A reflective commentary by Liporace revisiting his 2011 article on entering academic orthopedic practice. Written after 10 years of lived experience, it identifies what principles held true, what evolved, and what he would do entirely differently. Topics include staff hiring, lecture preparation, billing responsibility, partner dynamics, ABOS certification, and burnout prevention.
Residency training does not teach billing, staff management, ABOS logistics, or partner dynamics — and the gap shows immediately in the first year of practice. When you start your first attending job, set up a patient database before you see your first clinic patient. It will serve your ABOS Part II collection, your research, and your lectures all at once, and retrofitting it later is painful.
Protect half a day per week for administrative work and treat it as non-negotiable. This is not personal time. It is the minimum overhead required to keep billing accurate, records current, and research moving without burning out.
On billing: understand that coders help, but the legal responsibility is yours alone. Learn modifiers, precertification rules, and how to document correctly before you need it under pressure.
A reflective commentary by Liporace revisiting his 2011 article on entering academic orthopedic practice. Written after 10 years of lived experience, it identifies what principles held true, what evolved, and what he would do entirely differently. Topics include staff hiring, lecture preparation, billing responsibility, partner dynamics, ABOS certification, and burnout prevention.
Residency training does not teach billing, staff management, ABOS logistics, or partner dynamics — and the gap shows immediately in the first year of practice. When you start your first attending job, set up a patient database before you see your first clinic patient. It will serve your ABOS Part II collection, your research, and your lectures all at once, and retrofitting it later is painful.
Protect half a day per week for administrative work and treat it as non-negotiable. This is not personal time. It is the minimum overhead required to keep billing accurate, records current, and research moving without burning out.
On billing: understand that coders help, but the legal responsibility is yours alone. Learn modifiers, precertification rules, and how to document correctly before you need it under pressure.