Finding a Different Kind of Job

February 1, 2008

I recently changed jobs, becoming a hospitalist. I now realize I can’t handle the 12- to 15-hour days, nights, and weekend work, even though my previous job as a traditional internal medicine doc was busier. But I am just not sure how to go ahead and start a practice on my own. I feel as though internal medicine can’t support me anymore. What do I do?

Question: I recently changed jobs, becoming a hospitalist. I now realize I can’t handle the 12- to 15-hour days, nights, and weekend work, even though my previous job as a traditional internal medicine doc was busier. But I am just not sure how to go ahead and start a practice on my own. I feel as though internal medicine can’t support me anymore. What do I do?

Answer: Here are some thoughts:

1. First, your current employer surely doesn't want to lose you, so if you like the work itself, but not the hours, you could try to negotiate a change in hours. I’m sure it seems there is a standard everyone needs to stick with, but you never know unless you ask. Figure out exactly what you want and start bargaining from there.

2. If you do want to start your own practice, take some time to plan an alternative you can live with and still make money. For example, some physicians are opening low-overhead practices: You open an office with relatively low rent and no staff or just one employee. You file claims electronically yourself, or file no claims at all (have patients submit for reimbursement), greet your own patients, etc. You can work fewer hours, see fewer patients (and have fewer claims to worry about) but because you keep nearly all the revenue, you still make money.

Or, take a look at MDVIP. They love the boomer niche and can help you set up a different style of practice.

Whatever model you like, take a week off to imagine the ideal and build some simple spreadsheets to see if you think it can work financially.

3. Finally, you could look at positions as an employee in a group practice in your area. With a salaried job, you can worry less about the bottom line.