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IC 301-2022: Tips and Tricks for Surviving and Thr ...
Tips and Tricks for Surviving and Thriving During ...
Tips and Tricks for Surviving and Thriving During Your First Two Years of Practice (3/4)
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Awesome. All right, so we're going to move on to our third panel, assessing your job slash when is it time to make the change? Or you could also call this, I hate my job, what do I do now? So we have three panel members here. We have Gabby O'Day, Catherine Logan's going to stay up, and then Jordan Cancian's going to join us again. I'm going to go straight to Jordan because Jordan probably has one of the best like rags to riches stories from the, yeah, rags to riches stories of like, you know, first couple years of practice. Rags. I mean, not rags, but it's a saying, you know, it's like an idiom. Maybe not rags. That's pretty intentional. All right, Jordan, so just kind of tell us your journey of kind of, you know, your job process, what you've learned from that, kind of where you started and where you are now. So we'll get right to how to evaluate prospective jobs. These are all things that I didn't do enough. So I think the trap that we fall into or I fell into massively is that, you know, you go through residency and fellowship and you just take what you get, right? I'm so happy to have this opportunity. This is great. Great fellowship. Oh, you need me to cover a game? Great. You need me to do something else? Awesome, I'll do it. So you come out, you got this awesome fellowship and you're asking your mentors where you should work. I asked your fraternity brothers to get you these jobs. Winston did this for me and it was a disaster. So you need to vet the job relentlessly. So they should be able to tell you everything. You should look at who your partners are, what their clinic schedules look like, how many cases they do, who does what, where they get patients from, what's the trend over the last 10 years, five years, et cetera. Who's going to retire? When are they going to retire? What are they going to send you? Why do they need you? It's better to be needed than wanted when you go for a job. I went to a job, it was completely forced. They needed a guy to take call every third night and that's what I did for two years before waking up and it becomes incredibly frustrating. They didn't care that I went to Rush or UVA or anything. The guy was doing, one of my partners was doing four open rotator cuffs a week. I couldn't even book a decompression. So you need to find all these things out in the front. If they won't open the books, if they won't show you the financials, they're probably hiding something. So all of these things are important. You deserve to know everything about the job because it's a big decision and it costs you a lot of lost income, experience, reps when you pick the wrong job. In sports, when you have to get a new job, you're starting over. You don't take any of those patients with you. You're starting as if you just left fellowship. So that being said, 50% of people change jobs. I thought that was crazy and then I did it and half my residency class did it and we all did it. I think I'm the only one from our residency class who hasn't changed jobs yet. Riches to richer. Yeah. There's six of us. I love that. So you'll note there's six of us on this panel and there are three of us here who switched jobs. So that 50% rate is true. I made it two years. I got through my boards collection and then I left. But everything that Jordan said is accurate. You have to ask the questions. I agree. I didn't ask enough questions and there are various reasons you want to take a job. Geography can be part of it and that can end up being an important reason that you take a job, but you also have to vet the practice that you're in and you also have to be flexible. For me, same situation. I came in and they're like, hey, we have a need. We need kind of a complex shoulder person, et cetera. And then promptly I started and I found out that they got in a dispute with one of our main feeder hospitals and they were no longer operating there. So all of my partners who needed a complex shoulder person also now needed to save their practices. So all of those things went back to them and nothing was coming to me. And this is your first job, correct? That was my first job. Your first job. Yeah. So that was kind of the first thing. I was like, all right. We'll figure it out. That was month one. And I still was kind of flexible. And then things like COVID happened, right? And then everybody has their own challenges and struggles from that standpoint. People leave. Partners who were supportive may leave. And so it may be a completely different dynamic. So the advice I would give is every year, maybe even every six months, stop and evaluate where your practice is. Are you happy? Do you feel like you're on the track that you want to be? Can you make it work? And I would tell you a year ago at this meeting, I was happy in my job. And then a month later, I wasn't happy in my job when I actually stopped and reassessed and said, okay, now this, this, and this has come through and I've crossed this threshold where I think I'm off track with where I want to be. And I think it's important to have that evaluation because you can manage a few kind of like variations in your practice. But sometimes there's a threshold where you say, you know what, this, this is not the job that I got two years ago and I've fallen too far off the track. And it's important to do that assessment because what you don't want to do is leave when you're desperate to leave. You want to have some time to vet other positions and say, you know what, I'm not, I'm not desperate to leave. So you've probably got a year or so, you know, if something good comes, like I'll take it. You don't want to be like, this situation is untenable. I'm in like a total fight with my partners. I got to get out of here. Because then you're going to take the next thing that's