The Problem Has Arisen

How to Prevent It

For the Future…

You didn’t negotiate as well as you should have with the docs/community and want: more pay, fewer hours, more control over personnel, better call coverage, more retirement pay, etc.

You should have learned more negotiation skills or paid someone to help in this area. Not all is lost, you are more valuable there than elsewhere, just make sure you convince them and don’t burn any bridges in the process. Take your spouse, lawyer, consultant, office manager, or other who is likely to be a better negotiator with you

Understand your style of communication and your practice style

You realize that your colleagues are way behind in practice management and other issues and you feel very incompatible.

One of your partners has basically been forced into doing more and more administrative work to manage the group and your group must either hire someone or cut the administrative physician’s hours.

Someone is coming to your practice to talk about buying out the practice.

Managed Medicaid and Medicare have come to town, 50% of your patients could be impacted, and your group hasn’t got a clue where to turn.

Do a more complete job of assessing the practice. Encourage and perhaps demand expertise to be hired or bought in this area.

Always get the advice you need to make important financial and career decisions.

Your style of practice is slow and more detailed, offering a lot of support to patients but not rich in terms of income potential and now you find yourself staying later to see more patients to keep up. Or your colleagues are slow and you make most of the billings

Understand this up front and negotiate this. Top rural practices know that they need a variety of types of practitioners to keep good market share and share call and otherwise meet the needs of all of their patients.

Adjust to different practice styles

What kind of persons are you attracted to for bosses, colleagues, patients? Learn about the value of having a variety of types of physicians - amiables, drivers, etc.

You and your spouse just can’t seem to find some friends who share your strange unpredictable hours and interests.

Keep looking in various civic or church groups or through practice contacts. Good friends are the heart of rural practice.

Devote time to this area, especially in the early years of rural practice.

Your house is a nightmare to fix/pay for/etc.

Rural home sales are far more volatile, especially for larger homes.

Buy smaller early and move up later. Make more contacts that way also.

Your spouse is feeling the pull of family and you would like to visit more but....

Your spouse is feeling that there is more to life than taking care of the family while you work

Often a symptom of too much time in practice and not enough time or valuable time at home.

Achieve a balance between practice, marriage, and relatives.

You volunteer a lot, soon you are overwhelmed and it is easier to leave that deal with all of the overload.

You are so involved that you are just not very efficient.

What are your personal goals, ethics, positions, relationships in community, spouse and family, practice, patients, health system/hospital

Make adjustments, read "The Road Less Traveled by Scott Peck or similar books, remember that you came so that you could make a difference.

See the long term need to say no, carefully consider commitments in view of overall goals for self and family. Assertiveness improvement, say later which is a form of no

Take special training in leadership, personal management at Academy events, national meetings