The nephrologist shortage in this country introduces several pitfalls. In order to mitigate as many problems as possible, it’s important that young nephrologists be well prepared for the industry they’re entering. To increase retention, fellows should make their career choices carefully, and older nephrologists should mentor their younger counterparts. They’re in this together, after all, as their ranks decline and ESRD rates increase.
According to Mark Mazak, vice president of DaVita Practice Strategy Group, the number of ESRD patients is increasing 5.8 percent annually, whereas the number of nephrologists is “generously estimated” to be increasing at 3 percent annually.
This is not a perfect scenario. How can fellows prepare for the choppy waters that await them?
Fellowship Preparations
First off, fellows need to learn the medical knowledge and skills that will make them good doctors. Beyond that, they should try to learn about the business side of practice, including revenue sources, expenses, coding and documentation, said Mitchell Rosner, MD, an associate professor of medicine at the University of Virginia Health System. He is also vice chairman of the school’s department of medicine and is the fellowship training program director for the school’s division of nephrology.
“They also need to learn professionalism and how to be the best possible consultant—how to be helpful, respectful and give great service to the patients and the referring doctor,” Rosner said.
A good first step is to spend time figuring out whether academics or private practice is a good fit, said Adam Weinstein, MD. He is co-owner of the Kidney Health Center of Maryland, P.A., in Easton, Md., and started his practice with a co-fellow. He said they work together to create a stable and financially sound business that provides excellent care.
