Doctors spend a decade learning how to treat disease. But do they have the skills they need to practice medicine?

Dr. Derek Raghavan has had a distinguished career as a leader in oncology and is now president of the Levine Cancer Institute at Carolinas Healthcare System in Charlotte, N.C.

Yet he says some of his most important career training came from driving a cab during medical school. His plan was to pick up some evening and weekend shifts to help pay for the significant cost of a medical degree.

“What actually happened was the development of an epiphany,” he wrote in an article for LinkedIn. “As the heterogeneous population of transient back-seat dwellers passed through my cab, I came to realize how important it is to develop a social contract focused on personal relationships quickly, to express oneself in plain and simple terms, and to communicate at a level that reflects the background, social situation and education of each customer.”

Physicians practicing in the United States complete four years of medical school and then spend several more years in residency and fellowship. But all that clinical training, they say, doesn’t prepare them for the realities of a career in medicine. Instead, they get limited experience with the business side of healthcare, and they don’t get the chance to see the many ways they can contribute to the healthcare system beyond direct patient care.

Earlier this year, LinkedIn surveyed more than 500 of our physician members to ask about their professional goals and the non-clinical skills that they believe are most essential to their careers. You can read their perspectives on this topic below.

Our survey was conducted Feb. 7-19 and reached 511 physicians in the U.S. A total of 449 respondents are currently practicing in patient care. They were chosen at random, and reflect a number of different specialties and years of experience.

Among the findings:

Some 75 percent of respondents indicated that these non-clinical skills are more important than they were in the past because of how deeply and rapidly the healthcare industry is changing.

Among currently-practicing doctors, more than two-thirds of respondents (or 68 percent) said their career goals include better work-life balance, with early-career doctors more likely to desire balance than career-established clinicians.

Other career goals for currently-practicing doctors include pursuing corporate or consulting roles (39 percent) and adding administrative responsibilities (38 percent). 

And to get there, nearly half of respondents pointed to skills like business and finance, productivity and practice management as essential to their success.

These skills rose to the top despite—or perhaps because of—a new world order where doctors are less likely to be solo practitioners.

As more doctors leave private practice, it might be logical to assume that their business headaches are behind them. Indeed, many physicians join larger medical groups or seek hospital employment for precisely that reason: they’re overwhelmed by the mounting expenses associated with having their own practice—from investing in technology to hiring people who can manage patient billing to complying with ever-more-complex regulations.

Less than a third of physicians (or 32.7 percent) worked in an independent private practice last year, according to a survey from the not-for-profit Physicians Foundation. That number was as high as 48.5 percent only four years earlier.

The results from LinkedIn’s survey are in line with that trend. Only 14 percent of the currently-practicing physicians who responded to the survey were in a medical group with five or fewer clinicians. And only 10 percent of respondents said that their career goals include starting their own practice.

But doctors still need to be able to advocate for themselves when it comes to financial decisions like how much money to invest in office space or technology.

“Many physicians join these large healthcare systems with the goal of focusing more on patient care and less on the business of managing a group,” Dr. Christopher Mattern, an orthopedic surgeon at Greenwich (Conn.) Hospital, wrote in a LinkedIn article. “While there are clear benefits to larger healthcare groups, both to physicians and their patients, I would argue that physicians who do not take an active role in the management of their group may do so at their own risk.”

Moreover, the number of career options available to physicians has exploded in the era of managed care, when physicians and their staff spend countless hours negotiating with insurance companies. And as doctors align more closely with hospitals—which are also getting bigger—there are opportunities to set standards of care and oversee quality improvement programs across a multi-billion dollar enterprise.

“Suddenly, doctors could be health plan medical directors, experts in utilization management, or Chief Medical Officers,” Dr. Patricia Salber, founder and CEO of a popular medical blog, The Doctor Weighs In, wrote in her LinkedIn article on this topic. “They could manage large practice groups or run hospitals.”

More recently, opportunities have been fast emerging for physicians at technology companies, both at digital health startups as well as legacy companies moving into the digital health space. In a sign of the times, Apple this month hired Dr. Sumbul Desai, chief digital officer at Stanford’s Center for Digital Health, for an undisclosed senior role.

But physicians don’t even need Silicon Valley aspirations to appreciate the growing influence of technology on their field. Thirty-seven percent of respondents in LinkedIn’s survey identified computer and technology skills as key to advancement.

Dr. Aalap Shah, an anesthesiologist who practices in Los Angeles, said his formal training on electronic health records amounted to a 1-to 1.5-hour orientation during his third year of medical school, when students leave the classroom and begin their clinical rotations. His experience is not unusual.

That’s not nearly enough time to prepare for a world where digital recordkeeping permeates nearly every part of the patient encounter, from documenting medical histories to ordering tests and making referrals.

Not knowing how to interact with the EHR system can lead to less efficient care, both because it slows down doctors and also because they may not know all the various things they can do with it, like looking up prior records from other hospitals.

“It’s coming to the point where every five, six minutes … we are touching a computer or smartphone,” Shah said in an interview. “If you’re not as smooth with the electronic health record, not only are you not going to spend much time with that patient, you’re going to be getting calls and pages about your 59 other patients.”

Medical schools have gotten the memo. Some have started offering business courses to medical students as part of their curricula. Others allow students to complete non-clinical internships to experience other roles beyond patient care, such as working at a pharmaceutical company.

Students at New York Medical College, for instance, are working as interns at IBM Watson Research to learn about how artificial intelligence is reshaping medical care, according Dr. Douglas Miller, the school’s dean of medicine.

New York Medical College is also working with a consortium of other medical schools to develop an AI health curriculum with IBM Watson, Miller wrote in a LinkedIn article.

“The opportunities for physicians to make contributions to healthcare are endless and ever-changing,” wrote Salber of The Doctor Weighs In. “You just have to be willing to try new things. It is a great time to be a physician.”

Here's what doctors and educators see as the future of medical education:

Physicians who ignore business skills do so at their risk and here's why by Dr. Christopher Mattern, orthopedic surgeon at Greenwich Hospital

Educating Physicians for the Future Medical Education by Dr. Darrell Kirch, president and CEO of the Association of American Medical Colleges

5 Productivity Tips for Academic and Administrative Physicians That You Didn't Learn in Medical School by Dr. Ernest Wang, assistant dean for medical education, NorthShore University Health System

Are our medical students getting all the education and training they need to excel in a changing health care delivery environment? by Dr. Ray DuBois, dean of the college of medicine at the Medical University of South Carolina

Should Medical Students Acquire AI Skills? by Dr. Douglas Miller, dean of medicine at New York Medical College

Educating the Next Generation of Physicians with the Curriculum of the Future by Dr. Robert Hasty, founding dean and chief academic officer at Idaho College of Osteopathic Medicine

It's Major League Medicine - Can Your Rookie Doctor Hit? by Dr. Roy Smythe, chief medical officer, healthcare informatics at Philips

The Essential Difference Between Management in Medicine and Managing in Business by Dr. Margaret Cary, CEO of the Cary Group Global

How to Stay Excited and in Love with a Career in Medicine by Dr. Patricia Salber, founder and CEO, The Doctor Weighs In

What I Didn't Learn In Medical School … But Did Pick Up Behind the Wheel of a Taxi Cab by Dr. Derek Raghavan, president of the Levine Cancer Institute

The Matrix: What they didn't teach in Medical School by Dr. Jean Wright, chief innovation officer at Carolinas HealthCare System