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5 Tips to Build Your Perfect Practice for Employed Physicians

I’ve talked about the importance of building your optimal practice after finding your perfect job with these 7 do’s and don’ts of practice building. But I want to get more into specifics about building your perfect medical practice for employed physicians.

This is especially important as more and more physicians elect or find themselves in an employed practice model.

perfect practice employed physicians
Team work makes the dream work…

But first a quick refresher on your job…

Finding the perfect job for you is obviously super important for your overall well-being and to decrease the risk of burnout.

It’s also really important for your financial well-being. By finding a job you like, you are more likely to work longer and can enact the 6 easy steps for reaching financial freedom.

Once you find that job, you are going to want to build the best practice you can!

The importance of building a successful medical practice…for everyone

It seems like an obvious question but I’m still going to ask it, “Why is building a successful medical practice important?”

The converse of this would be to just get a job and go along for the ride. Punch in, punch out. Cash your pay check and hopefully save and invest to reach financial freedom.

This is a valid path, if not an ideal one.

You can use your high physician income to gain financial independence using this 7 step easy formula. But if you at best are neutral to your job or at worst hate it, the process of getting to financial freedom is not going to be fun.

And it should be fun, and fulfilling!

It’s also not the best for your patients…

So, I would really recommend taking the time, whether you are a new grad or years out as an attending physician, to build your practice into what you want it to be!

This goes for all physicians, but it is way too often overlooked especially by employed physicians…

5 tips for employed physicians to build your perfect medical practice

When you are in an employed or academic practice, you will have less direct control on some aspects of managing your practice like:

  • Hiring/firing employees
  • Determining/changing institution wide policy
  • Altering hours, etc

However, one of the biggest mistakes that I see healthcare professionals make in employed or academic practices is assuming that they can do nothing to optimize their practice.

This is ridiculous.

And this takes the perceived locus of control right out of your hands which is a direct path to moral injury and burnout.

Some contract talk first…

But with this being said, it is perhaps even more important for employed or academic physicians to work to build your perfect practice. This goes for private practice too but there is a bit more adaptability there then here in an employed setting.

If you are looking for help with contract negotiations, check out these 2 posts:

Regardless, I am an employed physician and I have done a great deal along with my partners to optimize out practice. It’s not perfect, but it’s really great and we are constantly looking to make it even better.

Ok, here are my 5 tips for employed physicians to build your perfect practice…

1. Get to know your administrators

Most physicians or healthcare professionals actively work to never interact with administrators. Or if they do, it is very curt.

Now I understand why this is at times, but the bottom line is that the administrators are the ones with the more broad power to enact changes in your practice. And they are much more likely to do that if they know you personally.

But even more than this, by developing a relationship, you can begin to educate about why the changes you want to make are important and how they can help you do your job better. And no matter what metric you are looking at, better healthcare is better business for a practice.

If you strike out with the first administrator you try to work with, move on to another.

But try to be a positive and constructive voice in their ear.

2. Play the numbers game

Take the time to figure out how much your department or your role is bringing in for the institution or practice. Then work to figure out how the changes that you are suggesting will improve the bottom line.

This may seem a bit dirty to you as a healthcare professional on first consideration. 

But like I said before, good healthcare is good for business. I truly believe this and have found this as I have worked to optimize my practice.

As an example as a surgeon, some procedures surgeons may do can actually be a financial wash for the institution. But, these procedures incorporate or lead to other factors that increase the productivity of the department. 

But, you need to know this before being to advocate for what you need to do.

Another example, do you need another employee to help make the practice run smoother, better, faster?

Well, figure out how much money is being wasted by not seeing or converting those patients who are being missed because of a lack of staff. How much does it cost to hire someone? Know how this extra employee can increase your bottom line and tell someone. 

So, take the time and do the work to know the financials of your practice and how you can make them better by taking better care of your patients and optimizing your practice.

With this information, the changes you wish to institute are much more likely to fall on attentive ears.

3. Optimize yourself

This comes down to time management in my eyes. I know a lot of surgeons who complain about not being able to finish their notes and having to stay late to do them. 

I also see these same surgeons wasting time doing nothing in between their cases in the surgeon lounge. 

Meanwhile, as soon as I finish a case, I dictate it, code it, and deliver my notes. And I never once have had to stay late to finish up paperwork.

I know a lot of you are probably saying how this doesn’t apply to you. And you may be inundated with just ridiculous levels of paperwork. It’s a ubiquitous and horrible reality of modern healthcare.

But I say this to illustrate that there are certain things that we all have to do.

So it makes sense to optimize how we are taking care of these things so it is in the most efficient and effective manner possible, whatever the task or minutia may be.

4. Meet with marketing

All institutions have a marketing team or key individual who handles these things.

Meet with them and see how you can work to optimize getting the word out about what you and your practice do.

Filter for what you actually want to do and what things you want to avoid.

Advertise for your ideal patient and ideal practice.

Too many people just show up and think their perfect practice will fall in their lap. It just doesn’t happen this way.

5. Know your productivity

Keep close track of your own productivity based on whatever metrics are most appropriate.

For physicians this is likely RVUs or some similar metric.

Throughout the length of your contract or agreement, track all of these numbers.

I talk more about the specifics here in terms of knowing your value as a physician in this post:

When you want to make a change or its time to renegotiate your contract, go in with these numbers.

Show them with hard and cold facts how much you are worth and why they don’t want to lose you.

Then follow with some of the changes you want to implement.

This is the build it and then ask approach. You have proven your worth and the success of what you can do. With this cred, you can now ask and receive what you want from a position of power.


With everything that we have discussed in this post, take the time to consider what changes are needed to optimize your practice and what actions you can take to make them a reality.

Again make sure to check your mindset along the way, identifying pain points and limiting beliefs and then flipping them using your big why as a guide along the way.

The case for financial freedom for physicians

Underlying everything that we discuss here is financial freedom. That is the great equalizer.

Because when you are financially free and you don’t enjoy your practice or situation, you negotiate from the ultimate position of power.

Basically, either you change the practice so it fits you and fulfills you…or you can leave. You can leave either for a better opportunity. You can leave working full time to work part time. Or you can leave to just leave.

Again, I am not pursuing financial freedom to retire…but rather so I can work on my own terms because I want to, not because I have to. I know myself and know I will be happiest doing this.

But it is a great parachute to have just in case I do ever decide to stop working due to burnout or any other unforeseen reason.

You can learn more about the 7 habits of financially successful physicians here or sign up for my free masterclass webinar, the 12 Steps to Financial Freedom for Physicians here!

What do you think? How should employed physicians build their perfect practice? Is financial freedom the key? Let me know in the comments below!

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    Jordan Frey MD, a plastic surgeon in Buffalo, NY, is one of the fastest-growing physician finance bloggers in the world. See how he went from financially clueless to increasing his net worth by $1M in 1 year and how you can do the same! Feel free to send Jordan a message at [email protected].

    6 thoughts on “5 Tips to Build Your Perfect Practice for Employed Physicians”

    1. How would your advice change for someone in a position that is essentially salaried? No incentives to work harder, be more efficient, see more patients or grow the practice.

    2. I truly wish you the best with this and hope that you will fare better than I (and my group) have with renegotiations. It looks like you’re still fairly early in your career.

      It seems that with a salaried structure you’re either overperforming and not being paid for the value you bring (and not getting annual raises like your administration colleagues are) or you perform at exactly where you’d be expected to or perhaps less and then have no chance at any raise.

      Respectfully, what would your game plan be if you are not successful with negotiating a big jump in your salary as planned? I’m asking because this is what happened to me/us.


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