Hello, this is Doctor Inc. Bringing you the truth about employed physicians. I want to thank you today for really the efforts you make to continually learn about what it means to be a physician and your area or field of interest. I know you, likely have a medical journal or a magazine article somewhere on your nightstand or, in your chair next to you in your living room where you maybe today Read an article that was pertinent to your area of medicine.

And although you were tired, although you didn’t really feel like doing it, you you pushed on, you read the article, you assimilated into your practice. You made some mental notes about how things may be a little different for you the next day, because of reading that and. And you have continued in that process of being a lifelong learner as a physician.

It’s one of the things I think that just really sets physicians apart is that we genuinely like to learn. But I want to thank you for making the effort to do that because it’s, I know it’s making you a better physician and when you’re a better physician you can take care of your patients better.

And they’re the benefactors of that. So thank you for your efforts to do that. You’re not doing it because your employers told you to do it. You’re doing it because deep down inside you have a drive. To be good at what you do, which is really incredible.

In this episode, we’re going to pick up the last element or last pieces of the conversation we’ve been having about the truth. That changing practice environments is normal for physicians. In my last episode, I began to unpack the story of the tale of eight physicians: expect change. And we talked about six of the physicians in the group and the changes that they experienced in their practice of medicine. We had a very successful group in my practice that about 10 to 15 years ago broke up for a number of individual reasons that are really related to all eight of us as physicians.

But at the end of the day, when that group broke up it really left a doctor and, myself holding the ball with all the patients in that group. As we reorganized ourself, we thought about what we wanted the future to look like after our group fell apart. We really had that crisis of identity moment when we had to make the decision about whether we want to stay where we were and remain employed , or look for jobs somewehre else.

I know. Dr. M looked at some practices outside of the Midwest. He’s a hunting and fishermen kind of guy and looked into Montana and areas out West where he could to really enjoy the outdoors a little bit more. I know I questioned what kind of practice model I want to work in and what did I want to do?

And, so we really had multiple meetings with ourself and with others. We hired some practice consultants that we met with via some private meetings. We talked with a number of people about what our options were. What we realized was that basically we both had no non-compete contracts in our back pocket with our current employer, which was pretty amazing. I didn’t know how important that would be at the time of signing my contract, but I did learn of it’s value at the negotiation table. Since Doctor M and I controlled our market share of naerly 10,000 patients, our preferences were a pretty big deal to our employer.

And we had a lot of options, including potentially suiting up with a competing hospital system that wanted to come to our own community. But we decied that wasn’t our interest. We were very aligned with our current organization and very much enjoyed them. But for a number of business and economic reasons, we decided it was wise to look at all options on the table and negotiate our best options that would allow us to practice medicine the way we wanted to.

And in that process we ultimately chose to both stay with our employer and develop our positions into our preferred future state.

Number one we were both in the same location within the same building at the time, and we chose to split locations.

I chose to go the route of buying a building and re modeling it into a medical office building for my practice site. My employer agreed to lease the MOB from me as part of the process. Dr. M stayed in the old practice site that was already prebuilt and owned by the hospital. This allowed us to each recreate practices in our own locations. Although we were similar to each other we both had different ideas about what we wanted our The model that we wanted to reorganize around, was a little bit different for each one of us. We both negotiated fair market value contracts that that we both thought would be maximized in the practice models we were pursuing. During this phase, we choose to be blinded to each others negotiation and restructering so as to have any perception of collusion. ‘

He chose the route of the traditional employment contract that had a few different incentives built into it. And, I chose the route of going to a A professional corporation and a professional services agreement model in which I really became an employment light contract where I regained control a little bit of my medical practice for my own company that I’m contracted with the hospital.

And allowed me to have a lot more control over my personal professional life. But really from the community standpoint, it looked like I was still an employee of the hospital and really not much had changed other than locations, but as I expound in, in, in other post and episodes that big change for me was massive and it really was a huge professional satisfier for me that brought autonomy and control back into my life and really salvaged me from the threat of burnout.

