Great is the art of beginning, but greater is the art of ending

9-27-14ending  Some of my most painful memories stem from the many goodbyes I’ve endured – leaving Zimbabwe after 3 glorious years in rural practice, leaving my home country South Africa to move to the US, leaving my family practice after 9 years, amongst others. Some farewells have been lightened by the promise of exciting new things to come, others weighed down by the circumstances prompting the separation.

I while back, I tracked a physician conversation thread on a discussion board. A tired, embittered physician who planned to quit an apparently mean-spirited, uncaring employment situation was asking the question “How to leave gracefully?”. The question addressed not only saying goodbye, but how even to begin a job search while still employed.

The responses from his physician colleagues exemplified the need for “art in ending” and I thought I’d summarize the conversation into the Top Ten Pieces of Advice for those of you contemplating new pastures, and having similar concerns:

1. Unless you have several months expenses saved, consider landing that new job first. Or plan ahead, save religiously for 6 to 12 months and create a cushion for your job search or practice start-up.

2. Check your employment agreement or contract.  It typically has a Notice clause for how many months’ notice you are required to give.

3. Watch out for that “stick” — your malpractice tail payment.  It is near impossible to get malpractice insurance unless you have absolutely no time lapses in coverage and tail policies in effect for previous malpractice policies.  If a tail is required, perhaps you can negotiate for your new employer may pay the cost.

4. Use your sick/vacation/weekend off time to search for jobs and to interview.

5. Do NOT use your employer’s email for any job inquiries, interview scheduling, or griping.

6. When the time comes, let your organization know you are leaving for a new opportunity.  Don’t mention that you’re unhappy with the current situation. Same goes for interviewing for new positions as well.  In other words, you’re leaving to change locations, want a better opportunity, higher wages, a different schedule, etc.  New employers do not want to hear you talking down your current employer.  You may come across as a disgruntled and difficult employee.

7. Don’t burn bridges. You will need references from your boss or colleagues, and you never know whom you may bump into in your future work situations!

8. Find a good recruiting firm.

9. Know what you want before you go interview to avoid wasting time chasing after a job that will leave you less than satisfied. For example, Dr X knew he wanted primarily outpatient work and use of the hospitalist group. But it wasn’t until he interviewed that he found out that the group was also the hospitalist group, working 1 week out of 5 as the hospitalists. That wasn’t what he was looking for and that opportunity was immediately crossed off his list.

10. Hold your head up high, as you walk out the door, after as brief a notice as your employment agreement permits. It’s your right to step away from The-Hamster-Wheel-is-Spinning-Medicine. Be proud and polite, and say a pleasant good bye.

No matter how frustrated or disgusted you have felt in your work environment, there will be people and experiences that are owed an “artful goodbye”. Creating satisfying closure is an important psychological step – we are working on that right now for my daughter as she moves to a new and different playground in the fall!

Happy hunting!

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