Bonnie Gregory, MD | Amiethab Aiyer, MD
July 3, 2023
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As many as 50% of orthopaedic surgeons leave their first job within 2-3 years of starting practice, and up to 70% in 5 years. In a recent study, most cited leaving for financial reasons or because the practice itself was not as advertised.1 The majority also felt like they had minimal training in selecting their first job and most felt inadequately prepared for the business side of orthopedics.1 Regardless of your reasons for leaving a practice, there are multiple challenges and considerations unique to healthcare and others that are true for leaving a job in any demanding career.
When deciding to leave your job, whether it’s for a new opportunity or a new career all together, the first step is to to make the decision. When making this decision it’s important to consider what’s motivating you to make a change as this may provide insight into future opportunities that may be a better fit. A recent Harvard Business Review article 2 discusses just this, asking readers to consider:
Am I working for the right organization?
Am I in the right position?
Am I positioned for the future career I want?
If any of those answers are “no,” then it’s likely time to look for something new. If it’s a problem with your organization and not your job, you may want to consider if the issues can be remedied and if not try to identify those things that make your organization a poor fit for you to ensure you will find a better fit in the future. If it’s a problem with your position, say you find yourself hospital-employed and wish to have the autonomy of private practice, or want thestability of a set salary without the headache of the business side of medicine, this can help guide your next step. Finally, reflecting on what you truly want out of your career in the short- and long-term can help guide your decision. Additional personal impacts are important consideration as well (i.e. proximity to extended family)
Once you made the choice, it’s important to understand some of the challenges unique to medical practice.3 First, it’s imperative to know your employment agreement/contact not only in terms of things like noncompete covenants, but also in terms of advanced notice and even retirement benefits. Next, it’s important to have a plan for notifying patients, this can vary depending on state and often requires written notification to patients. Similarly, you must determine if patient chart’s, demographics, imaging, etc. are owned by you or the practice, and also who must maintain these records and for how long. Malpractice insurance and “tail coverage” are also vital to understand, as some practices may require you to pay for this coverage for a certain time after your departure.
If leaving a practice to join a new one, it’s important to take the time to critically assess your own processes and practice management to ensure you don’t need to reinvent the wheel or face similar obstacles in a new organization. Starting a new role can be daunting, but it can also be a time to reflect, reset, reengage and recommit to being the surgeon you want to be/envisioned being when you started on this path.
Finally, an important consideration is the timing of letting your former practice know you are leaving or planning on doing so; this can certainly serve as opportunity to re-negotiate an existing contract or discuss current challenges/ways to improve. If you are ultimately planning to leave, it may be prudent to finalize signing your new contract before alerting the former practice about your departure. At the same time, it is also optimal to give your practice adequate time to start the process of looking for replacement.
Ref:
- Laratta JL, Gum JL, Shillingford JN, Reddy H, Lehman RA, Crawford CH, Glassman SD, Carreon L. Job Selection After Orthopedic Surgery Training: Why Are Our Trainees Failing to Select the Right Job? Cureus. 2019 Aug 31;11(8):e5539. doi: 10.7759/cureus.5539. PMID: 31687312; PMCID: PMC6819073.
- “How to Quit Your Job: An HBR Guide” Amy Gallow. Harvard Business Review. August 09, 2021
- “A Must-Do List for the Departing Physician:
From tail coverage to giving notice, here’s how to prepare yourself, your partners and your patients for your departure.” JAMES D. WALL, Esq.Fam Pract Manag. 2005;12(9):54-56
DISCLOSURES: Dr. Gregory This individual reported nothing to disclose 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
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Copyright© 2023 by the American Academy of Orthopaedic Surgeons
The satisfaction of being an orthopedist stems from the profound impact on patients’ lives. Orthopedic surgeons often help restore mobility, alleviate pain, and enhance quality of life through precise, life-changing interventions. Witnessing a patient’s recovery and return to normal activities, whether after an injury or chronic condition, brings a deep sense of accomplishment. The profession also offers diverse challenges and opportunities for continuous learning, keeping the work engaging and intellectually stimulating. Additionally, the ability to work closely with a multidisciplinary team and contribute to advancements in medical technology further enriches the sense of fulfillment in the field.
Abhinandan S Punit
Elite Orthocare
Bangalore