ASK THE CAREER COACH
Ten Tips to Keep New Associates on Track
By John Pinto

A: Here are the biggest mistakes I've seen even the smartest new ophthalmologists make in their first years of practice. While most of these points are germane to doctors joining established practices, many of them apply to those few rugged individuals who plan to establish new practices from scratch.

1. If you're a partner-track associate, don't act like an employee.

I talk to a lot of senior, employer-doctors who are unhappy with new associates. The most common complaint is not about clinical skills but behavior. Lapses include dating staff, discussing confidential practice business matters in the community or grumbling openly about salary. Decide if you're going to be a practice owner or an employee in the future, and then behave accordingly.

2. Don't be a loner.

Most practices are now or will soon be scaling up via consolidation into much larger single- and multispecialty organizations. You should be able work with other members of a multidisciplinary team and be willing to defer to group decisions.

3. Don't assume you're doing a great job.

If you haven't done so, prepare a list of goals you want to accomplish in your first few years of practice, and share them with your employer. Be sure to include extracurricular duties (vision screenings, community involvement and the like). Check in with your employer at least quarterly to compare notes on each others' perceptions of how you're doing.

4. Don't stop your education.

We're all paid for value. Continuously increase your value to the practice by learning new skills, either formally through meetings and continuing medical education, or informally through mini-fellowships and self-education on the job.

If your boss likes to teach, draw on him as a resource. Even if you're learning at a slower pace than you would in a more formal setting with a big-name professor, the contact time will provide invaluable secondary benefits. While you're building a foundation of clinical skills, develop a new competency in management skills, either formally through M.B.A.-level courses, or informally through reading, discussions with advisors and exposure to successful practices.

5. Don't be immature.

Some of my clients will now hire only mid-career surgeons based on a few bad experiences with breaking in young doctors. Show maturity in your attire, language, behavior and follow-through. Don't be defensive when you're told to shape up. Improve the quality — and the impression of quality — of who you are.

6. Don't adopt a lesser work ethic than your boss.

The average managing partner in a group practice is working much harder than ever before to maintain personal and clinical productivity as well as to manage the practice. While the managing partner is pulling hard in the harness, the last impression you want to give is that he or she is dragging you along.  

You'll likely be expected to work some Saturday mornings and weekday evenings, take extra on-call duties and travel to outlying satellites.

Discussing ways to grow the practice at an even faster pace is understandably attractive to any employer.

7. Don't be overly complacent or overly frightened about healthcare reform.

Your job as a new associate is to understand the dynamics of the market and use your knowledge to help the practice gain access to insurance panels. As more patients are covered by managed care, you'll probably have to commit significant personal time to helping the practice transition to and survive in this new environment. Managed care will not be the end of entrepreneurial eye care, but it will force the winners to fine-tune their game.

8. Don't ignore your spouse.

Chances are, both you and your spouse have made sacrifices to get you to this point in your career. It's payback time, not just economically but, more importantly, personally. Spend time together, giving proper attention to your spouse's career. Plan activities that build personal or family-related interests.

When you start working, a sudden influx of cash, combined with new surroundings and temptations can destabilize even the strongest marriage.

9. Don't live on more than 70% of your net after-tax income.

If you start investing now, even with falling fees, you'll retire comfortably in your 50s — or earlier if you desire. Steady wins the race. History shows that regular, level contributions to broad-index funds, along with a modest tapering of personal expenses, can yield a secure retirement. Watching your net worth rise year after year is a powerful antidote to the uncertainty of modern ophthalmology.

10. Once you've decided to leave a position, don't stick around.

Some of you reading this may be considering changing jobs. A few of you may have been on the edge of departure for some time. You're a trained surgeon. Be decisive. And don't get hung up about appearing "flighty" to your next employer. Career and job changes, which have long been common in the business world, will become increasingly common for ophthalmologists.

John Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm that provides strategic planning, economic analysis and operations enhancement services. Mr. Pinto is also a career advisor, providing individual coaching and contract negotiation services for new graduates and mid-career employed ophthalmologists, along with succession planning for surgeons nearing retirement. You can reach him at (619) 223-2233, pintoinc@aol.com or through his Web site pintoinc.com.