LIKE MOST PHYSICIANS FRESH OUT OF RESIDENCY, Karen Wicksmith, MD*, an internist, was excited about her first job. She had her eye on a position in a primary care clinic in the South owned by a not-for-profit hospital, a clinic that would soon be housed in a new, multimillion dollar facility. After being wined and dined, Wicksmith netted a nice offer complete with a tidy benefits package that included a 401(k). She was happy and hopeful. “I was going to get paid to make a difference.”
But within six months, things changed. The practice was sold to a for-profit corporation, and Wicksmith discovered that there was an urgent need to expand a practice that apparently had not been profitable. The new administration was counting on Wicksmith and her two colleagues, also new hires recently out of residency training, to do the entire job alone. “I was completely unaware of the business side of running a practice and making it profitable,” says Wicksmith. “I had suspected that you just hang out your shingle and people will just walk in the door.” Wicksmith found herself leaving her baby in daycare only to spend workdays sitting around with her colleagues figuring out how to get patients.
“It was then that the blinders were taken off, and I really saw things in a different light,” she says. Questions came to mind that she had never considered when interviewing.
The for-profit practice model was the polar opposite of the non-profit model she had signed on for. Within a year, it became clear to Wicksmith that she and her colleagues were going to have to bring in enough money to cover overhead costs, which were substantial on the new facility. Yet, there was no marketing program or other support to help them spread the word and build a patient base sufficient to establish a viable practice.
The three newcomers tried to stick it out, even attempting to lure some subspecialists into leasing part of the available space, but it quickly became apparent that,at this point in their careers, the young physicians were illequipped for business building. Wicksmith finally had to admit: “This is not going to work.”
An early departure wasn’t what Wicksmith had in mind when she had signed her three-year contract, and she was concerned about the financial and professional implications, but she knew she had to leave. After 18 months on the job, she secured another position and resigned; her two colleagues did the same.