Careers in Family Medicine: Multi-specialty Group Practice and Leadership

We are continuing our blog series, Careers in Family Medicine. Each week, I will highlight a family physician and their career path. Each one will share their pearls. So far, we have highlighted examples of Rural Practice, Value Based Care, Academic Medicine, and working within the US Department of State. This week, we take a look at a model of practice within a medical foundation, in which, the physicians are shareholders. Dr. Kelly Derbin highlights working clinically as a family physician within a Multi-Specialty Group Practice and also serves in Leadership within the foundation. 

Kelly, Please give the readers an overview of your career in family medicine. 

I attended medical school at UCLA and got involved in a Family Medicine interest group through which I met some of my early mentors.  I cannot overemphasize the importance of mentors.  They have inspired me, helped me when I felt lost or doubted myself, and encouraged me to be courageous and believe in my ability to stretch beyond my perfectionistic and fixed mindset. (This was before I was aware that perfectionism isn’t healthy for myself or those around me, and I also lacked awareness of the concept and power of a growth mindset!).

I did my Family Medicine residency at the University of South Alabama, where I also served as chief resident.  As I approached the end of residency training and everyone was making career decisions, I found myself in a quandary.  I was passionate about maternity care and envisioned that I needed to go practice in the community before fulfilling my dream of teaching at a residency program.  The problem?  The only FM docs doing Ob were faculty at the residency program where I trained (For personal reasons, I needed to work in the same city where I trained). I ultimately chose to accept a faculty position where I trained as my first “real job” out of residency so I could include Ob as a part of my practice.  I then started to contemplate paths to obtain additional education to develop new skills and knowledge to bring to my faculty role.  After attending an STFM meeting and speaking with many faculty development programs across the country, I asked the department chair for support to participate in a faculty development fellowship.  Fortunately, he said yes!  This experience helped set the stage for learning that it is so important to be courageous and ask for what I need. I ultimately earned a Master of Education through which I gained an external network of colleagues, tools and knowledge.  It also helped fuel growth in my confidence as I navigated the role and mindset change from resident to faculty. 

For personal reasons, I moved from the South to the Midwest where I worked at two community-based residency programs over a period of 9 years. The work I did as a faculty member allowed me to embrace my calling to connect with students and residents and support their education and development. I find it so gratifying to bear witness to individuals learning, connecting dots, gaining confidence and spreading their wings.   

After 11 years serving as faculty, I moved back to California to be near family and chose to join a large Multi-Specialty group, Palo Alto Foundation Medical Group, where I practiced clinical medicine full-time for the first time in my career. What I discovered is that the medical group is ripe with many opportunities to further connect with meaning and purpose. Through this experience, I’ve learned that I don’t have to live my life with “or” (ie this OR that) and I have the ability to embrace “and.”  Therefore, my big career change didn’t mean I had to give up my passions. I had the ability to connect with them in new ways, initially as a patient experience coach and later taking on the role as Medical Director for Leadership Development for my medical group. 

What are your favorite parts of your roles currently?

I currently practice half-time as a Family Physician in our multi-specialty group and work half-time as our Medical Director for Leadership Development. It has been a learning-filled journey, allowing me to balance patient care and my deep sense of meaning and purpose by supporting our talented and dedicated leaders while fostering the future leadership of our medical group. Over the past 2 years I also completed a coaching program and just became an Associate Certified Coach (ACC), through the International Coaching Federation (ICF). My team and I are now exploring how to scale and bring more coaching support to our leaders. Thus, I have had the ability to continue to grow personally and contribute to my organization in new ways.     

What lessons did you learn from your time in academics?

It feels so long ago!  What comes to mind is that I wish I knew then what I now know.  I created much of my own suffering as a perfectionist, and I now call myself a recovering perfectionist.  I no longer view mistakes as “who is to blame.”  I ask, “what can I/we learn?”.  I think I’d be a lot more fun as a faculty member today than when I was starting out 25 years ago.  I can laugh at myself more.          

What three tips would you tell those who are looking at options for their first job in family medicine?   

• How are my priorities and values aligned with the values of the organization?
• What support/mentorship will they provide to support me?
• What opportunities are there for me to grow? 

What three tips would you give attendings who are looking to pivot?

Give yourself time and space to think about what you want your future to look like. 

• Spend time reflecting on what is important to you.
• Ask yourself what you hope to become with the change.
• Consider getting a coach!   

In what ways have you found joy in your various roles? 

I’ve learned that I’m a kinder and more patient person when I’ve slept at least 7 hours, so I prioritize sleep to enable me to bring my best self to my various roles (sorry residents, I know that isn’t always possible).  I practice mindfulness and self-compassion regularly. 

I love to solve problems and collaborate. What I have learned is that I need to speak less, ask more questions, listen and ask more clarifying open-ended questions and bring out the diverse viewpoints and best thinking of the group.  It is a joyful relief to know it isn’t about me having all the answers! 

I better understand it is important to pause, reflect, create space for new ideas to percolate and reflect on what I can learn or do differently. Creating space sound impossible?  At times for me it is a small gap due to a busy time and at other times longer periods of time. Speaking of longer periods of time…breaks!  Taking vacation and refueling the soul. 

How do you “balance” or integrate work with life outside?

I think we have all struggled with this since the beginning of the pandemic. I’ll be honest, I’m typing on my laptop at the kitchen table on a Saturday morning. And it is a choice. I knew I needed some time and space to think about these questions, so I made that choice. Setting intentions helps. Sharing intentions with my loved ones or friends who can support and help hold me accountable. I do have a sticky note in my car that says, “Transition well” (Thank you, Jessie Mahoney! -Mindfulness Physician Coach). To me, it means that I think about how I want to show up and be present at home. I reflect on what boundaries I want to create to protect and foster my own health and wellness and the health of my relationships with friends and family. I don’t have it all figured out, but when I sense things are out of balance, I notice, sit with it, reflect and work on getting things more balanced again.        

Anything else that you’d like to share?

Tonya and I did our residency training together at the University of South Alabama.  I’m grateful for her friendship over the years and so proud of the work she is doing to support a more joyful career journey in Family Medicine!  I would have loved to have benefited from a program like hers early in my career.    

Great! Thank you for taking the time to share your wisdom with the readers. How can people find you if they want to talk more? [email protected]

So many pearls offered here. Continue to let me know what you found helpful.  

Next week, we'll dive into being a Direct Primary Care family physician with Dr Adriana Raus. Don't miss any in this series; sign-up to have them delivered to your inbox. 

Until then, have a joy-filled week! Tonya