Check your contract to make sure your non-compete is centered at the primary office in which you practice, rather than any office site the health system owns.     The “primary office”language has long been standard, but as competition for clinician labor heats up (I recently saw a pop up ad recruiting general internists for Mayo), non-competes are becoming as restrictive as the law can make them.     The fact that health systems...

  I find it curious to that even as clinicians, we ourselves have training in the process of helping our clinicians make positive change—quitting smoking, losing weight—we don’t see the process of our own career transitions as similar.       They are.     Change involves addressing both the emotional and practical aspects and implications altering our habits.     And whether it’s smoking or changing career focus, unless you address both in a...

    Just back from serving on the faculty of the SEAK Non-Clinical Careers Conference where I’m privileged to serve as faculty.       Over two days, I had direct contact for at least 15 minutes with over one hundred individual clinicians “seeking” information.       It made for two very long days indeed.       Now multiply that against dozens and dozens of similarly qualified faculty, and you can see the...

    Arizona is expediting PCP licensure applications.     Missouri is approving limited licensure for docs without internships.     Ohio has reduced CME requirements.     What do all those states have in common?     The are fully controlled by a limited number of large health systems.     Working conditions are miserable, Wages are below the mean. Burnout rates are higher.     All because of limited competition.     So...

    When looking for a job, it pays to be a “secret shopper.”       Make a routine appointment with a physician in the health system at an office where they don’t know you’re applying for a job.       Do the whole thing, the scheduling, the office visit, the exam.       Make it for a limited problem.       Pay cash, it should only cost a couple of...

    You should be able to explain your compensation formula to a peer while standing on one leg.     If you can’t, your job will demand far more of you than you will expect.     You will be asked to perform more non-clinical tasks than you prefer.     And you will feel less fulfilled than you desire.     There’s also a significant risk that you’ll be cheated.     You...

    Medical training does not prepare you for the corporate world.     Yet that’s where you’re probably going to be spending most of your career.     Without the knowledge of how and why things work, the flow of decisions and information will be mystifying.     That lack of understanding is a huge source of burnout and stress.     Interestingly, nurses do better than docs when they become employed clinicians—they’ve spent more...

    I physician I recently worked with came to me with a problem.     She wanted to open her own clinic but part of the non-compete in her most recent employment contract restricted her from owning any medical business of any kind, anywhere for seven years.     Otherwise, she would have to pay her former employer $250k—with interest if it took them time to find out what she had done.    ...

    When looking at employment opportunities, ask your employer how much control you will have over your patient schedule?     How many patients am I expected to see?     Get a vague answer? Run.     Get a specific answer, ask them to put it in your employment contract.       If they balk, if they say something like “our contracts are standardized,” then run.       If they say...