The questions Mikel Daniels, DPM, gets from job candidates today are almost unrecognizable compared with 25 years ago, he recently told Becker’s.
“It has been years since anybody I’ve interviewed asked me about how they become a partner in that practice. That is not the goal anymore. Now the goal is to get a job,” Dr. Daniels said.
Dr. Daniels is president and chief medical officer of WeTreatFeet Podiatry, a Maryland-based multispecialty practice he has grown to 10 offices and 10 physicians since going into practice in 2002, along with durable medical equipment, consulting, billing and clinical trials arms that together support roughly 50,000 patient visits a year. He is also a partner in a multiphysician, multispecialty surgical center in Washington, D.C.
What candidates are chasing instead, he said, is lifestyle.
“They don’t want to work nights. They don’t want to work weekends. They don’t want to take call. They don’t want to take care of sick people,” Dr. Daniels said.
That runs against how Dr. Daniels was trained to think about the job.
“When I went to school, when I did residency, when I came out, it was patients first, everybody else second. It didn’t matter what it was; patients were first. These are people’s lives; they’re counting on you. If something bad happens, it is your fault, and if you didn’t give it your all, I don’t know how you sleep with yourself,” Dr. Daniels said. “That was always, and that’s still to this day my mindset. I am still in the office by 5 a.m. every day. I don’t start patients till 8.”
The mismatch shows up directly in how WeTreatFeet structures its physician contracts. New hires start on three-year terms, and the math behind that number is deliberate.
“Our initial contract for doctors is three years. We always want three years, and that’s very simple. For the first year, we lose money. For the second year, we’re hoping to break even, and for that third year, we’re hoping to profit, because a lot of them will leave at the end of the third year,” Dr. Daniels said. “They’ll tell you right off the bat: ‘I’m staying here for three years, and then I want to move to California.’ We had one guy go to Alaska. They want the experience, and they don’t want to sit here and build something.”
He described a recent candidate who pushed back on even that timeline, asking for a two-year guaranteed contract instead of the standard three.
“Think about it: you’re half a million dollars in debt coming out of residency, somebody’s offering you a six-figure guaranteed job for three years, and you only want two years,” Dr. Daniels said. “Three years, I know I can pay my bills because I know what I’m making. Two years from now, when you’re finding another job, who knows what’s going to be out there?”
To Dr. Daniels, the calculation candidates are making has flipped entirely.
“The lifestyle and/or experience issue is much more important than the security issue, which is what you build with a long-term practice,” he said.
He traces part of the shift to who trains new physicians in the first place.
“When I trained, most of my attending physicians were private practice doctors who came to the hospital. Now, most of the people who train doctors are employed physicians with the system, so they don’t have that same private practice mentality,” Dr. Daniels said. “Most of them are paid on RVU-based contracts. “
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