available, which may not be a good fit for you either. And now you're chasing the right job. Absolutely. And how about you, Catherine, you kind of alluded to it earlier. You have some pretty awesome experience here with, you know, kind of assessing your job and starting something new. So we'd love to hear your kind of lessons you've learned throughout that process. Yeah, I think I definitely echo everything that's already been said. When I was in Vail, we have Tom Hackett there who would always talk to us about four buckets. So when you're looking at your job, you know, you have to think about, is it the clinical practice that I think I want to develop? You know, are they going to make me like, so coming out of Vail, a lot of people wanted me to be like a female hip arthroscopy specialist, which not for me. So you know, is it the clinical practice you want to have? The other is like the people. Are the people around me that, you know, do I want them to be my partners? Do they do good clinical practice? Are they ethical? Are they showing me the books? All those things. Then there's location. And then, you know, money. But I think you're never going to get all those four buckets coming out. So you have to sort of evaluate them. So for me, I put a lot of emphasis on location, which, you know, looking back is, you know, good or bad. I really thought I was going to go into more of an academic job. It just wasn't present in Colorado the year I was finishing up. So you know, I took an employee job with, you know, kind of what Jordan said. I think we probably had a pretty similar experience where I, a lot of my meetings were with more hospital executive type people and they were sort of selling me the world. And then the reality is, like, when you get there, you're not really seeing, like, that, you know, kind of friendship between attendings. They're, you know, not really sending you anything. Maybe they're unhappy you're there because they're threatened because, okay, now I have a Harvard veiled person in my practice and, you know, that's not what I, you know, they're taking away from me as opposed to joining me. So for me, I think the one twist is, so my first year in practice, you know, in the middle of boards collections, I was actually diagnosed with cancer. So I had colon cancer my first year in practice. And that was, like, a real sort of reality of, like, okay, location's real important, but I had terrible people around me. And that became really apparent very fast that, you know, like, my staff got fired right away because I had to take off some time for surgeries. I didn't have supportive faculty around me. And so that's really where I went into, like, okay, I want to go start a practice, like, I love my location. I love this community. But these are not the kind of people that I want to spend around, you know. So I think you have to be really flexible. And I never thought I'd be that statistic of, okay, I'm going to have changed my job within the first few years. But basically I delayed my board collection. I had to take it the next year. But as soon as I was done with those boards, I was out, like, days later. So I think, you know, have that flexibility. Ask a ton of questions. Don't be shy about it. Because I 100% agree with what is already said. You have to, you know, I don't want to say trust no one. I'm not a pessimistic type person. But you really do have to see the books. You have to ask those hard questions. Don't just, you know, I think for me, I just was, like, great, this is the only job in Denver coming out this year. I have to make it work. And I probably should have taken a little step back and said, okay, this really isn't the right job for me. And, you know, maybe I need to sort of understand where else I can pivot. So for the people on the panel, who did you lean on? So you have this realization, you're assessing your job, you say, this isn't what I thought it was going to be, it's not putting me on the track for what I want. You know, I think that's important. Because very few people like their job the first year, even if it is the right job. For all the things we've already talked about, the stress and the OR, the struggles building a practice, you know, like, I like where I'm at. I think it has great potential. But there's still a lot of things that, like, need to change and get better over time that I'm actively assessing. And I think that's true for a lot of people on the faculty here, even who haven't changed jobs yet. So you're assessing, you make that decision, you say, this isn't putting me on the right track. How did you go about finding your next job? Who did you lean on? You know, how, like, if you're in that situation, how do you kind of smartly go about it the second time around? So we can kind of, would love to hear some, you know, some advice on who to lean on and how to find a good second job. Yeah, I think exiting the job is a very important thing. You need to be careful with how you exit the job. Throughout your entire career, you cannot burn bridges and be thoughtful about how you do everything because you never know when you're going to rely on or need these people again down the road. It's a small community. Yeah, I think everyone in the practice is going to tell you it just takes time and then everybody outside is going to say time's up. It's not, it's not changing and then you need to make the decision of how you're going to do it. And I think it's pretty, you reach out to co-residents, co-fellows, mentors, residency, you know, fellowship, attendings, other people out and get their experience, get everyone's experience. Yours should not be super unique in that different. So constantly, not to compare in a competitive way, but get a sense of, am I on track here with what I thought was going to happen? And when you make the decision, you have to stick to it and go with it and start over. What about you, Gabby? Who did you lean on when you kind of were assessing your options and making that decision? Yeah, you know, I mean, I didn't, fortuitous, the people