Category: health

Negotiating Pitfalls for the young doctor

Negotiating Pitfalls for the young doctor

In an ideal world, we should all be compensated fairly for our services and skills.  The reality, as we all experience, is an amalgam of mistakes and victories.  One hopes that with time our skills will translate to a greater number of victories.  Most greenhorns entering the workforce are unfortunately poorly equipped to assess their worth.  I certainly was.  

Greenhorn doctors stand to lose a financial lot from mistakes simply because doctors tend to experience a significant jump in income after they finish their formal training.  Seemingly inconsequential mistakes can end up costing us a lot of green and sleep over time.

The significant jump in salary signals a well-deserved reward at the end of the rainbow, but what doctors frequently fail to recognize is how big or small that pot of gold ought to be.  In some ways it is difficult to believe that relatively intelligent, hard-working people who become doctors can have so little clue about our worth.  When I was in my training, business sense certainly wasn’t in the medical school or residency curriculum.  I doubt that much has changed over time either.

The last time I interviewed a high school student from New Jersey for college, I asked her if she knew how to pump gas.  The response was an overwhelmed deer in the headlights look.  (New Jersey law still doesn’t permit people to pump their own gas)  It really isn’t that difficult to find voids in one’s fund of knowledge, no matter how intelligent anyone is.

When I was a fledging greenhorn coming out of my training, I made plenty of mistakes in looking for a job.  Some of factors I overlooked were so egregious that I probably deserved to fumble.  Live and learn, as they say.  January and February are the typical months of year that graduating trainees start looking for jobs.  This is also the time I start getting questions about job hunting. 

I figured it was time to distill some of my impressions about rookie mistakes into a post.  

Underestimating your worth

Medical trainees provide way too many services pro bono.  In my training, I moved gurneys, waited for up to an hour over the phone for health insurance companies, cleaned up excrement, and performed many duties that didn’t require busting my ass.  When trainees enter the workforce, life suddenly becomes easier in most respects.  

What do you say when you’re offered this to take call on Christmas eve?

Sometimes if life becomes easier no matter how you spin it, we may be more willing to take anything we are given.  Maybe your potential employer intends to give you a signing bonus of $5,000.  Great!  Would you think any differently if they gave your coworker an $8,000 signing bonus instead? That’s where doing your research will pay off.  Most medical graduates do a good job in their sleuthing skills, because that’s what medicine is all about. 
The key is actually going to the right sources.  Your friends who are several years into practice can give you pointers.  But relying solely on their experience can only give you a certain picture into the situation.  Your friends might share similar views that you do, or even think like you do.  They are likely to provide the information that you want to hear, but there is also a possibility that their mindset leads them to overlook certain aspects of the job world that you’d miss too. 

Pro tip: Ask doctors who may be in a different generation as well as other maybe even in another specialty about their wisdom.  Get the advice of others who have worked for the employer that you’re considering, or those who have paved a career similar to what you envision your career to be.

Overestimating your worth

Not understanding your skill level can lead doctors to ask for too much as well.  There are statistics out there that include median starting salaries along with median mid-career salaries of all the specialties.  The problem is that these are median numbers, and you have to be able to extrapolate the statistics.  

For instance, if you plan to join a bustling medical practice that is drowning with patients you will be busy very quickly.  However, most new doctors fail to recognize that they still need time to ramp up their practice patterns. Just because the retiring doctor who touch-typed was seeing 100 patients a day doesn’t mean that you could see 120.  In fact, as someone learning the ropes you might only be capable of doing a fraction of the work and maybe even at a fraction of the quality!  There may be reasons why the employer would consider starting you at a much lower salary as someone else with a decade of practice under their belts.

Pro tip: Go into your negotiations with the facts, and make your potential employer give you good reasons why they think that you’re worth what they’re offering you. If you can prove them wrong, you can command a better arrangement. Just be aware of your own limitations too. Gray hair does come with some benefits.

