Welcome to the big leagues
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I recently completed my first multiyear contract as a member of a large multihospital health system with an academic affiliation on Long Island, New York. As I continue to grow and advance in my roles, I thought it would be appropriate to reflect on some challenges I have encountered during my 3 years in this transition from orthopedic training to orthopedic practice and to share my thoughts on a few lessons for which no amount of training can prepare you.
Get busy
Regardless of the contract and incentives highlighted within the fine print, your goal should be to provide the best care to patients. Being a physician is not only about being a great doctor, it is also about making colleagues and patients feel comfortable with care and competency within your specialty.
These relationships continue to flourish with patients and referring physicians. You never know who is going to provide you the best network, so all patients and referrals need to be treated equally. You can never stop interacting and the best advertising is through word of mouth following a great encounter. Getting my name out there has become my main effort, in conjunction with support staff within my hospital and practice group. Increasing my numbers in the office and the OR likely leads to more money being collected, a higher number of RVUs, which may, in turn, increase my financial bottom line.
Bear in mind that being accessible, available, able and affable can come at a price. Work-life balance can easily be overlooked as you start your career. A word to the wise — keep yourself grounded and remember your family and support should be number one.
Preparation
An important factor that aids in operative success, aside from competence and practicing surgery through cadaver labs, etc., is preoperative planning. While it seems trivial, oftentimes it helps prevent unexpected consequences. It takes a large amount of time as a new attending, and significant coordination with other players within the OR setting. When we let our guard down or think we have mastered a particular case throughout our training or early into an attending career, that is when we let an important detail slip by unaddressed. That is when a critical implant is not available for use and the surgical plan must be altered to avoid negative outcomes. Adding a block of time for preparation and an opportunity to seek opinions from your mentors and senior colleagues is paramount and should not be taken lightly.
Balance home life
We are now tasked more than ever to manage a busy clinic schedule, operate safely and within a timely manner, be home in time to enjoy a meal with family and have time to unwind before our young children go to bed. In a specialty where a surgical emergency or urgency may roll into your clinic at any time, we must remember the decision we made to enter this specialty and the responsibilities that go along with it. It is important to take time with your family and not bring frustrations home from the hospital or clinic. As your family has done throughout your training, they are likely the most supportive and loving people in your life, so make sure to treat them appropriately.
Remember to take care of yourself, too. Not only is your physical well-being important, but pay attention to your mental health, as well. It is easy to become super engrained in work and forget about other important things in life aside from family, like hobbies and extracurricular activities. Be sure to engage in all facets of your life outside work to create a positive balance between career and life. It is important to capture each moment throughout your professional career, including degrees, awards, honors and academic achievement. However, the framed photos of friends and family certainly deserve a spot on the wall.
Look to the future
Looking forward to the next stages of my career is an exciting task. I have been fortunate to be asked to lead and have goals to further advance my position. I frequently try to reflect on how far I have come, but also envision the next path I wish to take. It is important to understand and look back on the challenges we have had to get to this point all while assessing what is ahead.
My goal is to continue my involvement all at a pace convenient for me. It is easy to get caught up in the hype and try to move too fast at a cost that may be detrimental to overall growth. Stay grounded and focused on goals. Stay close to your department leadership, as they make excellent sounding boards for feedback and appropriate guidance.
In closing, one cliché comes to the forefront, but I never thought much of it when I first started practice. It is a comment I heard from a mentor about managing work, life and career goals: Realize that your family won’t care about or remember the many thousands of surgeries you did but instead will be certain to remind you of the good times you missed. Stay true to yourself and be sure to understand exactly who you are, where you stand and where you want to end.
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Adam Bitterman, DO, is an assistant professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Huntington, New York. He can be emailed at abitterman@northwell.edu.
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