Both Dr. M and I also really made some demands in regards to our clinical support. We both had very large Patient load. Since many doctors had left I had four to 5,000 patients that I was going to be responsible for. He had three to 4,000 patients going to be responsible for in order for that to, work well, we were going to have adequate support to meet those patient needs.

That included nurse practitioners to support the practices that included a new practice model that would allow for what we’ve called team care or scribed care of medicine in which our nurses where a larger number than just a one nurse for one doctor. And those nurses were also becoming scribes and care team members that allowed us to be more proficient and efficient at what we did.

Really to be more productive and efficient with our time. And we both developed medical directorships that allowed us to pursue interests that we had. Dr. M was very interested in wound care and become, it became very involved in our local wound care clinic, ultimately becoming the director and a very successful director of wound care.

I B agreed to pilot, a model of patient center, medical home for our organization to begin to really explore what we thought was going to be a, an effective model of. Of care that ultimately we decided to move away from after two to three years, but it was a great experience for me. I also took on some medical directorship over some sports medicine programs in the area for our hospital organization.

That allowed me to really diversify my experiences, but also to add to my income. Really stuff that I was already doing because frankly, I was already volunteering as a team physician at the school. And now rather than doing it for free, I was now having the organization pay me to really do what I’ve been doing all along.

And that was also a great experience for me in the process, but those were really some of the decision trees that we walked through when doctor Em, and I decided to whether to stay with the organization or to stay not with the organization. We both chose to stay and really saw herself flourish.

Dr. M is still in practice, still met the other sites, still highly successful wound care doctor. He speaks all over the country now doing wound care and, lectures and teaching has really become a national expert when it comes to wound care, but it’s continued to flourish in and grow.

And, practice medicine and a primary care site doing really a number of things in primary care that we’ve done all along. He has given up obstetrical practice because that allowed him to simplify his schedule a whole lot more. But but he has really done well in, in medicine and is very happy in the model that he has really chartered and developed.

And for me as well, I’m extremely happy with the fact that I’m now in a position where my own, my medical office building and it’s leased to the hospital at our practice site where we have a three physicians and two nurse practitioners working alongside me. It’s a thriving growing practice.

That’s very successful. We have Eight and 10,000 patients in the practice and totality now that we’re responsible for which is all about market share for our health care corporation. But I’ve organized myself in a way that allows me to maximize my productivity in that clinic allows my pay to be tied to that productivity.

And allows me to continue really reap the benefits of leasing my medical office, building to the hospital practice, all done legally, all done, properly and organized in a way that really has allowed me to flourish. It’s also allowed me to diversify what I do inside of medicine and outside of medicine by having my own company, even starting this Social media site blog and vlog has really grown out of my own business venture, my own business interest.

And when it comes to employ physicians, I just believe there’s so much out there for employed physicians to enjoy. If they can just see the benefits of the employment light. Environment that I’ve chosen to be a part of. I think it opens the door for so many possibilities for side gigs, for passive income for really maintaining all the benefits of being employed, but really reducing some of the downsides of being employed.

And that tale of eight physicians, including myself, has really led to the fact that change is normal. For us as physicians. And if you, as a doctor, struggle with that at all, or you think, man, is it okay to make a change or should I make a change? Or when should I make a change? I just encourage you as employed physician to just listen to some of these stories that I’ve told you about these eight physicians that have all successfully transitioned in different ways in different locations and and including myself that are.

So much happier now because of those transitions that we’ve made, I don’t want you as an employed physician to feel like you’re stuck. You’re stuck working for the man you’re stuck. Really having third parties control and manage and manipulate you because there, there are opportunities out there for you don’t have to stay stuck and fill the burdens that ultimately lead to burnout.

And I invite you to add in your comments too. Our social media locations your thoughts and own experiences with maybe transitions that you’ve made. If you’re a newer physician, I encourage you to just use your experiences in residency and as an attending physician to sorta really shape and mold You into really ultimately your, destination as a doctor that is ever changing and ever evolving.

And that’s a normal part of the process. So the truth today is changing. Practice environments is normal for physicians. I encourage you to embrace that and thrive in that.