The Drop-Out Doc: Why Not Residency?

Instead of pursuing residency after medical school, James Dickhoner co-founded the digital health startup Orderly Health.

It might surprise many to hear medicine referred to as the most miserable career. A recent survey found 9 out of 10 physicians wouldn’t recommend it to a friend. And after surviving medical school, I’m not sure I would either. Taking care of patients is an amazing privilege, but nearly everything else about the profession is a nightmare.

In a revealing interview with Malcolm Gladwell on the topic of what it’s really like to be a physician, the author of Outliers insists that “most doctors (particularly those in individual and small practices) lament… the business of healthcare,” and asks why we “train someone for all of those years of medical school and residency… and then have them run a claims processing operation for insurance companies.”

Having experienced these exact frustrations firsthand throughout my four years of medical school, I ultimately (after lots of internal debate) decided to pass on residency. Instead of pursuing years of clinical training and hoping to catalyze change from the inside, I opted to be an outsider and start a tech company – and thus became a “dropout doc,” a term created to describe people like me.

I have heard the refrain from the dean’s office and senior physicians that I wasted my training, that I took a spot from someone who wanted to take care of patients, that I am a quitter.

I know that others who have taken a similar path have heard these same barbs. But those criticisms are misguided. When someone suggests that my work at Orderly Health is not about putting patients first, sacrificing personal short-term gains and making a difference, I can only shrug my shoulders.

“They just don’t get it,” I have to remind myself.

Software connects the world in a way that was inconceivable a few decades ago. Almost fifteen percent of the world will log onto Facebook with a cell phone today. Twitter catalyzes revolutions. And we use Google to “hangout” with people half a world away.

The software we use daily has changed our lives, and technology is going to change healthcare!

Armed with this worldview, I had to take my chance to speak up as health care is redefined in the 21st century. One major reason that being a physician became the most miserable profession in America is because the majority of doctors were unwilling or unable to communicate their perspective as healthcare evolved.

And I, along with many of my fellow “dropout docs”, will loudly communicate that viewpoint, to the benefit of both patient and provider, through the vehicle of startups.

I am currently eight months into the transition from academia to entrepreneurship. It has been every bit as challenging as medical school. I struggle with the same self-doubt and terror that seemingly every founder feels.

Thankfully, I have been supported by an amazing network. My mentors encouraged the exploration of leaving clinical medicine. My family provided understanding. The Ignite program at the Stanford GSB gave validation. And my kick-ass cofounder has made it a possibility.

Going forward, I plan to continue to write periodic blog posts about my journey away from clinical medicine and into the world of technology startups. My goal is to provide another perspective on the entrepreneurial journey of a ‘dropout doc’.

Reach out to me @Dickhoner_MD on twitter or via email at james@orderlyhealth.com to continue the conversation in the interim.

 

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