of like 80%. 453 00:26:37,060 --> 00:26:40,260 And 60% to 70% patient care is really like 100%. 454 00:26:40,260 --> 00:26:43,500 Actually, to be honest, 50% is really like 100%. 455 00:26:43,500 --> 00:26:45,500 But I'm trying to be conservative here. 456 00:26:45,500 --> 00:26:46,620 But you understand what I'm saying. 457 00:26:46,620 --> 00:26:51,020 So when someone who's never done any research, who's not had any significant research training 458 00:26:51,020 --> 00:26:55,980 shows up at the door and says, I have a lot to learn, but I'd like to do it in 25% of 459 00:26:55,980 --> 00:26:59,620 my time, we know that that person doesn't understand what they're getting themselves 460 00:26:59,620 --> 00:27:00,620 into. 461 00:27:00,620 --> 00:27:04,140 And clearly, they don't know what it takes to succeed as a researcher, because research 462 00:27:04,140 --> 00:27:05,140 is a full time job. 463 00:27:05,140 --> 00:27:11,980 And when somebody says 75%, that's not even really enough, because you really need 100% 464 00:27:11,980 --> 00:27:15,660 to be able to understand, to really learn, to learn the skills, and then later on, you 465 00:27:15,660 --> 00:27:17,100 can cut back. 466 00:27:17,100 --> 00:27:19,860 But you need a lot upfront. 467 00:27:19,860 --> 00:27:24,540 And so when you are coming to your academic job, and you're asking for that time, be clear 468 00:27:24,540 --> 00:27:25,740 what you need. 469 00:27:25,740 --> 00:27:27,820 Be clear what it's going to give you. 470 00:27:27,820 --> 00:27:32,700 And be very specific as to how you see your career unfolding. 471 00:27:32,700 --> 00:27:37,820 If you are not clear as to how your research career unfolds, you cannot convince anybody 472 00:27:37,820 --> 00:27:38,820 else. 473 00:27:38,820 --> 00:27:43,620 That's what you're going to fall into the pot of people who are going to generate clinical 474 00:27:43,620 --> 00:27:45,700 revenue for the institution. 475 00:27:45,700 --> 00:27:48,260 And it's not a bad thing to generate clinical revenue. 476 00:27:48,260 --> 00:27:50,060 Again, it's a great service. 477 00:27:50,060 --> 00:27:54,420 The institution runs on clinical revenue, but you're not going to achieve your academic 478 00:27:54,420 --> 00:27:55,420 pursuits. 479 00:27:55,420 --> 00:27:59,660 And for many of you, you're coming to academic medicine, not just so you can see patients, 480 00:27:59,660 --> 00:28:04,540 you're coming so you can satisfy that part of you that wants to build the legacy through 481 00:28:04,540 --> 00:28:08,340 education, that wants to contribute through research. 482 00:28:08,340 --> 00:28:10,500 And so if that's what you want to do, then you got to be prepared. 483 00:28:10,500 --> 00:28:11,900 You got to be prepared. 484 00:28:11,900 --> 00:28:13,260 You got to be prepared. 485 00:28:13,260 --> 00:28:14,940 You got to be prepared. 486 00:28:14,940 --> 00:28:15,940 All right. 487 00:28:15,940 --> 00:28:18,180 I hope this has not been bad news. 488 00:28:18,180 --> 00:28:24,340 And even though, even as I say it, I recognize that to some extent, it's an eye-opening conversation, 489 00:28:24,340 --> 00:28:26,460 one that I want to have with as many people as possible. 490 00:28:26,460 --> 00:28:29,660 And for that reason, I want to invite you to please share this episode. 491 00:28:29,660 --> 00:28:34,640 Please, please, please, if you share no other episode on this podcast, I want you to share 492 00:28:34,640 --> 00:28:35,640 this episode. 493 00:28:35,640 --> 00:28:38,060 Because people need to know. 494 00:28:38,060 --> 00:28:43,700 There need to be fewer people showing up wide-eyed and bushy-tailed like a dare stuck in the 495 00:28:43,700 --> 00:28:46,540 headlights like I was saying, I want to do research. 496 00:28:46,540 --> 00:28:48,460 I have no idea exactly what research I want to do. 497 00:28:48,460 --> 00:28:51,100 I have no real significant research training. 498 00:28:51,100 --> 00:28:55,380 And yes, I don't want to do the clinical time that you say I should do. 499 00:28:55,380 --> 00:28:57,700 And in reality, it's not realistic. 500 00:28:57,700 --> 00:29:01,700 But when somebody shows up at the door and they're like, yeah, I've been doing research. 501 00:29:01,700 --> 00:29:05,780 I've published these number of papers and I've been focused in this area. 502 00:29:05,780 --> 00:29:10,260 And in the next three years, I'm going to build this portfolio in this specific area. 503 00:29:10,260 --> 00:29:12,380 And then I'm going to apply for funding. 