If it’s time to establish your first practice or change to a new one, don’t make the mistake of thinking it’s no big deal where you go. The decision you’re about to make will positively or negatively impact the rest of your life. If you don’t choose right, the correction can be very expensive and take a high emotional toll. The cost attributed to one of my friend’s moves to a new practice was over $170,000!

What happens when you change practices? You may have a problem getting out of your contract. Some advances may need to be paid back. You may have to pay for a very expensive “tail” on your malpractice insurance. You incur another set of moving expenses. Your house may not sell. You have to find new friends. Your children will need to start at a new school. All these issues not only take a bite out of your finances, but also your time, your energy, and your family’s well-being.

Here’s how I found my first job, which lasted 20 years. My wife and I both grew up in Oregon. Most of my family lives in southern Oregon, near Medford. Most of her family lives in northern Oregon, near Portland. I knew living close enough to visit our families was going to be an important part of our lives for many years to come. I set out to find a practice between these two locations.

I began my search with a physician recruiter and stated I was only willing to join a practice on Interstate 5 between Medford and Portland. This would situate us between our two extended families for the rest of our lives.

Initially, the recruiter didn’t find anything and started presenting other locations. His pay depended on finding me a job. He called one day to ask if I was interested in a really good job in Idaho. I asked him if Idaho was in Oregon between Medford and Portland on Interstate 5. He wasn’t amused. The job he was proposing was 450 miles away from where I wanted to live. He said there was nothing available where I wanted to live, so I should expand my options. I told him no.

The part of the country where I wanted to spend the rest of my life was not negotiable. I was not willing to take a position that didn’t fit my needs. Such compromise would guarantee my dissatisfaction, and I would end up looking for another job later. He was very unhappy with my narrow thinking and told me I would never find what I sought.

Since nothing was advertised where I wanted to live, I decided to go hunting for what was not advertised. I called every hospital between Medford and Portland on Interstate 5. Six practices were thinking about adding another surgeon and had not yet advertised the position. I took a road trip to interview with all six practices, and landed my dream job.

Starting a journey pointing in the wrong direction will never get you to the destination you seek. A lifetime of happiness hinges on the decisions you make as you head into your new practice. I stuck to my guns and found my dream job in Grants Pass, Oregon: on Interstate 5 between Medford and Portland.

Setting my goals and sticking to my plan created some great effects. I was able to spend holidays with my extended family. There was never a year when I didn’t have the time or money to fly home for Thanksgiving. My children got to know their grandparents, aunts, uncles, and cousins. Relatives were able to attend my children’s school functions and sporting events. The weather was to my liking. I could stay in touch with some of my high school friends and didn’t need to travel to reunions. A small fortune on travel expenses was saved. Grandparents were available as sitters when needed. I helped my parents and grandparents as they aged. My family enjoyed a long list of benefits and rewards because I thought about what I wanted, and joined a practice where I wanted to live.

Beginning a journey in the right direction is always the best choice. Decide in what direction your happiness lies and head for it. Do not pass go, do not collect $200. Choose your location wisely and you will save a fortune in money, time, and heartache.

Cory Fawcett is a general surgeon and can be reached at his self-titled site, Dr. Cory S. Fawcett.  He is the author of The Doctors Guide to Starting Your Practice Right.

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