What I wish someone had told me as a cardiology fellow or new attending (or started doing on my own)
The single best ROI I ever did was to learn basic coding. No one teaches this in residency or fellowship and it affects your like beyond how much you get paid in most work settings, from academia to private practice.
Is not only about money. Knowing what is reimbursable or not and what are the documentation requirements for any given E&M encounter will make you more efficient, get you out of the door sooner, and concentrate on things that matter.
E.g. What makes a level 4 vs 5 visit? When can I bill for critical care? What are the documentation requirements when working with APPs? This applies to any current field in current medicine (in the US) but as a proceduralist, even more so… what is procedurally bundled or not, etc.
Your best tool nowadays is AI. If you don’t know already, start from the simplest ‘what are RVUs‘ or CPT codes? How do I get paid in x model? Ask those questions as simply and conversationally as they occur to you.
That has paid dividends up to this day and was key in my former academic, private practice or employed model. Remember, your job coders’ priority is to be in compliance and tend to err on the side of undercoding. And that is when they are correct, which they are often not. A typical coder in most places is multispecialty and is supposed to know the constantly changing rules for a knee replacement or for a NSTEMI or STEMI stent (coded differently, BTW).
Resources beyond AI (if at all needed): the AACP website and forums. For proceduralists (IC and EP): ZHealth.
OK… the next other random few things that come to mind are:
- DO NOT f*ck where you work (applies to interns, nurses, reps, God forbid…patients, etc). Seems obvious but you would be surprised.
- If you wear lead, work your core. I do kettlebell swings but there are other ways. 20+ years in, no back pain, a rarity among my partners. Incidentally work the muscles contrary to ’computer head / shoulders’. Google it if not clear.
- Sneakers or squishy shoes are for running and feel good on your feet at the expense of an unbalanced platform for your spine. Stand on firm soles. Learned this from my mentor who cathed on cowboy boots. Thats not my vibe so I use boat shoes.
- If you stand a lot, wear compression stockings. Venous reflux is rampant and not fun.
- From academia to private partnership, employed models, etc. It will always be a transactional relationship. You are good as long as you are of benefit to the work. Approach it the same. Look out for your interests first and protect them. No one else will.
- Speaking of, your biggest asset and the most wantonly disposed of by others is your time. Learn to say ’no’. No to BS meetings, no to after-work gratuitous work, etc. Look up ‘how to say no’ with Tim Ferris.
- Max out your 401k, 403b etc. If there is matching make it a life priority to contribute enough to max the match. The sooner you start the better. Compounding is an awesome thing. If you have no idea where to start, get advice, check out the Boglehead forum here in Reddit, if your hospital has Fidelity or Vanguard most offer free basic consultation, if not search for an independent fee only financial advisors.
- Earn as a cardiologist but live as a pediatrician (sorry pediatric colleagues). Luxe creep and ever-increasing social expectations are real. Look for them, recognize them, avoid them.
- Don’t let your work define you. Develop some interests of your own outside of work and separate from your family or kids. Your post retirement you will thank you.