March 27th, 2012
Transitioning from Trainee to Attending? The Business Details
Several Cardiology Fellows who are attending ACC.12 this week are blogging together on CardioExchange. The Fellows include Tariq Ahmad, Bill Cornwell, Megan Coylewright, Jeremiah Depta, and John Ryan (moderator). Read the previous post here. Read the next one here.
As trainees, we are so preoccupied with learning the fundamentals of cardiology that we have hardly any time to learn, or even think about, the business of medicine. Fortunately, Dr. Justin Matthew Bachmann, chair of the ACC Fellow in Training Center, organized on Monday a great session on career development to help us gain a better understanding of some critical issues, which we need to be familiar with as soon as we enter the workforce. For example, regarding interviewing and contract negotiations, there are many general things to mull over, like group strengths and interests, key affiliations, electronic medical records and liability claims. Specific considerations include meeting the practice manager and determining whether you agree with how he/she runs the group.
What about the contract length? Terms and termination? Assistance with relocating? Loan repayment assistance? CME allowance? These are important for both the applicant and the employer. According to Susan Childs, founder of Evolution Healthcare Consulting, groups can spend excessive amounts of money on recruiting and relocating new partners, sometimes in excess of $100,000. In light of these numbers, it is critical that the “t”s are crossed, the “i”‘s dotted, and no stone left unturned when determining whether a group is the right fit for you and you are the right fit for the group. Childs explained that job dissatisfaction usually stems from a failure to clearly define terms during contract negotiations; so this issue is critically important when transitioning from fellow to attending physician.
Financial planners were also present and offered counseling for those of us who have accrued exorbitant amounts of debt. According to Michael Merrill, of Finity Group, the average graduate has $180,000 of debt upon entering the workforce. His goal for trainees is “Become worthless!” — meaning reach the point where you are finally out of the red with a net worth of zero. Some goal! He offered tips to achieve this goal, including meeting with financial planners to establish good money management strategies early, before we “get those contracts” with the big bucks. Merrill explained that all too often he meets with cardiologists who only worsened their debt by making poor decisions with regard to their finances. Early financial planning clearly is another critical piece in the transition from trainee to attending.
Fellows simply don’t have time during their training to consider these issues to any appreciable extent. This was a great opportunity for experts to reinforce important principles, from identifying the right group to negotiating a contract, starting financial planning, and establishing healthy financial habits.