What to do when you are stuck with a tough clinical case? What if all labs and imaging that you do is not giving you an answer. You feel like a detective but not like Sherlock Holmes. Here are the ten commandments to solve a difficult clinical case.

It is almost July and most of the residents should have landed a physician job. If not, but you are mulling over several physician job offers -- then you are still good to go. But if you have not done a single interview yet or worse if you have not started applying yet, then you are really getting late. But do not despair, as there are plenty of physician jobs available.  Those who have visa issues need to be extra careful about the deadlines for applying for one.

There are several strategies to catch up for your Doctor job search. These techniques can be used by the early birds too as they are very effective in getting the contract in hand.

1) Networking: Talk to your attending physicians in the hospital and program. Many if them will be looking for a partner in the near future. May be you can fit into that role. Even if they are not looking, they may know someone , who is looking for physician employees.

2) Medical Staff Office: Talk to the Medical Staff Office in your training hospital. They are usually aware of MDs looking for potential partners/ employees. 

3) Pick up the phone!: Yes! pick up the phone and call up all the places you have put your resume to. Ask them for the physician responsible for making hiring decision. Talk to the hiring MD and ask him if you can set up an  interview to discuss the opportunity further. Many a times, a reverse interview offer like this does work.

4) Physician recruiters: Call the physician recruiters in your specialty and they will be do glad to have you signed up somewhere. Why? Because that's how they make the big bucks.

5) Friends and Seniors: Do not forget friends and seniors who are already employed or own their own medical practice. They can also hook you up with a physician job.

What if the worst fear comes true. What if you graduate and there is no physician job in sight for you. Well that is a rare thing and should not happen if you have read the 'Secrets of physician job hunt'.  But even if it does, then you still have option of locum tenens and moonlighting. This option is not for you if you need a visa for employment. The biggest drawback of having a  gap between residency and employment -- you will have  to explain it on all  your applications  in the future. I hope this sets you on fire to get started!!!

Technology is changing all around us. So is the way of doing business. More and more people are using internet to find what they want to find or shop. Patients used to search for doctors in the yellow book. That is all changing very fast. Now patients are using google and other search engines to find doctors. Many a times they end up on sites like healthgrades from google. They are able to review your credentials, what insurance you accept etc. Once they chose a doctor, they go to that physician’s website and evaluate him or her further. So if you or your medical practice does not have a website – you need to get it now.

Website names (also called domain names) are running out! More than 80 million websites have been registered so far per ICANN. Do you realize that there are no single word website names left in most languages including English. People who invest in website names (also called Domain Name Investors) have taken them all. In fact to get a two word website name is also very hard.

But what can a website do for a doctor? Ever heard of HillaryClinton.com or BarrackObama.com? A website in your name can make it easy for your patients to follow you on the web. Many a times they will enter your name in the browser and see if they could get some information about you. Now if your competitor registers a website in your name before you could, he can lead your potential patients to his website. And worst of all, you won’t even know.

It is vitally important for you to at least register your name as a website name or domain name. e.g. RobertSmith.com or RobertSmithMD.com. If you know what you will name your medical practice in the future, then you should register that website name too.

Here are some FAQs for registering  a website. 

But I am in the medical school why should I register now? Can I do that later? Registering website names or domain names is very cheap to do. If you wait too long, someone else may register your name as a domain name. Then you will have to buy it from those domain investors or you will have to settle for something different.

But isn’t registering Domain names a highly technical stuff?

No. In fact it is as simple as typing the name and click submit. Follow the instructions to a credit card payment and you can get your own website name (domain name) at www.HelloDello.com where CareerMedicine.com is registered.

But how do I make a website on my domain name?

The easiest way to make a website is to use a website template. It is a readymade website design. All you have to do is type in the content just like you do in Microsoft word. I register website or domain names at www.HelloDello.com because they give access to a website builder for free. Some of the registrars charge for that kind of stuff. That way I do not have to spend more cash to design the website or keep it running.

What can I do on my website?

You can write a blog on your website, share pictures, and advertise your services etc on your website. The possibilities are endless.

How do I register domain names?

You can go to easy to use website such as www.HelloDello.com. Then type in the desired website name. Press search button. It will tell you if it is available or not. If it is then you may want to register it right then and there, to prevent any other person from registering it.

Summary:

Advantages of Domain name registration (or registering website names)

Creates your identity on the web.

Easy for patients to find you.

Easy for you to find patients.

Once registered by you, no one can snatch your website name from you.

