Doing things the MBA way

Essential business skills physicians need to know.

By Joe Capko | Feature Articles | Winter 2012


Ask a doctor why he or she decided on a career in medicine, and you might hear a mix of reasons: a yearning to help people; a keen interest in science; desire for a role that commands respect. Maybe some will even admit to wanting a potentially lucrative career that is also prestigious.

One thing you probably won’t hear, though, is a longing for a management role in a $3 trillion industry—even though that is another way to describe what being a physician means today in the U.S. health care system.

Lack of appreciation for medicine as a business—and reluctance to develop business skills—can hold new doctors back, making it harder for them to reach their primary goals of providing excellent patient care and achieving enduring career success and financial security.

“It’s a travesty that physicians do not receive a business education,” says Maria Young Chandler, M.D., MBA, associate clinical professor of pediatrics and management, University of California, Irvine and chief medical officer of The Children’s Clinic, a six-site nonprofit health center in Long Beach, Calif. “Medicine is a business. Without business skills, physicians could find themselves swimming upstream.”

After as much as 10 years of post-graduate education, though, getting an MBA may not be appealing or feasible for many young physicians. The good news is, any physician can become more conscious of the business aspects of the health care field. more »


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What physicians need to do when starting a new job

What do you have to do before you start?

By Christine Hinz | Feature Articles | Winter 2012


When Nicole Ottens, D.O., joined Mattoon, Ill.’s Sarah Bush Lincoln Health Center in July 2010, setting up her practice was “incredibly easy,” she recalls. As an emergency room physician employed by the 128-bed rural hospital, she didn’t have to make many decisions.

Setting up your practice

The hospital’s recruiter and human resources department processed the paperwork for securing her credentials. She didn’t have to market her services, because sooner or later people use the ER. And because she joined a department already staffed with nurses, she just became one of the team.

Ottens, who will soon be dual boarded in emergency and family medicine, was delighted with the process and even happier with her choice of employers. “All I want to do is to provide quality care to my patients,” she says. “This is the perfect job and the perfect way to do that.”

Perhaps you’re looking for the same streamlined experience. You want to sail through the formalities of launching a practice so you can just take care of patients. But establishing your practice is as important as anything you’ll do in medicine. It usually takes time, patience and attention to detail to make the smooth transition from training to your first job or from your first job to the next. To launch yourself as a skilled practitioner open for business, you’ll have to focus like a laser on key tasks: putting your credentials in order, marketing your name, staffing your office and equipping it too.

Are you in this alone? If you’re flying solo, you’ll have to take care of every aspect—unless, of course, you’ve already tapped a business manager. It’s the nature of being a lone wolf. But if you’re destined to join a group or hospital staff, you’ll likely have lots of guidelines, to-do lists and helping hands.

Organizations are usually quick to help physicians navigate a practice setup. Depending on the size, you’ll have plenty of assistance for mastering the terrain.

As Dorrie LeForce, director of operations for the Dallas-based HealthTexas Provider Network (HTPN), the 500-physician Baylor Health Care System-affiliated group, notes of their extensive soup-to-nuts assistance they give new hires: “We’re the legs and arms to support them in everything they need to open their doors.”

Credentials first on to-do list
You can’t treat patients unless you have proper credentials. It’s that simple. The first order of business in setting up your practice will be to get licensed by the state, affiliated with area hospitals and approved by Medicare, Medicaid and the major payers your employer wants to bill for your services.

Some fundamental items—such as NPI (National Provider Identifier) and DEA (Drug Enforcement Administration) numbers—you’ve likely already presented as part of your application. If not, you’ll need to apply for them before you can bill and prescribe drugs. Likewise if you’re staying in the same state in which you trained, you already have your medical license. But if you’re moving to a new area, getting it will be a priority.

Once you have those basics, you can complete the paperwork for your group’s major payers and professional liability insurance. In terms of malpractice, you’ll likely have the same carrier and coverage as your colleagues in your specialty, but you’ll still have to apply separately. Educate yourself about the coverage limits, how any suit might be settled, and what happens with the tail.

Chances are very good that the group or hospital you’re joining will help you navigate the paper chase. Start dates are usually contractually contingent on having your ducks in a row so you can see and bill patients on day one. Most organizations have an office or function to handle the details and keep the process moving forward.

So what’s your responsibility?

more »


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Who’s the happiest?

Flexibility, predictable schedules and immediate impact influence these satisfied specialties.

By PracticeLink Staff | Vital Stats


Most satisfied physicians by specialtyWhat specialty has the most satisfied physicians? Dermatologists take the cake, with radiologists and oncologists following.

Medscape’s Physician Compensation Report 2011 determined the overall satisfaction level of 22 specialties. Overall satisfaction was ranked by averaging responses to questions about compensation and career and specialty choice.

Dermatologists ranked highest in every question, coming in with an 80 percent overall satisfaction rate.