Overestimating what the employer can afford

This is a touchy subject.  Financially and business savvy new doctors can make very informed decisions about their qualifications and practice goals to potential employers.  The problem arises when everything is a great fit except that the potential employer isn’t actually able to financially afford what you’re asking.  Sometimes this happens.  

Pro tip: You cannot earn more than your boss. If you do, then they are in either a horribly desperate situation to bring you on board or a situation to make you work like a dog.  Neither situation is sustainable long-term.

You have to set realistic expectations in any situation. I have known plenty of doctors who calculate how much they should be earning based on professional charges, negotiate based on expected overheads, and anger many potential employers.  The reason? Many of these doctors don’t realize that there is give or take. They may have underestimated the costs of running a business.  

Pro Tip 2: Do your homework. Go into your negotiations with reasoning. But don’t forget that you could be wrong too.

What other tips do you have for new doctors?

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Implications of job hopping for doctors

Implications of job hopping for doctors

A large percentage of doctors end up switching jobs within the first five years of practice.  This really isn’t surprising given that the medical training experience doesn’t necessarily correlate with the medical practice experience. Many doctors work hard throughout their entire training only to realize that their expectations do not necessarily align with reality.  Is it our fault that we don’t really know what we got ourselves into? 


You might also like: Five reasons why doctors leave their first job

Perhaps taking q3 call as a resident didn’t seem too tough in your late twenties, but getting brutalized every third night in your thirties and forties starts getting really old.  Maybe your kids’ private school tuition is really digging into your academic salary, and your escape plan might entail joining your medical school roommate whose surgical center pays out dividends the size of your salary.


Do you call it quits and seek greener pastures?  Or do you grit your teeth and adjust up your savings rate to weather the storm?  Before you decide to jump ship, you have to make sure that you are really coming out ahead.  I’ve seen plenty of doctors job change every few years, some even more frequent than that.  I cringe at the number of 401k accounts that these doctors actually have opened with all of these job changes.  What about the bank accounts that they’ve opened and closed in every city that they’ve moved to?  Every time you start afresh, you end up picking up extra baggage that you have to decide whether to purge with each move.
If you feel like you are working in living hell at your job, here are some considerations to make before deciding to jump ship:

Financial strain

Life alone can be expensive.  Bills, lifestyle creep, and unexpected repairs add up over time.  Any sort of disruption in your routine will have the potential to incur costs.  One way to analyze financially whether a move would be worthwhile to make a move is to place a hard number on the increased costs during a job change process:

You’re potentially looking at a five to six figure cost when you change jobs.

In this scenario, you might be looking an all-in expense of roughly $60,000 if you make a move.  Chances are that there will be additional costs with licensing, credentialing, and immeasurable costs. Is that worth the change of scenery? Only you can decide.

Social Disruption 

Moving elsewhere means that you will have to re-establish your social circles.  Your children will end up separating ways from their friends and school.  If they are in high school, then their chances of entering college might be affected by a move.  You might have to find a new church group.  Depending on how much you value your social environment, there can a significant opportunity cost if you end up relocating.  Ultimately, you have to decide which factors are more important to you and your family long term.  Money? Friends? Sanity at work?

Learning curve at work

No matter how seasoned you are in your profession, change comes at a cost.  New hospital environments mean that you will need to learn a new electronic health record, repeat the oft-hated online HIPAA training modules, and become acclimated to the new work environment.  You will have new coworkers, new culture, and new regulations.  Depending on what you are escaping from your original job, a new environment might be refreshing.

Family disruption

If you are the sole breadwinner in your household, you will have the additional stress that your family’s well-being is dependent upon your income.  For any of you who are in this situation, you realize that if you make the wrong decision they will also have to ensure the stress.  Are the gains worth it?

