Re: Career Advice Needed

[Guest guest]

Hi Andew.Welcome1 Your first problem is that you get up way too early:)2 Northern NJ I think is hard from what I hear Glad you are thinking about t hat it will help prevent crashing later3 You have good insight and seem to analyze things well that is a big strength

Could you do a hybrid plan- start your own practice near the nursing home so the NH gives you work- and some patietns when they leave the skilled unit if there is one to fill your practice-- and start a practice that will have flexible hrs essentially being part time for several yrs . iMP principles would allow you th e flexibility you need and the nice thing about nh is the flexibility of scheduling they offer- those patients don't go no where so you could see patietns in the office more or less as is needed and the nh fits in around that

That you have financial security is greatSince you have been working recently ther e would be some patietns who would follow you to start the practice and you could expect a 3-5 yr time til maturity

Just keep a way low overhead Run off a laptop-you take it to the nH with you ,and one room, and minimal " Stuff " in the office.My two cents SignedI am not magnetic either...in MAIne 1 degree this am we got 2 feet of snow on sunday.

Hello all, sorry if this post is slightly off-topic in that IMP is

just one career option I am considering. I've been in internal

medicine practice now for 4.5 yrs total (first 2 in a larger 6 doc

group, last 2.5 in a smaller 3 doc group). I just left the last group

after the older doc wanted a ridiculous amount of money to buy him

out. I've looked around for other practice opportunities but in the

last few months I've only found 2 others which primarily consist of

inpatient/nursing home work without much outpatient/office. I like

the outpatient work for the continuity of relationships, but don't

like nursing home work as much for the amount of phone calls it generates.

So I feel like I am at a crossroads now. Should I try to wait it out

until an opportunity that has more outpatient work comes along? This

would entail then some period of unemployment which I can handle

financially but might look bad to future employers(?) Or should I

take one of the present positions with the thinking that it would just

be temporary for the next 1-2 years until the economy improves and/or

we get some health care reform after which I might start my own

practice. The idea of starting my own practice is attractive for the

independence aspect, avoiding the feeling that you are on a hamster

wheel trying to keep as productive as everyone else in the group

(particularly in groups where revenue is divided evenly). Also, I

don't mind the business aspect even though I'm sure there would be a

lot to learn. On the other hand, starting my own practice would be

risky in that I live in Northern NJ which might be considered a dead

zone that is saturated with PMD's already. (I currently don't have

the option to move due to my wife's job.) In addition, I've come to

realize that I don't exactly have the magnetic personality that draws

patients in droves (in addition to the disadvantage of being male).

The low overhead model of practice would be attractive in that I might

not necessarily need to see 20 or more patients a day to make a living.

So...I'm not sure what to do at this point. If anyone has any

thoughts, suggestions or words of advice it would be greatly appreciated.

-

-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

First of all, I think is very magnetic (of course magnets also

repel things)

Living here in the great Northeast-land of underpaid family

physicians and overpaid specialists-my advice is to sponge off your

wife as long as possible-it's worked for me. Working in this

environment is very overrated.

Seriously-I work part time simply because I can and that also in

this environment I refuse to devote full time in a basically

dysfunctional system. (I believe this is doing my part to bring on

the inevitable catastrophe that will hopefully occur very soon in

the medical system as it has in the financial system) I work for a

hospital system but have enough years in the system that I can

basically write my own ticket and while I do not do a very low

volume practice I do not do a high volume practice either.

If I were you, I would look at something part time that tries to

combine some clinical and some monetary satisfaction for you.

So basically-as the saying went in medical school

" play when you can, work when you have to..Don't F*** with the

pancreas "

Just my four cents (inflation)

>

> > Hello all, sorry if this post is slightly off-topic in that

IMP is

> > just one career option I am considering. I've been in internal

> > medicine practice now for 4.5 yrs total (first 2 in a larger 6

doc

> > group, last 2.5 in a smaller 3 doc group). I just left the last

group

> > after the older doc wanted a ridiculous amount of money to buy

him

> > out. I've looked around for other practice opportunities but in

the

> > last few months I've only found 2 others which primarily consist

of

> > inpatient/nursing home work without much outpatient/office. I

like

> > the outpatient work for the continuity of relationships, but

don't

> > like nursing home work as much for the amount of phone calls it

generates.

