What every new physician should know

Fourteen physician leaders and recruiters recently connected with Becker's to share what new physicians should know.

Editor's note: Responses have been lightly edited for length and clarity. If you would like to contribute to our next question, please email Paige Haeffele at phaeffele@beckershealthcare.com.

Question: What are three things that all new physicians should know?

Laurie Bankston, MD. Medical Director of Primary Care Quality at Kettering (Ohio) Health: 

1. Patients will always remember that you listened and were kind. 

2. Maintaining your own exercise and heart healthy diet is critical for your resilience throughout your life.

3. Hang on to the meaningful parts of practicing medicine for dear life. Cynicism is truly a thief of joy.

Samuel Bauer, MD. Medical Director at Duke Perinatal Consultants of Durham (N.C.), Duke University and Associate Professor of Obstetrics and Gynecology: Early-career physicians entering the medical profession should be aware of several key aspects to ensure long-term job satisfaction and success.

1. Patient-centered care and communication. At the heart of a physician’s practice should be an unwavering commitment to patient-centered care. This involves prioritizing the treatment of patients with the utmost respect, empathy and compassion. The ability to actively listen to patients' concerns, involve them in decision-making processes and ensure transparent communication is paramount. Equally important is understanding the holistic needs of patients, considering factors beyond their medical conditions, such as social, cultural and emotional well-being. By adopting this approach, physicians can deliver comprehensive care that addresses the diverse facets of patients' lives. 

Strong communication skills are indispensable for building trust with patients, collaborating with colleagues and ensuring the seamless delivery of healthcare. Physicians must be adept at conveying complex medical information in an understandable manner to patients and their families. Active listening, empathy and clear communication foster positive patient-physician relationships. Additionally, effective communication within the healthcare team is pivotal for the coordination of patient care.

2. Continuous learning. Continuous learning provides a foundational cornerstone for success in the dynamic field of medicine. Given its rapid evolution with frequent breakthroughs in research, technologies and treatment modalities, new physicians must embrace a mindset of lifelong learning. Actively engaging in continuing medical education, participating in conferences and proactively seeking both formal and informal opportunities to expand knowledge and skills are imperative. This commitment to ongoing learning ensures that physicians remain well-informed of the latest medical advancements, enabling them to provide evidence-based and state-of-the-art care to their patients.

3. Self-care is not optional. Recognizing the demanding nature of a medical career, new physicians should recognize that self-care is not optional. The profession's intensity can lead to burnout and stress, making it essential for physicians to prioritize their physical and mental well-being. Establishing a healthy work-life balance, seeking support when needed and carving out time for relaxation and recreation are crucial components of self-care. Identifying signs of burnout early and developing strategies to cope with stress are imperative for long-term success and satisfaction in the medical field. Beyond these key points, new physicians should also recognize the importance of ethical practice, implicit bias, cultural competence and the significance of teamwork within a healthcare setting. The ability to adapt to change, navigate uncertainty, and uphold the highest standards of professionalism are qualities that contribute to a thriving and successful medical career.

Kendall Bly. Assistant to the Director of Physician Recruitment and Retention at CHI Mercy Health (Roseburg, Ore.): I would say first and foremost, never stop learning. Always find CME to expand your knowledge and skillset. Two, being open to leadership opportunities, if desired.  Three, if you want work-life balance, make it a clear expectation at the very beginning of your career. 

Dean Frate, MD. Physician Adviser and President of Medical Staff at Summa Health (Akron, Ohio): 

1. The best opportunities for success exist in compromise positions. It’s rare that best patient care is found solely in one guideline that aligns perfectly with our patients' goals, access, means and values. 

2. The business of medicine similarly respects compromise. Generally, there are conflicting measures impacting any one proposition. While different stakeholders in that proposition may have exclusive views, successfully owning and stewarding it requires assessment of the weights of those measures and finding a best balance.

3. Balance in both medicine and the business of medicine is a verb. Balance points are dynamic. Maintaining individual balance, as a noun, requires developed skill for mental and emotional agility, acceptance that targets aren't fixed and human connections to those we serve and those we serve with.