Play the long ball

Your career plans should aim to win the war.  Take into account the financial, social, and mental challenges that come with any switch and make a decision.  Life is short; you have to remind yourself to take charge of your own life and take calculated chances.  If a career move will end up costing you $100,000 for the first year but allows you to enjoy a fruitful thirty year career, it might be worthwhile.  

What risks have you taken to improve your career? 

The calculated approach to outsourcing your life

The calculated approach to outsourcing your life

One of my biggest frustrations early in my career was accepting that outsourcing tasks comes at a cost. My colleagues were always able to justify house cleaners, home-pickup dry cleaners, and handymen even as residents. Their main argument was that it helps stimulate the economy.  I understood that we should all help those around us, but I could never convince myself that anyone with a $40,000 annual residency salary truly needed a dry-cleaning pick-up service even if she was working 100 hours a week.  If I had only outsourced my chores as a resident, perhaps I would have published more papers.  I guess I’ll never know.  Did doing my own laundry cost me a career as a superstar doctor?

Fast forward to today.  I’m no longer working 100 hours a week, but 50 hours a week is still taxing.  Life evolves as we age. We get arthritis. Kids need to be shuffled to their activities. Elderly parents need medical care. Suddenly there are too many events and obligations to meet in a given day. How do we find more time?

Outsource your life.

Welcome to the world of personal assistants. TaskRabbit. You name it, you’ve got it. You pay a negotiated amount for someone else to take care of your unfinished business. Buying furniture. Putting together your furniture that they bought for you. Cleaning your house. There is almost always a price to be named for a chore that you don’t want to complete yourself.  If you have an unlimited budget, you could outsource every aspect of your life.

These feline friends know how to take life easy

As reality dictates, most of us do not have unlimited budgets.  How do you put a price on time? I generally follow these two principles:

Put a rate on the job.

What is the going rate for a chore that you’d like to outsource? How easy is it to get the job outsourced? It may actually be more difficult to outsource a job than you’d otherwise think.

For instance, two years ago my air conditioning unit stopped working. One of the capacitors broke in the unit, and the unit was mounted on the roof of my two-story house. The cost of the job was clearly over my normal pay scale as a physician, but it was not prudent to for me to risk breaking my neck from a fall on the roof. Unfortunately it was high season for the air conditioners, so the wait-time for a routine repair was 2 weeks! An emergency call would’ve cost 2.5x!

An analysis table was useful in this situation:

Advantage of outsourcing

  • Avoid fall and shock risk
  • Avoid other potential injury to unit.
  • Exchange money easily to no worry about details
  • Instant resolution of a problem

Disadvantage of outsourcing

  • Relatively expensive post-tax cost—would need to perform a roux en y surgery to cover the after-tax cost of the air conditioning repair
  • The paid help may not do a good job on the work.

I ended up paying up for the emergency repair, and all was well for one day.   Another part of the air conditioner ended up breaking (supposedly), and I ended up having the call the repairmen back.  They had to charge me another fee, stating that the second malfunctioning part was not related to the original repair!  Go figure.

Another $400 later, I was back enjoying cold air in the hot summer.  Thank goodness for having a decent paying job. The biggest sting when you have to cough up for a big ticket item is that mathematically it delays getting to financial independence. Sometimes that is the only option that you have.

Prioritize according to what gives you pleasure.

In contrast, you can cherry pick what you want to do with your time.  One of my friend’s husband, a gastroenterologist managing a relatively large practice, enjoys washing his car.  He takes call every three weeks, has limited time for the family yet he spends a few hours every month washing and waxing his car. Is that time well spent?

In a purely time per cost model, he should be outsourcing his car washes. In fact as a highly paid physician, he should actually outsource essentially every task that costs less than what he could generate from his profession if money were the only goal. There are two problems with this logic:

  1.  In order to make a direct financial comparison, he would need the ability to generate income from his profession while his car is getting washed elsewhere.  Good luck finding a way to match that up. At best, he could generate income through taking more call or working more during the workweek. However, that still doesn’t confer a perfect 1:1 exchange of time for money.
  2. Your day job may actually be mentally taxing, even if it confers a great pay rate.  How much mental and physical energy does take to do the day job instead of washing a car? What if every additional weekend you work confers a week of shorter lifespan?  What is the price you can place on your health?