> >

> > So I feel like I am at a crossroads now. Should I try to wait it

out

> > until an opportunity that has more outpatient work comes along?

This

> > would entail then some period of unemployment which I can handle

> > financially but might look bad to future employers(?) Or should I

> > take one of the present positions with the thinking that it

would just

> > be temporary for the next 1-2 years until the economy improves

and/or

> > we get some health care reform after which I might start my own

> > practice. The idea of starting my own practice is attractive for

the

> > independence aspect, avoiding the feeling that you are on a

hamster

> > wheel trying to keep as productive as everyone else in the group

> > (particularly in groups where revenue is divided evenly). Also, I

> > don't mind the business aspect even though I'm sure there would

be a

> > lot to learn. On the other hand, starting my own practice would

be

> > risky in that I live in Northern NJ which might be considered a

dead

> > zone that is saturated with PMD's already. (I currently don't

have

> > the option to move due to my wife's job.) In addition, I've come

to

> > realize that I don't exactly have the magnetic personality that

draws

> > patients in droves (in addition to the disadvantage of being

male).

> > The low overhead model of practice would be attractive in that I

might

> > not necessarily need to see 20 or more patients a day to make a

living.

> >

> > So...I'm not sure what to do at this point. If anyone has any

> > thoughts, suggestions or words of advice it would be greatly

appreciated.

> >

> > -

> >

> >

> >

>

>

>

> --

> If you are a patient please allow up to 24 hours for a reply by

email/

> please note the new email address.

> Remember that e-mail may not be entirely secure/

> MD

>

>

> ph fax

>

[Guest guest]

Damn I went med school 1 mile from Spikol and I learned it as eat when you can , sleep when you can ,and don't F with the Pancreas.Consistency is sooo hard to get in medicine....Love Jean

First of all, I think is very magnetic (of course magnets also

repel things)

Living here in the great Northeast-land of underpaid family

physicians and overpaid specialists-my advice is to sponge off your

wife as long as possible-it's worked for me. Working in this

environment is very overrated.

Seriously-I work part time simply because I can and that also in

this environment I refuse to devote full time in a basically

dysfunctional system. (I believe this is doing my part to bring on

the inevitable catastrophe that will hopefully occur very soon in

the medical system as it has in the financial system) I work for a

hospital system but have enough years in the system that I can

basically write my own ticket and while I do not do a very low

volume practice I do not do a high volume practice either.

If I were you, I would look at something part time that tries to

combine some clinical and some monetary satisfaction for you.

So basically-as the saying went in medical school

" play when you can, work when you have to..Don't F*** with the

pancreas "

Just my four cents (inflation)

>

> > Hello all, sorry if this post is slightly off-topic in that

IMP is

> > just one career option I am considering. I've been in internal

> > medicine practice now for 4.5 yrs total (first 2 in a larger 6

doc

> > group, last 2.5 in a smaller 3 doc group). I just left the last

group

> > after the older doc wanted a ridiculous amount of money to buy

him

> > out. I've looked around for other practice opportunities but in

the

> > last few months I've only found 2 others which primarily consist

of

> > inpatient/nursing home work without much outpatient/office. I

like

> > the outpatient work for the continuity of relationships, but

don't

> > like nursing home work as much for the amount of phone calls it

generates.

> >

> > So I feel like I am at a crossroads now. Should I try to wait it

out

> > until an opportunity that has more outpatient work comes along?

