In 1961, the medical sociologist Anselm Strauss published his seminal study, “The Boys in White,” about how the treatment of medical students affects their characters and behaviors.
In 1956 and 1957, at the University of Kansas Medical School, the authors “lived, ate, and, figuratively speaking, slept with medical students.” The process of socialization strives to reinforce traits that serve physicians in practicing medicine. Through medical school and residency, trainees are forced to make decisions with limited data, within a limited timeframe, with limited assistance, because that’s what happens in real life.
According to Edwin Harari, consultant psychiatrist in Victoria, Australia, physicians possess traits that may adversely affect their social function. The training process often fortifies behaviors that are adaptive in a medical practice, but are dysfunctional in other settings. These include:
• Obsessional traits
• Self doubt
• Excessive fear of failure
• Excessive fear of making a mistake
• Exaggerated sense of responsibility
(I think I have all of the above. I still obsess about every missed diagnosis, every time I was curt or rude with staff or patients, every negative encounter during my practice years.)
These traits do not exactly prepare physicians to work in industry, where we often work in teams. The work is not “hands on” with lab work and clinical studies commonly done by offsite contract organizations. You review adverse events, but you do not participate in the management of complications during clinical trials. In many ways, you become a watcher, not a doer.
I moved from being in solo practice to working at a pharmaceutical company with 40,500 employees. In clinical practice, I made every decision from what color to paint the office walls to what stamps we put on the mail (breast cancer stamp, of course). The transition was particularly tough because I was a surgeon (though surgeons might challenge the title being appropriated by a gynecologist). In the operating room, there is one person in charge. I was an absolute despot; I was czarina. I also did obstetrics, which is hours of boredom (aka labor) punctuated by moments of sheer terror (loss of fetal heart tones, profuse hemorrhage, massive lacerations). You have to make decisions and you have to make them fast and, most times, alone. Almost all the successes and failures were mine to claim.
Hiring physicians is a risky business for pharma companies. Many MDs cannot make the transition and very soon leave industry with bitter regrets. Life in big pharma can be a real shocker. After being my own boss for two decades, I moved into a 6 x 6 cubical in a large shared workspace. Everything was done electronically: training documents, compliance manuals, and FDA filings. I spent my day at monitor and keyboard or sitting in a conference room. Sometimes, the day seemed to be an endless succession of meetings to develop “consensus” (or what marketing calls “buy in”). In my practice, I was on the move all day — rounds, office, OR, DR, office and round and round. I rarely sat down. I found sitting in a chair for hours at a time almost oppressive.
I felt disoriented. I went from the top of my game as a doc, to being a fledging in pharma. There was so much to learn. So, I tried to use all that meeting time to learn the ropes and to see how people interacted. There were, if I paid attention, constant lessons in how to draw people out, how to hold attention, how to build confidence, how to be respectful, and how to give feedback.
Have any of you Docs that transferred into Industry had similar experiences?