In the future, you may be able to sell your website name just like real estate. But not all website names sell for millions, most of them sell for few hundreds to thousands dollars only.

It is cheap to do so. HelloDello.com charges only $9.99/ year to register most website name.

Disadvantages of not registering a name as soon as possible:

Someone else may register it and you will never get a chance at it.

You will miss out on a lot of business because of not having a web presence.

To register a website:

Go to www.HelloDello.com

Type in your desired website name in the search bar.

If the domain name is available to register, grab the domain name right away.

If not available, try a different variation to see if that is available - such as RobertJones.com, RobertJonesMD.com, RJones.com and so on.

Also consider registering different extensions of the website name such as .com .net .org etc.

The two most common issues facing graduating medical residents are the ones that we will discuss in this post. As a graduating date is near, we all think about taking a break and also to postpone the medical board exams by an year or two. Why are these big mistakes? Lets find out.

Let us talk about taking a break after a medical residency program. Once we are through with the hard labor of medical residency program, the long hours, and the stress, which has haunted as for at least last three years, there is a natural tendency to take a break, To rest, to rejuvenate.

Lets consider the question of financial implications of taking a break after residency. Since you have not the started a Physician job, it is quiet clear that you will not be paid for this vacation time. Other thing to note is that your salary would almost quadruple after graduation. And so taking a break will cost you more than $10K for each month you do not work assuming your starting salary is $120K. This does not includes the money you will spend to enjoy that vacation. That makes it a very very expensive break!

You should rather start working at the physician job and then take a vacation maybe three to four months later which would be paid vacation at that time. So by delaying gratification by four months, you actually earned more than 15K. If you have a higher starting salary then 150K, then the stakes are even high.

The other issue to be discussed is the timing of your board examinations. Should you give board examination right after residency, or may be two or three years down the road?

The likely reason medical residents try to take a break is because of all the stress of examinations. But remember this stress is something that you have been used to already. So why not go through the stressful medical board exams, while you’re used to taking huge amounts of stress. Almost all hospitals require board certification for approving your privileges to the hospital. If you do not have privileges to the hospital, you cannot enter the hospital to work there.

The problem with delaying the boards is that the longer you are away from the residency graduation, the harder preparation you will need for the boards. It is the easiest to pass the medical board’s or specialty medical boards right after residency. Why? Right after residency the knowledge is fresh in your mind. That reduces the amount of readings you may have to do. Also it is the latest knowledge, which is most relevant for the medical board exams. Not to mention your recent practice in preparing for multiple in-house examinations does keep your efficiency at the highest.

So make sure you avoid these two big mistakes often graduating from the residency program. Number one, do not take a break right after residency whether to relax or to prepare for the board exams. It is not worth it. Number two, take your board exams right away.

Once you receive a medical office layout plan designed by your architect for the medical office, it is time to review it yourself and see if all of your major goals are met or not. If not then you have another chance to voice it out now. Remember once the plans become more detailed or the construction starts it becomes more and more expensive to change anything. So you really need to look into the details and make sure you like every inch of the floor plan.

How to do it ? Well you compare the program we made in the last post and make sure those things are incorporated in there.  Also if you have forgotten something to include in the program you can easily ask the architect to modify the layout.

So here is a project for you. Please compare this layout received from the architect with the program we developed. And lets see what is missing. You can post your answers as comments. You can also download a full page copy of file called layout2.jpg at our download section here.

NOTE: The image is rotated perpendicular to the diagram of the shell, here just to add to the confusion ! Point I am making is it matters from which direction you are looking at the plans. Especially during signing real estate contracts for medical office building, check and double check to make sure that you know exactly which wall are you looking it.  Say if you wanted your sign on the front door but it is marked on the back wall of the building in the diagram-- then you will have a problem !!

In continuation of the previous post on designing a medical office space, now is the time for the readers to participate in designing a medical office layout plan. Here is the outline of an empty medical office or floor plan. It is just outside walls and is called a 'shell'. Now we will develop a  program or a list of requirements we need in the space. Here is a sample program:

 THE PROGRAM

1. Four Exam Rooms

2. Two Restrooms

3. One Break Room

4. One Doctor's Office

5. One Billing Office

6. One Manager's Office

7. One Reception Desk

8. One Waiting Room 

9. One Conference Room

10. Storage Room 

11. Keep as many windows as possible in the hallway. 

Remember list everything that you want in a program for the architect. They then can try to get as much as they can incorporated into the medical office lay out plan. You can list 100 rooms in the program. Then the architect can come and let  you know that it is impossible to get 100 rooms in there so you can get 8 rooms only.