This

> > would entail then some period of unemployment which I can handle

> > financially but might look bad to future employers(?) Or should I

> > take one of the present positions with the thinking that it

would just

> > be temporary for the next 1-2 years until the economy improves

and/or

> > we get some health care reform after which I might start my own

> > practice. The idea of starting my own practice is attractive for

the

> > independence aspect, avoiding the feeling that you are on a

hamster

> > wheel trying to keep as productive as everyone else in the group

> > (particularly in groups where revenue is divided evenly). Also, I

> > don't mind the business aspect even though I'm sure there would

be a

> > lot to learn. On the other hand, starting my own practice would

be

> > risky in that I live in Northern NJ which might be considered a

dead

> > zone that is saturated with PMD's already. (I currently don't

have

> > the option to move due to my wife's job.) In addition, I've come

to

> > realize that I don't exactly have the magnetic personality that

draws

> > patients in droves (in addition to the disadvantage of being

male).

> > The low overhead model of practice would be attractive in that I

might

> > not necessarily need to see 20 or more patients a day to make a

living.

> >

> > So...I'm not sure what to do at this point. If anyone has any

> > thoughts, suggestions or words of advice it would be greatly

appreciated.

> >

> > -

> >

> >

> >

>

>

>

> --

> If you are a patient please allow up to 24 hours for a reply by

email/

> please note the new email address.

> Remember that e-mail may not be entirely secure/

> MD

>

>

> ph fax

>

-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

the value of a good education can pay dividends in life! I hope your

school loans were smaller than Lou's. ;-)For me, the absolutely

best piece of advise in med school was, " If you save their lives, patients like

you a lot, But they LOVE you if you keep them regular! " I use that

to keep perspective of long-term quality of life issues we care about (less risk of

stroke, MI, etc, if control DM/HTN/chol/etc) vs the short-term quality of life

issues patients care about (pain, depression, erections, urine incontinence,

etc).Somehow I think that actually can fit into the questions you have,

. But you have to find the right answer for you as you keep the

short-term and long-term goals, and potential pains, in your focus. If your

family has the benefits of financial health, you have a better chance of going for

the IMP and likely have a drop in pay, or lose money for a while, but be

happier. If finances force you to, you may need a backup job for a while as

your office develops if you choose IMP. Otherwise, you may prefer to grit your teeth

and work with patients in whatever standard office you can find in time.But, my advise, if you love being a doctor and working with patients, don't let

the work environment burn you out. I don't like the medical economic/financial

world, but, very profoundly, I love being a doctor. And for any hassles of being a

small business owner/entrepreneur/IMP doctor, I am so happy that I get to work as a

doctor on my own terms now. I hope you have the same experience no matter what

you choose to do.Good luck.Tim

Damn I went med school 1 mile from Spikol

and I learned it as eat when you can , sleep when you can ,and don't F

with the Pancreas.Consistency is sooo hard to get in medicine....Love Jean

First of all, I think is very magnetic (of course magnets also repel

things)Living here in the great Northeast-land of underpaid family physicians and overpaid specialists-my advice is to sponge off your wife as

long as possible-it's worked for me. Working in this environment is very

overrated.Seriously-I work part time simply because I can and that also

in this environment I refuse to devote full time in a basically dysfunctional system. (I believe this is doing my part to bring on the

inevitable catastrophe that will hopefully occur very soon in the medical

system as it has in the financial system) I work for a hospital system but

have enough years in the system that I can basically write my own ticket and

while I do not do a very low volume practice I do not do a high volume

practice either.If I were you, I would look at something part time that

tries to combine some clinical and some monetary satisfaction for you.So basically-as the saying went in medical school " play when

you can, work when you have to..Don't F*** with the pancreas " Just my four cents (inflation)> > > Hello all, sorry if this post is slightly off-topic in that

IMP is> > just one career option I am considering. I've been in

internal> > medicine practice now for 4.5 yrs total (first 2 in a larger

6 doc> > group, last 2.5 in a smaller 3 doc group). I just left

the last group> > after the older doc wanted a ridiculous amount

of money to buy him> > out. I've looked around for other practice

opportunities but in the> > last few months I've only found 2

others which primarily consist of> > inpatient/nursing home work

without much outpatient/office. I like> > the outpatient work for

the continuity of relationships, but don't> > like nursing home

work as much for the amount of phone calls it generates.> >> > So I feel like I am at a crossroads now. Should I try to wait it out> > until an opportunity that has more outpatient work comes along?

