Hello everyone this is Dr. Incorporated bringing you the truth about employed physicians. I hope your week has been a good one. I’ll be honest, this week was a disappointing one for me personally. I practice maternity care and deliver babies as a primary care physician in a rural community. One of the things that I enjoy most about delivering babies is being present for the entire journey. The fact that I’m able to walk alongside a prospective mother all the way through the pregnancy process and at the end I’m the one delivering the baby is frankly an incredible feeling. The birth of a child is truly one of the best things you’ll witness in life. I get invested in that process and the excitement that surrounds it almost as much as the patients do.

This past week I had a patient in her first pregnancy who lived in a neighboring community and was at term. I was on call all weekend and I had that “half anticipation” feeling that she was going to come in to deliver the baby. The weekend came and went and she didn’t deliver. She had an appointment with me early that next week but she no-showed, even though she was past her due date. We reached out to her and lo and behold she went into labor and went to the local hospital rather than coming into our community to deliver. I’m happy for her–both baby and mother are doing well. 

There are Disappointments In Life

There are a few things to unpack here. First, I’m thankful for our tribe of employed physicians who look out for one another and take care of patients.The OB doctor had my records and provided good maternity care for her and delivered her baby without any severe complications. I’m glad that the physician was there to provide her with good care. But I’d be lying to you if I said I wasn’t disappointed. I was invested in my patient and missed out on the delivery. Life goes that way sometimes. 

Common Experience

You’ve probably felt that at some point as well. Perhaps you had been working with a patient to get them to a certain point with their medical illness, disease process, or even on the wellness side of the equation, but you weren’t the one to help them across the finish line to bookend that process. Of course, you’re happy for the patient but you were still probably at least a tiny bit disappointed when you weren’t the physician that got to be there for that joyous occasion. 

Today we’re going to talk about a truth in medicine that I think has a lot of power. If you’ve been in the practice of medicine for awhile you’ll understand this; but if you’re younger in your career you might not have learned this yet. 

The longer you practice medicine in one location, the greater the power you possess. 

We’ve discussed before how employed physicians can move from one employer to another, or perhaps one community to another. That’s a real dynamic that exists. Doctors tend to move around a lot. I think that will become even more of a reality in the next 20-30 years. But I’ve really found there to be many benefits to practicing medicine in one place (for nearly 25 years now) and I wanted to discuss this today.

Loyalty Increases Demand

The longer you are in one location the more likely you are to have patients see you and follow you and establish continuity and develop relationships with you strictly out of patient loyalty. It’s a simple formula but I’ve found it to be very reliable. The longer you’re in the same location the demand for your services will continue to increase. If you’re a physician that provides good care, you care about patients, and you do the right thing as much as possible you’re going to develop patient loyalty. Those patients will recommend you to their friends and family and that net continues to grow the longer you’re at your practice or place of employment. 

Longevity Leads To Influence

Your influence grows just by providing adequate care and staying put. As your influence grows so too does your trust amongst your peers. You’re not just a transient, a locum tenens who has come in for a few years only to move on to the next opportunity. You’re here for a while. Once this is noticed you’re going to become highly trusted and you’ll see other physicians begin to seek you out. You’ll receive more referrals and more opportunities because your peers trust and depend on you.

Market Control Increases Economic Forces

There’s economic power that will begin to come into play for you and huge financial downstream that will result in this. FIrst of all, your market share of any particular specialty begins to grow. Even better, you begin to control that market share, as well as the downstream revenue that results in that market share. As you begin to garner that control, the stakeholders in the medical neighborhood take notice and realize that you have controlling power over the patients, over their medical care, and over their medical procedures. 

Economic Opportunities Grow

The greater the power you have over that market share, the more interested those business people are in connecting to you in terms of the economics of the business of medicine. And trust me, when that begins to happen you’ll have more opportunities arise. As a trusted and local medical influencer, numerous medical side gigs will roll towards you as ancillary medical businesses often need reliable medical directors for their business structure. And then there are numerous non-medical business opportunities that are afforded high income earners, like real estate, rentals, and other joint ventures. The longer you’re in one location the greater the diversification of income you’ll receive.

The more influence you have and the more income you earn, the more you can develop alternative channels of income. There are scores of passive income options available to physicians, and longevity increases those opportunities in any given location.. 

Enlarging Patient Panel Size, Enlarges Revenue

Another thing that happens is productivity will increase when your network and influence grows as a result of staying in the same location. It’s not complicated–the more patients you have the more work you’re going to do. The more work you do the more revenue comes in. In most employment agreements you’ll have productivity bonuses built in in addition to your salary. If you plan on staying put for a long duration those productivity bonuses become much more valuable. 

Local Community Benefits

The last thing I want to touch on is the longer you stay in the same location people will see you as a trusted professional who is interested in the development and future of the community. This leads to a plethora of open doors that swing wide open for you. It’s amazing to me how accessible all of the local leaders are based solely on the fact that I’ve been here for 25 years. They know my name, they trust me, and they’ve seen my interest in pursuing things that benefit my patients and community. That’s a nonpolitical stance that I think all people appreciate. 

Never underestimate your economic and intellectual power within a community you are working within. In rural settings like mine, our small business operations generate taxes, stability, and community well being that is truly unique to physicians in small communities. In urban settings that influence may not be quite as pronounced, but it is still present due to the professional altruism that physicians are known for.  I believe it’s our duty to embrace our role in making our communities better for all.

I’m very interested in hearing your thoughts on this subject.

 I realize among millennials & Gen-Z this idea of longevity in a location is likely less appealing, yet it’s still something worth considering for physicians early in their medical career.

 Best to you and I hope you have a great week in medicine.