Login | Register

          Audrey Becker 
          2341 Seven Pines Suite 5
          St. Louis, MO 63146

Phone: 314.878.6888
Toll-free: 877.583.3255
Fax: 314.878.1827
Audrey@ObOnly.com

It all depends on you. A job coveted by one physician may have no appeal for another. The ideal job is as personal a choice as the ideal mate.

There are generally four components to consider in deciding what is, or is not, the right spot for you:

1. Type of practice
2. Quality of life
3. Location
4. Income potential

Type of Practice

Let us assume that you intend to practice good medicine and are qualified to do so. Let us also assume that you would not align yourself with a practice in which you perceive the other staff members to be incapable or uncaring. This still leaves much to consider.

Would you enjoy solo practice? Such positions are often lucrative and can offer tax advantages. You can run the practice as you think best and be your own boss. The downside is that you may have no call coverage, camaraderie or mentorship. Additionally, you are, in effect, running a small business, a topic that was not covered in your training.

A small practice, with one or two other physicians, may be to your liking. Call coverage is inherent, other physicians share the overhead, and you can expect eventual partnership. You are still likely to bear some responsibility for running the office, but the full burden will not fall on your shoulders. You might face a problem if you decide that you like your location but not your associates, for you will have to deal with the restrictions imposed by the non-compete clauses and restrictive covenants in your contract.

A large single specialty group will give you great call coverage and little office responsibility. You can look forward to becoming a partner or shareholder. However, there will be more personalities to deal with, and office overhead will likely be higher. Should you leave, you will face the strictures of non-compete clauses and restrictive covenants.

A multi-specialty group offers a built-in referral system and a management team to take care of business. Your take-home pay will be lower as a result of the higher office overhead, and you will need to scrutinize the compensation arrangements, which can be intricate. Again, should you wish to leave the group but remain in the community, you will deal with contractual limitations.

Quality of Life

A difficult component to define! Basically, what makes you happy? Are you devoted to your work? Or do you wish you could spend more time with your children? Would you be miserable far from your parents and friends? Or do you long for new vistas? Do you yearn for the outdoors? Or do you need to hear opera? Is your paramount concern the payment of your school loans? Think about your priorities. Write them down. Juggle the items on the list. Find the balance most likely to please you. Then consider each opportunity in terms of your personal needs and desires.

Location

You’ve heard it: “Location, location, location.” But don’t assume that the right city will make you happy. If you don’t like your job, the scenery won’t mean much. Five days a week, you will get up and go to work. If you are too busy, too poor, or too grouchy to enjoy the beach or climb the mountain, you won’t be happy. Try to let location take second place. Find a job that fulfills your professional and financial aims; with enough money, you can take a plane to Broadway, Vail, or Malibu.

Location will affect your earning power. Be sure you are not diving into a saturated market. Find a place that needs your specialty. Realize that lots of people want to live on the Carolina beaches and in the hills of San Francisco. The laws of supply and demand work even in medicine. Understand the economics of the market. In general, larger cities pay less than smaller ones. The Northwest pays less than the Southeast. As the Music Man said, ‘You’ve got to know the territory.”

Income Potential

You will need to know the population statistics and the number of competing physicians in the area. You will need to know if the prior lack of a physician in your specialty has set up a self-referral pattern, whereby patients are accustomed to driving twenty miles to the nearest large community and will probably continue to do so. You need to know about reimbursement rates, malpractice premiums, and managed-care penetration. You need to know not just what you will earn the first year, when you are on salary or guarantee, but what you can expect to earn in the succeeding years. Think in terms of a minimum three-year commitment. Moving around is hard on you, your family, and your CV.

Balancing Act

Will you find everything you want: right city, right practice, enough money, good colleagues, and personal fulfillment? It’s a lot to ask. You may end up compromising on one area or another. But that’s not just medicine, that’s life.