Tung Giep, MD, recently published a book, “The Business of Medicine: The Definitive Guide to Help New Physicians Start Their Career on the Right Path and Avoid Costly Mistakes,” which reflects on his career in medicine and shares insights into mistakes physicians often make at each step of their careers.
From medical school to private practice ownership and employment contracts, here are some of Dr. Giep’s takeaways for physicians at the early, middle and final stages of their careers:
Early career
Dr. Giep told Becker’s that too often, when interviewing for a position within a practice, young physicians fail to properly research that practice.
“If you’re a brand new resident coming out of training, I highly recommend that you find out as much as you can about the practice that you’re interested in,” he said. “There’s a lot of things that you can find out, not just on the internet.”
Dr. Giep, a neonatalogist in Charleston, S.C., said that the surrounding community can sometimes be the best source of information about a medical practice.
“What I usually do when I’m looking at a hospital is that I come in and I have breakfast at the diner or restaurant across the street from the hospital. I sit down at least an hour before my meeting and talk to the waitress and ask them about that hospital down the street,” he said. “Would you have your baby there? Would you have your family members taken care of? What do you think of that hospital? And, they will tell you.”
Dr. Giep also said that young physicians often get caught up asking questions related to benefits and compensation, which capture only part of what a practice can offer a prospective hire.
“When you’re doing your interview, you need to be asking questions, like who’s going to run the practice? Are they going to teach me anything about the business? Who [will be] your mentor?” he said. “They expect you to know the clinical part. You want to know who’s going to be marketing you and how they’re going to be marketing you, and what is their responsibility to make you successful. Those are things that a lot of new grads don’t ask.”
He specifically cautioned against expecting partnerships or equity stakes too early in the process.
“Partnership is something that’s not quite often offered anymore, and when they do offer something in a very short period of time, be very leery,” he said. If it [seems] too good to be true, it probably is. Since you’re not a business person, if they do have contracts for partnership papers, have your attorney look at it and make sure you know exactly what it is.”
Mid-career
For physicians in the middle years of their career, and especially for those in private practice, Dr. Giep advises continued caution. “One of the biggest mistakes is trusting too much,” Dr. Giep said. “You need to trust, but verify.”
This can apply to a number of circumstances and situations, especially when it comes to hiring. Dr. Giep specifically cautions against hiring friends and family members, as physicians may be over trusting of these relationships and not apply the same scrutiny or oversight to their work. In the book, he references anecdotes in which physicians hire family members to manage billing or frontdesk operations despite a lack of qualification, ultimately leading to fraud or embezzlement, usually unbeknownst to the physician.
“Don’t have a rubber signature stamp because it can easily be abused,” he said. ” I once had an office manager who used a signature stamp to open up a second bank account under my name, with her being the main beneficiary. I didn’t find out about it until the bank statement came back to the office.”
This relates to his next major piece of advice for mid-career physicians, who are often so inundated with clinical work that they do not adequately review administrative or clerical documents.
“Read everything that you sign,” he said. “Otherwise, things like that can easily happen.”
He also cautions against cash boxes or anything that creates unmonitored access to the practice’s funds. Physicians can also get ahead of these incidents by taking the time to familiarize themselves with coding and billing processes so they can catch errors or suspicious behavior before it endangers their practice.
“You gotta pay attention to compliance issues. You gotta understand about coding and billing, because if you don’t, you’re still responsible. The government’s still gonna accuse you of fraud if you did not know what you were doing,especially if there’s upcoding or downcoding — and nobody teaches you [that],” he said.
Without proper research, private practice physicians can also get themselves into financial holes as they rack up operational costs.
“Everything costs money, and that’s one reason why a lot of practices don’t succeed. I know a lot of doctors who are just bad business people. They find themselves heavily in debt and having to get out of their practice and they can’t sell it because there’s so much in debt,” he said. “So they just fold it and join another group and then have that group take advantage of that doctor, because they know they’ve got you in a desperate situation. There’s plenty of practices that would love to bring in a doctor who’s in distress. That means the employer can dictate the terms to that doctor, so instead of paying them what their market rate is. They can undercut you and hire you for very little and take advantage of it.”
Late career and retiring physicians
Dr. Giep also reflects on his brief encounter with retirement in the book, which lasted only five months before he took a position at the Medical University of South Carolina in Charleston.
“When I retired for five months, I had no hobbies, so thinking about doing this the second time around, I need hobbies,” he said. “Writing this book is sort of a way for me to sort of segue from clinical work to doing something that I can give back to the community, medical students, residents and fellow doctors.”
He also cites the experience of his now 93-year-old father, who was an OB-GYN and also saw a lessening of his mental acuity during the transition from the highly engaged, intellectually stimulating life as a physician to the slower pace of retirement
“Seeing that experience, people who are getting ready to exit the medical field better find something to do,” he said. “You better find a hobby besides just golf. You need to find things to do to keep your mind going and keep yourself physically active.”
