When otolaryngologists leave clinical practice to pursue other vocations, the reasons for making the move vary, as do the factors that might have prevented the transition. Here, several otolaryngologists who have pursued different career paths, from writing to working at or even founding healthcare-related companies, tell their unique stories.
Anthony Chin-Quee, MD, who practiced as a board-certified otolaryngologist for three years after residency, knew within the first few months that he did not love his job. “I couldn’t see myself being happy with the monotony of the clinic–OR schedule for the rest of my career, and the options for advancement within my organization didn’t interest me,” he said. “I thought perhaps I needed a change of pace, and so I took interviews at other practices and academic institutions, but either couldn’t find the right fit or wasn’t offered a position.”
Taking the Leap
“Even though I hadn’t quite figured out what my next job would be, I put my notice in a few months prior to leaving and decided to take a leap of faith,” Dr. Chin-Quee said. He works as a television writer, was a medical consultant for “Grey’s Anatomy,” and is the author of I Can’t Save You: A Memoir. “I was nearly sucked into staying for reasons of ‘security,’” he said. “I realized that the most pressing issues were my mental health and quality of life. What use was future ‘stability’ if I was going to need to be miserable to achieve it?”
Casey Means, MD, quit her five-year ENT surgical residency a few months before completion. Soon after meeting a patient with recurrent sinus infections that were not responding to treatment, I felt “an overwhelming conviction that I couldn’t cut into another patient until I figured out why—despite the monumental size and scope of our healthcare system—the patients and people around me were sick in the first place,” wrote Dr. Means in her 2024 book Good Energy: The Surprising Connection Between Metabolism and Limitless Health. The New York Times bestseller explains metabolic dysfunction as the connecting point between most major chronic diseases, including many of those seen in ENT practice.
“The healthcare system needs major reform to be functional and to generate better outcomes for Americans, and I couldn’t continue working in a system that fundamentally profits off illness rather than prevention,” she explained.
After leaving residency, Dr. Means trained in nutritional biochemistry, cell biology, and functional medicine, opened a medical practice, and served on faculty at Stanford University teaching about food, technology, and design. She is the co-founder of Levels, a company providing metabolic health data to customers via continuous glucose monitors to empower better dietary and lifestyle habits.
For Anya Miller, MD, the decision to leave ENT clinical practice after seven years was multifactorial, including changed priorities after becoming a parent, combined with childcare issues and working in an unstable practice environment compounded by the COVID-19 pandemic.
“You are very reliant on referrals,” Dr. Miller explained. During the COVID-19 pandemic, surgeries were halted and clinical volumes decreased. She added, “I found I was getting more and more anxious about doing surgery.”
Dr. Miller, who now works as a field medical director at Evolent, decided that she needed a new job that would fit with daycare hours, enabling her to be available for her children, remove her family’s dependence on a nanny, allow her to sleep at night rather than worrying about patients, and provide financial stability.
After looking intermittently for other jobs for a while, “I started to look in earnest about one year before I finally left. I took odd jobs here and there to gain experience in other fields adjacent to medicine,” Dr. Miller explained.
Making the Decision
Leaving clinical practice was a tough decision for Dr. Miller. “You are taught that the only path in medicine is clinical medicine. I didn’t think I was qualified to do anything else,” Dr. Miller said. You wonder why you did all this training and, as a surgeon, she explained, you must be ready to give up surgery entirely. “Once your case numbers drop to zero after two years, you will be unable to obtain privileges to do surgery and will need to be supervised for each surgery before being able to do them again.”
The decision to leave clinical practice was not so tough for Dr. Chin-Quee. “Once I made my decision, I felt a profound relief,” he said. “I always felt myself to be a bit of an outsider as far as the typical medical personality type; being a doctor was not as enmeshed into my identity as it might be for some of my colleagues, and so it was relatively easy to let it go.”
For Donald Gonzales, MD, leaving clinical ENT practice after two years was an easy decision. He serves as the founder, chief medical officer, and director of Cryosa, a medical device company developing treatment for patients with sleep-disordered breathing.
I was nearly sucked into staying for reasons of ‘security.’ I realized that the most pressing issues were my mental health and quality of life. What use was future ‘stability’ if I was going to need to be miserable to achieve it? —Anthony Chin-Quee, MD
“I founded my first medical device company during residency. I worked on the company in my spare time as I moved to private practice. I was able to close a series A VC funding round after my second year of practice. The investment allowed me to become chief medical officer for the company and devote all
my time to making the company successful,” he explained. “Since I had completed residency, I knew I could return to medicine if my company did not work out.”
Inspiration to Leave
Initially, Dr. Gonzales did not believe he could make a career out of inventing devices and founding companies in med tech. “I took the gamble of following what I truly enjoyed. Also, I realized that by creating devices that change outcomes, I can still make a dramatic impact on patient care,” he said.
Dr. Chin-Quee explained that as “an artist and storyteller at heart when I came upon the opportunity to apply to work as a medical script consultant for ‘Grey’s Anatomy,’ I jumped at it.” While it was an intern position offering a fraction of his previous earnings, he noted that “it brought me into a world I never knew existed: the Hollywood writers’ room. As I participated in the collaborative storytelling process required to make a television show, I was hooked and immediately sought out information on how to become a television writer full time. I met some wonderful mentors and friends who helped guide me along the way and make my transition possible.”