Scott Huitink, MD. Pediatrician and Owner of Compass Pediatrics (Gallatin, Tenn.): 

1. Know your worth. As a physician, ability, affability and availability determine your economic value. Those with great ability who avoid interacting with others and want to work a limited schedule will not have as much worth as those who are able to communicate well and work a full load of patients. But it is not your paycheck that defines your worth nor your employer — it is you. Knowledge, people skills and work ethic are keys to success in medicine. Develop them all and understand your value is directly related to these characteristics manifested in your patient following.

2. Know your design. You are unique and have characteristics that will make you flourish in the right setting. And in the wrong setting, you will likely burn out quickly. For the individual who has always loved bench science, academic medicine will provide the greatest opportunities. For the person who has loved solving problems and worked odd jobs in high school or college to make ends meet, private practice will likely be the place where your entrepreneurial wiring will come together with your medical expertise.

3. Know the professional opportunities in medicine are tremendous. Medicine is extremely diverse with people of different backgrounds and biases who are highly sought out by patients for those individual peculiarities. Consider finding people who share your values and interests and are willing to allow you to be who you are designed to be and will financially compensate you for what you do without exploiting you. This will bring you great joy and fulfillment. Employment as a well-compensated factory-line worker in a large system will only fulfill you if that is how you are designed.

Kanchan Koirala, MD. Chief of Medical Staff at Palomar Medical Center (Escondido, Calif.): 

1. Learn proper documentation/chart hygiene for accurate patient care, coordination of care and for billing/coding. 

2. Choose your job/employer well so that you and your family can thrive in the community you choose to make home. 

3. Find hobbies/activities outside the medical field to improve your "beauty-to-death ratio" in life.

Bill Mawhinney. Senior Medical Staff Recruiter at Tower Health (Reading, Pa.): Take time to know what you want in a job. If you want a high salary, then be prepared to work for it. If you want to be near family, then focus your search early on the set location. If you want to earn the 90th percentile of MGMA income, you are going to need to go to a location that might not be near family; you might be the only physician and your work-life balance is going to be unbalanced. Know what you are willing to negotiate in order to achieve your desired job. 

If you are a new physician coming out of training, you don't have a lot of bargaining chips. While you might be in a specialty that is in demand, as a new physician, know that your first year of practice will be a loss for the organization. You'll need six months or more to get comfortable with your new surroundings. You will not bring a patient following or a well-known reputation to a new job.

Know what you bring and what your value is to your new employer. Express how you as a new physician can make an impact for the patients, community and the organization. Sell yourself! 

Be honest with the organization. If you are not interested, then let them know. Nothing is worse than having a candidate play games and ghost a recruiter. Don't play one offer against the other.  In-house recruiters that are employed by the organization have a vested interest in getting you the best salary and benefits possible. We also know when we are getting played. If you want the job, like the team, the hospital/practice and the location, then tell your recruiter. Let the recruiter know that their position is your first choice. You just want to know if there is room to negotiate the offer. If you are honest, a good in-house recruiter will fight to get you the best deal. Work with your recruiter; they can be your strongest partner. 

Don't wait till the last minute to start your search. If, for example, you want to be near family, then start reaching out to hospitals, practices, organizations in the area. Also, know that working with an in-house recruiter or someone employed by the hospital will get you in faster than working with a contingency firm. If you get a call for a job, ask the recruiter if they work for the organization or a search firm. If they work for a search firm, the recruiter doesn't always have the full details on the job or the commitment from the hospital/practice to present candidates.

Shaibal Mazumdar, MD. Gastroenterologist at Aurora Health Care (Menomonee Falls, Wis.): 

1. Medicine is a team sport. Create a culture where you respect, appreciate and value people; encourage critical thinking so that you can recruit and retain the best people around you, e.g. nurses, techs, nurse practitioners, PAs, etc; they will create value with good patient outcomes. Have strategic clarity along with empathic communication in your practice.

2. Be curious about the technological disruptions in medicine, including AI, quantum computing, telehealth, etc. It will change the way we practice medicine in the future.

3. Practice gratitude and self-care, including organized downtime with family, friends, hobbies, etc.

Bhaskar Padakandla, MD. Anesthesiologist at US Anesthesia Partners of Texas (Dallas): I strongly believe there are three things every physician needs to learn before coming out of residency program. However, most of them only learn one.

Clinical education: the science of medicine.

Healthcare economics: the nuances of market forces and insurance industry in the providing (or not) of healthcare.