This> > would entail then some period of unemployment which I can

handle> > financially but might look bad to future employers(?) Or

should I> > take one of the present positions with the thinking that it

would just> > be temporary for the next 1-2 years until the

economy improves and/or> > we get some health care reform after

which I might start my own> > practice. The idea of starting my own

practice is attractive for the> > independence aspect, avoiding

the feeling that you are on a hamster> > wheel trying to keep as

productive as everyone else in the group> > (particularly in groups

where revenue is divided evenly). Also, I> > don't mind the business

aspect even though I'm sure there would be a> > lot to learn. On

the other hand, starting my own practice would be> > risky in that

I live in Northern NJ which might be considered a dead> > zone

that is saturated with PMD's already. (I currently don't have> >

the option to move due to my wife's job.) In addition, I've come to>

> realize that I don't exactly have the magnetic personality that draws> > patients in droves (in addition to the disadvantage of being male).> > The low overhead model of practice would be attractive in

that I might> > not necessarily need to see 20 or more patients a

day to make a living.> >> > So...I'm not sure what to

do at this point. If anyone has any> > thoughts, suggestions or words of

advice it would be greatly appreciated.> >> >

-> >> > > >> > >

> -- > If you are a patient please allow up to

24 hours for a reply by email/> please note the new email

address.> Remember that e-mail may not be entirely secure/> MD> > Farmington ME

04938> ph fax >

-- If you are a patient please allow up to 24

hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD 115 Mt

Blue Circle ph fax 207 778

3544

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[Guest guest]

How much northern nj. If you have a NY license, you can open in Manhattan.

To: Sent: Tuesday, December 23, 2008 5:50:31 AMSubject: Career Advice NeededHello all, sorry if this post is slightly off-topic in that IMP isjust one career option I am considering. I've been in internalmedicine practice now for 4.5 yrs total (first 2 in a larger 6 docgroup, last 2.5 in a smaller 3 doc group). I just left the last groupafter the older doc wanted a ridiculous amount of money to buy himout. I've looked around for other practice opportunities but in thelast few months I've only found 2 others which primarily consist ofinpatient/nursing home work without much outpatient/office. I

likethe outpatient work for the continuity of relationships, but don'tlike nursing home work as much for the amount of phone calls it generates.So I feel like I am at a crossroads now. Should I try to wait it outuntil an opportunity that has more outpatient work comes along? Thiswould entail then some period of unemployment which I can handlefinancially but might look bad to future employers(?) Or should Itake one of the present positions with the thinking that it would justbe temporary for the next 1-2 years until the economy improves and/orwe get some health care reform after which I might start my ownpractice. The idea of starting my own practice is attractive for theindependence aspect, avoiding the feeling that you are on a hamsterwheel trying to keep as productive as everyone else in the group(particularly in groups where revenue is divided evenly). Also,

Idon't mind the business aspect even though I'm sure there would be alot to learn. On the other hand, starting my own practice would berisky in that I live in Northern NJ which might be considered a deadzone that is saturated with PMD's already. (I currently don't havethe option to move due to my wife's job.) In addition, I've come torealize that I don't exactly have the magnetic personality that drawspatients in droves (in addition to the disadvantage of being male). The low overhead model of practice would be attractive in that I mightnot necessarily need to see 20 or more patients a day to make a living.So...I'm not sure what to do at this point. If anyone has anythoughts, suggestions or words of advice it would be greatly appreciated.-------------------------------------

[Guest guest]

Thanks everyone for all the great advice so far. Wayne, I actually

did recently get a NY license. Any reason why you mentioned

Manhattan? I would think the rents there are quite high with an equal

saturation of doctors. Please let me know if my assumptions are

incorrect. Thanks,

>

>

>

> How much northern nj. If you have a NY license, you can open in

Manhattan.