Also the program may change later in the design phase as we will demonstrate. For example you may want to increase the number of exam rooms to five instead of four in the above program. But you may need to delete one restroom to make space for it.

For those who would like to download this plan and try to design according to the program given above, you can download the File called FLOORPLAN.JPG Here ! 

One day for those who realize the dream of starting their own medical practice will face the exciting opportunity to design their own medical office space. This is a primer article to kick off a series of articles in which we (The CareerMedicine authors and the readers) will design our own medical office space. We are not talking about renting or leasing a medical office space. It is mainly about either building a medical o office from scratch ("including the building!") or buying a "Shell" building and then upfitting it - aka adding rooms etc to the shell.

How does the whole process work. Lets look at the bird's eye view of the whole process:

If you own or run a medical practice, or plan to do so, one of the most frequent decision you will have to make is whether or not to buy or lease a medical equipment. As the cost of technology is going down, more and more medical equipment is becoming affordable for medical practices to acquire. As technology advances, older models are becoming available in the used medical equipment market for fraction of the price.

Why should a medical practice acquire medical equipment: Reasons can be:

But beware of the medical  equipment salesmen. Many of them are good but many of them are not. Their job is to sell the equipment. They may promise to stick by you after the sale but admit it, how many times have you seen a any sales guy checking on you after a sale. Also the only way they can convince a physician to buy  a medical equipment is  to talk about the profitability of the tests. So ultimately it is the duty of the physician purchasing the medical equipment to decide whether or not it is a good buy.

How do you determine if an equipment is a good buy or not ? How do you know if the medical equipment salesman is telling you the truth about the reimbursement rates. The answer is you cannot guarantee the reimbursement rate by insurance companies for a particular test. The only way to do it will be to submit a claim to the insurance company. You can submit a claim only after you buy the equipment and do the procedure. Even if you submit the claim, whether it gets paid or not will take atleast one to three months. Thanks to the processing times of various insurance companies.

So here is a list of questions you should ask before purchasing any medical equipment:

You can find a list of Medical Vendors from the Medical Vendors Directory VendorMD.com for your research. Answer the above questions you do not get stuck with a medical equipment sitting in your office and laughing at you !

Several times in a  day, physicians find themselves in a situation breaking bad news to the patients. At other times, physicians are informing patients about a preliminary results which needs further testing. And that further testing can lead to a potentially disastrous news. ( Or may be a good news ! ) How should a doctor handle that. One can make an argument that since empathy is a skill not taught in the medical school, may be it is not  a Doctor's job to comfort their patient. But lets not jump to a conclusion

Before answering this question, lets put ourselves in the patients shoes.

Imagine yourself being taken to a big corporate building (aka hospital). Then you are put into one of the rooms in that big building. You know you cannot leave that building without permission. Then several strangers come into the room and poke needles, take your blood, put cuffs and tubes around you. When you ask them what is going on, they have no clue. They tell you to talk to another stranger (aka doctor) about it. Finally this busy looking stranger comes in to the room. He flaunts his power, tells you the results of a test done on you, casually tells you that further testing may show a diagnosis which can result in your death. Before you could overcome the shock, he leaves the room. You lean  to your family for support but in your heart you know that they cannot help you. The only person who may have the key to your cure was that stranger who had been in the room for 5 seconds. How do you feel at this point !

If you do feel scared, disgusted or hurt, you would rather leave the building. But you can't leave without that stranger's (aka doctor's) permission, who does not give a dime on how you feel. If you do sign out AMA you will be stuck with a big hospital bill which your insurance may refuse to pay. So you wait in that room again to have more strangers come into the room and poke needles into you. And of course a long cold night dealing with the suspense of what that stranger is going to say tomorrow.

This is how the patients view their experience. Now lets tackle the argument that if empathy is so important then why is it not taught in the medical school. It is because the whole academic system believes that empathy is common sense. Every physician has empathy but it needs to be triggered. Empathy is common sense until the humanity of a physician is constantly dealing with death, disease and misery. Persistent exposure to vulnerability of a human being makes physicians so numb that the empathetic response does not get triggered when someone is diagnosed with cancer etc.

It is a physician's duty not only to diagnose and treat patients but also to make patients comfortable to their new surroundings and experience. Patients call it bedside manners. Those extra minutes spent to comfort the patients may not be reimbursed, but the value they add to your reputation is enormous. It is what defines a good doctor and makes them a popular doctor.

