Here is the best advice we could find to help make the transition from residency to the real world of dermatology a little easier.
The dermatology practice has grown more complex since I graduated residency and began practice in 1984. But it has also become more dynamic. We all have learned to grow and evolve with the changes. However, it could have been a little easier if I had known a few tricks to make transitioning from residency to the real world of dermatology a little easier.
Advice – Get Started in an Academic Position
This is a great way to extend your residency and expand your knowledge. In the academic environment, you will be nurtured and guided into a more mature clinician and surgeon. However, you are giving all the control of your professional decisions to one entity.
You have to be able to work diligently and sacrifice many of your own personal needs to satisfy those of your immediate supervisors. Remember that his and/or her reputation and growth depends on you and others like you. And in this new era is not only reputation, but economics as well.
Advice – Women in Dermatology
If you are a woman, minority and have not graduated from an ivy league institution, you will have to work five times as hard to get the same recognition. In addition, they will not pay the same as your male counterparts or for the freezing of your eggs, so postponing motherhood is all on you. My recommendation is if you are planning to develop an academic professional life, take into consideration all the personal sacrifices that will be involved and move forward with clear expectations. If it becomes too difficult, have an alternative plan or what we call “option B.”
Advice – Associate Yourself with a Practice
This is great way to get paid for what you do best without investing in the infrastructure. This association will give you more time to expand your knowledge, get more confidence in your clinical acumen, and develop your own style of delivering patient care. It will give you time to let yourself become known in a specific geographic area(s) depending on how many offices you work out off. You will most likely receive a salary or incentive, or both, or might be an independent contractor remunerated with a percentage of your collections.
Make sure that you will be allowed to manage your patients in the ethical way you have been educated to manage them. Ensure that your time and knowledge are not going to be micromanaged for others’ benefits at your own expense, and that your intellectual property will not be questioned as been part of the practice.
Review your contract to ensure it won’t exclude you from eventually practicing on your own (if you decide to do so) in a certain geographic area because of a signed non-compete agreement.
Advice – Becoming a Partner
Joining a group practice with the potential of partnership is another great way of transitioning from residence to the real world of practicing medicine. In this type of arrangement there is a contract that should give an idea how much money you have to produce for the practice before you are given the opportunity to buy into it.
For the most part, it takes two years of making double your salary with incentives to make you eligible for partnership. At that time, you will be offered some way to buy into the practice. It will take a few years to pay off, but you should be a full partner from the time you start paying your participation into the practice to the full-time partners.
After becoming a partner, you will receive equal benefits to full-time partners that might include productivity incentives, bonuses, profit-sharing, paid vacations, malpractice insurance coverage, and life insurance, among others. Your contract should also provide for a buy-out for when you or any of the partners decide to retire. All these are great incentives for joining an established practice.
However, make sure that your opinions and votes are really taken into consideration when the decisions are made to buy equipment, maintain or fire employees, take on new partners, and decide on anything that increases the practice’s overhead. If you do not do so, you will be paying for the overhead of other people’s pet projects and subsidizing the practice.
Make sure that any other contracts that you have with any industry are separated from the partnership, and that your intellectual property belongs solely to you. If you do not, you may find yourself in legal predicaments because your partners will feel that they own you, your connections in the industry, and your intellectual productivity.
Advice – When to Start a Solo Practice
Finally, if your passion resides in a solo practice model, then go for it. You will have the satisfaction of making all the purchases, designs, marketing, website development, mission statements, decorations, contacts and affiliations with industry – and everything else that will represent you as a practitioner. However, you will be the sole provider for everything, including but not exclusive of payments, taxes, personnel, ideas for expansion, selection of associates or partners, etc. You will be the only responsible entity in charge. This may make this decision a great decision for you, just as it does for me.
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