By YiDing Yu, MD, a practicing physician and serial health tech and AI entrepreneur

There’s a question I hear from physicians almost every time the topic of industry comes up: “Will I have to give up practicing?”

It’s the right question to ask. After decades of training, our clinical identity runs deep. The idea of leaving it entirely can feel like losing a part of yourself, even when the opportunity on the other side is genuinely exciting.

My advice every time is the same: If you love practicing medicine, you should keep practicing medicine.

Fortunately, most of the time, you can. With some compromise, of course.

Working in the private sector — whether at an early-stage startup or a growth-stage health tech company — does require compromise. But compromise is not the same as abandonment. With intentionality and the right structure, you can maintain a meaningful clinical practice while doing high-impact work in industry. I’ve practiced throughout my career, and I’ve seen colleagues do it across a range of specialties and roles.

Why staying clinical actually makes you better at your day job

Before getting into the how, let’s start with the “why.” Keeping a foot in the clinic isn’t just personally fulfilling; it’s also professionally strategic.

Nearly every role you might take in health tech benefits directly from your clinical experience. Whether you’re leading product, guiding clinical strategy, building clinical relationships, or shaping go-to-market decisions, your judgment as a practicing physician is a differentiator that non-clinical colleagues simply cannot replicate. You speak the language; you know the secret handshake; and you can spot when something is technically elegant but a clinical nonstarter. You are being hired for your clinical experience and instincts.

Companies know this. The good ones will work with you to protect clinical time because they understand that a clinician who stays grounded in practice is part of the value you bring to the role and adds credibility and real-world experience to their team.

Shift work: the most flexible model

For emergency physicians, internists, and others who work in shift-based environments, balancing industry and practice is straightforward. Throughout various points in my career, including in demanding executive roles, I’ve maintained between half a day and one full day of clinical work per week on average. I could request a shift in advance and trade shifts when I had a change in schedule, and I had the peace of mind that my time in the clinical world was discrete — I didn’t have lingering follow-ups or calls to take afterwards.

Emergency medicine and urgent care are the obvious examples, but this model extends further than people often realize. Anesthesiologists can pick up overnight call or procedure blocks. Interventional radiologists can schedule procedure days. Some hospitalists do nocturnist shifts. These shifts allow you to work single shifts without continuity burden, and that flexibility makes them the most compatible with the unpredictable rhythms of startup life.

Inpatient blocks: more disruptive, but still meaningful

For hospitalists and intensivists, concentrated inpatient blocks may also be acceptable. I’ve hired and worked alongside colleagues in these roles who practice four to six weeks a year while working full-time health tech roles. That’s enough to keep skills sharp, maintain licensure, and stay meaningfully connected to the clinical world.

That said, being on inpatient service for usually two weeks at a time is more disruptive to your life and your full-time job. When you’re on an inpatient block, the startup doesn’t pause. Slack keeps moving. Decisions still need to get made. You’ll find yourself checking messages between patient encounters and catching up in the evening. It takes discipline and good organizational trust and, most of all, the self-care and support around you to sustain the intense schedule without burning out. Some of my colleagues actually enjoy inpatient blocks compared to shiftwork because they feel they can focus during their long stretches of time between inpatient blocks. On the other hand, you will find that some companies are less accepting of this schedule for full-time employees because four or six weeks away from work (on top of your paid time off) is a significant amount of time away from your duties. In some cases, physicians have started in part-time or contract work to accommodate their clinical schedules.

The harder path: procedural and surgical specialties

Physicians in surgical specialties, obstetrics, and other highly procedural fields have different considerations. Skill maintenance in these fields requires regular, sustained practice and consistent availability.

For colleagues in these fields, the better-fitting model is often an advisory role or a fractional engagement, where their clinical expertise informs the company’s direction without requiring them to step back from a primary clinical career. These roles can be enormously valuable — to the company and to the physician — without creating the tension of trying to maintain surgical volume alongside full-time industry work.

What really matters

The physicians who best navigate the balance of industry and clinical practice share a few traits: they are honest with themselves about what they can sustain, they understand that balance can require compromise, and they communicate clearly with both their clinical and industry colleagues.

If you love to practice, don’t let the startup world talk you out of it. Find the model that fits your specialty, negotiate for protected time, and pick companies that value your clinical credibility.