>

>

> ________________________________

>

> To:

> Sent: Tuesday, December 23, 2008 5:50:31 AM

> Subject: Career Advice Needed

>

> Hello all, sorry if this post is slightly off-topic in that IMP is

> just one career option I am considering.  I've been in internal

> medicine practice now for 4.5 yrs total (first 2 in a larger 6 doc

> group, last 2.5 in a smaller 3 doc group).  I just left the last group

> after the older doc wanted a ridiculous amount of money to buy him

> out.  I've looked around for other practice opportunities but in the

> last few months I've only found 2 others which primarily consist of

> inpatient/nursing home work without much outpatient/office.  I like

> the outpatient work for the continuity of relationships, but don't

> like nursing home work as much for the amount of phone calls it

generates.

>

> So I feel like I am at a crossroads now.  Should I try to wait it out

> until an opportunity that has more outpatient work comes along?  This

> would entail then some period of unemployment which I can handle

> financially but might look bad to future employers(?)  Or should I

> take one of the present positions with the thinking that it would just

> be temporary for the next 1-2 years until the economy improves and/or

> we get some health care reform after which I might start my own

> practice.  The idea of starting my own practice is attractive for the

> independence aspect, avoiding the feeling that you are on a hamster

> wheel trying to keep as productive as everyone else in the group

> (particularly in groups where revenue is divided evenly).  Also, I

> don't mind the business aspect even though I'm sure there would be a

> lot to learn.  On the other hand, starting my own practice would be

> risky in that I live in Northern NJ which might be considered a dead

> zone that is saturated with PMD's already.  (I currently don't have

> the option to move due to my wife's job.)  In addition, I've come to

> realize that I don't exactly have the magnetic personality that draws

> patients in droves (in addition to the disadvantage of being male).

> The low overhead model of practice would be attractive in that I might

> not necessarily need to see 20 or more patients a day to make a living.

>

> So...I'm not sure what to do at this point.  If anyone has any

> thoughts, suggestions or words of advice it would be greatly

appreciated.

>

> -

>

>

> ------------------------------------

>

>

[Guest guest]

NYC isn't saturated. The trick is to find the areas that aren't saturated that also have access to the type of patients that you want. For example, if you plan on primarily accepting insurance plans in-network, East Midtown may be a rough area. Saturated. West Midtown much less so. Fewer overall patients, but sooooooo few doctors. Its important to check out the area. And to be near a subway station.

To: Sent: Tuesday, December 23, 2008 6:44:31 PMSubject: Re: Career Advice NeededThanks everyone for all the great advice so far. Wayne, I actuallydid recently get a NY license. Any reason why you mentionedManhattan? I would think the rents there are quite high with an equalsaturation of doctors. Please let me know if my assumptions areincorrect. Thanks, >> > > How much

northern nj. If you have a NY license, you can open inManhattan.> > > ________________________________> > To: > Sent: Tuesday, December 23, 2008 5:50:31 AM> Subject: Career Advice Needed> > Hello all, sorry if this post is slightly off-topic in that IMP is> just one career option I am considering. I've been in internal> medicine practice now for 4.5 yrs total (first 2 in a larger 6 doc> group, last 2.5 in a smaller 3 doc group). I just left the last group> after the older doc wanted a ridiculous amount of money to buy him> out. I've looked around for other practice opportunities but in the> last few months I've only found 2

others which primarily consist of> inpatient/nursing home work without much outpatient/office. I like> the outpatient work for the continuity of relationships, but don't> like nursing home work as much for the amount of phone calls itgenerates.> > So I feel like I am at a crossroads now. Should I try to wait it out> until an opportunity that has more outpatient work comes along? This> would entail then some period of unemployment which I can handle> financially but might look bad to future employers(?) Or should I> take one of the present positions with the thinking that it would just> be temporary for the next 1-2 years until the economy improves and/or> we get some health care reform after which I might start my own> practice. The idea of starting my own practice is attractive for the> independence aspect, avoiding the feeling

