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What's Next: Getting Started in
Practice
Today is April 21st. That means graduating
residents have two months left to make plans for their life after residency.
Hopefully, you already have some idea of the direction you will be taking. I
might suggest that you listen to Dr. Guiliani’s lecture or attend one of the
Future Medical Solutions Regional Seminars. (contact info)
So, what’s it going to be? Start your own practice, buy one, or work as an
associate. Whatever suits you is fine. Let’s talk a little about some ideas for
your future.
If you haven’t done so already, prepare your CV. Scrutinize it carefully. The
information contained within it is somewhat different than when you first
applied for residency. You could probably leave out that you were treasurer of
the Heel Spur Club.
Deciding Where To Go
My residency director advised his residents to seek out practice opportunities
in places where they would want to live. This was based on the simple assumption
that you could succeed anywhere. This advice is not valid in today’s medical
climate unless you are willing to make some sacrifices. These decisions are much
more complicated today. More appropriate advice for today’s new practitioner
would be to practice where you are most needed. Of course, this may call for
some compromise in lifestyle.
South Florida was my choice. Twenty-one years ago, podiatrists called this area
the “Gold Coast”. There was very little managed care and a large geriatric
population existed. This allowed just about any podiatrist, who hung out a
shingle, to make a reasonably good living.
Well, things have changed here. It is very difficult for young, independent
practitioners to get on managed care panels in over served areas like mine. This
limits the pool of patients who may have access to them. Compensation is down,
yet the cost of running a practice is way up. At any given time there are a
finite number of patients who require foot care, but there are a growing number
of doctors willing to treat them. In Economics 101, we learned that when there
is more supply than demand, prices fall. Adding to the problem for the new
practitioner is debt payment from school loans.
The moral is: You can find happiness in an
underserved area. Patients tend to have more appreciation for your efforts and
the medical economy is usually more stable.
Some Ideas For Succeeding On Your Own Or In A
Group
The goal after graduation is to find a way to be content, but it is also nice to
be able to provide for yourself and your family, and have opportunities for
professional growth. I often receive letters from graduates, emphasizing their
extensive training and surgical prowess. There are practices out there that are
anxiously seeking talented surgeons who are well versed in limb salvage, ankle
fractures and reconstructive foot surgery. However, the majority of practices
are seeking a likeable person who will work hard and be willing to market him or
herself.
The question you need to ask yourself is, “What will make me a valuable addition
to a practice”. Perhaps your skills in trauma, sports medicine and wound care
will add a new dimension to the practice.
When you first start in either private practice or as an associate, chances are
that patients will not be knocking the doors down asking for reconstructive foot
surgery. Be Smart! Be Practical! Don’t Limit Yourself! To succeed as an
associate you have to demonstrate a willingness to help the practice grow! Be
Available! Be Caring!!
How do you make a practice grow?
Dr. Michael Shore has a
great lecture on this very topic. You can usually catch it at a
Future Medical Solutions meeting or at the Practice Management
Track of a Regional Seminar.
Join a professional group. Live and practice in the same area.
Work with local clubs. Eat in the hospital cafeteria every day
and introduce yourself to the staff. Call some of the doctors in
the area and ask to stop by and introduce yourself.
When a senior associate takes on a new associate, it “usually”
means that he is making a serious commitment. In years past a
new associate could easily bring in additional income for the
practice. Today, compensation for services is low and overhead
is high. If the new associate is not willing to work hard and
market him or herself, the whole scenario could be a financial
disaster. It could then become clear that the practice would be
better off financially by lowering the overhead and limiting
patient access or dropping low paying managed care contracts.
Be ready to answer the question. What will you bring to the
table? What will you be able to deliver?
Send
Feedback
Jay
Lieberman, DPM
Editor - PRESENT
Director of
Podiatric Medical Education
Northwest
Medical Center
Margate,
Florida
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