Congratulations to all you new podiatric residency graduates. I hope your first years in practice are both fruitful and personally enriching. The only problem with the early years of practice is that residency does not prepare us for it. Now, don’t get me wrong: our podiatric residents are the best trained foot and ankle specialists in the world. The skills you have learned in clinic and the operating room will hold you in good stead for your careers. However, medical school and residency do not teach us the daily skills we need when running a practice, including marketing, advertising, business, personnel management, coding, billing, etc.

	Tonight's Premier Lecture is Diabetes Mellitus by Jeffrey M. Robbins

Shapiro’s top ten pieces of advice:

1. Take inventory of yourself.  What skills do you have?  What skills do you lack?  You are your own best asset after all those years of training.  You’ve made it all this way, honing not only your clinical skills but also your judgment.  Think about your skills and your deficiencies as well as what you enjoy and dislike.  Write out your inventory and then focus on your deficiencies, considering how you can gain those skills that you lack.  For example, if you don’t understand coding, then search out opportunities to learn.
2. Collect your Boards cases now.  The single biggest mistake I’ve made thus far was not being proactive enough with organizing my board certification materials.  Due to my mistake, I lost a large number of potentially submittable cases when I moved from Michigan to Oregon.  Review the ABPS and ABPOPPM documents for their requirements and then carefully track and copy all materials as you go.  For instance, be certain you understand the postoperative time points for postop radiographs.  Don’t lose good cases because of technicalities.  Keep copies of all your surgical charts, in case you transfer to a new job.
3. Put in the time.  Whether you’re an associate or in solo practice, developing a new practice takes time and effort.  There are lots of hands to shake and people to meet.  If you hide behind your desk, no one will ever learn about your remarkable clinical skills and excellent bedside manner.
4. But leave time for yourself.  Be certain to make time for your family and also for yourself.  Whatever that hobby or extracurricular activity is that refills the engine, continue to do it at least periodically.  Rest and eat appropriately.  You’ll function better.
5. Market yourself.  For many of us, this is a difficult part of starting practice.  For the introverted, meeting a strange doctor, shaking their hand, and explaining why you’re the best choice to send their patients is difficult at best.  Unfortunately, there’s no way around it.  Just suck it up and meet as many doctors, therapists, nurses, technicians, etc as possible.  Before you know it, you’ll be busier than you thought possible.
6. Protect yourself.  There are two ways to protect yourself: treating patients well and documentation.  Care for your patients as if they’re family, and they’ll be less likely to litigate if something untoward occurs.  Documentation should be careful, comprehensive, and concise.  Document all patient encounters, no matter how trivial seeming.  This includes phone conversations.  Remember, if you didn’t document it, it didn’t happen.
7. Join everything you can.  Whenever you have the opportunity to join a club, hospital committee, state membership, etc, then just do it.  The most successful podiatrists I know are those who understand the importance of networking. 
8. Learn from your seniors.  For you associates, use your boss as a resource for how to handle business, as well as making a study of their clinical judgment.  If you’re going through it, they’ve probably gone through the same at least once.  If you don’t have direct access to another experienced podiatrist, then find someone who would be willing to be a mentor.  Our senior physicians are a wealth of knowledge, and most of them are happy to give back.  Then, when you’re the senior doctor, you can mentor the next generation.
9. Continue your education.  Remember, you’re a lifetime learner.  If you don’t keep up on the newest information as it comes out, you’ll quickly lose your base of knowledge.  Medicine is a knowledge based industry.  If you don’t know anything, you’re no longer a physician.  There are many ways to keep current without breaking the bank account.  You can even obtain most of your CME credits online using services like PRESENT Podiatry and PRESENT Diabetes. 
10. Have fun.  Podiatry is an enjoyable and rewarding medical specialty.  Enjoy your coworkers, staff, patients, and other physicians. 

One more piece of advice.  Consider it a bonus.  Remember that this is the “practice of medicine.”  You’re not going to do everything perfectly every time.  Keep your eyes open for mistakes, analyze your methods for ways to improve, and don’t beat yourself up when things don’t go your way.

You have the opportunity to affect the lives of many people over your years of practice and maintain an upwardly mobile lifestyle with a significant chance for professional satisfaction.  Start good habits early and your life will be that much easier.  Best wishes on your new practice situations.

What do you think?

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Keep writing in with your thoughts and comments. Better yet, post them in our eTalk forum. Best wishes.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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