After more than 20 years in the Army and two deployments with forward surgical teams in Afghanistan, I thought I was prepared for anything, and I was looking forward to retirement and settling in to private practice. However, there are a few things I wish I’d known about the transition:
1. Remember, medicine is a business in private practice.
Unlike your military career, where cost was secondary, cost of delivering medical services is primary in the private practice setting. From budgeting for your marketing efforts, to the cost of diagnostic tests, to paying your employees, everything has a cost. One benefit of private practice is that you do have more direct control over managing your costs and your resources. However, this also means that you need to have enough volume in your practice to cover your overhead costs. Unlike in the military, where there were more patients than time to see them, in civilian practice there are not enough patients but there is plenty of time.
2. Consider the practice setting that will work best for you.
You must decide if it will be better for you to take an employed position with a hospital, which is most similar to the military, move to a private practice, join a group or strike out on your own. With declining reimbursements, it is much more difficult to maintain a solo practice than it used to be, so a group may be preferable if you choose the private practice route. In my opinion, the advantage of private practice is that you get to control the environment of care and, therefore, the efficiency and quality of the medical services you provide.
3. Complete your credentialing early.
It is very important to have credentialing with hospitals and insurance plans completed prior to starting your new job. If you do not complete this relatively simple task, it may be several months before you begin to see any reimbursements for the services that you provide.
4. Do your research when deciding where to practice.
Geography plays a very important part in the type and volume of patients you’ll be able to see. The American Academy of Orthopaedic Surgeons conducts a survey every two years that can provide good information regarding orthopedic surgeon density in all parts of the country, for example. This can be very helpful in identifying the location to practice once you complete your military service.
5. Embrace your experience and training.
Military service and providing medical care within the military system gives you a unique perspective that civilians do not have. You are very well-prepared to take on all the challenges in the changing healthcare environment.
Kevin L. Kirk, DO, is a board-certified orthopedic surgeon, fellowship-trained in conditions of the foot, ankle and lower leg. Following his retirement from the Army, he joined University Orthopedic Associates in New Jersey and has recently relocated his practice to San Antonio, where he has joined The San Antonio Orthopaedic Group. For more information, visit http://www.tsaog.com/drkirk.