Clearly this gastroenterologist has decided that washing his own car provides enough enjoyment that he chooses not to outsource the task. There is nothing wrong with that.

How do you decide to outsource your life?

Definition of Disability – Does it Really Matter?

Definition of Disability – Does it Really Matter?

Happy Easter! The following is a post by one of our sponsors, Chris Wimberly from TheDisabilityDoc. Every doctor or high income professional should have disability coverage. If you don’t, head over to TheDisabilityDoc and get a free quote. 

Well, it depends.  It depends on the type of work you do.  Ultimately, the goal is to make sure your income is protected in the event you are too sick or hurt to work.  With that goal in mind, it is not a “one-size fits all” answer.

If your plan is not designed correctly, you could either “over pay” (costing you lots of extra premium), or you could find yourself with a “less than adequate plan” (that ends up not protecting you at all).  Neither scenario is beneficial to you.

Explained, the “Definition of Disability” is the contract language that an insurance carrier will use to determine when an individual is officially considered to be disabled and eligible for benefits. It is arguably the most important part of your plan.  If your disability situation does not satisfy the contract language, you would not be considered disabled, and therefore… no benefits will be paid to you. This would be a major bummer to say the least.

With that in mind, read below to breakdown a few common definitions found in the market:

Any Occupation
This is just as it sounds – because of an illness or injury, you are unable to work in any feasible occupation.  For a “desk job” with mundane tasks (like simple data entry for example), this definition could be argued as being sufficient because you have no “special duties” or “significant training” involved.

However, it should be noted that this is by far the hardest definition of disability to meet (meaning very few disability scenarios would actually result in benefits being paid out).  Even in the most mundane administration position imaginable, it is possible the insurance carrier might deem you able to theoretically work in some sort of job out there, and therefore, no benefits. This definition is extremely common with many “group” disability plans.

Own Occupation
This definition does cover you in your occupation – on a general level.  This means the insurance carrier could consider your occupation to be that of a “generally recognized physician”, but does not recognize you in your actual “specialty of medicine.”  It is a very common definition with “group” disability plans offered through employers as well.

To help illustrate – if you are in pediatrics, psychology, or an internist, then this definition may be sufficient for you.  But, if you are a “procedural based” professional (like ER or anesthesiology), it might not. For example, if you are procedural based, and in your disability situation the insurance carrier determines that you can still do the do duties of a “generally recognized physician”, then you will likely not be considered disabled under this definition (even though you cannot perform the duties of your actual specialty).  This is not good.

We all need disability insurance



Own Occupation (Specialty Specific)
This is exactly as it sounds. You are covered based on your specialty or area of expertise.  This is an excellent definition of disability for procedural based professionals, but it does have potential downsides.  If the majority (or even a small portion of your income) comes from a procedure that is new, advanced, or a possibly a brand new technology, and not all specialists in your field are generally using this new procedure or technology, you could have an issue and not receive adequate disability pay out.

Own Occupation (Actual Duties)
This is the most comprehensive definition when determining someone’s occupation. It is based on the actual duties performed just prior to filing a disability claim. Documentation such as: insurance billing records, financial statements, etc. are used to determine one’s actual duties.  If it is found that you are unable to perform one or more of those duties, you would be considered disabled. This definition is very common with “individual” disability plans and rarely offered with “group” plans.

True Own Occupation
This definition is typically only offered through certain “individual” carriers. It allows you the option to generate income in a new occupation should you choose (without negatively impacting your disability benefits). In a sense, with this definition, you can “double dip”.  For example, maybe you are a surgeon and injure your hand, so you can no longer perform surgery, but you choose to teach at a medical school. In this case, you could earn a full income as a professor, and also still receive full disability benefits, because you can no longer perform surgery.

