From Residency to Orthopaedic Practice: 20/20 Hindsight

By: Cindy Bracy, RHIA, MPH

Transitioning from residency into practice can be an eye-opening experience for many young physicians. Residents are protected and operate in an environment that is partly out of their control. The business of medicine, regulatory compliance requirements, and the roster of physician team players are all predetermined and managed by the hospital. In moving on, residents are at a crossroads, embarking on their first employment contract and assuming the full responsibility of practicing medicine.


Brent A. Ponce, MD

Brent A. Ponce, MD, spoke at the Practice Management Seminar for Residents and Fellows-in-Training on Tuesday to shed light on the transition into orthopaedic practice. Dr. Ponce described medicine as a business. He said residents should learn how to interpret a profit-and-loss statement to understand the financial health of their practice. Both solo and employed physicians must hone their business acumen, he said, as today’s medical practice is based on dollars and cents as much as it is based on the tenets of medicine. 

Residents should also be aware of potential pitfalls of practice and be knowledgeable about how to prevent or avoid them. Inadequate insurance coverage, fraudulent billing practices, money left on the table from nonappeals and inaccurate coding, and employee embezzlement are all real day-to-day concerns for the practicing physician. A practice should have a system of checks and balances in place to ensure that financial accounts are secure and in order. This safeguard will also discourage inappropriate behavior.

Becoming a leader will be a new role for the rising physician. Characteristics of a leader include honesty, transparency, integrity, humility, and vision. Treating people with respect and empowering others goes a long way in building relationships and becoming a leader. This is a time to start mentoring others. The newly minted physician should consider creating a team of mentors to include senior faculty, peer mentors, and scholarly mentors.

Finally, Dr. Ponce noted the importance of taking care of one’s health and well-being. The average orthopaedic surgeon is said to work more than 55 hours per week. The rates of divorce, suicide, and addiction are higher for doctors than for the general population. Take time to nurture relationships and create a work/life balance from the beginning. The rewards are worth the years of work and dedication.