If you are a Primary Care physician, then  Inter-Physician Marketing can boost the growth of your medical practice. If you are a specialist, inter-physician marketing is a must for you. Whether you are employed physician or you own your medical practice, inter-physician marketing is something you will always need to do.

As discussed before in the last article, inter-physician marketing is the subtle marketing that goes on between physicians to promote themselves and get more referrals. You can be the best doctor in the world, but if no one knows you, no one sends any patients to you, then what good it is to be the best.

Here at CareerMedicine.com,  I will list everything that I have observed and learnt over the years about inter-physician marketing. You can use the following tips and techniques, in any order or sequence and see it work wonders.

BASIC INTER-PHYSICIAN  MARKETING TECHNIQUES:

These are something you should always remember to do. Its simple, its subtle and it works !

1) SMILE and say Hello to each other: All physicians are very busy. They are overworked and under pressure. What a refreshment it is to see a smiling physician colleague once in a while. Life is short, it will end soon, whether you run down the hallway looking at the floor or you run down the hallway smiling. There is nothing wrong in saying hello to your competition either. After all they are colleagues too. If they discontinue an insurance plan, they will be more than happy to send those patients your way.

2) Hang out in the Doctor's Lounge: At least once or twice a week go to the lunch at the doctors lounge. OR breakfast, if you prefer. You will meet a lot of colleagues and everyone is informal while eating.

3) Keep your business cards handy: Pass your business card whenever you meet someone new. Especially if you have complicated name :) Keep some always in the pocket.

4) Be courteous to the staff: You have no idea how many patients ask the hospital or clinic staff for recommendations regarding a doctor. If the staff likes you, they will recommend you.

5) Be available: Whenever you get consulted, give prompt service. It may mean you have to get up in the night and see a patient. But that is something you should be doing anyways.

6) Communicate: Call the referring physician or send a letter once you have seen his or her patient.  Always sound cheerful to see the patient.

ADVANCED INTER-PHYSICIAN MARKETING TECHNIQUES

These tips include the ones in which the physicians have to put themselves out in the field. If you are shy in nature then start with those strategies which you feel more comfortable with. Then once you are in it - take it to the next level ;)

1) SEND OUT A LETTER OF INTRODUCTION: Whenever you arrive in a new town, as an employed physician or starting your own medical practice, send a letter of introduction out. DO NOT make it long. No one reads a long letter. (There is a reason all posts in CareerMedicine are short.) Short and sweet introduction will suffice. Send it to every physician in the town.

2) GO OUT and MEET OTHER PHYSICIANS: Have your staff make appointments and then you can go and personally introduce yourself to other physicians. A face to a name solidifies branding. Suddenly you are not a figment of imagination, you are a person. When you meet them, explain to them that you are new in town, to start practicing medicine. And tell them your strengths. Most physicians will be happy to see you.

3) GET ON THE ER UNASSIGNED LIST: Always make sure you are on the ER unassigned list. That is a sure way of generating patients.

4) MEET THE ER DOCTORS: Do introduce yourself to ER physicians and let them know you are interested in providing prompt care to the patients. ER Physicians like prompt medical care for their patients. It helps them clear the ER faster.

So try these tips and see what happens.  

 

One of the goals of CareerMedicine (www.CareerMedicine.com) is to talk about topics which even we physicians hesitate to talk about. Physicians not only market their medical practice to patients, but also to other physicians, who can refer patients to them. It is a legit topic to discuss. For this purpose, lets coin it a term: Inter-Physician Marketing.

We define Inter-Physician Marketing  as the subtle (but legal !) art with which physicians try to encourage their other colleagues to refer patients to them.

There is a difference though in medicine. In Medicine, kick backs or commissions are not allowed in return for referrals. Any attempt to do so will trigger Stark Laws and can wreck havoc on the medical practice. Having said that, Inter-Physician Marketing  when done ethically without any commissions or kickbacks, is a perfect way of developing a medical practice. For specialist  there is no other way to survive a medical practice start up. They have to do Inter Physician Marketing, as referrals is the primary source of patients for specialists. For doctors in primary care, Inter-Physician Marketing is not the first thing they think of, but they can take advantage of this tool to accelerate the growth of their medical practice.

When a new physician arrives to this town, where the referral patterns are already set, how does he break into the circle ?

1) The new physician in town will send a letter out to all other physicians letting them know he has opened a new medical practice.

2) The new physician will go around to other medical offices and introduce himself or herself. 

3) The new physician will enroll on the unassigned call list for his specialty in the Emergency Room.

