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A resource to help physicians pick the best practice-FirstMedPractice

Updated: Nov 27, 2019

Introduction: Tom Ellis, of Ellis & Associates, Dallas, TX, is a medical practice consultant who works with physicians to help them find the best practice opportunity. Tom was kind enough to answer a few of my questions:

AW: What is First Med Practice? What's its purpose?

Ellis: FirstMEDPractice was founded to help graduating residents and fellows understand the business of medicine and quantify job offers and potential employers. The goal is to make sure there is a clear understanding of the opportunities by asking key questions about a potential employer and how they are going to create a job environment that promotes job satisfaction and longevity.

AW: Tell me about your background that prepared you to offer these services?

Ellis: I've been working with "new" physicians for over twenty years, helping them in their first practices. Unfortunately, I have also worked with a number of dissatisfied doctors who failed to follow a focused, comprehensive "entrance strategy." In many of these situations, the physician left the practice resulting in significant disruption to the physician's career and the care of his or her patients. I've helped these physicians structure new employment opportunities.

AW: Which physicians should consider consulting you or a similar consultant?

Ellis: Since recruiting for physicians usually starts in earnest two years before they leave academia, soon-to-graduate fellows and residents at this point in their training should be using FirstMEDPractice and digesting the content so they can ask the critical questions of a potential employer that follow from each of the 12 modules that make up the course. The FirstMEDPractice platform gives them leverage in the choice of jobs by giving them the questions they should ask as part of the interview process and conducting a more thorough analysis.

AW: How do you help physicians who are currently interviewing for a job?

Ellis: The platform explains the business of medicine they will have to deal with when entering employment (and more). In what I believe are the 12 most important areas, FirstMEDPractice provides 60 key questions they should ask as part of the interview process, then outlines how the business of their first practice should be structured. It also offers the most important metrics they should monitor during their first years in practice.

AW: Can you give me an example of common mistakes that young physicians make when selecting their first job?

Ellis: They focus only on the contract: Salary, benefits, moving expenses, etc. They do not vet how an employer can help make their practice a success, or require the necessary metrics to monitor their practice and track its successful trajectory. They don't seek out information on the strategic planning of an employer and where they fit. All of this should be considered and much of it incorporated into the original employment agreement.

AW: How often does a first job work out and turn out to be permanent?

Ellis: The last information I saw indicated that close to 40% of new hires leave their first job within three years. As noted, this is disruptive to the physician, but also for an employer who has been funding the shortfall as the physician's practice grows; this can be a significant investment. It can also be disruptive to a hospital if it's a surgeon who suddenly leaves, directly impacting surgical revenue. FirstMEDPractice is an important step in reducing this high turnover rate.

AW: Do young physicians have any leverage when it comes to negotiating their compensation?

Ellis: Yes and No. Certainly, most compensation today is based on "market" information available through groups like the MGMA and Sullivan Cotter. So those salary numbers are somewhat fixed, with some small movement, on benefits for example. However, that's the wrong emphasis. Salary numbers don't move around much. Instead, young docs need to negotiate to make sure that their new "business" is well structured and they understand their role in its success, as well as their employers. There will be a requirement that at some point their practice revenues will have to cover all of its costs.

AW: Is compensation the biggest point of contention when physicians are unhappy in a new job?

Ellis: Not from what I've seen. Contention and dissatisfaction arise when there is little definition on the operations of their first practice, the control they have, what's expected of them, and how they are being aided in creating a successful business, possibly leading to departure.

AW: What have you learned about physician recruiting firms? Do they represent the physician or employers?

Ellis: I think both. My platform is not pro- or anti-recruiter. I want the job seeker to have a full understanding of what an employer is offering to help them succeed on the business side. The questions I provide are what any employer would want—a comprehensive conversation that leads to contract signing, evolving into a good relationship between physician and employer that has sustainability.

AW: Anything else you would like to add?

Ellis: With the growing shortage of physicians, the high turnover rate, and the disruption caused by the latter, new doctors need to be much more careful in the job selection process. The platform and its 12 modules provide direction and a way to explore opportunities as jobs are considered. The platform is also useful for established doctors changing jobs (or looking to) who should be considering the same aspects of vetting new opportunities.

AW: If physicians use an attorney to review their contract, do they still need services like those available from FirstMedPractice?

Ellis: Yes. My platform is not the "12 things you need to know when negotiating your employment contract" so readily available on the internet, although I do touch on some overlooked aspects of these contract basics. It's a much deeper, analytical dive into the business of a first practice and key questions to vet this side of an employment relationship.

AW: How many physicians have you helped with your service?

Ellis: I've been working with physicians for 25 years. Built a couple of medical businesses with my clients. Ran an anesthesia company for over a decade. But if you want to aggregate all of them, probably close to 100, including those in solo practices, small groups, multi-specialty groups, pathology, anesthesia, and a range of specialties.

AW: How much does it cost to use your service?

Ellis: FirstMEDPractice is a eBook. The cost is $400. The website address is You'll find an expanded overview of the platform and modules there.

AW: How can young physicians learn more about the business of medicine?

Ellis: The platform is a big first step. It also examines the role of ACOs, payer contracting, hospital relationships, and understanding how practice governance impacts a newly hired physician. Intrapreneurship. I think it provides the foundation to work from in expanding that educational directive.

AW: What should physicians do who aren't interested in the business of medicine?

Ellis: Fully understand how it will impact them. You just can't ignore it completely. You have to remember your practice is a business. You still have to understand the basics and realize that you are going to be looked at as a revenue generator in any practice situation.

AW: Thanks very much for sharing your insights about the healthcare marketplace and how physicians can improve management of their careers. More information about Tom's services is available on this health care podcast and at

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