This resonates! The traditional model with high volume, low autonomy, limited time, limited creativity is burning physicians out and not serving patients either. Leaving it was the scariest professional decision I've made. It was also the best.
Having the autonomy to practice the way I believe medicine should be practiced, to spend real time with patients, to build something that reflects my values... that's what brought me back to why I went into medicine in the first place.
Thank you for sharing this - this is the response and story I hoped this piece would create. Autonomy, real time with patients, & a practice that reflects your values - kudos to you!
It actually sounds less like leaving medicine and more like redesigning the container it happens in, which is its own version of the same idea - the practice itself, built on purpose instead of inherited. A portfolio can get built around an anchor like that too.
I’m curious what the new structure looks like day to day for you, if you're open to sharing? (conceirge, DPC, other…?)
I still practice clinical medicine and that's really the core and always will be... seeing patients, managing chronic conditions, doing the longitudinal care I've always believed in. The difference is the model: digital-first, with more time and more continuity than a traditional clinic allowed.
Alongside that, I get to contribute to leadership and innovation in ways that weren't possible before. And I love writing about all of it here. The combination has made me a better physician and a more complete version of myself professionally.
This is it, exactly! - the anchor still fully intact (the longitudinal care you clearly love), with leadership, innovation, and writing built around it rather than in place of it. That combination adding up to "a more complete version of myself professionally" is about as solid a description of a portfolio physician career as I could ask for.
Digital-first with more time and continuity for patients sounds like a great model, and I'll be checking out The Practice of Longevity. Thanks for sharing this, and great to e-meet a fellow portfolio physician!
Love this framing. Worth flagging that exclusivity clauses in a lot of physician contracts can rule this out before it even starts, so that’s worth checking closely before building toward it.
Thanks, I’m glad you appreciated this framework! Yes, it’s important to make sure employer compliance documents / contracts are reviewed thoroughly, to make sure you know all your options.
I really enjoyed this article. It is deep and covers a lot of topics and ground. I think every medical and surgical resident should read it in the middle of their training with the fast changing worlds of reimbursement and consumer preferences (and needs?) for healthcare. I really had no idea what I was doing over the last year but I am becoming a Portfolio Physician. I believe everyone should and honestly I'd recommend all medical professionals - Nurses, APPs, Exercise Physiologists, our amazing Technologists across the various specialties (Cath Lab, Echo, Nuclear, CT, MRI most specific to Cardiology) should consider their roles and how they can increase their value through diversification. I look forward to reading and learning more from you Scott. Great read.
Jake, thank you so much for the thoughtful comments, and for reading my article. I really appreciate that it resonated with you, and I certainly agree that you are the embodiment of a Portfolio Physician! The earlier physicians (and even other allied healthcare professionals) can be exposed to these ideas and concepts, the better off they’ll be to make up their own minds with how they want their careers to progress. And if they feel like implementing some of these things, the earlier on in their journey they do it, the more time there is for compounding and for all of these things to work synergistically together. I wish I had even started sooner with a lot of these things that I have, but I'm glad at least that in my 40s I'm able to really turn that flywheel. Thank you also for all the work that you're doing and look forward to keeping up with your body of work as well!
Hi! Thanks for your note. I think the VA can offer excellent opportunities. I don’t have first hand experience with them, but from what I’ve heard, they have a more lifestyle friendly practice environment compared to some others out there, and some flexibility in scheduling as well. This way, the physician could practice clinically there, while still having time for other portfolio pursuits. Happy to hear your thoughts as well!
This resonates! The traditional model with high volume, low autonomy, limited time, limited creativity is burning physicians out and not serving patients either. Leaving it was the scariest professional decision I've made. It was also the best.
Having the autonomy to practice the way I believe medicine should be practiced, to spend real time with patients, to build something that reflects my values... that's what brought me back to why I went into medicine in the first place.
This is the future. Thank you for encouraging it!
Thank you for sharing this - this is the response and story I hoped this piece would create. Autonomy, real time with patients, & a practice that reflects your values - kudos to you!
It actually sounds less like leaving medicine and more like redesigning the container it happens in, which is its own version of the same idea - the practice itself, built on purpose instead of inherited. A portfolio can get built around an anchor like that too.
I’m curious what the new structure looks like day to day for you, if you're open to sharing? (conceirge, DPC, other…?)
I still practice clinical medicine and that's really the core and always will be... seeing patients, managing chronic conditions, doing the longitudinal care I've always believed in. The difference is the model: digital-first, with more time and more continuity than a traditional clinic allowed.
Alongside that, I get to contribute to leadership and innovation in ways that weren't possible before. And I love writing about all of it here. The combination has made me a better physician and a more complete version of myself professionally.
This is it, exactly! - the anchor still fully intact (the longitudinal care you clearly love), with leadership, innovation, and writing built around it rather than in place of it. That combination adding up to "a more complete version of myself professionally" is about as solid a description of a portfolio physician career as I could ask for.
Digital-first with more time and continuity for patients sounds like a great model, and I'll be checking out The Practice of Longevity. Thanks for sharing this, and great to e-meet a fellow portfolio physician!
Love this framing. Worth flagging that exclusivity clauses in a lot of physician contracts can rule this out before it even starts, so that’s worth checking closely before building toward it.
Thanks, I’m glad you appreciated this framework! Yes, it’s important to make sure employer compliance documents / contracts are reviewed thoroughly, to make sure you know all your options.
I really enjoyed this article. It is deep and covers a lot of topics and ground. I think every medical and surgical resident should read it in the middle of their training with the fast changing worlds of reimbursement and consumer preferences (and needs?) for healthcare. I really had no idea what I was doing over the last year but I am becoming a Portfolio Physician. I believe everyone should and honestly I'd recommend all medical professionals - Nurses, APPs, Exercise Physiologists, our amazing Technologists across the various specialties (Cath Lab, Echo, Nuclear, CT, MRI most specific to Cardiology) should consider their roles and how they can increase their value through diversification. I look forward to reading and learning more from you Scott. Great read.
Jake, thank you so much for the thoughtful comments, and for reading my article. I really appreciate that it resonated with you, and I certainly agree that you are the embodiment of a Portfolio Physician! The earlier physicians (and even other allied healthcare professionals) can be exposed to these ideas and concepts, the better off they’ll be to make up their own minds with how they want their careers to progress. And if they feel like implementing some of these things, the earlier on in their journey they do it, the more time there is for compounding and for all of these things to work synergistically together. I wish I had even started sooner with a lot of these things that I have, but I'm glad at least that in my 40s I'm able to really turn that flywheel. Thank you also for all the work that you're doing and look forward to keeping up with your body of work as well!
Fascinating! As a former exec at VA, I would love to know what role you feel VA opportunities can offer the Portfolio Physician.
Hi! Thanks for your note. I think the VA can offer excellent opportunities. I don’t have first hand experience with them, but from what I’ve heard, they have a more lifestyle friendly practice environment compared to some others out there, and some flexibility in scheduling as well. This way, the physician could practice clinically there, while still having time for other portfolio pursuits. Happy to hear your thoughts as well!