Modified Own Occupation
This definition is similar to True Own Occupation; however, if you choose to earn an income in a new occupation, your benefits will be reduced by whatever income it is that you are earning in that new occupation. It does not allow you to “double dip” and earn income elsewhere while receiving full benefits.  If you do choose to earn an income elsewhere, your benefits will be reduced proportionately. It is a very common definition with “association” style disability plans.

Enhanced Own Occupation
This is an extremely comprehensive definition of disability only available with one carrier in the individual market.  The plan specifies that you can become disabled and be losing income, but still working within your own occupation, and receive full benefit payout as if you were totally disabled. It is designed specifically for physicians and would only be beneficial for those physicians whose income is at least 50% procedural based.

Medical Own Occupation
This is a very complex and convoluted definition only available with one carrier in the individual market.  It closely resembles the “modified” definition of disability and is unique to the carrier that developed it. It is a definition that is difficult to interpret and leaves many opportunities for the insurance carrier to decide not to pay.  Tricky, because the name itself implies it is built for medical professionals, when in fact it can actually be harmful for certain specialties of medicine.

As you can see, there are many definitions to consider. It is advised that you work with someone you trust, and who knows what they’re doing, to help you correctly protect your income!

 

To learn more, watch a short video here

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How to become a healthy doctor Part 1 – Don’t sweat the small stuff

How to become a healthy doctor Part 1 – Don’t sweat the small stuff

All of us have obsessive compulsive tendencies, whether or not they’re pathological. In a way, attention to detail is critical to our career success. It is also the achilles heel to our interactions with friends and family.  I see this in my patients all the time. We all have our stories of taking care of unreasonable (read: crazy) patients. When I encounter crazy patients with crazy spouses or family members (read: folie a deux), I just want to run out of the exam room screaming. We’ve all encountered these situations.

But the name of the game in having a financially successful medical career is also to have some insight on what your flaws are. That’s the only way you can figure out what tendencies are not compatible with happiness of those around you and your own happiness. Case in point: I know a guy who always kept his office desk messy. The spouse was always neat and organized.  They are no longer together.  It would be short-sighted to assume that differing views on organization resulted in incompatibility, but correlation and causation are murky relationships.

What constitutes the small stuff?

We’ve all read arguments about how daily coffees from your local fancy barista will cost you thousands of dollars in additional annual expenses, and when invested appropriately in financial-blogger-approved funds you’d shave off a few years from your working career.

The math on the savings is clear, but how is the duration of your working career impacted if you are earning $200,000 a year?

What about $60,000?

What about $1.3 million?

Your earning velocity will determine which expenses are going to be considered “small”.

Micromanagement of financially inconsequential circumstances may be detrimental to your health. 

I hate overpaying for gas. How many of you live in a place that has gas like this when the rest of the country pays a third less than what you are?

Hey, we’ve got it better than the folks in Europe.

Prices like these entice me to search for a Costco or Sam’s Club to fill up. Lines at the pump typically also go three to four cars deep on weekdays, and even ten back on busy weekends. Whether you drive an extra five miles, wait an extra 20 minutes, and save 40 cents a gallon ultimately depends on a huge number of factors:

  • How much time do you have to spend in a day
  • How often you fill up your car
  • How much you save per fill-up
  • If you drive a Hummer H2 with a 32 gallon tank

This is the small stuff that is frankly unhealthy to have to decide. I know a surgeon who goes out of her way to save on gas fill-ups for a very fancy car. I think that over the course of a career, she’d probably save a few months of work by saving on gas. But is it worth it?

I used to struggle with minutiae, but I’ve slowly let the reins loose as life gets busier and as I strengthen my financial plan.  It’s unhealthy to have to make these decisions, and the goal is not to get yourself in a situation to need to deal with them in the first place.

