When newly graduated residents and fellows embark on their journeys as attending physicians, there is an abundance of financial guidance available. Gradually acclimate to your salary. Avoid purchasing a home immediately. Obtain disability insurance. Prepare for the tax implications that often catch attendings off guard during that transitional half-trainee/half-attending year.
Today, we will not delve into any of those topics. Instead, we will concentrate on a business concept that you need to discard upon completing your residency: How to be a reliable team player.
The process of becoming a dependable team player is instilled in you throughout your medical training. During residency, you accept the remuneration they provide without objection, and seeking a pay increase is simply not an option. You are trained to take pride in the staggering number of hours you devote and to manage it all with ease. If a scheduling error results in your latest night shift overlapping with a lengthy day shift, you persevere, maintain a cheerful demeanor, and display no signs of weakness until you finally crumble in the solitude of your own home. Those who excel at this become chief residents and are prime candidates for fellowship.
During your training, you are recognized for your perseverance, your fortitude, your calmness, and your capacity to surpass even the toughest expectations. However, these same qualities can turn into a disadvantage once you become an attending.
If you never voice your discontent, necessary improvements will never materialize.
If you never refuse additional responsibilities or shifts, the inevitable consequence will be fatigue or burnout.
If you consistently perform the tasks others expect of you, you will never take control of your own career.
If you never interrogate the details of your compensation, you will neither learn nor receive what you truly deserve.
Upon becoming an attending, you must adopt a new self-perception. Your ideal self-image should no longer be that of the stoic, tireless team player who never lets anyone down. Instead, I encourage you to embrace a drastically different and potentially uncomfortable identity: I am the CEO of my own enterprise. For physicians in private practice who will own their own offices, this will be a literal truth. But even for those working as W-2 employees, this mentality can transform everything.
Try vocalizing the following phrases. The first phrase illustrates the previous mindset, while the second corresponds to the new mindset.
Previous mindset: “I am a physician at [your practice].”
New mindset: “I am the CEO of my own enterprise, and one of my current clients is [your practice].”
Do you see the distinction? Previously, you were part of a team, and your role was to fulfill the needs of that team. Now, you have a collaborative relationship with that team, both invested in achieving shared professional fulfillment. There are several significant implications here.
1. Never accept a professional relationship that isn’t mutually beneficial. If a health practice makes unreasonable demands of a good team player, they may grit their teeth, endure for the collective good, and complete the task. But a CEO would approach their client and say, “I’m uncertain how the professional relationship you are suggesting can be mutually sustainable. Can we discuss further?” If this feels uncomfortable to articulate, consider whether your employer would hesitate to inform you if some aspect of your employment was unsatisfactory to them. There is no reason you shouldn’t do the same.
2. Always safeguard your relationship with a valuable client. I am not suggesting you become self-serving or reject teamwork; that is the quickest path to losing a client who deserves more. A mutually beneficial relationship is not only an expectation but a responsibility you must uphold. The work ethic, determination, and commitment to excellence you cultivated during your training? Put it to use, but take ownership as part of your brand. Channel that old medical student tenacity to surpass expectations by asking yourself: “How can I provide additional value to my client? What challenges does my client face that I am uniquely positioned to solve?” This secures your business by reducing the risk that your client will terminate your relationship first.
3. Having multiple clients provides you with greater flexibility. What will happen if a great client decides to end your relationship? Like any other business, you are more robust if you have several clients for your income. You operate in a free market system. There’s no rule barring you from collaborating with multiple clients simultaneously, provided you can maintain that mutually beneficial relationship. Your personal business could engage with another medical practice client, an expert witness client, an asynchronous telemedicine client, a pharmaceutical or industry client, or a non-medical consulting client. Keep this in mind when you are agreeing to a contract that includes a non-compete clause, a clause restricting you from working with others while employed, or a clause that grants them ownership of anything you develop.