I took the gamble of following what I truly enjoyed. Also, I realized that by creating devices that change outcomes, I can still make a dramatic impact on patient care. —Donald Gonzales, MD
For Dr. Miller, her love of science inspired her to change career paths. “I love the wonder of the human body and disease pathology. I love the dissection of the puzzle, the diagnostic journey, the medical quandaries.” She previously completed medical legal reviews, and enjoyed “reading medical charts, dissecting each part and putting it all together to determine if and where things went wrong.” She also enjoyed considering the doctor’s thought process of the patient’s problem.
Now working in utilization management, Dr. Miller reads charts, deliberates on the patient’s problem, and considers the next steps in their clinical journey.
Life-Changing Experience
Dr. Miller does not miss clinical practice. Her current position provides both a better work-life balance, given that she now works remotely and sets her own hours, and intellectual stimulation. It “hits everything that I love about medicine. It allows me to be exposed to a much wider breadth of medicine than I would ever have encountered in clinical practice,” she said. Dr. Miller noted that she likely would never have considered leaving clinical practice, however, if she had not had children.
Since leaving ENT practice, Dr. Means’ life has changed dramatically. “I collaborate with policymakers, entrepreneurs, hospital and insurance company CEOs, researchers, healthcare practitioners, and patients towards a singular goal of reversing the rapidly growing chronic disease epidemic in America that is rooted in a toxic food system and other environmental factors that are destroying our cellular health,” she explained.
“I am more fulfilled in my work because I am free to focus on the root causes of why Americans are sick, and the financial incentives of my work are no longer tied to patient volume, charting, and billing,” Dr. Means continued. “It was challenging to see a culture of intense burnout in the surgical field as a resident, and my perception is that this results because many doctors feel trapped working tirelessly in a broken system. Getting to focus on how to fix the system through education, policy, writing, and advocacy has been deeply fulfilling, and I have gotten to collaborate with some of my former ENT colleagues along the way.”
Dr. Gonzales stated that a benefit of clinical practice over entrepreneurship is stability. “A small fraction of start-ups become successful. All aspects of the company must work out against the odds for fundraising and a successful exit. This can create several unknowns and can be stressful.” He added, “I would not have left practice without raising enough money to be able to make the venture successful.”
“My life has changed in every way possible. I have founded and sold two med tech companies and helped the acquirers in the ENT space. I am now working on a third,” Dr. Gonzales said. “Instead of direct patient care, I spend my day patenting, working with R&D for product development, and working with my clinical team on trials.”
Value of Clinical Practice
“My years of training and practice were integral for being successful in the med-tech space,” Dr. Gonzales said. “There is no other way to understand the ENT issues and therapeutic problems that need new solutions.”
While Dr. Chin-Quee does not miss clinical practice, life is more unpredictable, as television writing is fickle, and he is supplementing his income with health equity consulting. Still, “I wouldn’t have it any other way. When I’m in the flow of writing a new story that I know can evoke emotions and meaningful conversations in a viewing audience, I love it. And that’s a feeling I’ve never had before professionally, and I’d never trade,” he said.
Dr. Chin-Quee doubts that anything could have prevented him from leaving clinical practice. “Perhaps if alternative career paths were discussed more openly and without judgment during residency, I might have found a way to have a foot in both worlds and be happy.”
Many mental hurdles need to be overcome to follow an alternative career path after working in the traditional medical field, according to Dr. Chin-Quee. He shared two insights: “1) Don’t be a slave to the fallacy of sunken costs. Just because you’ve put years of money and time into one path does not obligate you to follow it, and 2) Your years of experience in medicine will never be a waste. Whichever path you choose to explore, you’ll take the wisdom from lessons learned along the way, making yourself an exciting and unique candidate with a fresh perspective to share with whichever new industry you find.”
Pursuits To Enhance, Not Replace, Clinical Practice
Bradley B. Block, MD, otolaryngologist–head and neck surgeon at ENT and Allergy Associates, in Garden City, N.Y., hosts a podcast, “Physician’s Guide to Doctoring.”
“The tagline for the podcast is ‘everything we should have been learning while we were memorizing the Krebs cycle.’ It is a personal and professional development show that helps physicians be their best versions in and out of the exam room.
“I started podcasting because I wanted to learn how to communicate with my patients in an effective, yet still efficient, way.
“Since the podcast addresses my questions about life and medicine, both personally and professionally, my life has improved inordinately. I am a better spouse, parent, boss, partner, physician, investor, communicator, networker, entrepreneur, and overall person because of the advice that I have received.”
William Reisacher, MD, a professor in the department of otolaryngology–head and neck surgery and director of allergy services at Weill Cornell Medical College, New York–Presbyterian Hospital, is the co-founder of three biopharmaceutical companies: Intrommune Therapeutics, currently in clinical trials with an allergy immunotherapy toothpaste containing peanut protein; Immunovent, which developed the LAMB-Dx assay for allergy testing; and Allovate Therapeutics/Easily Healthcare, providing allergy immunotherapy via the toothpaste vehicle for airborne allergies.
Being involved with these companies has enhanced my love and appreciation for clinical practice. It’s a common misconception that physicians become entrepreneurs to escape the difficulties of clinical practice when, for many, it brings them much closer to it. —William Reisacher, MD
“Being involved with these companies has enhanced my love and appreciation for clinical practice. It’s a common misconception that physicians become entrepreneurs to escape the difficulties of clinical practice when, for many, it brings them much closer to it.
“Most of my ideas and innovations came directly from difficulties that either I was having in clinical practice or that patients were having in their lives.
“Physicians are naturally innovative and creative people. We make great leaders, as well as team players, and that is a great fit for entrepreneurship.”
Katie Robinson is a freelance medical writer based in New York.