Leaving a medical practice is usually accompanied with bittersweet emotions. A lot depends on the circumstances behind the departure: voluntary versus involuntary, hasty or well planned, leaving on good terms or otherwise.

Perhaps you will stay on your current job for a long time. If and when you do make a career move, the smart thing to do is to bow out gracefully and definitely not "burn your bridges" behind you. The following suggestions should come in handy when the time arrives for a voluntary departure. (Afterward, we'll consider involuntary termination.)

Winding Down

Once you give notice, for all practical purposes your association with the organization is severed. Although you might remain on the premises for another 60 or 90 days, your actual involvement with the practice will gradually diminish.

As you wind down your practice, make sure you maintain the highest level of patient care you are capable of providing. Instead of slacking off on patient contact and office duties, be all the more diligent in performing quality service day in, day out. This includes completing patient files in a timely manner and finishing other projects to which you have been assigned.

You may be asked to help select and / or train your replacement. The gracious response is to acquiesce to such a request and accommodate the needs of the organization during the transition period.

Parting impressions are as lasting as initial impressions. Displaying a cooperative spirit and positive attitude will go a long way in making a favorable impression as you prepare to exit the company. Furthermore, if your boss and colleagues hold you in high respect, they will be more prone to provide favorable references whenever you need them.

The Exit Interview

The exit interview may be brief or rather lengthy. It might be conducted by your superior or by the director of Human Resources. Regardless of who conducts it, it's important to tie up some loose ends prior to your departure.

First of all, you will be asked why you are leaving. How honest and specific should your answer be? The standard response is, "I've certainly enjoyed working here, but I'm leaving for a better opportunity."

More than likely, some follow-up questions will be voiced. "Weren't you happy working here?" "Is there anything we could have done differently to make it worth your while to stay with us?"

Questions like these suggest the possibility of a counter-offer being extended. Should you accept a counter-offer? The short answer is, "No." If you have given careful thought to making a career change and the offer that you have accepted reasonably meets all your expectations, why complicate matters by getting into a tug-of-war over your services?

Secondly, the exit interviewer will be curious to know where you will be working. Most doctors have no hesitation to mention where they will be setting up shop. Not only is it professionally courteous to name your new employer, it's smart to do so for another reason. Some patients are loyal to physicians who have treated them well more so than to a given medical practice. If your new practice is within commuting distance, loyal patients may want retain your services as their provider.

An exit interview with Human Resources will address additional matters such as insurance coverage, conversion of 401(k) savings, the cash value of unused vacation time, etc. More complex issues such as determining equity settlements would likely involve discussion with a tax accountant and / or an attorney.

Involuntary Termination

Exiting a company is much more problematic when the situation involves involuntary dismissal. It's difficult to bow out gracefully if you feel you have been the victim of unfortunate circumstances beyond your control-such as company downsizing.

Whenever job loss occurs without warning, the knee-jerk response is to retaliate in some manner. Such action might provide momentary emotional satisfaction, but you will likely face unfavorable consequences as the aftermath.

Even if you believe you have been treated unfairly, the better approach is to take the moral high ground and exit on a note of courtesy and professionalism.

Specifically, avoid voicing all the pent-up negative things you'd like to say before you leave the firm. Save such vituperations for your spouse or a close friend who can sympathize with your unfortunate situation.

Instead, channel your energy into more productive actions. In particular, try to obtain written references from the practice to include in your professional dossier. The reason for doing so should be obvious.

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