that you are on a hamster> wheel trying to keep as productive as everyone else in the group> (particularly in groups where revenue is divided evenly). Also, I> don't mind the business aspect even though I'm sure there would be a> lot to learn. On the other hand, starting my own practice would be> risky in that I live in Northern NJ which might be considered a dead> zone that is saturated with PMD's already. (I currently don't have> the option to move due to my wife's job.) In addition, I've come to> realize that I don't exactly have the magnetic personality that draws> patients in droves (in addition to the disadvantage of being male). > The low overhead model of practice would be attractive in that I might> not necessarily need to see 20 or more patients a day to make a living.> > So...I'm not sure what to do at this point. If anyone

has any> thoughts, suggestions or words of advice it would be greatlyappreciated.> > -> > > ------------------------------------> >

[Guest guest]

The Upper West Side in the 70's (the streets numbered 70-79n ot the 1970's!) is where I would go if I was to set up an IMP Family Practice. Wow, I miss home...

To: Sent: Sunday, December 28, 2008 10:27:00 AMSubject: Re: Re: Career Advice Needed

NYC isn't saturated. The trick is to find the areas that aren't saturated that also have access to the type of patients that you want. For example, if you plan on primarily accepting insurance plans in-network, East Midtown may be a rough area. Saturated. West Midtown much less so. Fewer overall patients, but sooooooo few doctors. Its important to check out the area. And to be near a subway station.

From: aelan2 <aelan2yahoo (DOT) com>To: Practiceimprovement 1yahoogroups (DOT) comSent: Tuesday, December 23, 2008 6:44:31 PMSubject: [Practiceimprovemen t1] Re: Career Advice NeededThanks everyone for all the great advice so far. Wayne, I actuallydid recently get a NY license. Any reason why you mentionedManhattan? I would think the rents there are quite high with an equalsaturation of doctors. Please let me know if my assumptions areincorrect. Thanks, >> > > How much northern nj. If you have a NY license, you can open inManhattan.> > > ____________ _________ _________ __> > To: Practiceimprovement 1yahoogroups (DOT) com> Sent: Tuesday, December 23, 2008 5:50:31 AM> Subject: [Practiceimprovemen t1] Career Advice Needed> > Hello all, sorry if this post is slightly off-topic in that IMP is> just one career option I am considering. I've been in internal> medicine practice now for 4.5 yrs total (first 2 in a larger 6 doc> group, last 2.5 in a smaller 3 doc group). I just left the last group> after the older doc wanted a ridiculous amount of money to buy him> out. I've looked around for

other practice opportunities but in the> last few months I've only found 2 others which primarily consist of> inpatient/nursing home work without much outpatient/office. I like> the outpatient work for the continuity of relationships, but don't> like nursing home work as much for the amount of phone calls itgenerates.> > So I feel like I am at a crossroads now. Should I try to wait it out> until an opportunity that has more outpatient work comes along? This> would entail then some period of unemployment which I can handle> financially but might look bad to future employers(?) Or should I> take one of the present positions with the thinking that it would just> be temporary for the next 1-2 years until the economy improves and/or> we get some health care reform after which I might start my own> practice. The idea of starting my own

practice is attractive for the> independence aspect, avoiding the feeling that you are on a hamster> wheel trying to keep as productive as everyone else in the group> (particularly in groups where revenue is divided evenly). Also, I> don't mind the business aspect even though I'm sure there would be a> lot to learn. On the other hand, starting my own practice would be> risky in that I live in Northern NJ which might be considered a dead> zone that is saturated with PMD's already. (I currently don't have> the option to move due to my wife's job.) In addition, I've come to> realize that I don't exactly have the magnetic personality that draws> patients in droves (in addition to the disadvantage of being male). > The low overhead model of practice would be attractive in that I might> not necessarily need to see 20 or more patients a day to make a

living.> > So...I'm not sure what to do at this point. If anyone has any> thoughts, suggestions or words of advice it would be greatlyappreciated.> > -> > > ------------ --------- --------- ------> >