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10 Things I Wish I Knew Before Entering Practice

By Michele Shermak, MD Reprinted from Young Plastic Surgeons Perspective, April 2003 Plastic Surgery News.Despite exuberant clinical exposure during plastic surgery training, important practical issues related to day-to-day practice as an attending may not be addressed, particularly for private practice situations. Having come to terms with this lack of education, our Young Plastic Surgeons (YPS) group has compiled a “Top Ten” list of focus areas that require greater attention prior to entering the real world – so that those currently in training or thinking of entering a different practice scheme might be better prepared:

  • Coding
  • Job selection – Working in practice with a partner is like a marriage. Don’t be seduced by money alone. Check into your predecessors’ experiences
  • Direction – Determine the direction you want your practice to take. Don’t let someone else do it for you
  • Marketing – How to successfully market a plastic surgery practice and reach the best referral sources
  • Ethics – Understand what is allowed and what isn’t
  • Mentors – Identify supportive mentors early in your career, and avoid individuals who perceive you as competition
  • Advocacy – The importance of reaching out beyond the scope of daily plastic surgery practice and making a difference
  • Negotiating with insurance companies – Whether to join programs; which ones to join and which ones to avoid (you may only need to be on a few specific plans)
  • Patience – Be patient while building your career and practice. It takes four to five years to get busy Balance – How to balance life and work

Additional active education may be necessary on the trainee’s part to research these focus areas and effectively improve the transition between residency and practice. In fact, resources are in place to ease the process. ASPS sponsors programs specifically directed at practice management, marketing and coding. Friends and colleagues several years out would be useful mentors as well, having recently experienced the process. - Dr. Shermak is the YPS Perspective editor and an assistant professor of plastic surgery at Johns Hopkins Medical Institutions.