To a physician transitioning to practice and looking ahead to that first physician job, onboarding might seem like a formality. It is, in fact, an important first step in every doctor’s career.
An AMA STEPS Forward® toolkit details some of the best practices employers should follow to pave the way for physician success, satisfaction and well-being. Its content can help job applicants determine whether prospective employers provide adequate onboarding.
“A clear and defined clinical ramp-up schedule for a new physician or [nonphysician provider] is critical to the clinician’s well-being and success,” the toolkit says, adding that health professionals should be provided adequate time to complete their onboarding modules and sign up for insurance.
“Importantly, ramp-up schedules should differ for a physician who has been in practice many years versus a physician just out of training,” it notes.
The AMA Transitioning to Practice series has guidance and resources on deciding where to practice, negotiating an employment contract, managing work-life balance, and other essential tips about starting in practice.
What to expect out of the gate
“The ramp-up should start slowly to allow for EHR learning, at-the-elbow support and time for the new physician,” the toolkits advises, “to meet and build relationships with the patients and care team, all while navigating a new system.”
Ramp-up schedules are not one size fits all, the toolkit notes. Rather, they should be tailored to the role and the individual. A physician in practice for many years should see a different ramp-up period than a doctor fresh out of residency training.
The following is a sample ramp-up schedule, available in the toolkit, for new-to-practice physicians from an academic medical center in Illinois. It is designed for an outpatient clinic in which a physician at full capacity would see 16–20 patients in a typical eight-hour workday.
Weeks 1–4:
- Begin with scheduling one patient per hour, or four patients per half-day session.
- Provide a one-hour lunch block to allow for additional catch-up time if needed.
- Schedule daily check-ins with the practice manager. “This time should be built into the schedule template,” the toolkit notes. “Open, frequent and clear communication with the physician helps them feel supported and valued.”
Weeks 4–12:
- When the physician is ready, slowly ramp up their schedule by adding one patient per session.
- Continue weekly or bi-monthly check-ins to see how the ramp-up is going and determine if the physician needs any additional support.
- Continue to provide one-hour lunch breaks.
- “The goal is for the physician to see six to eight patients per session by the end of the first 90 days,” the toolkit says.
Weeks 13–24:
- Continue to slowly increase patients per session with the goal to reach full capacity—eight to 10 patients per session or 16–20 patients per day—by the six-month mark.
- Continue check-ins monthly or every other month.
- If desired by the physician, consider decreasing the amount of time for lunch.
If you’re seeking your first physician job post-residency, get your cheat sheet now.
Dive deeper:
- What to look for when onboarding at your first physician job
- In transition to practice, know these 8 steps for evaluating jobs
- When seeking new physician job opportunities, follow this advice
- What I wish I knew in residency about being an employed physician
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Feedback makes it work
Frequent communication between the new physician and operational leaders is central to understanding both what is going well for the physician and what barriers they may be facing, the toolkit notes.
“They will work together to create a plan for increasing the number of patients being seen,” it says.
For residents transitioning to practice or those already in practice who are considering a midcareer switch, a separate AMA STEPS Forward toolkit, “What to Look for in Your First or Next Practice: Evaluate the Practice Environment to Match Your Priorities,” will help you identify available practice settings and understand how they may impact your experience, clarify your priorities, and tailor your search for a fulfilling career in a positive and supportive environment.
Learn more about optimizing onboarding in an Aug. 26 AMA STEPS Forward Innovation Academy webinar featuring Dr. Chen and Balchunas. Register now.
Learn more about the AMA Young Physicians Section, which gives voice to and advocates on issues that affect physicians under 40 or within the first eight years of professional practice after their training as residents and fellows.