“Flexibility and predictability are two reasons dermatologists enjoy higher levels of job satisfaction,” says Amy Derick, M.D., owner of Derick Dermatology, LLC. “Dermatologists can sub-specialize or do it all: pathology, surgery, cosmetics, pediatrics, adult patients, etc. Dermatologists can work routine daytime hours (full time or part time) and thus have predictable family time in the evenings not typically interrupted by emergencies.”

Radiologists came in second as a group in overall satisfaction (72 percent).

John A. Patti, M.D., FACR, radiologist at Massachusetts General Hospital and chairman of the American College of Radiology Board of Chancellors, has been practicing for 36 years.

He’s not surprised that his specialty ranked so high among physician


“You’re at the center

of everything,” he says. “There’s very little diagnosis that occurs today without the use of imaging. That makes you able to interact with a wide range of physicians and a wide range of patients.” more »


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How your spouse can help with your job search

By Therese Karsten, MBA, CMSR | Feature Articles | Summer 2011


One of the fundamental rules of successful recruiting is that practices recruit the spouse as well as the physician.

James Lopez, M.D.

James Lopez, M.D., and his wife, Melissa, a critical care RN, ranked each of their top 10 needs in a post-residency opportunity. Criteria included proximity to family, cost of living and nights on call. The exercise helped them determine if a job would meet their family’s priorities.

Hospitals and practices expect to interact at some point with the spouse or significant other who will be making the relocation decision with the physician. That interaction can shape the hiring authority’s perception of the candidate’s fit with the practice and community. The spouse has an opportunity to help or hinder the chances of landing the right job offer.

These tips will help your spouse help you.


Edit the CV and cover letter

The majority of physicians interviewing today have been immersed in a heavily science-oriented curriculum since 5 minutes after birth.

Spelling, grammar and graphic layout are not usually on the same gene map that leads to highly competitive MCAT scores. Luckily, physicians often marry people whose natural gifts complement their own skills.

If that describes your spouse, give your spouse sample CVs and cover letters to work with so that the final product has the right structure and components. Take the resulting draft to physician mentors or peers known for good written communication.


Get the word out that you’re looking

Your spouse can help you set up your online search. Create a job-search email account and keep a master list of sites where your CV is posted so that you can remove or edit as needed.

Your spouse can copy, paste and adapt your cover letter and CV to use on major job-search sites—like

After registering on a physician job bank, you may get a call to gather more information about what you’re looking for in a practice. It’s fine to have your spouse respond, as long as you have agreed on the key messaging points. more »


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Careers for you in the military

By Mark Terry | Feature Articles | Summer 2011


Col. Frederick Lough, M.D., director of cardiac surgery at George Washington University Hospital

Taking care of soldiers is a huge job. “We have 4 or 5 million people, once you blend in the active duty, the reserves, the dependents and retirees,” says Frederick Lough, M.D., director of cardiac surgery at George Washington University Hospital and a colonel in the Army Reserve. “It’s an immense medical system that takes care of neonates to retirees to the actively injured in combat.”


The classic TV show and film MASH has given us a distorted view of military doctors. First, it focused on surgeons drafted into a war zone. Second, it was both comedy and anti-war satire. Third, times change, and the military changes with it: The classic Mobile Army Surgical Hospital no longer exists, having been phased out in 2006 and replaced with a smaller, more efficient system of treating battlefield casualties. And finally, physicians are no longer drafted—physicians in the military want to be there. And many want to be there because it can be a unique situation for a rewarding long-term medical career. more »


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DeVry Anderson, M.D.

By PracticeLink Staff | Snapshot | Summer 2011


DeVry Anderson, M.D., Chief medical officer, CEO, owner: Quick Care Walk In Clinic; brigade surgeon, Warrior Transition Brigade, Fort Hood, TX



Chief medical officer, CEO, owner: Quick Care Walk In Clinic; brigade surgeon, Warrior Transition Brigade, Fort Hood, Texas


MEDICAL SCHOOL: Thomas Jefferson Medical College, 2000

INTERNSHIP: Completed an orthopaedic internship in 2000.

RESIDENCY: Carl R. Darnall Army Medical Center, Fort Hood, Texas

IN PRACTICE SINCE: Practiced as a military surgeon until returning to family medicine residency in 2006. more »


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Sharing your wealth

Changes in federal estate and gift taxes offer planning opportunities

By Bruce D. Armon, Esquire, and Bob Louis, Esquire | Legal Matters | Summer 2011


Benjamin Franklin said that nothing is certain in life but death and taxes. As someone said more recently, taxes are the only one of the two that you can postpone or reduce.

Though you can’t avoid the inevitable, you can and should take steps to protect those closest to you with careful estate planning. This applies whether you are a multimillionaire at the twilight of your career or a physician who recently finished or is about to finish training.

In the last few weeks of 2010, Congress and the president agreed to extend the so-called Bush tax cuts through 2012. The same law made several very favorable changes in federal estate and gift taxes, and these changes offer opportunities for significant tax savings.

Where we started

In 2001, the federal tax law was amended to increase the threshold exemption from federal estate taxes. Over a period of years, the exemption rose to $3.5 million per person, which meant that, with careful planning, a husband and wife could pass as much as $7 million to the next generation free of federal estate tax.

