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Young Ophthalmologists
One to One: Wesley Millican

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Wesley D. Millican, MBA, is the founder and CEO of CareerPhysician Advisors L.P., one of the nation’s leading providers of comprehensive career and business education resources to residents, fellows and training program directors. He is also founder and President of MillicanSolutions Inc., an executive search and consulting firm focused on strategic leadership initiatives for children’s hospitals nationally. Millican serves on the boards of the Center for New Ventures and Entrepreneurship, Texas A&M University, as well as the Central Texas Conference of the United Methodist Church. He will be the key presenter at the YO Program in Atlanta.  

YO Info: What drew you to work with members of the medical field?
Wesley Millican: I got into health care by chance some 16 years ago, but is has been my realized passion for working with and supporting young physicians (i.e. residents/fellows) that led to the creation of CareerPhysician eight years ago. We are the only company in the United States exclusively committed to empowering the careers of residents and fellows.

YI: How did you become interested/involved in contract negotiations?
WM: Ninety-nine percent of all residents and fellows wish they had received more business and career education as a part of their training experience. Understanding the employment agreement is one of the principal needs of all ophthalmology residents and fellows as they seek to transition from training into practice. CareerPhysician was created to and is committed to providing all residents and fellows in the United States with the tools and resources necessary to empower decisions that lead to each student’s long-term professional success.

YI: How have contracts changed over the years?
WM: The basic physician employment agreement has changed very little over the last 10 years. The noticeable changes have been more in the cultural differences between senior physicians and generations X and Y. There truly appear to be differences in the definitions of balance and work ethic and their impact on one’s quality of life and total career satisfaction. These differences, when taken in the context of contract negotiation, can cause two committed parties to feel at odds in the process.

YI: Given this, what should a young ophthalmologist look for during contract negotiations?
WM: The chemistry created during the interview process must exist between the employer and employee at the end of the negotiation if the relationship is to succeed. Contracts are only as good as the character of those entering into the relationship.

Avoid taking the position “sophisticated negotiator,” as it will only breed competition in the process. The smaller the practice, the higher the likelihood that emotions will play a role in the negotiation process.

Also, you should negotiate with a long-term, five-year focus versus a one-year, salary-and-benefits focus. Keep your focus on potential and remember that you have not yet provided any benefit to the employer.

If your professional and economic success in a new practice is contingent on someone leaving, it should be in writing as to when and how that transition will occur. Finally, if you ask sound business questions in a professional manner and it kills the chemistry with a practice, then you have probably overestimated the chemistry that existed in the first place.

YI: When it comes to buy-ins, what is the more important thing for a YO to know?
WM: They should seek to get all terms clearly specified in writing in their employment agreement. The agreement should specify in clear detail all things necessary for the employee to see his/her first patient. This includes, but is not limited to, term, termination, malpractice, salary and production incentives, benefits, restrictive covenants and the ability to add details of one becoming partner or shareholder in a practice.

Unfortunately, few practices are willing to put the details of the partnership relationship in writing as a part of the initial employment agreement. In my opinion, it is optimal for both parties to go into the relationship with knowledge of these specific details if they want to empower their collective future. That being said, few young physicians are willing to push the issue with a prospective employer, for fear of losing the opportunity. However, the issue really should be pushed.

YI: What should YOs consider when evaluating their employment options?
WM: There is no longer a black-and-white option of private practice or academics. One can be partner and reside at an academic institution, or one can be the director of clinical research and teach and reside in private practice. The key is truly taking the time to set your goals and to clearly define the ideal practice. This will convert the process from uneducated job-hunting to a targeted practice search. This will have a significant impact on the ultimate employment agreement and relationship.

YI: In your opinion, what should a YO focus on over the next five years?
WM: They need to put the time and effort in on the front end to give themselves the best chance of still being a member of the practice they join five years from now. The real loss in the negotiation is not an initial salary of $170K or $150K. It is the loss, economically and professionally, of having to repeat the employment process again in a new location.

YI: Any final thoughts?
WM: Residents and fellows in all specialties need a focused advocate that is exclusively committed to their well-being and resource needs. At CareerPhysician, we are proud to assume that role and pleased that our efforts have put hundreds of young ophthalmologists on the path to success.

Want more advice like this? Don't miss Wesley's presentation at the YO Program in Atlanta. Register now.

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