Tips For Leaving a Practice

Cara Cipriano MD, FAAOS | Amiethab Aiyer, MD

June 8, 2022


Congratulations on your new practice opportunity! Now that you have gone through the hard work of searching, interviewing, negotiating, and deciding to make the move, don’t forget these important steps to facilitate the transition:

1Informing Your Current Practice

There are many ways to do this depending on your situation, but make sure your chair and division chief learn from you directly, rather than hear it from someone else. This can be a difficult conversation, especially when the news is unexpected, so prepare and practice the message you would like to convey. Be respectful and appreciative of the opportunity afforded to you at your current job. By presenting a thoughtful rationale for why you are leaving, you can offer valuable feedback while maintaining relationships. Your chair will typically work with you to determine when and how the news will be communicated to the rest of the department, often via email announcement. Before then, consider telling the colleagues that are important to you in person. This could include partners, your clinical/OR team, administrative assistant, and any dedicated staff.

2Planning Your Transition

Once it is generally known that you will be leaving, start gathering the information you will need from your current practice to help you start your new position. Ask your OR team for a list of the instruments and equipment you use and send this to your new practice as soon as possible so they can be prepared for your arrival. Collect any forms, protocols, and templates that you use in clinic and send these ahead as well. There may be limitations related to electronic medical records, so speak with your technology team about how best to accomplish this. For example, it is unfortunately not possible to directly transfer order sets and smart phrases in Epic, but they can be downloaded as a word document, then adjusted and re-uploaded in the new Epic system with the help of technology experts on each end. 

At the same time, your new employer will send you information about licensure and credentialing. These are critical processes that will take time and effort, so start as soon as so that you can begin your new role as seamlessly as possible. If you don’t already know from the recruitment process, find out details such as how many appointment slots are in your clinic, whether you will have a scribe, who is your office coordinator, what is your block time, are the implants you want to use approved? The more you know and address in advance, the smoother your arrival will be. It is ALWAYS preferable to have addressed all of these issues during your negotiation to change positions, not after you have signed your new offer letter/contract.

3Managing Your Own Reaction

Transitions are challenging on many levels, and neuroscience/psychology has taught us that we are physiologically programmed to resist change. Once we have made the decision to move on, our mind will try every trick to convince us to return life to the status quo. You may experience anxiety, regret, or even panic in the weeks and months following your decision. Remind yourself that this is largely a biological reaction that originally developed for self-protection but may inhibit you from seeking critical growth experiences. Trust the motives and process that helped you arrive at your decision and be patient with yourself, acknowledging that change is inherently challenging as well as beneficial. Take advantage of new opportunities and use them to launch for the next chapter of your career. It’s an exciting time!


DISCLOSURES: Dr. Cipriano KCI: Paid consultant, Link Orthopaedics: Paid consultant, Musculoskeletal Tumor Society: Board or committee member Dr. Aiyer American Orthopaedic Foot and Ankle Society: Board or committee member, Delee & Drez Orthopaedic Sports Medicine (Elsevier): Publishing royalties, financial or material support, Medline: Paid consultant, Medshape: Paid consultant, Miller’s Review of Orthopaedics (Elsevier): Publishing royalties, financial or material support

Read the AAOS Code of Conduct for Discussion Group Terms, Conditions and Disclaimers HERE.

Copyright© 2022 by the American Academy of Orthopaedic Surgeons

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