Residency Insight -- A PRESENT Podiatry eZine

Guest Editorial: Today's Residency Insight is presented by esteemed colleague, Suhad Hadi, DPM, FACFAS. Upon completion of her BS in Biology at Youngstown State University, she completed her Doctorate in Podiatric Medicine at OCPM in 1997. After completing a 3-year residency at University of Texas Health Science Center at San Antonio from 1997-2000, where she served as the Co-Chief Resident from 1999-2000, Suhad remained as faculty and assistant professor from 2000-2003. She was recruited in 2003 and moved to private practice with Mercy Medical group in Sacramento, where she served as Chief of Podiatry until December 2008. Dr. Hadi and her husband, Johnny Alayon (who is also a podiatrist), have been together since they met during their residency program. They now reside, with their two sons, in Dr. Alayon's hometown of San Antonio, where they are both employed by the Veterans Hospital.

—Ryan Fitzgerald, DPM, PRESENT RI Associate Editor

Joining a Multi-Specialty Group/Practice

Suhad Hadi, DPM, FACFAS

Ask most residents as they near the end of their third year what they want beyond residency. It is surprising how many are not quite sure. They all know they want to be part of or have a successful practice. Though many are aware of the options available, many are unsure as to the pros and cons associated with different opportunities.

Upon completion of my residency, I was offered a position as an attending and clinical instructor with my program. I accepted the position. Three years into practice, I opted to “move on” and find my professional independence, in essence to leave the “umbrella” under which I trained. I started my search in an effort to return to my home state. As fate would have it, that was not in my future.

Upon hearing of my plans to leave my current position, a past co-resident had recommended a medical group in search of a Podiatrist with hospital training contact me. The Chief Medical Officer of the group contacted me, and before I knew it I was undergoing a telephone interview. I was intrigued by the opportunity and potential of being part of his team within a multi-specialty group. I agreed to fly out for an interview and tour of the group and the affiliated clinics and hospitals.

the pros outweighed the cons. I realized within this group, I was going to have a constant referral base from my colleagues and in return, I had a group of doctors from whom I could tap into as valuable resources in optimizing my patient care.

What the multi-specialty group had to offer was full of pros. There were few cons in terms of location being far from my home state of Ohio, working to establish myself among a new group of doctors and peers of every specialty and a little less control of the business side. However, the pros outweighed the cons. I realized within this group, I was going to have a constant referral base from my colleagues and in return, I had a group of doctors from whom I could tap into as valuable resources in optimizing my patient care. There was a hospitalist system within the group that would facilitate my hospital admissions and monitor my patients while I was in the clinic or surgery. This was the ideal situation in regards of a “multidisciplinary approach”, and I was going to be one of the team members.

I discovered that I was able to learn the business side of not only a podiatric practice, but also a multi-specialty group clinic.

What I never thought I would gain was further potential for professional growth. I was afforded opportunities for CME conferences in which I was an attendee and at times an invited speaker. There was opportunity for growth within the system. I progressed from staff podiatrist, to Chief of Podiatry and eventually to Clinical Director of one of the satellite clinics. I discovered that I was able to learn the business side of not only a podiatric practice, but also a multi-specialty group clinic. I was afforded a degree of autonomy in the sense of establishing a clinical, surgical and hospital based practice. I was active in staff recruitment, decision making and all of the responsibility surrounding my practice. I was also able to participate in instructional courses which included Research and IRB courses, Professional development and leadership courses, and practice management courses.

I believe it also goes without saying that there is financial security and incentive built into joining such a practice. The starting salary was very competitive for the area, and the built in bonus incentives made the offer more attractive. There was also a pathway to becoming a shareholder within the group. Retirement savings opportunities were afforded to all members with a group “match” up to a designated percent of my contributions which made saving for retirement easier. The group also covered my malpractice expense and portion of health and dental plans.

I gained a lot from being part of the multi-specialty group. I formed strong medical relationships and lasting friendships. The constant referral base allowed me to focus on my patient care and my professional and personal growth. I came to realize what I did, and did not want to do in regards to practice, techniques, surgeries, etc. Though I had already taken my boards prior to joining the group, this environment optimizes one’s ability to secure an appropriate case load and variety to submit for board certification. I came to appreciate the importance of a good referral base whether allopathic, or podiatric in optimizing patient care and my own development.

At the risk of sounding like I’m wearing “rose colored glasses”, I believe the multi-specialty approach is a good way to go especially for those out of residency for the reasons mentioned above. I believe one will acquire personal and professional development, a continuous case-load, knowledge of the business side of practice, and financial benefits/security while reinforcing podiatry’s role within the multi-disciplinary setting as a major player. It is important to understand contracts and contractual obligations and seek assistance prior to joining. It is also important to understand your obligations should you choose to depart the group, tail-policies, retirement contributions, etc. All in all, I believe it is a worthwhile venue to pursue for the young practitioner.

###