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Spring 2014
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The Road Also Taken
A growing number of MDs are leaving their stethoscopes behind.
Some conversations stick with you. Four years later, Joel Selanikio can still recite the dialogue of the heart-to-heart that launched the latest phase of his career. The pediatrician had been doing a lot of soul-searching—OK, maybe a bit of complaining, too—about his job at the Centers for Disease Control and Prevention (CDC) and about his ideas for ways to use new technologies like cell phones for public health. One night, while having dinner with a friend and going over his career choices for perhaps the hundredth time, the friend stopped him.

“Joel, you’re a doctor, aren’t you?” Yes, Selanikio said, you know that.

“So you’re a white, male, American doctor?” Again, yes.

“Well,” said his friend, “if I go to the circus and I’m watching the trapeze artists and they’re practicing and there’s no net, I can understand caution. But if they’re practicing over a big, comfy safety net, I expect to see amazing stuff. I think you are capable of amazing stuff, but I don’t see it happening.”

Risk With A Safety Net

She had a point. The next day, Selanikio tendered his resignation at the CDC and began laying the foundation for DataDyne.org, a non-profit software development company that specializes in open-source programming for mobile phones and handheld computers to facilitate epidemiological survey design and delivery (see Brown Medicine, Spring 2005). “[That conversation] made me see the absurdity of my position,” says Selanikio. “I had such a strong safety net. My worst case scenario was to work clinically and have a nice life.”

Even as U.S. policymakers grapple with the prospect of growing physician shortages as the Baby Boomers age and demand for primary care docs accelerates, MDs are finding that their training provides both a safety net for personal career exploration and a launching pad for a rich array of professional opportunities. “You have all these emerging roles— chief medical officers at hospitals, medical directors of biotech start-up firms, companies that are being developed to handle the devices—the opportunities for physicians are growing enormously,” says John Ferry ’73 MD’76, a senior consultant with the executive search firm Korn/Ferry International.

“Years ago, it was almost considered inappropriate to not practice medicine,” says Ferry, who trained as a pediatrician and has served as a health care executive and academic administrator in Manhattan, Cleveland, and throughout New England, and now specializes in recruitment and leadership development of senior-level executives in health care, life sciences, and academic medicine. “If you didn’t practice, your mother was asking ‘Why did I send you to medical school?’ Even your own friends would wonder why you went into medicine.”

Joel Selanikio figures he couldn’t do his current job if he hadn’t gone into medicine. Not only does the one-time Wall Street programmer have the capacity to translate between the software developers and physicians who collaborate to design DataDyne’s products, he has enhanced credibility to reassure the grant makers who fund his work at the non-profit and substantial authority in the board room. “You would not believe the schemes technologists come up with that will supposedly work well in a clinic,” says Selanikio, who still puts in a half-day with patients every week. “I can say with authority, ‘You’re never going to get doctors to do that.’”

Case in point: telemedicine, a buzz-word just vague enough to garner enormous traction among companies hoping to commercialize videoconferencing services so remote clinicians can show colleagues a worrisome or confusing case. “I’m a technologist but I’m also a clinician,” says Selanikio, who points out that even docs in high-tech practices in rich countries rarely use the videoconferencing services already available to them. “Sometimes what’s needed is technology, but sometimes that ‘technology’ is a set of books with drug dosages, atlases for identifying what they see, and so forth. I can make those assertions because I know how clinics work.”

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