9 Post-residency Mistakes

Learn these common errors now to know what to avoid in your early career

By Vicki Gerson | Feature Articles | Spring 2011


Hutton says it’s also important that the contract offers some disability insurance. If it’s not in the contract and you can’t negotiate it in, you must purchase it yourself.

“The contract isn’t written in stone,” says Wilturner. “Make a Xerox and mark it up. Then negotiate. Don’t be fearful of saying what you don’t like in the contract. If you don’t ask, you can’t receive a better contract. You are worth a lot more than you think you are.”

“Because many residents don’t know what they’re worth, research the area you plan to practice in and find out what you should be paid. Unfortunately, many practices will take advantage of residents because they have no idea what the pay should be,” says Hutton.

Even as a solo practitioner, you can find contract problems with the other physicians you plan to share overhead with. Initially, Wilturner thought an agreement had been finalized with two other physicians. “When I saw the proposed contract, it was very different from what we discussed. It was like the physicians had a loss of memory,” she says. “Each of us would have shared space, and had our own practice. In theory, we would have been three different businesses. The contract they showed me gave them direct access to my earnings as opposed to trusting me to pay one third of the rent and supply expenses. The physicians even wanted to manage my bank account.”

Refusing to accept this contract, Wilturner got access to a list from the local hospital of all the family practice doctors in the area, and sent them a fax explaining she was new to the area and wanted to start her own practice and share expenses.

She met eight physicians until she felt comfortable with one of them. They had shared space, totally separate businesses, and one of the physicians even took her under his wing. They stayed together for three years in this arrangement.

One clause in the contract that can cause a problem for new residency graduates is a non-compete clause. New residents encounter this clause quite frequently in their contracts. If you sign a contract with a non-compete clause, points out Potter, it can include that you can’t practice within a 15- to 30-mile radius. “If you agree to sign a non-compete clause, make it as narrow as possible,” he says. “The ideal contract doesn’t have this clause.” By agreeing to a non-compete contract, if you want to leave the practice, you may have to move to another city—which could include the need to sell your home and put your children in a new school.

Mistake 7: Lacking knowledge about tail coverage
Potter emphasizes that it’s important for residents to have knowledge about malpractice insurance tail coverage. After you leave a practice, tail coverage covers malpractice claims that are made after a doctor leaves—but that concern care provided while in that job.

Tail coverage protects you from claims that you haven’t been sued for yet at the time you leave a practice. Tail coverage can be bought for one year or longer, depending upon your specialty. Tail coverage is often inexpensive for the first year of a practice, but it can rise in price to tens of thousands of dollars, which can limit a doctor’s ability to change jobs.

“As a result of the cost of tail coverage, physicians may feel trapped by the cost of changing jobs and can’t leave the practice. They may not have the money to pay for this insurance.”
Potter suggests that new physicians try to get their employer to pay for tail coverage for the first few years and have this written into their contracts, or negotiate for “occurrence based” malpractice insurance rather than “claims made” malpractice insurance.

Mistake 8: Vacationing and not taking the boards seriously
Dallas says doctors need to be in a “study mentality” if they want to take and pass their boards. Planning a post-residency vacation? Bring your books with you and plan to study two hours a day. Yes, even while on vacation.

In her opinion, taking a break and going on vacation is not a wise choice because it gets residents out of the habit of studying.

Hutton has seen her fellow residents, upon ending their residencies, become so busy with life and going on vacation that they forget about studying. Then the boards sneak up on them and they panic. This may result in having to take them over.

She recommends studying one to two hours a day starting nine months in advance so you can still live life.


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