New Physicians Tell All to Residents, Students

Practice medicine according to your principles. Don't compromise on your values, but be flexible enough to ensure financial health. Listen to your patients. Realize "you don't need a BMW."

Do that, and you will flourish in an era when hospitals and communities are scrambling to hire family physicians.

That advice -- offered by new physicians Saria Saccocio, M.D., of Fort Lauderdale, Fla.; Kendall Campbell, M.D., of Gainesville, Fla.; Marguerite Duane, M.D., M.H.A., of Washington, D.C.; and Russell Kohl, M.D., of Venita, Okla. -- brought medical students and family medicine residents face to face with the real world Aug. 5 during "New Physicians Tell Their Stories" at the National Conference of Family Medicine Residents and Medical Students here.

Newly minted family physicians are entering practice on the cusp of an upcoming serious primary care shortage. FPs can choose from a full menu of career options: urban or rural solo practices, academic medicine, or group or multispecialty practice.

"You all have futures in family medicine," said Saccocio. "It is a little scary. I owed $70,000 to $80,000 (in school loans). But there are primary care shortages everywhere, in every state. Several hospitals in my area are begging for primary care physicians. There is no one to take care of the public. Emergency rooms are overloaded. And hospitals out there are offering income guarantees."

Saccocio launched her solo practice in Fort Lauderdale with the help of a contract that guaranteed $16,000 a month for two years. The guarantee quickly became unnecessary, and Soccocio's practice soon was earning $22,000 a month. Recently, she realized she needed to give herself a raise.

A successful medical career goes beyond income, however, said Saccocio. "You don't need a BMW," she said.

Speakers urged participants to remember the key points of practicing satisfying, high-quality medicine: Capitalize on educational opportunities, delegate responsibilities for which you aren't trained, learn to say "no," and keep your patients' perspectives foremost in mind.

"You will always continue to learn," said Duane, who is the family medicine clerkship director at the Georgetown University School of Medicine and who cares for underserved patients at Columbia Road Health Services in Washington. "The thing family medicine does so well -- more than other specialties -- is preparing our residents to know how to learn, to use resources to expand their knowledge base."

Kohl urged students and residents to capitalize on any learning opportunity.

"If there's anything you can learn, do it," he said. "It's better to have the skills that will lead to credentialing and choose not to use them than to have to do a procedure and not know how. Because when someone asks, 'Is there a doctor in the house?' -- all of your friends are going to look at you."

Too often, physicians open an office expecting to practice medicine but end up operating a business.

"Contract out your billing," advised Kohl. "Hire an attorney you can trust to help you with employment law and other issues. And you need an accountant. Don't let your billing company be your accountant. That's like the fox watching the henhouse."

Take these actions, said Kohl, "and you're not wasting your brain power fighting those little battles. You can take care of patients and hire people to take care of you."

Saccocio agreed. However, that doesn't mean ignore the health of your business.

"Have an interest in the business," she advised. "Understand what's coming in and what's going out, and that (the bottom line) should be black instead of red."

Family physicians enjoy as much, if not more, personal time than some of their counterparts. The key, said the speakers, is time management.

"Protect your time. You're going to be called on for so many different things," advised Campbell, who is assistant dean for minority affairs and a clinical assistant professor in community health and family medicine at the University of Florida. He's also a staff physician at a multispecialty clinic that cares for underserved people.

Set aside workday time for administrative tasks and -- equally important -- preserve family and personal time, he advised.

"Maintain those interests outside work. They breathe vitality into your life and into you," said Campbell, who has attended all of his daughter's soccer games and who serves as organist and choir director for his church's two choirs.

The doctor-patient relationship begins with the first telephone call, so ensure that patients interact with people, not technology, said Saccocio.

"Answer the telephone with a person," she advised, ticking off a series of other practice principles: "Listen to your patients. It's OK to say you're sorry. Be honest with your patients. If there are things you don't know, tell them. When you refer them, tell them why.

"Always, always be reasonable with your patients," says Saccocio. "You may not like all of your patients, but recognize your feelings and your responsibility to give them the same quality of care. If you're humble and modest, mistakes won't be a big deal and you'll get past them."

Do that, she said, and you'll love your work.