For the gas savings scenario: if going out of my way to save at the pump is going to make a significant impact in my financial situation, then I’d better unload that Hummer and figure out my commute problem instead.

How much do you guys sweat the small stuff?

How often do you leave work exhausted?

I’ve written about physician burnout before, and it continues to be a prevalent issue in our profession. The Happy Philosopher highlights many of these issues on his website, and I continue to be an avid follower of his wisdom. Truth is that we all have our ways to deal with the ups and downs of our jobs, and one of the issues plaguing us is that we care about our jobs.

You might also like: Perils of being a physician leader

More often than not, I end the workday in the office exhausted. Ironically, the clinical work is rarely the challenge—it’s the environment that we work within. Sometimes problems arise from the myriad of personalities from the front desk to the back office. Other occasions the headaches come of the onerous regulations of the insurance companies. And of course, we don’t want to forget about that extra meeting someone in administration decides to squeeze in just to take away that hour and half of your life.

How do doctors deal with exhaustion and stress?

Apathy

We all know someone in every profession who fits into this category. These folks just go along with whatever rules are dished out to them.  As someone with moderate compulsivity, I have been guilty of trying “reform” the apathetic into sharing my beliefs.  You can correctly assume how well these initiatives turned out.  Over the years, I think that I’ve come to understand better why we are all prone to apathy.  It’s simply a path of lesser resistance.  I’m sure that many people who appear to be apathetic were once energetic, young, visionaries who succumbed to failures of our system to effect a change. Most importantly, if you start becoming apathetic, you might have a good shot at reducing your work-related exhaustion.

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Resistance

Some of us are perennially disgruntled. There are doctors at my staff meetings who always raise their hands and interject, sometimes only for the sake of interruption and stirring up controversy. Many of these disruptive comments are warranted, however. When you put together a group of high functioning professionals in a room, there is always a good chance that someone will be able to identify something to fix or a problem with something the hospital or administration proposes. Frankly, I’d imagine that putting up resistance will eventually wear you down and exacerbate any ongoing stress. Anecdotally, many of these personality types either have secondary family conflicts that arise because of stress at work.

 

Some people are born to become party poopers.

Problem Resolution

This is the personality type that I admire the most. These gals seem to have a positive spin on even the most negative situations. Hospital going bankrupt? No problem! Let’s cut the budget in the doctor’s lounge, and work a little harder! I do see doctors who have an endless amount of energy. They are likely hypomanic, their spouses are angels to allow them to focus their energies on work, and they do get stuff done.

You might also like: One Less Hour of Sleep Each Night Can Make You Richer

I find myself cycling through all three of these personality modes. It really depends on what the issue I’m faced with, and whether I decide it is worth fighting for.  I typically consider myself a positive person, so I tend to look for a way to find a compromise.  If I ever become more apathetic than not, that will certainly be a sign that I need to hang up my hat. Until then, I plan to stick to the plan. Get my fair share of compensation at work, save as much as I can in the process, and enjoy the journey. Some exhaustion never hurt anyone, right?

How do you deal with exhaustion from work?

What should doctors do if their jobs are not a good fit?

We’ve all seen it. Some of us have experienced it.  The rest of us WILL experience it.  You take your dream job after your training, and it turns out that the dream job was really a dream.  Perhaps your q2 call schedule turned out to be tougher than you had anticipated.  Maybe your hospital ends up being short on doctors so you end up taking more shifts than you’d prefer to. And no, you don’t get overtime pay as a doctor! You get the same rate as you would otherwise. I’ve known a few unfortunate doctors who actually end up taking new jobs and finding themselves in another similarly unfavorable situation. What gives? Is the world out to get you?

Find out what makes the situation unpleasant to you. 

Everyone is different.  I have friends who are okay with taking two to three weeks off a year and working holidays.  I have others who cringe at taking no less than six weeks.  I have friends who are okay with spending their weekends rounding (their spouses and kids are apparently okay with it as well) instead of hanging out at home or taking a road trip.

