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Only Hire When the Time is Right at Your Medical Practice


A colleague came to me seeking a change as a solo private practitioner, but my office isn't ready for the change she needs.

I recently received a call from a colleague, Dr. A, who is in a solo private practice. She said she needed to talk to me because she needed to make a change. I wanted her to tell me over the phone, what kind of "change" she was thinking of, but she wanted to meet in person and discuss it. "When is good for you?" Well, never. I work all day, I have small kids, and have to get home. "I can meet you in the evening." No good. We decided she could come during our lunch break.

So we met and she starts explaining to me why she doesn’t want to be a solo practitioner anymore. It’s not cost-effective. It’s too hard being alone. There’s no one to bounce ideas off of, no one to discuss cases with. There’s no one to cover when you go away. Expenses go up, revenue is going down. Yeah, I got all that. I was solo, too. I fully understand the downside to being alone.

Dr. A doesn’t want to hire someone fresh out of fellowship. You need to teach them so much about private practice. They expect a big salary right away before they are even generating revenue. It’s too much work and it’s not cost-effective. I’ll admit, I lucked out with my associate. I’d known her for over five years by the time I hired her. I trained her for much of those five years. She works like I work, and she has the same attitude toward practice. Sure, she is still green when it comes to the business side of things, but that’s fine. At the moment, she is an employed physician, and not expected to partake in the business responsibilities.

Dr. A shares an office with her husband at her practice. Apparently, they don’t agree on things like staff and other management issues, so she doesn’t want to share an office with him anymore. I understand. It must be very difficult to work with your spouse. While you may disagree with a co-worker, most people get to go home and complain about them to spouse. And when your spouse makes you crazy, you get to go to work and complain about him to your co-workers. But when your spouse is your co-worker, when you are in the same office for 8 hours to 10 hours a day, and then you have to go home and have dinner together? Don’t get me wrong. I love my husband. But I need a little hubbyless time.

I finally had to stop her. I got it. You don’t want to be solo, you don’t want to share your office. So what exactly do you want? Quite honestly, I could not think of anything she could say that would make me say, “That’s a brilliant idea!”

But I had to get to the heart of this conversation. Did she want employment? Partnership? "A change." Well, bottom line is, at this time, we don’t have the space for another doc. We don’t have the need for another doc. I’m not looking to hire someone. My associate will have the option to make partner next year, and it wouldn’t be right to bring on another partner before she’s a partner. Furthermore, she had nothing to bring to the table. She offered nothing. She just told me what she wanted and why. She has no particular skill or expertise that our practice doesn’t already have (if anything, she’s lacking a few). She’s not bringing staff. Patients? Yes, she will bring some of her patients with her, but we’re already getting some of her patients because she doesn’t accept their insurance (another black ball against her - we’d have to get her credentialed with everybody).

Will we need another associate someday? I’d like to think the practice will continue to grow, but I think, we’ll go out and look when we’re ready.

Find out more about Melissa Young and our other Practice Notes bloggers.

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