504 00:29:12,380 --> 00:29:14,820 That's a different experience. 505 00:29:14,820 --> 00:29:16,820 That's someone who's very clear. 506 00:29:16,820 --> 00:29:21,420 That's somebody who I can see this because they're telling it to me in a way that's very 507 00:29:21,420 --> 00:29:22,420 clear. 508 00:29:22,420 --> 00:29:26,140 And so really, this episode is not to bring you bad news. 509 00:29:26,140 --> 00:29:28,340 It's to help you be strategic. 510 00:29:28,340 --> 00:29:31,700 It's to help you prepare to be strategic. 511 00:29:31,700 --> 00:29:34,820 It's to help you prepare to show up and get the job you actually want. 512 00:29:34,820 --> 00:29:40,380 And be able to craft the job that you actually want. 513 00:29:40,380 --> 00:29:42,300 As always, I'm here to help you. 514 00:29:42,300 --> 00:29:43,660 I do coach. 515 00:29:43,660 --> 00:29:50,140 And I would love to help you craft your strategic plan as you move forward into your research 516 00:29:50,140 --> 00:29:51,140 career. 517 00:29:51,140 --> 00:29:55,860 And I will tell you that if you are a fellow or you are still in training, you can come 518 00:29:55,860 --> 00:29:58,580 to my coaching sessions on Mondays. 519 00:29:58,580 --> 00:30:01,620 And they are free to fellows, free to trainees. 520 00:30:01,620 --> 00:30:07,900 And just send me an instant message through or direct message through LinkedIn. 521 00:30:07,900 --> 00:30:12,140 And I will give you information about registering for these sessions. 522 00:30:12,140 --> 00:30:16,740 But I really want to help you because I don't want anybody to end up struggling in the way 523 00:30:16,740 --> 00:30:17,740 that I did. 524 00:30:17,740 --> 00:30:20,580 And maybe struggle is good for you, but people quit. 525 00:30:20,580 --> 00:30:22,780 People quit because it's so hard. 526 00:30:22,780 --> 00:30:26,620 And even when you have everything, all your docs in a row, it's still hard. 527 00:30:26,620 --> 00:30:30,060 And you can make it because you have already made it. 528 00:30:30,060 --> 00:30:32,260 You've shown yourself to be someone who can succeed. 529 00:30:32,260 --> 00:30:33,260 All right. 530 00:30:33,260 --> 00:30:34,260 Let's summarize those seven steps. 531 00:30:34,260 --> 00:30:37,020 Number one, recognize that academic medicine is a business. 532 00:30:37,020 --> 00:30:40,420 Number two, understand how academic medical centers make money. 533 00:30:40,420 --> 00:30:45,740 Number three, recognize your role in the business making, in the money making for the business. 534 00:30:45,740 --> 00:30:50,220 Number four, understand how your academic pursuits fit within the revenue generation 535 00:30:50,220 --> 00:30:51,220 model. 536 00:30:51,220 --> 00:30:55,100 Number five, understand what it means to the business system for you to request protective 537 00:30:55,100 --> 00:30:56,100 time. 538 00:30:56,100 --> 00:30:58,940 Number six, don't start an academic job before you're ready. 539 00:30:58,940 --> 00:31:01,620 And number seven, prepare yourself strategically. 540 00:31:01,620 --> 00:31:03,380 All right. 541 00:31:03,380 --> 00:31:07,860 Next time on this podcast, I'm going to talk about what it means to be prepared strategically. 542 00:31:07,860 --> 00:31:11,340 So I hope you'll join us and share this episode widely. 543 00:31:11,340 --> 00:31:17,140 I look forward to talking with you again next time on the Clinician Researcher Podcast. 544 00:31:17,140 --> 00:31:24,100 Thank you for listening. 545 00:31:24,100 --> 00:31:29,460 Thanks for listening to this episode of the Clinician Researcher Podcast, where academic 546 00:31:29,460 --> 00:31:34,900 clinicians learn the skills to build their own research program, whether or not they 547 00:31:34,900 --> 00:31:36,260 have a mentor. 548 00:31:36,260 --> 00:31:42,360 If you found the information in this episode to be helpful, don't keep it all to yourself. 549 00:31:42,360 --> 00:31:44,100 Someone else needs to hear it. 550 00:31:44,100 --> 00:31:48,140 So take a minute right now and share it. 551 00:31:48,140 --> 00:31:53,620 As you share this episode, you become part of our mission to help launch a new generation 552 00:31:53,620 --> 00:31:59,260 of clinician researchers who make transformative discoveries that change the way we do health 553 00:31:59,260 --> 00:32:27,180 care.