Ben Miller, a Harvard-trained surgeon hired me to help him navigate his transition out of clinical medicine into the commercial world. When we began, he presented me with this “brain dump,” a collection of his thoughts and ideas, and I found it extremely useful in understanding his situation. You can re-create this chart yourself, and it will be a good beginning point:

1. Principle
   I have a great wife and 2 kids (2 and 5) whom I enjoy very much. The stress/dread of current job is beginning to make me (and thus my family) unhappy—and we like being happy.

2. GOOD aspects of current job as private practice Internist
   
   • Work with good people whom I respect.
   • Get to perform fun procedures.
   • Earn $250K-$500K/year.
   • Get to take +/- 4-6 weeks off a year (at my choosing).
   • Prestige.
   • Can live in a smaller town with amazing house and no commute.

3. BAD aspects of current job as private practice Internist
   
   • Pace is punishing and unpredictable.
   • Always fearing I am overlooking something.
   • No end to call nights.
   • Unrealistic patient expectations.
   • Constant fear of being sued.
   • Little time to interact (chit-chat) with co-workers.
   • Not vetting new ideas or meeting interesting new people.
   • Little changes.
   • Extremely high (e.g. difficult to meet) paperwork and other performance standards.
   • Feels like I’m swimming upstream.

4. Current Goals
   
   • Find job that I look forward to on Sunday afternoon.
   • Minimize move distance: stay in Seattle > Portland > Vancouver BC > San Francisco > San Diego (I expect that we will move).
   • Make over 130K/year and have somewhat flexible shedule.
   • Have less constant stress.
   • Have my wife work part time and have me work less to have better balance.

5. Elements that I have/or think I might like in a job
   
   • Work with a small group of people I like.
   • Work hard in spurts and conversely be able to take time off if work light.
   • Working with people from diverse backgrounds, but share intelligence and sense of humor.
   • Reasonable salary and/or possibility of very large payout down the road.
   • Developing novel devices.
   • Doing medical (or animal lab) procedures/flying?.
   • Somewhat casual (but no sloppy) work environment.
   • Meeting with bright individuals with novel ideas.
   • Searching for and learning about new ideas/devices.
   • Compatible with a family.
   • I enjoy being there.

6. My strengths
   
   • Not brilliant but very clever—can quickly grasp and contribute to new ideas.
   • Can read people very well and network.
   • Can work very hard—in spurts.
   • Am loyal to friends.
   • Willing to take calculated risks.

7. My Weaknesses
   
   • It’s challenging to hide feelings if I dislike someone.
   • Can lose interest if something drags on. (But do not lose interest in individuals.)
   • Bristle at criticism—a subtle hint from someone I respect is all I need—otherwise I get defensive.
   • Can be distracted by thinking of new options.

8. Fear
   
   • Passing up big money doctor job and dragging my family along on a Quixotic search for my dream job and subsequently not finding it.

9. Approach
   
   • Relax. Realize that my current job is not sustainable and look for something else.
   • Carefully weigh my options.

10. Practical Considerations
    
    • I have to tell my practice I’m leaving by May—it’s getting difficult not to tell them now.
    • Would rather not move, but it’s possible to do so.
    • Willing to take salary cut for better fitting job, but still need to make some $.