Healthcare advocacy: the knowledge of and the need to get involved in the legislative and regulatory impact on healthcare. As Plato said, "One of the penalties for refusing to participate in politics is that you end up being governed by your inferiors."

Nina Phatak, MD. Gastroenterologist at Gastroenterology Associates (Warrenton, Va.): This is the advice I wish someone had told me when I was starting out:

1. Understand the business side of medicine. It's not something that's routinely taught at any point in one's training, but it is vital to understand regardless of whether you work in a private practice, hospital or managed care setting. 

2. Understand the importance of networking and building a community. Medicine at times can be a very lonely profession. It helps to build solid relationships that will help sustain you over the course of your career.

3. Make sure you join a practice/department with like-minded physicians. You will be spending a lot of time with these individuals, and having a supportive, collegial work environment will quickly become the most important factor in your decision to stay in a practice/job.

4.  Take all your vacations and be truly present for your family when you are away from work. It will prevent burnout and maintain the longevity of your career.

Bruce Robinson. Provider Recruiter at MercyHealth Wisconsin and Illinois (Rockford, Ill.): 

1. Every practice location is different. The way you did things in residency or medical school no longer applies. And every time you change practices, you somehow change the approach to medical practice. The fundamental ingredients may remain the same, though the recipe may change. Make change your friend or it will become your enemy.

2. We hear this all the time and it happens to be true: Medicine is changing nonstop, and that means nonstop learning. Exceeding your CMEs. Doing deep personal learning. It is always concerning when a physician displays thinking or approaches from a decade or two ago. Being a great physician in the 21st century mandates that one is a curious and voracious learner.

3. A physician’s life can be difficult. Now, more than ever. Scheduling, reimbursements, coding, corporate ownership, referrals, staffing, EHR/EMR, telehealth, the arrival of big-box primary care through Walmart, Amazon, CVS, Walgreens, etc. However, remember that for millennia, being a physician was a vocation. You are a healer, not a technician. So medicine is an art, not just a science. In tough times, your calling will protect and assure you. Your vocation will also fuel you to become the transformative healer upon whom your patients can fully rely.

Scott Sasser, MD. Chief Physician Executive at University Hospitals (Cleveland): First and foremost, don't lose focus on why you became a physician. While we each have our individual reasons, all of us have an embedded missional focus to care for patients, families and communities. In our ever-changing world of healthcare, it is imperative that we maintain our grounding in what led us to medicine. As an extension of this, my second recommendation would be to dive into your chosen specialty and profession: Have fun caring for patients and building your individual clinical practice. This will make you an outstanding clinician and give you remarkable insight into the opportunities and challenges in healthcare today. Finally, lean in to being a part of the broader conversation at your practice, your hospital or your healthcare system. Learn about operations, finance and administration. As an engaged physician, you will not only help solve challenges, but also you will ensure the voice of the patient is in the room as critical decisions are being made. Healthcare is dynamic, evolving and faces enormous external pressures; in this environment, practicing medicine is a combination of art, science and business. As a new physician, put yourself on the road to success by embracing all three.

Sri Sundaram, MD. Cardiologist at South Denver Cardiology: 

1. Never stop learning. As a cardiac electrophysiologist, three-quarters of the procedures I do now did not exist when I finished fellowship. You constantly have to adapt and learn to stay ahead of the game. Part of the joy of being a physician is always learning new things. Keep the attitude of always learning. It will benefit you throughout your whole career.

2. Become friends with the administration of your hospital. I've been in situations in which we did not have a good relationship with the hospital administration and others where we do. You will get so much more done when you have a cordial relationship with your hospital administrators. You will work together to improve your hospital. Getting to know your hospital administrators as people and working together with them will have a much bigger long-term impact than an adversarial relationship.

3. Learn the business side of medicine. In a heavily dependent technological field such as cardiac electrophysiology, you have to be able to understand the finances of medicine. You don't necessarily need a master's degree, you just need to pay attention and ask a lot of questions. To get the latest, greatest tools for procedures, you have to be able to understand the finances from industry perspective, hospital perspective, third-party payers and physicians.  

Sheldon Taub, MD. Gastroenterologist at Jupiter (Fla.) Medical Center: There are several things that all new physicians should know, but most importantly, they must be ethically responsible to themselves and others. They must be resilient and adaptable, now more than ever, and be able to effectively communicate and have the capacity for improvement.

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