I leaned on are the ones who got me a job. But aside from that, you know, you reach out to your mentors and fellowship and they're the first people that you can, you know, really talk to and say, you know, I'm not sure about this place. What do you think about the situation I'm in? And you have to be honest with them because I think I sugarcoated it for a while. I was like, yeah, I'm good. I'm good. I'm good. I'm like, am I good? And then as you ask more questions, they can give you that feedback from their experience as somebody in an established sports practice to be like, no, you need to ask for this. So the advice they can give is often first, can you salvage this? You know, particularly if you're up for renegotiations. This is what you need to ask for from your chair, your department chief. And if that doesn't happen, then yeah, you need to, you know, start looking around. And so that advice is really helpful to get from your mentors. But they're also good for those kind of like quiet conversations about, hey, you know, I'm thinking. I want to explore what's out there and ask them, hey, can you give me some avenues of where there may be some job openings? Because they'll know, right? They're people from your fellowship. So they're the ones who know where the jobs are also. Another important point that Jordan meant is don't burn bridges. You know, I see one of my old partners here at this meeting. We have an excellent relationship. You know, I gave him a big hug when I saw him. He sent me patients in New York. And I value that I kept that good relationship with him. Because the worst thing is we're all in sports, right? The worst thing is like having to like dodge people that like you were trashing at a meeting because you said the job was so bad and it wasn't this. You're going to see people at meetings. You're going to see people around. And so you want to leave on good terms and really not burn any of those bridges. Because you never know how stuff changes. You may end up back in that market. Absolutely. You know? So it's important to be positive about it on the way out. For sure. And before Kathleen gets to her thing, I think the other thing echoed by the, you know, our panel is that, you know, direction is oftentimes more important than speed when you're assessing your job. So it's really a matter of is this job sending me in the direction that I want to go? And if the answer is yes, but it's taking really slow, then, you know, maybe it's worth waiting it out. I think a common denominator for all three of, you know, our faculty member peers, they've all kind of, you know, said this job is not sending me in the direction that's right for me. And then you have to ask yourself, can I get it to go in the right direction? And if the answer is yes, you know, there's things I can do, whether it's time or work differently or whatever, you know, or wait for someone to retire, whatever that, you know, thing may be, then maybe it's worth hanging on. But if the answer is no, this job is not getting me in the right direction where I want to be, then maybe then it's time to, you know, to pull the plug. You know, I think that's an incredibly important point. It is really about the direction. I could have stayed in my last job for five years and been totally fine, been on cruise control and, you know, it would have been okay. But you know, if you're diverting off that path, you need to figure out if it's correctable or if, hey, you know, I'm really sailing off. And that's where not looking when you're getting desperate is important because you're seeing the veer, but you're not already off the road when you're looking. For sure. And so, Catherine, how about you? Who did you lean on? How did you kind of get to where you're at now? I definitely leaned a lot on fellowship and residency attendings. I agree, like, the speed thing is really important. As much as I sort of identified I was unhappy and not on the right path, you know, I took my time and I met with a lot of people. I had a lot of cups of coffee. I had, you know, a lot of conversations. Was really open about just reaching out to even who else could I talk to? Who else has sort of, you know, been in private practice? What lessons can I learn? And then with the burning bridges, I think that is huge. So I was I stayed within my same hospital. So even though I was very unhappy as an employed physician, super transparent, I actually really liked our CEO and just said, you know, to the CEO, hey, Ryan, like, you know, I love this community. I love my patients here. I think I can still do good things. I don't think this is the right model for me. And, you know, basically at the end he said, as long as you pay us some rent and, you know, open up your practice on one of our, you know, within our campus, I'm going to support you. And it's been a really great, you know, there's no burn bridges. I don't ever feel like I'm walking around the hospital thinking, oh, these are my ex-whatever, my ex-boss or my ex-partners. You know, I think you just have to be really honest, transparent, and, you know, it's business. And I think there's a way that you can do it that doesn't feel like you're sitting in a dumpster fire. Absolutely. And so would you, you know, I haven't changed jobs, but I would love to kind of get the panel's impressions on this. Would you say, I mean, obviously changing jobs isn't just a cure-all. It's not like you traded in for the perfect destination. Is it fair to say that changing jobs, you are, you know, kind of swapping out, you know, just for different circumstances, obviously more favorable for what you need, but still, obviously you still have challenges, right? You still have challenges for, maybe they look differently, you know, maybe they, you know, but you still have to build a practice or you still have to, you know, trade in one set of challenges for another set. It's just maybe more of the challenges that are still allowing you to get to where you want to go. I don't know if that's a fair, fair way of putting it. Yeah, I absolutely