Then, in 2010, the federal estate tax expired for one year. Those who died during 2010, which included some very wealthy people, could avoid the estate tax altogether. Many people thought Congress would act long before the year of a no estate tax arrived, but stalemate in Washington, D.C., prevented any action from being taken.

The 2001 law provided that the estate tax was to spring back into existence in 2011, but at the rates and with the exemption that were in effect before the 2001 law. That meant that the estate tax rate could be as high as 55 percent, with an exemption of only $1 million. A reversion to that law would have “caught” many people in the federal estate tax, since the tax is imposed on, among other assets, retirement accounts, certain life insurance and homes owned.  more »


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Apps make it possible

From education to communication, a variety of medical apps enrich patient and physician experiences.

By David Geer | Summer 2011 | Tech Notes


DEVELOPERS ARE INCREASINGLY WRITING mobile apps that operate on and across multiple platforms. Mobile apps for doctors, which are available on a variety of devices including Android phones, the iPhone, iPad and Blackberry, reflect that trend. We’ve explored the practical benefits of certain mobile medical apps as observed by physicians working in the trenches.

The Heart Pro    [ iPhone: $9.99; iPad: $17.99 ] 

The Heart Pro app, a 3-D interactive reference tool of the human heart.

The Heart Pro app helps users understand the anatomy of a heart as they rotate, cut open and label it on screen.

The Heart Pro app is a 3-D interactive reference tool depicting the anatomy of the human heart. Designed by cardiologists and cardiac surgeons, The Heart Pro presents 3-D images of all heart components, enabling physicians to rotate the visual representations, cut them open and label sections of the heart via touchscreen. The app comes with controls for accessing an index of English and Latin terms, transparent heart layers, animations and quizzes.

Lacy E. Harville III, M.D., a thoracic and cardiovascular surgeon in Knoxville, Tenn., who performs up to 1,400 cardiac operations annually, uses the app to educate nursing staff and demonstrate the heart’s anatomy and functions to patients.

“Nurses and staff assisting in arduous cardiac operations are not always certain what they are looking at, even though you as a cardiac surgeon are certain,” says Harville.

Harville likes the fact that he can have people looking over his shoulder as he educates them using 3-D images of a moving heart, transecting it to reveal the valves. “Any time patients can better understand the operation they are about to undergo or what their heart problem is, it helps,” says Harville.

Harville is particularly pleased that the application developers are working on 3-D images of abnormal hearts so he can explain these abnormalities to patients. more »


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Organizational culture: Physician satisfaction and success

You might have all the right skills, but will you fit in with the culture?

By PracticeLink Staff | Web Exclusive


Where is the practice located? How much compensation will I receive? What type of practice is the opportunity?Workplace culture and physician satisfaction

These are just a few of the questions, as physicians, you might ask yourself when you begin your search for the right practice opportunity. There’s an even bigger question you should consider, and one that employers may be asking of you.  “Are you a good fit for the organization, socially and culturally?”

Organizations and even medical schools, like Virginia Tech Carilion, are conducting pre-screenings to help determine if candidates will be a good match, socially and culturally. Virginia Tech Carilion uses a method called multiple mini interview, or M.M.I., and its use is spreading.  Check out this recent article by The New York Times, New for Aspiring Doctors, the People Skills Test.

Organizational culture, that mysterious word that characterizes a work environment, can mean just as much to a recruiter as a physician’s credentials. Behavior assessments give a recruiter an idea of how well a physician will fit in with the organization and also within the community they’ll be serving.

As job seekers, you should also consider cultural fit when searching for your first or next practice, or even when looking for a partner for your medical practice. more »


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Protect the value of your future earnings

Protect your most valuable asset—the earning power that your training has provided you—with insurance.

By Michael Lewellen, CFP | Financial Fitness | Spring 2011


As advisors to young physicians across the country, we are often asked, “What is the most important thing I should be doing financially in the first years of practice?” Our answer is simple: “You need to build a solid foundation.” The application of the concept of a foundation is different for each physician. However, as with patients, we often see very common symptoms and can make some generalizations about what is involved in creating a financial foundation for many young doctors.

Foundation building for young physicians depends on where they are in their personal lives (single, married, kids, etc.). Also, it can and needs to begin before the physician even leaves training because, like most things, establishing the right habits are key to building a financial foundation.

Most young physicians will see a significant increase in their incomes when they begin their practice. Up to this point, they have typically been living paycheck to paycheck, and a jump in income by five-fold or more can be a bit euphoric. With a “spend now and plan later” attitude, many young physicians will indulge a bit and make large purchases. Often taken too far, they find themselves once again living paycheck to paycheck. The attitude then becomes: “Once I make partner in a few years, I’ll address my financial plan…”

At the outset of their medical career, physicians in training are told “first, do no harm.” As advisors to young physicians at the outset of their financial careers, we give similar advice: “First, build your foundation.” That foundation includes protecting your future income and earning potential with disability and life insurance. more »


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