Prepping for Primary Care

1. Prepping for Primary Care While trying to keep your head above water David Chung, M.D. Primary Care Breakout, November 2013

2. About the presenter • Medical degree Harvard Medical School 1997 • Graduate of BCRP 2000 • Pediatric Associates of Brockton August 2000 to present • Created Beansprout Networks 1997 – an Internet company the created free templatized websites for pediatricians to communicate with families • Interested in clinical research in obesity

3. About the presenter

4. How did you get here?

5. Looking for direction?

6. Where are you going?

7. Topics for conversation • Deciding on an area of interest • Writing a clear and concise CV • Writing a cover letter • How to find potential employers • Honing effective interview skills • Understanding practice structure • Evaluating a contract

8. Deciding on an area of interest • Primary care • Longitudinal relationships • Median salary+bonus $199k, starting salary $125-145k (10/13) • Autonomy = long hours • Hospitalist • Shift work • Medial salary+bonus $227k, lower LT salary potential • Lack of autonomy • Specialty care • 3+ years of indentured servitude • Higher income potential • Can be harder to find job • Industry • High risk/high reward • Corporate culture ≠ medical culture

9. Writing a CV • Contact Information • Educational Background • Certifications and Licensure • Experience • Professional Affiliations • Publications, Presentations and Awards • References • Please refer to written article for greater detail

10. Good composition

11. Writing a cover letter • OMG, I meant a cover email • Take your emails seriously • Write a draft or two • Consider having your first one proof-read • Do not use emoticons or U will B :’ ( • Think about your audience • Remember that emails can and will be forwarded

12. How to find employers • To do list: • Check hourly labs and adjust K+ on DKA’er • Examine tracheitis infant on hourly racemic epi nebs • Talk down father wanting to sign out anorexic AMA • Get a job • Network, network, network • Do not bite the hand that feeds you • Use a recruiter at you own peril

13. Stand out from the flock

14. Honing interviewing skills • What the practices are looking for • Social competence • Medical competence • What you should be looking for • To be treated fairly • Short term versus long term considerations • Questions to be asked • Tell me about yourself • Tell me about the practice

15. Practice structure • Staff model (Atrius – aka Harvard Vanguard) • Ownership model • Partnership opportunity • Part-time/full-time

16. Evaluating a contract • Benefits • Malpractice – occurrence versus claims-made + tail • Profit-sharing • Disability and life insurance • Buy-ins/buy-outs • Bonus structure – refer to article 7 for nitty-gritty

17. Trust your instinct

18. This is the most important slide • How do you determine if you will be treated fairly? • Spend time at the practice • Talk to as many of the docs at different phases in their career • Ask the following questions: • How long is the buy-in process for partnership? • How many docs are full partners, and how many are in the buy in process? • How many docs have left the practice in the last five years?

19. Fairness math • The average career length is approximately 30 years • Divide the years of buy in by 30 years • This is the percentage of docs that should be buying in • The remainder is the percentage of docs who are full partners • If there is a greater proportion of partners:associates, then you will not be treated fairly • Long buy-in versus short buy-in pros/cons

20. Contact Info • David Chung, M.D. Pediatric Associates of Brockton d5chung@yahoo.com