How to Choose the Right Medical Practice for Your Personality | MD&D #13

Evidence based insights into physician compensation, RVUs, contracts, healthcare economics, and personal finances. For residents, fellows, and early-career attendings.

Life and Finances, in Medicine.

Carl Jung, the famous Swiss psychiatrist, is often quoted as saying, “Who looks outside, dreams; who looks inside, awakes.” There may be few moments when this is more relevant to a doctor than when deciding what type of practice is best for you.

When it comes to our career decisions, we spend a lot of time looking outside. Especially when we are presented with a contract, the first thing most doctors look at is the salary part. Others move on to the details of the agreement, like call, benefits, and earning potential. And these things matter. Of course they do. But there is an inside factor that matters just as much. Your personality.

In medicine, we tend to follow many stereotypes. For example, we associate certain personalities with certain medical specialties, sometimes almost comically so. Surgeons are often stereotyped as aggressive and decisive. Internists as thinkers. Pathologists as more introspective, and pediatricians as warmhearted people.

Obviously, these are generalizations that don’t necessarily apply to all members of a specialty made up of thousands of different people. But there are some hidden truths underneath the stereotype.

Your personality probably influenced the specialty you chose. And whether you fit the stereotype of your specialty or not, your personality will also influence the type of practice in which you will feel most comfortable.

Not everyone likes to think about RVUs, production, collections, or maximizing compensation. I am very comfortable with all of these, but that is not the case for everyone. Some doctors are perfectly comfortable receiving a salary, doing their work, taking care of patients, and not worrying very much about the financial side of medicine.

There is absolutely nothing wrong with that. That is how they feel comfortable. It may simply match their personality. Others, like me, thrive in an environment where production matters, where compensation can increase dramatically, and where there may be higher financial risk accompanied by greater opportunity. A lot like investing in the stock market.

I have lived several versions of medical practice, and only later did I understand how much my personality had to do with my choices at those specific times.

For example, at one point, I worked in academia. I genuinely enjoyed the intellectual work. But I eventually found myself working on papers that I did not always feel were contributing as much as I wanted them to contribute.

Later, I worked for a community hospital on salary. That experience was very different. I developed wonderful relationships with my patients, and although I was still very busy, I had time to walk to the cafeteria, eat lunch, and talk with other physicians.

Then, I moved into private practice, where things move very quickly. Every minute, every patient encounter, documentation, and coding matter. You become very conscious of how you use your time, and eventually I learned to have lunch at my desk.

That environment is not necessarily better or worse than any other model. It is just different. I love the operating room. I like the fast pace. I like the challenge of making decisions in seconds. I like productivity and the financial part of medicine. That environment fits my personality. But that is my personality. It does not mean it should be yours.

That is why, before deciding which type of practice is right for you, you should spend some time understanding yourself. Assess what makes you happy in a practice. What pace and type of practice better align with what you know about yourself?  Of course, you must also consider your outside circumstances, like your partner, children, or debt, if you have any. But knowing yourself well is the first step before you even embark on the process of looking for the appropriate practice. If you have the choice. Because some physicians simply take the first good job they are offered because their circumstances narrow their choices. That is understandable too.

Just remember, your first job probably will not be your last. According to data cited by the American Medical Association, nearly 60% of physicians leave their first job after residency or fellowship within three years. There are many factors for this. Internal and external. But this is undeniably a large number.

There is another layer to this personality equation. You should not only understand your own personality. You should try to understand the personality of the organization you intend to join.

Organizations are made of people, and over time organizations develop personalities of their own. Some are aggressive. Some are more lenient. Many are bureaucratic, and great number are very entrepreneurial. Matching personalities is not an easy task.  Patience is of much importance.

When I joined private practice, I actually accepted a pay cut. On paper, that may have looked like the wrong financial decision. But I knew I was joining an organization where I could grow, professionally and financially. The environment matched the way I thought and worked. And I matched the type of provider they were looking for. And I have to say, it worked for both parties.

Now, there is one more thing we must consider, personalities change as life changes.

I am not the same person who finished residency 17 years ago. I am certainly not the same person who started residency. Life shapes the changes that make us who we are today. Priorities, finances, and families change. And so do we.

Perhaps someday I will find that I am no longer the person who enjoys the fast-paced life of this fast-paced city that I call home. The life that I have loved for so long. And there is nothing wrong with that. It would simply mean that I evolved. And my decisions most probably will adjust accordingly.

So before saying yes to a practice offering you a big, startling salary, or the partnership opportunity, the academic title, or whatever else the practice believes you want, spend some time looking in both directions.

Look outside. Study the contract, the compensation, the call schedule, your family, and your financial circumstances. But give the same amount of importance to looking inside. Who are you at that moment? Who do you want to become? And how well do you and this practice align with each other?  If you are consistent, you will always make the right decision. God knows I did it, every step of the way.

Choosing the right practice is about more than salary and family circumstances. It is also about knowing yourself.

✓ You must know who you are, what you like, and what you don’t like before joining a practice.

✓ Your decisions must consider your internal factors as much as the external ones.

✓ Just like you have a type of personality, so does the practice you intend to join.

“Your personality changes as life changes.”

Next: You Can Handle Your First Physician Contract
What Every Doctor Should Know Before Signing a Physician Employment Contract

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Life and Finances, in Medicine.