What You Need to Know About Changing Practices

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It is not uncommon to change practices during a medical career. Though it is an exciting time and serves as a fresh start, it can still be overwhelming and even challenging as you navigate updated rules and regulations, different state requirements, new office policies, staff, commuting, and new hours, as well as other variables such as electronic medical records and different computer operating systems. Not only that, leaving the practice in which you have built can be bittersweet.

It is always essential to have clear communication regarding expectations at your new practice, specifically in the form of an employment contract, so that both parties agree on the foundation for working optimally together. When both you and your employer are successful and content, long-term relationships are formed, which is the ultimate goal. An employment contract is the first place to start, and both parties should mutually respect it. Unfortunately, that may not always happen, and if it does not, that should be a sign to walk away.

If you plan on working in a different state, obtaining a license to practice may take several months, with requirements varying significantly by state. For example, I changed practices from Illinois to Indiana. I had extensive paperwork asking for my transcripts from 20 years ago and my recent score on the board exam, which physician assistants have to take every 10 years, in addition to my certification as a physician assistant, fingerprinting, and proof of an Illinois license. This approval took 3 months to complete and was completely different from what was required for Illinois. Additionally, it came with frustrations concerning coordinating efforts needed from multiple departments.

Once I received my new state license, getting credentialed with the insurance companies took another 3 months. Knowing this timeline, both parties signed the employment contract with an agreement to start in 6 months so patients could be seen immediately and know reimbursements would be coming into the practice to pay for the salary. It is also helpful to keep your original state license if you plan on practicing in another state. Keeping your original state license allows flexibility and smooth transitions should the same practice open in that state or if telemedicine be considered in the future.

Leaving a practice where you established yourself can be very emotional and challenging. Many employment contracts do not allow one to solicit patients or staff for a period of time, and if you know months ahead of time you are leaving, you must stay discreet. Ensure you are allowed to make general non-targeted announcements of a move to a new practice on social media or other outlets so that you don't run afoul of a solicitation clause in your employment agreement. Again, this is why employment contracts are so important and need to be drafted properly, as you may be the reason patients are coming in to see you, specifically from the community outreach you do on your own time or friends and family that come into the clinic. For example, my husband, a melanoma survivor, gets his annual exam from a colleague at the office but would like to leave and continue his care by a colleague at the new office.

How you can proceed after you notify and leave your current practice needs to be carefully detailed in writing. However, both parties should be mutually respectful and understanding, not letting emotions control the departure. Often, egos can dominate and lead to a bitter exit, which does not benefit anyone. Again, a detailed employment contract addresses these issues, among others, and you have something to refer to in case leaving the practice becomes a challenge instead of a positive experience.

Having been in practice for over 20 years, speaking to colleagues, I have learned that most of them, like myself, move to another practice to enhance their skills and professional growth.

Learning from other colleagues has taught me these top 3 tips for changing practices:

1. Be well-informed and engaged in the entire transition.
2. Be patient and strategic.
3. Trust the process, be professional, and don't let your ego get in the way.

When practicing in any specialty, a long-term relationship is always the goal. Unfortunately, that may not always be the case. Still, professional growth is essential because you need to be challenged and respected and continue accelerating your skills. Supervising physicians serve as mentors, which dermatology physician assistants rely heavily on, no matter whether they are just starting or have been practicing for many years.

In the end, the team approach benefits the practice and the patients. A medical career requires building a relationship with your patient, community, and staff. However, as a dermatology provider, you are also building your reputation with the community publicly and professionally, which is vital, and that is why we should invest in your knowledge to educate the public and your colleagues. Working on this goal builds a reputation of merit; no matter where you practice, this will always follow you and represent who you are.

Renata Block, MMS, PA-C, is a board-certified physician assistant at SKIN Dermatology in Munster, Indiana, and a Dermatology Times Editorial Advisory Board member.