Beat 5 Hazards That Can Hurt Your Career as a New Physician

Your first year in practice is uniquely pivotal. It’s a time of intense excitement and possibility, but also one with a fair amount of vulnerability and fear. The transition from resident to new physician comes with pitfalls.

But many of them are avoidable.

Over my 23 years as a health lawyer who does nothing but counsel and represent physicians, I’ve developed ways to not only step over obstacles but also move beyond them. Recognizing and dealing with these challenges will let you maximize your excitement and your possibilities, and minimize your exposure to unnecessary risk.

I detail strategies to help you recognize and deal with these challenges in a video you'll find in the Business Fundamentals micro-session of this new AAFP package for graduating residents, which includes more tips and stories.

Hazard No. 1: Not Knowing Your Full Value

Why It Matters: Your prospective employer knows what the market should pay you.

How to Beat It:

1. Do your homework. Find out the range of salaries for your area and your expertise. One tool: the AAFP’s Family Medicine Career Benchmark Dashboard.

2. Slow things way down. When you get an offer, give yourself more than just 48 hours to talk to your lawyer and really understand the contract.

3. Pick your battles. A higher bonus? No noncompete? More salary? Fight for what’s really most important to you.

4. Lead with excitement but be willing to walk away.

Remember, when you’ve found the data, slowed the pace of negotiation, figured out what you really need and approached the conversation with enthusiasm, only to see that the other side won’t meet you, is this where you want to work? Protect your boundary.

Hazard No. 2: Forgetting the Unique Skills You Offer

Why It Matters: The other candidates interviewing for the job you’re interested in may have very similar backgrounds.

How to Beat It:

Present your unique skills, not just your credentials. So you went to an amazing school or were chief resident — five other new physicians angling for this job might be able to say that, too. Were you the shoulder the other residents leaned on? Are you bilingual? Did you run a diversity committee? Are you an EHR whiz? Say so.

Hazard No. 3: Slipping on Compliance

Why It Matters: New physicians are very attractive to fraudsters.

How to Beat It:

1. Make sure that your decisions and relationships center on sound clinical work rather than on money.

2. Use caution when you’re presented with a side deal — real estate, sharing practice space, a medical directorship, anything outside your practice — and consider having a lawyer look over the arrangement. Don’t assume it’s fine.

3. Anytime there is a referral arrangement and you accept Medicare, pay close attention.

4. Avoid any situation in which you would write prescriptions without seeing patients.

5. Protect your NPI like it’s gold.

Let me emphasize these points with a true story. I counseled a doctor whose parents had diabetes and were having trouble keeping up with their glucose levels. A company came to her and said, “We install remote glucose monitoring for elderly people. You write a prescription for it for the patient. We have a nurse practitioner who follows them. We put the equipment in their home. It's really going to save these diabetic patients time and money.”

Given her personal experience with her own parents, she took the bait. She wrote prescriptions, believing the whole thing was legit. But it was a scam.

When you put your name to something — anything — remember that your NPI number is an important asset. Guard it accordingly.

Hazard No. 4: Losing Sight of Exit Details

Why It Matters: It’s easy to miss a penalty or a claw-back in an employment contract.

How to beat it:

1. Know how long you’re under contract, how to get out of it and what strings are attached, such as bonus payback, tail coverage, or acceleration of your last day during your notice period.

2. Use the resources available to you, including a lawyer.

3. Be aware that although you don't always need a lawyer, a lawyer can help you — as long as you tell your lawyer everything.

4. Remember that nobody has to know you’re working with a lawyer.

Hazard No. 5: Mishandling Conflict

Why It Matters: Sometimes people on the same team don’t have good chemistry. But even when communication styles vary and you’re working within a complex hierarchy, disagreements don’t have to get out of hand.

How to Beat It:

1. Examine your conflict from the other person's perspective.

2. Think about the other party’s communication style — Is it logical? Emotional? — and work to match it.

3. When you need to talk with HR, billing or compliance about a problem, always make it about the issue, not about a person.

4. Edit yourself and focus only on the big stuff.

5. Know when to walk away from a toxic environment.

All of these challenges are within your power to conquer. Remember, your goals as you embark on this first career phase are to stand up for yourself, make the most of everything you know, base your decisions on more than just money and always have a backup plan.

Amanda Hill, J.D., is the founder of Guard My Practice.