Navigating Your Practice Roadmap to Success Eve Feinberg

Navigating Your Practice: Roadmap to Success Eve Feinberg, MD, FACOG Fertility Centers of Illinois

Introductions Name Where are you in fellowship? What are you are hoping to learn? Favorite flavor of ice cream?

Structure of this talk Fellowship • The job search: what do I want to be when I grow up? Years 1 & 2 Years 3 & 4 Striking a balance and finding happiness

Fellowship

The Job Search Finding a job • Be honest with yourself in terms of goals. What do you really want? What are things that are important to you? • Money? • Time with family? • Research? • Prestige?

Private vs. Academic • Different practice models • Academic • Private • Hybrid • Academic practices are run on RVUs • Private Practices do research and have teaching opportunities.

Location, location • Location • Advantages to practicing where you grew up or where you trained • REFERRALS: dependent on these as a subspecialist

Practice structure • Large vs. small • Integramed vs. non-integramed • Who are your partners? • Partnership is like a marriage • Solo practitioner? • If solo practitioner and he/she has had a rotating door of associates, chances are you are next in the rotation • Growth opportunity? New markets? Saturated market?

Negotiating your contract • Get a good attorney. • Decide what factors are important • Partnership? Should be clearly defined up front. • How many years until eligible • Is partnership guaranteed or contingent upon set performance goals and what are those goals? • How is the buy-in calculated? • How is it structured? Loan from practice, pretax? Interest? • How may partners does the practice have and how many associates?

Negotiating your contract • Non-compete. What is fair? Is it upheld in your state? • Part time vs. full time. Who covers on days off? • Call schedule. Equal? • Compensation. Salary, bonus eligibility. How is bonus structured? Percent earnings or other measure. • Other perks, boards, memberships, car allowance, mileage, moving allowance

Years 1 and 2

Getting off to a good start Establishing yourself as a professional in your community • Outreach with Church groups, synagogues, local organizations. Volunteer work Establishing yourself as the newest physician in town • Make the rounds with referring physicians. It takes time to build referrals. Find common interests. Referrals are built on relationships and trust. Become friends with your referring MDs. Chances are you have a lot in common, shared interests, children the same age. • Give Grand Rounds

Jumping over the hurdles BOARDS General boards – do as a Fellow if possible REI boards – year 2 post fellowship. • Time consuming • Huge effort

Get to know your friends in the field Acupuncturists Nutritionists Therapists Internists/FP weight loss MDs Urologists Donor agencies Reproductive attorneys

Building knowledge and identifying gaps How do you keep current when you don’t have weekly lectures or monthly Journal clubs? • Never stop reading • Go to conferences/review courses • MRS • Santa Barbara • Journal club or topic review

The busywork of years 1 & 2 Getting on staff at local hospitals. Does your group have a person responsible for credentialing? • Initial and maintenance State license Controlled substance Documentation of CME

Practicing medicine in the real world Mandated state? Insurance contracts Fertility benefits Billing Coding

Mentorship Identify a mentor in your practice who will gently show you the ropes Learn about the players in your practice • What are the dynamics? • Who makes the decisions? • Be respectful of those that built your practice from the ground up.

Mentorship Keep in touch with your former mentors. Those relationships continue long past fellowship and can be beneficial for years to come. Keep in touch with your co-fellows and Fellow cohort. Friends for life.

Have a baby. . and/or another Better to have your children as an associate and while you are salaried Practice what we preach, respect your own age.

Work life balance Begin to create work life balance NOW is the time to set up your childcare situation the way you want it. • Nanny vs. daycare • Live in vs. live out

Years 3 & 4 Taking things to the next level

Advanced practice development You’ve made the rounds, you’ve met the players, how to really develop meaningful relationships with referring MDs • Assist with surgery (let them bill) • Mentorship for General Boards • Be an excellent resource. Pass along pertinent articles • Never make anyone feel stupid when they call with questions. • Always make the patients feel as though their referring MD is amazing • Do excellent work. Successful outcomes are the best marketing for your practice

Develop a niche

Develop a niche Find an area in which you can be an invaluable resource and strengthen your practice • • Fertility preservation PCOS Recurrent pregnancy loss Reproductive genetics Robotic surgery Social media Business development Billing and coding

Contribute to the field: research Research keeps you current Puts your practice on the national map Consider becoming a CREST scholar Collaborate with others • You don’t need to be in a University setting to collaborate with basic scientists

Education Teaching Does your practice work with residents? Med students? Can you create rotations? Many benefits: 1) 2) 3) 4) Education: definitely a two way street Training your future referring physicians Emissaries Research help

Get involved in the bigger picture

Give back

Set long term financial goals Pay off debt Save for college Invest Save for retirement

Achieving happiness Having a good support network including supportive partner and good childcare Figure out tricks that work for you. • Living close to work • Enjoying your commute • Audiobooks • Callbacks from the car

Achieving happiness Find interests outside of the office. • It is never too late to find a new activity or hobby Schedule some fun into your life.

Achieving happiness Treat your staff well. Chances are you spend as much time inside the office as out. Take care of the people who take care of your patients. • You take care of them and they will take care of you too.

Achieving happiness Travel • Getting away a few times a year is essential to prevent burnout • When away, do not bring a computer • The world continues to revolve even while you are on a beach in Hawaii • • Unplug, focus on your partner, family, etc.

Connect with those around you Work is infinitely more satisfying if you connect on a meaningful level and remember why you chose this field in the first place We have the ability to change lives on a daily basis It is an honor and a privilege. Mourn the bad. Relish the good.

Celebrate life