Common issues that I’ve seen my colleagues complain about include:

  • Call schedule too onerous.
  • Pay is too low.
  • Patients are too sick.
  • Patients are too healthy.
  • Job is too boring.
  • Location of the practice/hospital is too remote.
  • Senior partners abuse them.
  • Too many satellite locations.
  • Partnership track too unfavorable (they find out two-three years into employment).
  • Work hours too long (many outpatient specialties are open on weekends)

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Whatever situation that makes your life unpleasant, you need to identify what needs to change in order for you to be happy.  As doctors, we are great at shutting out unpleasant memories.  It would be a shame for you to seek out a new opportunity only to have the same problems that you encountered in a previous job.

You might have problem if you sleep here more frequently than in your own bed.

Try to remedy the unpleasant situations at your current job first.

Look, most people don’t like to move, especially if they have established friends and family in a particular area.  Some of us have strong religious ties to a location.  Even most financially independent early retirees with school-aged children choose to stick around most of the time (That’s you Justin @RootOfGood and @RetireBy40).  It would behoove you to talk to your coworkers, managers, administrators, and bosses to determine if any of your gripes can be resolved amicably.  I’ve discovered that in negotiation, you have to figure out what you bring to the table in order to justify your worth.

You might also like: How are doctors paid?

If you are the world’s expert on melanoma, you probably will have more negotiating power than even the most skilled orthopedic surgeon.  Even then, the negotiating power has to align with what your employer needs.  A private practice Dermatology practice may prefer to have a proficient and friendly general Dermatologist over the world’s smartest melanoma guru.

Not all of us will have that magical ace up our sleeves for improving our work/life situation, but it is definitely financially advantageous for most people to keep the same job if possible.  This is mostly because of the effort and potential lost income that comes from job changes.

If you end up moving to another state, you will need to apply for a new medical license, get credentialed on insurance plans, and potentially spend months without income if you end your prior job prematurely.

You need to figure out an exit plan.

If all else fails and you find that your current situation cannot be rectified, you will have to find greener pastures.  But wait, you shouldn’t just march into your boss’s office and give her the middle finger! You need a backup plan. It is easier and less stressful to find alternative opportunities if you have an existing job.  Once you’ve made the decision to make the switch, plan out your next steps:

  1. Look for opportunities nearby. Perhaps in the same city or nearby regions. Then look elsewhere in the same state, if you would prefer minimize your move.  You already have an active medical license in your state, so that is the easiest route to take if you decide to change jobs. Be sure to check if your existing practice has restrictive covenants.
  2. Check with your colleagues elsewhere who might have some leads on potential opportunities. An potential opportunity might crop up that you might otherwise not know about.
  3. Look at your professional society job bulletins for opportunities.  Given that there are so many postings, it can be confusing if you are not locked into a particular region.  Try to narrow down opportunities that might suit you, and check them out. Make sure that you have an updated CV, clean up your online profiles, and go at it. You might find yourself looking for over a year for the right fit. That is okay, if you are able to maintain you current job.
  4. As with any profession, the more people you speak to, the more that you will learn about the profession. You will develop a better understanding of what is important to your lifestyle and what the critical questions to ask a practice or hospital.  You are also more marketable as a doctor if you have already been in practice for several years.
  5. Don’t be afraid! Many doctors in this situation are primary breadwinners in the household. They may have kids, a stay-at-home spouse, and no ancillary income. If you have been playing your cards appropriate, you should have an emergency fund and have been living below your means!

You might also like: How to burn through a $1 million salary

Go for it.

It is not easy to pull the trigger. A new job means a potentially big move. Take a breath, don’t fret. You are still (hopefully) an able-bodied doctor with good earning potential.  Don’t be worried that you might make a mistake.  We all do. Don’t be afraid to keep your head high, regroup if you have to, and keep whittling away. Good luck!

Any tips for the job hunter?

(Photo courtesy of Flickr)