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Tuesday Apr 08, 2014

Don't Accept Limits on Your Family Medicine Opportunities

With our broad, extensive training, family physicians have opportunities beyond working in family medicine practices. Family docs are working in geriatrics, sports medicine, long-term care facilities, urgent care clinics, hospice care, and as hospitalists, administrators, researchers and more.

It's that diversity that draws some medical students to family medicine in the first place.

When I travel around the country to state chapter meetings, I hear from a lot of family physicians who love what they do. Occasionally, I also hear from members who say they feel trapped.

That was the case recently when I spoke to a colleague who had done research and developed a business plan that would expand primary care services for her health system. The idea, she thought, would improve outcomes and generate new revenue streams.

Her employer, however, was thoroughly disinterested.

Disappointed and disillusioned, she told me she felt stuck in her job because she had signed a two-year restrictive covenant agreement, or noncompete clause, when she was hired. That agreement excluded her from working in other family medicine clinics within 50 miles of any facility owned by her employer, which has locations in multiple counties in her area.

In my opinion, she was so close to her own situation that she had lost perspective. I told her to think about the diversity of her training and reminded her that family medicine is the No. 1 specialty for which recruiters are hiring. We are only trapped if we accept limitations others try to put on us.

These days there are incredible career opportunities across a wide spectrum because primary care is the backbone of our health care system. Family physicians are in high demand. In fact, there were more than 300 new job postings on the AAFP's CareerLink website during the first seven days of this month.

If you're feeling burned out or resentful, it's time to step back and consider what you might be able to do differently. Personally, I've left a job when I wasn't being compensated fairly and was unable to change unsatisfactory circumstances. When advocating for change within your system doesn't work, it's appropriate to consider other opportunities. Don't sell yourself short.

One of my colleagues recently made the decision to leave New England and move to a new opportunity in South Carolina. After more than 20 years of dealing with the same payers, she was ready to try something new.

That brings us back to the issue of restrictive covenants and whether physicians should be signing them. The AMA adopted principles two years ago that discourage physicians from entering employment agreements that contain noncompete provisions or other restrictions on future employment.

Personally, I've refused to sign restrictive covenants twice. Both times, I was told it was standard operating procedure. Both times, I let them know it was a deal breaker for me, and the employers backed down.

If an employer isn't willing to hire you without placing restrictions on your future, maybe it's not the right place for you. It's important to be able to walk away on your own terms, and there will always be other people who will hire you.

With a shortage of primary care physicians, our health care system can't afford to lose our training and expertise. If you're feeling burned out or trapped, you always can reach out to your colleagues or mentors for perspective and advice. Getting involved with your state chapter and national family medicine activities can expand your professional network.

Remember, there are always other options. With training as a family physician, you are invaluable, and you can find professional satisfaction in other settings where you can provide the expert care our nation needs.

Wanda Filer, M.D., M.B.A., is a member of the AAFP Board of Directors.

Comments:

This is very timely and good advice to graduating residents. I'm new to my new role as program director but spent over 30 years in practice and have seen many FPs victimized by restrictive contracts and non-compete clauses. We need to remember that we are in ever increasing demand (if not reimbursement) and can use that to our advantage in negotiations. We are only powerless if we allow ourselves to be.

Posted by Glenn V. Dregansky, DO, FAAFP on April 10, 2014 at 08:16 AM CDT #

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.