Occasionally, someone asks me about my career path (a jumpy one) and in general, I'm happy to share some of the key surprises and decisions here.
Short Form
I did an MD-PhD, planning to be a med school professor. I stayed with that til about 2000, in the last couple years I got interested in management and took MBA classes. In 2001, I jumped from academics to strategy consulting (with a global firm, Accenture). A head hunter called me about a regional Medicare job, which I did from 2004-2008. Since then, I've been in policy consulting to companies with innovative technology and CMS policy issues. The major part of my career 2001-2023 has taken me from age 43 to 65.
Long Form
College & Med School
In college, 1978-1982, I was interested in neuroscience, at the time having almost a double major in biology and psychology. It was a dilemma for me to apply for PhD programs alone, or MD-PhD programs. I probably decided if I started an MD-PhD, I could if needed cut back to one of the pair. I did MD-PhD at Stanford 1982-1988, focusing on peptide chemistry and on the then-new neuroanatomy of opioid pathways. I had two PhD advisors. Dr. Jack Barchas is a psychiatrist who was running a large neuroscience lab at Stanford Medical School. He went on to an associate dean position at UCLA, and the chair position in Psychiatry at Cornell. Dr. Eckard Weber was an MD with a full-time science career, and went on to a successful career in biotech startups and as a venture capital partner.
Postdoc and Residency
Finishing grad school, I now debated about whether to do a residency, and if so, in psychiatry, neurology, or neuropathology. I took a postdoc in neuroscience at MIT, 1989-1990, with Prof. Ann Graybiel, during which I settled on neuropathology.
I did my medical residency in pathology at UCLA, 1990-1994, beginning a lifelong love of the city of Los Angeles. My clinical mentor was Dr. Harry Vinters, and I did research in the neuroimaging lab of Prof. Art Toga. They let us do 3 months away from UCLA, and I did one month at Queen's Square in London, and two months in an Alzheimer lab at Albert Einstein in the Bronx.
Faculty Jobs
I had several faculty job interviews in 1994, taking a tenure-track job at NYU in the Pathology department. Working with their Alzheimer center, I later was given a co-appointment in Psychiatry as well. In 1997, I moved to a different faculty job which offered some advantages, at Northwestern University in Chicago.
I was interested in how hospital management worked at NYU and at Bellevue City Hospital, and I took two night school classes in management at NY City College. (One was in general management, one was an intro to healthcare management.)
Department management also intrigued me at Northwestern, and my wife was chief of staff to the med school dean, giving me some visibility to that area. I thought it might be helpful to take a few night school MBA classes at Northwestern, and to my surprise, I actually finished the whole MBA by June 2021. (You might see a parallel to my testing the waters by starting an MD-PhD program, and then finishing the whole thing.)
Consulting and Medicare
Accenture. I got interesting in a field unknown to me, strategy consulting. In Spring 2001, I interviewed with Bain, McKinsey, and Accenture, and got a job offer with Accenture in pharma consulting. I made the big leap to give up a medical school position and start my career over in consulting. (One fact was that it was a lateral salary move that year, but consulting salaries and rank could double in a few years.) For the next several years, I was often on site at a pharma from Monday to Thursday, such as BMS in Princeton or Genentech in San Francisco.
On a personal note, I got married in 1997 and as we lived in Chicago, our daughters were born in 2000 and 2002. In 2003, we moved to a house in mid-city Los Angeles, where we still live. Our daughters grew up and one finished college in Boston, the other will graduate in 2024 in NYC.
Medicare. In 2004, just a few years into my Accenture career, I got a cold call to interview for a senior Medicare job for the state of California. To my surprise, when I interviewed in person, I was offered a job within a few hours. So I had the role of California's Part B medical director from 2004-2008. The office, with several hundred employees, was a few miles from home, in downtown LA.
Foley Hoag LLP and Faegre Baker Daniels LLP. In 2008, my company's Medicare contract was not renewed. I was offered a full time in house consultant position at Foley Hoag LLP, a Boston- and DC-based law firm with a top-end Medicare policy practice. Policy means you are negotiating with CMS over rules and implementations - you are never, for example, suing the agency. Foley Hoag was a stellar place to work - I was not only the only remote employee (from Los Angeles), but one of only 2 or 3 non-attorney executives staffed along with their 300 attorneys. I worked for Foley Hoag from 2008-2015. A couple competitive job offers came my way, and I worked in the health policy group of Faegre Baker Daniels in 2015-2016.
Solo Practice. In 2016, I found my practice was tilting more to my own work (like writing my own research memos for client problems) and I set up my own business as an LLC.
California North and South. From 2015, with Faegre, to 2020, under COVID, I had an SF office and worked from their 5-10 days every month.
Overall? Where I ended up? Overall, I've been very happy running a busy one-man consulting service from 2016 to the present. I run a busy blog on Medicare policy and diagnostics ("Discoveries in Health Policy") and enjoy giving-back also by speaking every quarter or so at conferences and writing a trade journal article every year. My work brings together my MD background with clinical issues, my PhD background with rapidly changing technology, and my MBA and Medicare backgrounds for strategy consulting skills and a brain full of Medicare rules and alternatives.
