From medicine to management consulting – life on the other side

Five years ago I resigned from a radiology number in London to become a management consultant at a large strategy consulting firm. One of the many implications of this has been that most people – particularly medics – have absolutely no idea what I do for a living any more. I've been promising Claire and Emma that I'd do my best to explain what it means for over a year now, and so with apologies for the long delay, here is my best attempt.





One of the reasons that people find the whole concept baffling is that the consulting industry varies hugely from firm to firm and project to project. Consultancies come in all shapes and sizes – specialist, generalist, small, large, local, global – and each project a firm does will be different to the last one – in a different industry, for a different company, with a different team, for a different reason. Even within healthcare, projects can range from redesigning manufacturing at a large pharmaceutical company to improving patient safety at an NHS trust. However, in its most basic form, consulting has many parallels to medicine. Companies have many ailments (currently they mostly have costs) and consultancies find ways of making them better. At its worst it involves spending a lot of money for no discernible improvement, but often it can help overcome difficult problems with the benefit of an external perspective and additional manpower.




On a personal level, becoming a management consultant has offered me a whole new perspective on the world - many doctors are fairly business minded but I really wasn't, and so for me it has been transforming. I read The Economist, recognise supermarket pricing strategies targeted at me, and have coherent conversations about my mortgage interest rates. Importantly, I also see healthcare differently. I understand the debate about finite funding and expanding demand, about how outcomes tend to be better with centralisation but nobody wants to close their local hospital, about tariffs, PCTs, SHAs, CCGs and all manner of three letter acronyms so beloved of the NHS. I also recognise the importance of having medics who understand management in the system (and indeed, managers who understand medics), instead of viewing them with deep scepticism. Many are finding flexible ways of balancing their management, leadership and clinical aspirations - they attend Diagnosis Salons, participate in SHA leadership schemes, and follow role models like Claire and Emma down an alternative path. I think back to the angry junior doctor that I was and wish I'd understood the bigger picture to feel less helpless. Had these opportunities been more available five years ago, would I still have left? Or was I so disillusioned that I wouldn't even have recognised them as opportunities?




There have been other advantages to leaving though. I have a career which I control, and am no longer drifting in the uncertain quagmire of medical training. Things that make my work more productive are sorted out – like having a desk, an IT service, a career advisor, health insurance, and office bonding trips to warm places. People ask me how I'm feeling the whole time, which at first felt very intrusive, but now feels like a license to ask for more office bonding trips. I get sent on training to learn about financial accounting in Paris and business school essentials in Barcelona. And not once have I been told to 'feel free to cope' in the middle of the night, holding the bleep as patients go off all around me.




Of course there are downsides. Practicing medicine is a privilege: we are allowed to see so deeply into aspects of other peoples' lives. I miss the human interactions that come with taking care of patients, and if I'm honest I also miss the instant gratification that comes with making them better. I miss the shared sense of cynicism about life that is so particular to medics – my current colleagues still have their innocence utterly intact, unbroken by that first massive haematemesis or first messy arrest.




Finally, part of me still can't believe I really did this. I jumped off the proverbial cliff and resigned from a hard won MMC number at my own medical school to be a management consultant. I also (as people frequently tell me) squandered a quarter of a million pounds worth of taxpayers' money spent on my training. And so I for a long time I felt deeply guilty about my newfound professional happiness. But overall, I am sad to reflect that leaving medicine has been one of the most rewarding and fulfilling things I have ever done, even if nobody does have a clue what I do for a living.