agree. I think I have a whole set of new challenges. I'm a managing partner of a practice, so I have to really pay attention, obviously, to all the financial day-to-day. I'm also, you know, figuring out who do we want to hire, you know, do we want to add another PA? Do we want to add another surgeon? You know, all those decisions come to me. So I have a new set of challenges, but I think it's also allowed me a lot more flexibility. If I want to, I'm still covering professional sports, I'm still doing research now. Like those things I had a lot more red tape before and had to get a lot of approvals. Now I can just sort of sit down with, you know, a company or, you know, whomever and say, yep, I want to do that study with you or, you know, so there's always new challenges. It's trying to figure out, I think, as Gabby said, are you on the path you want to be? And for me, I wasn't on the path. I didn't feel like I was getting the professional sports access. I didn't feel like I was starting to carve out some research time, and now, you know, I can do that. Absolutely. Let's see, we have just a few more minutes, about three minutes on this panel. Any kind of final words of wisdom from the panel? Gabby, you can start, then we can let Jordan and Catherine speak. Yeah, I mean, I think just kind of echoing on the last thing that was said, you know, it has to be a constant evaluation of where you're at. And when you're looking at other jobs, you know, I looked at several jobs, you know, so I was lucky with where I landed. But even in the other jobs, they probably were reasonable fits, but they felt like lateral moves. They felt like the things that I was still feeling unsatisfied about, I would still be unsatisfied about, but I was just in a different community. And so I think an important part is figuring out what is your absolute priority? Is your priority geography? Is your priority research support? Is your priority teaching? Is your priority money, if you're honest, you know? And money, I think, should be the last thing, because there are still ways to kind of make money, even in the community and the job that you're in, and with a renegotiation of your practice. And money always tends to come as, you know, everyone in this room is going to make money, right? We're sports medicine fellowship trainers, sports medicine docs. But you know, you may not necessarily become the prolific researcher that you want to be if you're not in the right situation. Or you may not be the resident or fellow teacher that you want to be if you're not in the right situation. So you have to kind of evaluate, where are those buckets? Is there a burning need that I'm missing? And is the next job going to address this, and is it going to mitigate the headaches? Not all of them, but, you know, the biggest headaches that you have a challenge with. Because yeah, there's no job that's perfect. Healthcare right now is a challenge. So you're not going to walk into some, you know, golden situation regardless. But you want to walk into a better situation if that's where your needs are. And sometimes, just hold tight. If that better situation's not there. Absolutely. For sure. Jordan, any final words of wisdom or thoughts on this topic? Not much. I think the first job, get board certified, cut your teeth, 50% of you will change jobs. There's no shame in it. That's great. That's it. Awesome. Thanks for it. Any final words of wisdom, Catherine? You good? All right. So take home points. Loving your initial job is a rarity. You may or may not grow to love it as your practice develops. So it's all about that direction versus speed. 40 to 50% of orthosurgeons will change jobs in the first three years. Don't be ashamed if it's you. It's a normal thing. Lean on your mentors for job opportunities. That's probably where you'll find your best jobs, both initially and second jobs. The grass may or may not be greener, so you need to have a holistic assessment. And then changing jobs will not fix all of your problems. Each job has its unique benefits and frustrations. And so don't change jobs and expect it all to be perfect and rainbows and butterflies when you do. And that perfect job is a myth, especially when you're starting out. So again, it's really just kind of assessing, is this getting me where I want to go? Is this satisfying the things that are most important to me, whatever those values are? And then if the answer is yes, holding tight. If not, maybe look elsewhere.
Video Summary
In this video, a panel of three speakers, Gabby O'Day, Catherine Logan, and Jordan Cancian, discuss the topic of assessing your job and knowing when it's time to make a change. They emphasize the importance of evaluating prospective jobs thoroughly and not settling for just any opportunity that comes your way. Jordan shares his personal experience of taking a job that turned out to be unsatisfactory and advises against blindly accepting offers without doing your due diligence. The panel discusses the need to understand factors such as the clinic schedules, case volume, patient source, future retirements, and financials of a potential job. They stress the importance of being needed rather than just wanted in a job and caution against staying in a job that is not putting you on the right track. They advise seeking advice from mentors, leaning on co-residents and fellowship friends, and being transparent about your concerns with your current employer. They also emphasize the importance of not burning bridges and being open to the possibility of changing jobs if it aligns with your goals. Overall, they highlight the need for ongoing evaluation and direction in your career, as well as the understanding that changing jobs may come with new challenges but can be necessary for professional growth. No credits were granted in the video.
Asset Caption
Gabriella Ode, MD; Jourdan Cancienne, MD; Catherine Logan, MD, MSPT, MBA
Keywords
job assessment
due diligence
job change
career evaluation
job satisfaction
professional growth
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