Rare is the occasion when business training
intersects with medical education.
Absent in most medical curricula and
nearly taboo in academic residency and fellowship training, understanding the operational aspects
of nephrology is imperative in preparing young fellows
for practice. Too often, budding nephrologists are ensnared in complicated contracts, beguiled by partner
promises, or seduced by transient gains. Unaware and
unprepared, young and enthusiastic nephrologists often
learn the business as they go, eager to see patients but often without the means or knowledge of how to achieve
though we often tell ourselves, “just 4 years of medical
school, just 3 years of residency, just 2 years of fellowship before the next step…,” entering the workplace becomes a lifetime commitment many are ill-equipped to
make. Our focus on short-term goals quickly becomes
apparent as we search for our next position. By focusing
on salary, weekend calls, and working hours, young physicians often lose sight of long-term plans, potential for
ten results in quick turnover of positions, loss of patient
continuity, and overall dissatisfaction. In the end, we are
often left with the same series of questions: What questions should I ask? What should I look for in a practice?
How do I know this is a good fit?
A theme frequently voiced to fellows by many mentors in both academic and private practice is, “What I
wish I had known when I was in your shoes.” Too often,
young fellows are thrown into an arena equipped with
medical knowledge, able to manage hypertension and
proteinuria, but uneducated in the business of nephrology. Shielded throughout training, they enter practice
encumbered by billing and coding, submerged in Quality Assurance and Performance Improvement (QAPI)
and MACRA (Medicare Access and CHIP Reauthorization Act of 2015), and overwhelmed by insurance
and investment. Although none would argue that the
focus of nephrology education should be on economics,
many practicing physicians say they were ill-equipped
to handle the challenges thrust upon them in practice.
To address these shortcomings, the Nephrology
Business Leadership University (NBLU) was created.
from training to practice, with emphasis on providing
the tools needed to interview, to find the right job, and
to grasp the economics of nephrology.
I attended the conference not knowing what to expect. I left with a better understanding of how to analyze a practice, assess a market, and screen for red flags.
I left with competence, now able to interview with assuredness, tailor my resume with expertise, and parse
a contract with awareness. I left with the confidence
needed to evaluate programs, screen for overhead, and
question my fit in a practice.
While there, I met with nephrologists working in
traditional and nontraditional roles as presidents of
hospitals, chief executive ocers of companies, fellowship program directors, basic science researchers, joint
nephrology hospitalists, and consultant nocturnists of
large multispecialty groups and solo rural practices.
Hearing their perspectives not only has provided me
with a cabinet of mentors but also has encouraged me
to break the traditional workplace stereotype and apply
for more leadership roles in the field. Overall, I found
the experience to be valuable, empowering, and eyeopening.
Now more than ever, being a nephrologist requires
more than just an understanding of medicine. With a
decrease in the number of nephrologists, we must push
ourselves further to improve the care of our patients.
Before this experience, I was more eager to just find
a job rather than try to find one that was the right fit.
NBLU has condensed lifetimes of learning experiences
and provided me with the tools necessary to make this
leap and become an independent, satisfied physician.
At the end of the conference, the energy, enthusiasm, and excitement about being a nephrologist were
palpable, partly owing to a focus often lost in training
programs. Education in the business aspects of nephrology is crucial in preparing the young fellow for future
practice.
For more information regarding NBLU, please visit
http://nbluniv.com/ or @NBLUniv.
Sapna Shah is a second yearfellowatMt. Sinai inNewYork.