As a resident physician, are you thinking about where you want to build your future in medicine? Meet AMA member Kunwarjit Duggal, MD, a physical medicine and rehabilitation physician, also known as physiatry, and a featured voice in the AMA’s “Finding My Place in Medicine” series.
In this series, physicians reflect on what influenced their decisions when choosing where to work—and what they wish they had known earlier. Explore his journey to help guide your own path toward a fulfilling medical career.
If you are looking for your first physician job after residency, get your cheat sheet now from the AMA. In addition, the AMA Transitioning to Practice series has guidance and resources on deciding where to practice, negotiating an employment contract, managing work-life balance, and other essential tips about starting in practice—including in private practice.
Also, check out Dr. Duggal’s profile in the AMA's “Shadow Me” Specialty Series, which offers advice directly from doctors about life in their specialties.
"Following” Dr. Kunwarjit Duggal
Specialty: Physical medicine and rehabilitation.
Practice setting: Subacute rehab in nursing homes.
Employment type: Employed by Medrina, in Chicago. Medrina is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Years in practice: 13.
Key factors that led to me choosing to work at Medrina: I appreciated the practice’s emphasis on autonomy, support and transparency.
The owner, with whom I interviewed, is a physician himself. He was very clear that this is a physician-friendly group, and that there would be no instruction on a way in which anything needs to be done. He told me I had full autonomy and that it was my practice. He also let me know about all the resources available to help streamline my process and make it more efficient and to my liking.
He also helped me with support on dictation, documentation, billing, and other support services that made my day-to-day workflow much more efficient. There was also a clear emphasis on billing and collection transparency so that I was absolutely aware of what money was being collected for services rendered by me.
What stood out to me during the interview and hiring process: The owners are extremely transparent and genuinely care about supporting their physicians for optimal work-life balance.
When I first started in this position, I used to spend painstaking hours each day typing out each note one by one in a very time-consuming process. Once the owners showed me a dictation service that could streamline this process and how to properly use note templates and smart phrases, it cut down my documentation time by about 80%. This was a change that was tremendous for my work life balance as it gave me time to enjoy things outside of work. I now have time for my wife and growing family.
As my practice got busier and busier, the company saw that I needed more ancillary support and proactively helped me hire a nurse practitioner so that my patients could get optimally seen. As time went on and I continued to get busier, I added two more APPs, which really helped me see more patients, but also ensured that they were getting great care. Medrina was instrumental in helping train my APPs so that we had a wonderful team atmosphere.
How feedback from peers and mentors influenced my evaluation process: I was advised to go into it with an open mind, which I now greatly appreciate. I could never have imagined I would be so fulfilled working in the subacute rehab setting when I first heard about it. As I learned more and more through experience in this setting, I grew to cherish providing care for an underserved and well-deserving population. We should all be so lucky to provide care for our seniors and help them age gracefully.
Why I chose to work in this practice setting: I value having autonomy, being able to make the practice my own and maintaining the flexibility to set my own schedule.
The top three qualities for a great place to work for physicians: Support, organization and communication.
How my current practice supports physician well-being and work-life balance: I feel extremely supported in anything I need.
The workplace attributes that contribute most to my job satisfaction at Medrina: The organization shows confidence in me to build my practice in the way I see fit. It also provides support to help me improve and streamline any workflow.
The biggest challenges I faced when transitioning from residency to practice: The subacute setting was the “Wild West” when I started in practice, and I had to learn a lot on my own. But we have done an amazing job since then to better prepare new physicians and also nonphysician providers for the work.
As one of the earlier doctors hired in this practice, my colleagues and I learned a lot in the field that was not a part of any classroom or education we had learned beforehand. We original physicians in the company have gathered all of our information and pulled them together to help new physicians in this area try for success much more easily. Online tutorials have been created for education on a plethora of topics that we come across in the subacute rehab setting so that our new hires can learn from our experience.
I teach the residents at Rush University Medical Center, and they are now required to do a rotation in the subacute rehab setting with me so that they can learn more about this aspect of physical medicine and rehab rehabilitation. This early education of rehab in the subacute setting is critical with our aging population that is living longer and with more disability. By getting to residents early in their training, we can better equip them to handle the population at large and all the diversity of Rehab needs.
What I wish I had known about evaluating a job offer before choosing my first position: I wish I better understood the details of management roles and finances. I felt a lot of useful information was hidden from me.
In my first practice out of residency, I was in an outpatient setting and on a management track. As the youngest physician in that practice, I often got dumped on with regards to extra patients on my schedule—much more than anybody else in the practice. This happened even when my colleagues’ schedules were completely open and mine was jampacked.
All financial information was out of my purview and not accessible or available to me. Because of this, it was very hard to see a future in management and potential partnership of the practice without having any information regarding the financial side of things. I felt that the information was not nearly as transparent as I had hoped.
Luckily, since joining Medrina, I have had no issues with transparency on the financial side whatsoever. All information regarding billing collections, and any other financial information is fully available to me at any moment in a very easy to use app that makes things very simple and clear cut. I couldn't ask for a better group to be a part of and work with. I'm very proud of my company and hope others see this as an employer that can help all of us find ourselves in our career and succeed in the way we all want.
What I would have done differently when choosing my first job after residency: I wish we learned the business of medicine better as residents. We were given no training as to what to expect and look for in the real world. Clinically, we were very well taught, but training in other practical knowledge was limited.
Why I changed practice settings midcareer: I became frustrated in my patient population and their limited motivation to improve. I felt that my skills and knowledge were being wasted.
How I knew I was ready for a change: I would be driving home and wondering if I had actually helped or reached anyone in my pain clinic that day. I worried I wasn’t making a positive difference.
How my current role compares with what I imagined: I absolutely LOVE what I do. I feel I can truly help patients, their families and the healthcare system by providing optimal care and bettering people’s lives. I couldn’t be happier with my current employment.
