Don't retire: Get a job

June 2, 2006

This sixtysomething internist faced a no-win dilemma: rebuild hispractice or dismantle it. Then he came up with a third option.

I can't say that my employees-Betty who handled the front-office and Ellie who assisted me in back-didn't give plenty of notice when they said they planned to retire. In fact, I had six full months to contemplate what to do next.

But I faced a dilemma: I didn't want to retire along with my employees, yet the thought of rebuilding a staff was daunting. Betty had been with me for 27 years, typing my office notes, doing billing and collections, handling insurance problems, making appointments, and dealing very professionally with the public. Ellie, who had worked for me for 11 years, was just as patient-centric. She handled traffic flow, assisted me with female exams, drew blood, and did basic lab work. Both women saw to it that I didn't fall too far behind schedule when my fondness for chatting made me forget the clock.

And it would be tough to recruit competent replacements because, as a doctor already in his 60s, I couldn't really offer long-term employment. Plus, the pay scale I could afford had slipped below what local businesses were paying. Mine was an old-fashioned solo practice, the kind that most experts put on the endangered species list.

Opportunity knocks

One day during this period, a physician came to see me about a job she'd erroneously heard I was offering. I would have set her straight, but some sixth sense led me to invite her to sit down and tell me about herself.

What a story! Nani Khananashvili was raised and went to medical school in Tbilisi in then Soviet Georgia. After practicing cardiology in Moscow, she came to the US with her twin children and physician-husband. Although she was still learning English, she managed to secure a coveted internal medicine internship at Albert Einstein College of Medicine in New York. While she was redoing her training, the couple divorced. Following her training, she went to work for a New York City internist, eventually buying his practice and running it for a couple of years.

So why was she here? She'd gotten remarried to a man whom she'd known as a child and who now lived in California. They'd tried a bicoastal marriage with meetings on weekends, but it was too tough on both of them. So she sold her New York practice, came to California as a housewife, and, after three months, was going stir-crazy. She wanted to get back to medicine.

I was impressed. "I wish I could offer you a job," I said. Then, because she was so clearly entrepreneurial, that same sixth sense led me to ask, "Is there any chance you might like to have your own practice?" When her eyes lit up, I knew there really was something to talk about.

That was three years ago. Nani bought my practice and I became her part-time employee. I didn't have to leave my own patients and take a job elsewhere. Nor did I have to continue running an office.

A rocky start

Of course, my friends said I was crazy to try to work for a considerably younger doctor in what was once my own practice. "Run away as fast as you can," they said. Her friends bluntly told her, "Nobody buys a primary care practice in northern California anymore."

In fact, it wasn't a smooth start. Showing more guts than prudence, the first thing Nani did was to redecorate. Painters showed up during office hours. The carpenter quit, leaving newly stained cabinets in the garden.