4) The new physician will be quick to respond to consult request, give a good service to the patient and update the referring physician on the treatment plan.

5) The new physician will try his best to accomodate same day appointments for emergency referrals, thus relieving the referring physician.

6) The new physician will try to go to as many professional meetings as he could to get a chance to introduce himself. AKA Self marketing. 

All these actions are to break down the barrier other physicians may have to refer patients to a new physician in the town. In our next post we will discuss the details and what are some good ways for inter-physician marketing. Till then think about it.....it is not eew, its just business !

We have received a request from UniteMD (www.UniteMD.com). For those who don't know about UniteMD, let me explain. Unite MD is a group of physicians who are launching a website where physicians can network with other physicians. UniteMD is poised to become the largest exclusive physician social network. The Online physician community has launched its beta testing just a few days ago. UniteMD is inviting all Physicians, Residents and Medical Students to join as members to beta test the site.

Beta testing is fun. You get to test the site, and complain as much as you like. And of course you continue to stay  on as senior members, as the website is officially launched. Since this is a group of physicians putting in effort to unite all the physicians, Residents and Medical Students, CareerMedicine is endorsing this site. I hope UniteMD becomes something like an online AMA, where at least we can contact all the other members. Another good thing, its FREE !

 

Just like the payors continue to get miserly to pay the doctors, the hospitals are facing such problems too. The video news content is worth watching. If you do not document a decubitus ulcer if present on admission, in your History and Physical, Medicare may assume that it developed in the hospital and not pay for its care at all. Surgeons already do not get paid for the care of most complications from the surgery. Even from medico legal standpoint, such observations should be noted in the initial H&P. For example a lawsuit claiming that hospital was responsible for decubitus ulcer was quickly dropped, after a note in the H&P stated that it was present on admission.

Rock P.

We all went through the medical residency programs and did just fine. But there is always more that we could have learnt or done in the medical residency years. Medical residency is a great place to learn medical skills, as there is plenty of time to learn and lots of physicians willing to teach. This all changes rapidly after graduation. After graduation from a medical residency program, there is almost no time to learn anything radically new. Also there are very few willing individuals to learn from, as no one wants competition.

Here are the biggest  mistakes medical residents make during their residency. Hopefully if your are one, you will avoid them. 

1) Not taking rotations in different specialty in the elective: Experiment and take chances. Rotate through an entirely different clinical specialty. You may learn new procedures you can use later and boost your bottom line. You may gain perspective and experience which will differentiate you and make you a better physician.

2) Becoming Chief Resident and spending extra year in residency: Yes! That is a shocker. There are only two reasons you may want to become a Chief Resident. One, you want to go into academic medicine. Second, you want to get into a certain fellowship program you could not get into after graduating. If you are gearing towards private practice, the extra chief residency year will not come in  handy. Not to mention the hefty pay cut you inadvertently took.

3) Taking outpatient clinics too easy or completely ignoring them: During medical residency, there is a lot of focus on inpatient treatment. However the most time you will spend as a practicing physician is outpatient clinic. Ever got that feeling that you may not be ready for practice as yet? Half of it stems from not doing enough outpatient clinic.

4) Not asking someone to teach medical billing: No one talks about the business of medicine in medical residency. But medical residents need to find someone who can teach them medical billing.

5) Ignoring medical students: If your medical residency program has medical students, take some time out to teach them some clinical skills. Their persistent questioning will give tremendous boost to your learning ability.

6) Not taking advantage of retirement plan and matching program offered by the medical residency program: If your medical residency offers you a retirement plan, more than likely they match the contributions you make to it. If you do not contribute, you lose that match. That is lost money. So call the human resources or the education office, find out what retirement plan they have, and contribute into it.

7) Not starting job search early enough: To get the best job, the physician job search should be started at least within the first three months of the final year. Good jobs don't last till the end. Also early birds get more interview. Follow the timeline.

8) Ignoring your family or friends: Medical residency is a busy time. The notion that it is temporary, makes many physicians ignore their family and friends. As a physician, we are doomed to be busy for life. But keep your family and friends for life an be efficient enough to take care of them. And I mean to include your parents, brothers and sisters also.

Many a times, an inexperienced physician is excited to find an offer of physician job where partnership is offered after the first year. Now just because he is going to become a partner aka owner of the medical practice, is not the formula for success.  Timing of partnership in a medical practice is very crucial.  It can make or break a deal.

To make the point clear let me use some examples:

SCENARIO A: Imagine you are in a medical practice, practicing medicine and your yearly earning reports looks as follow.

