I was talking with a neurologist recently and the conversation turned to another neurologist. “I don’t understand why Dr. “X” went into sleep medicine,” the first neurologist said,”He’s one of the best neurologists I know and he must be bored silly.” Well, the more I found out about the billable services available to sleep medicine practitioners, the more I understood exactly why Dr. “X” made the switch: there’s good money to be made in that growing field!
The confusion in the first doctor’s mind about his friend’s choice of specialty reminds me of situations that Mitch and I have seen a lot in our careers and in CMG’s practice, and we’ve seen it in multi-billion dollar corporations as well as in privately-held under $50M companies. Namely: the focus on what’s new and interesting and the loss of focus on the “boring” segments of the business that make today’s money. No matter their size, these have all been technology companies, and they were all founded, staffed, and still run by engineers. When a product line got to be technologically uninteresting (that is, a cash cow), they hired their idea of “business people” to run that part of the business. Usually the “business” people they hired were smart enough not to do anything business-wise that caused their boss any cognitive dissonance or discomfort, and predictably the profitable segments of the business started to be less and less profitable.
I’m glad that MDs often stay with practice areas that interest them; I believe that I get better medical care as a result. But If you are running a company your responsibility isn’t to keep your job interesting, it’s to return a profit to your shareholders. And that often requires hiring people with very different skills and outlooks that you have.
And that’s a difficult thing to do, and a difficult thing to know when to do (and when not).