Life After Emergency Medicine: Dr. Stephens

Navigating Life After Emergency Medicine: A Family's Transition

I practiced Emergency Medicine for 30 years as a PA but have an Academic Doctorate.  My wife was in the ER for the same time as well first as a nurse then as an NP after working briefly in Family Medicine.  She also has an Academic Doctorate.  My son is a PA and worked a couple of years in the ER as well.  Our other son is an attorney.

We contemplated life after Emergency Medicine.  If you’ve ever been there – its chaos and we worked in one of the busiest ER’s in the state.  We have an Emergency medicine residency program so in addition to shift work we had teaching responsibilities as well.

I am an adjunct professor for Doctoral Programs at two Universities and was the only Academic Doctorate on faculty serving as an Assistant Professor at the Residency Program. The rest of the faculty were Clinical Doctorates.

The Birth of a New Vision: Opening Our Clinic

The anxiety and stress of many years of ER & academics had to be weighed against the anxiety and stress of opening our own facility.  If you’ve been in large medical centers you understand you are a cog in a machine that turns slowly with little control.  Although I was a supervisor, our impact on the community seemed limited.  Our own clinic seemed to be a way to impact the community on our own terms.  It also would get us off on nights, holidays and weekends.  Have you ever lied to your children when they were small that Santa Claus was coming tonight and it was Dec 23rd?  If you’re in Emergency Medicine and had to work Christmas you have.

Our initial emotions were balancing the stress of a new venture but it paled in comparison to the stresses of a medical center.  It was simply a different stress.  We hoped a good stress.

The facility we opened was in a historic building across the street from the Medical Center.

We opened at the very worst possible time.  We opened exactly one month before Covid really hit the US.  While we were trying to grow a practice, the local medical center closed two.

We turned the challenge into an opportunity.  We became one of the few clinics that performed Covid testing.  Employers began to require testing and we initially increased volume by testing when other clinics would not see patients until they were tested.

Building a Brand and a Team

We decided to create a Family Practice clinic that provided academic care & had the appearance of a sleek, clean Aesthetic Practice.  Pt’s coming in for covid or urgent care stayed to become primary care patients after the experience with our staff that came with us from the Emergency Dept.

So, we overcame the challenges by developing good supply chains (covid tests) & marketing/outreach (Infinity & others) to establish a brand rather than simply open a clinic.  We were well known in the community so that helped too.  Within a year we were voted #1 clinic in the county by an annual survey conducted by the local newspaper.

Our advice would be not to just open a clinic and hope business rolls in.  Decide what the brand of medicine you are providing and the need you fill in the community.  Then don’t execute that brand or fill that need without a team.

We surrounded ourselves with not only the best marketing folks and people who have done it before us.  We developed referral patterns and relationships with local physicians, supply chains, clinics and service providers.

We also learned quickly that your staff will be your success or failure.  We fortunately staffed with people with whom we had worked for years.  We all knew the community and considered patients our family and friends.

Lessons Learned and Continued Growth

The last advice is not to give up too soon.  Again, covid shut down a couple of local clinics just as we were opening.  That was discouraging.  But we accepted the patients who suddenly had nowhere to go. 

Interestingly, despite having the best marketing teams – the best advertisement has always been word of mouth.  Marketing material has always been supplementary to support the image that was already created by patient’s direct experience.  You also don’t have to invest in expensive equipment or gimmicks to build a large practice.

We have three full time providers (2 Pas & NP) along with a physician that is a part of the practice as well.  We could use another full-time provider and we just purchased the two-story building we started renting when we opened 3 years ago. 

There is life after Emergency Medicine. It’s busy.  We never catch up.  But we get weekends and holidays off.  What’s more – is you have complete control of what happens to your practice.  The CEO of the medical center comes to visit us rather us having to see him in his office.

Having control of what happens in all aspects of your practice can be a blessing or a curse depending on how you respond to challenges.  You have to be a good business person as well as a good clinician.

For us, it’s worked.  We are off this weekend and every weekend.  And I can have a cup of coffee at my desk if I want to and have a pleasant chat with a patient without feeling rushed.

There is life after Emergency Medicine.



Written by:

Dr. Phillip Stephens of Carolina Acute Care & Wellness Center