Gross Revenue: $200,000 per year.

Overhead: $150,000 / year  [Overhead is the cost of doing business eg. expenses including rent, nurse salary, equipment and supplies cost etc.]

 In the above scenario, a physician is better off being an employee than a partner in the medical practice. Why? Because a physician employee salary is guaranteed. Even though there is $200,000 in gross revenue, the net profit is only $50,000 and would be the take home income of a medical practice partner.

Lets look at another aspect:

SCENARIO B: Few years later, your  earning reports look like this:

Gross Earnings: $500,000 / year

Overhead: $ 200,000 / year 

 As you see, the increase in gross earning does increase the overheads, but not proportionately. The increase in overheads is because of increased volume of patients resulting in increased use of supplies and increase in the number of support employees. The disproportion is because of fixed costs such as rent and malpractice insurance. But here the Net Income is $300,000 and would be the take home income for a partner in the medical practice. If, as an employee, a physician is being paid significantly less than this amount as salary, then it makes more sense for him to buy in and become a partner in the medical practice.

If the salary is only few thousand dollars less than the above amount, the only reason for becoming a partner is for job security and sense of ownership. Because, with partnership in the medical practice, also comes the never ending responsibility of managing the business aspect of it.

Before a physician even raises the issue of becoming a partner a look at the current year earnings' and projected earnings in the next few years, is vital. Nobody wants their income to go down. Especially if you have to pay money to buy into the business. If the numbers don't look right, it is probably better to wait an year or two before reconsidering the medical partnership.

This is the biggest problem with those jobs which offer mandatory partnership in one year. The problem is that the physician has no clue what his earning will look like at the end of the year. So for accepting a physician job with an opportunity for partnership, make sure becoming a partner is not manadatory in the contract, to continue practicing in the same medical practice. 

Every graduating medical student has dreamt of owning a medical practice. It is the ultimate goal of becoming a physician. Why do most, if not all physicians want to own their practice. There are several reasons for that.

1) Physicians are intelligent and independent creatures. They became physicians in the first place to call the shots.

2) Physicians have high sense of self esteem and this fuels their stubbornness and inability to follow orders. They rather command than follow.

3) Over time physicians develop a relationship with their patients - a sense of owning them aka being responsible for their well being. This creates a conflict about who owns the patients - the medical practice or the physician. (My take on it? It is the patient who owns the physician or medical practice!)

4) Becoming the owner or partner appears lucrative - both financially and spiritually.

What are the ways you can own a medical practice ? There are only three:

1) Start your own medical practice

2) Buy a medical practice

3) Become a partner in already existing medical practice ( i.e. buy a share of the medical practice) 

Pros of becoming a partner in a  medical practice:

1) You do not have to start a medical practice from scratch

2) Already operating infrastructure available to you in the medical practice.

3) Business risk is shared in a medical partnership.

4) Easier to get business loans once a business is deemed established. Usually two years of operation is considered adequate by the banks.

5) More flexibility in scheduling vacations.

6) Already existing networks and word of mouth reputation established. (Hopefully good reputation!)

7) Ability to get higher reimbursement rates from the insurance companies.

8) You do get business related tax breaks. 

Cons of partnering with a medical practice:

1) Income levels not guaranteed. They may vary based on overhead for that year.

2) You still are not the ultimate boss you dreamt of. The most senior partner usually retains the ability to call the shots.

3) You still cannot do whatever you want. You have to go through a partner voting system.

4) Medical partnership usually retain a restrictive covenant in the contracts.

5) Getting out of partnership is akin to a messy divorce.

 

Everyone remembers the first Code Blue they had to lead. It is a surreal experience where everyone is freaking out and everything is overwhelming. It is the place where psychology meets technology. Mastering the art of leading a Code Blue team is an art. It lasts few minutes but those minutes define you as a physician.

Have you seen some Code Blue leaders completely ignored and others seamlessly able to carry out the ACLS ( Advanced Cardiac Life Support ) protocol. Leading the Code Blue is not just about knowledge but also about psychology. Yes! Psychology. Your ability to convince in the first few seconds that you can actually lead a code blue.

As you enter the room of a patient in cardiac arrest, it is a mayhem going on. Even though initial BLS is being performed, trust me , everybody in that room is freaking out. Everyone wants to be able to find that person, who they feel knows it all, and can tell them exactly what to do. After all, calling the shots in a code blue is a great responsibility. Every order given, every action taken, will be peer reviewed. And to make it worse, someone's life depends on your orders.

Follow these steps to take full control of a code blue: