The Dating Game

Finding a partner for your retina practice can be a lot like dating-you need to find someone whose values align with your values, who enhances your best qualities, and who doesn't make you pull your hair out. In this episode, New Retina Radio goes retro-think The Dating Game but (slightly) less corny. Featuring Geeta Lalwani, MD, and Charlie Mango, MD.

Krzywonos: I'm Scott.

Jaraha: I'm Ranna.

Krzywonos: This is New Retina Radio. In this episode, we're going to be talking to two retina specialists, Geeta Lalwani.

Lalwani: Hi, I'm Geeta Lalwani. I am a retina specialist at Rocky Mountain Retina Associates, in Boulder, Colorado.

Krzywonos: And, Charlie Mango ...

Mango: Charlie Mango, clinical associate at Weill Cornell Medical College and in private practice in Westchester, New York.

Krzywonos: Let's hear a little bit about their practice structures. Geeta, first.

Lalwani: I'm a solo practice. I started my own practice, in my hometown of Boulder, Colorado.

Mango: I'm in a two-partner practice. And, uh, I've been there for ten years.

Krzywonos: They're on opposite sides of the country, in similar practice structures and they've been in practice for about the same amount of time.

Jaraha: How did you cross paths with them?

Krzywonos: It's a long story. This one takes us back to over a year ago. I was at this get-together with Geeta and Charlie, and a bunch of other retina docs, in Pasadena. We were all gathered in the kitchen, where people always gather at these events, and we're snacking and drinking and having a good time. And, I moved from chatting with Geeta, to chatting with Charlie, and oddly enough they were both talking about finding a partner.

Jaraha: Okay.

Krzywonos: The three of us were eventually in the corner together, all talking about it and I was asking all types of questions, and I finally said, "Stop. We'll have to interview you two and make a podcast episode out of it."

Jaraha: (laughs) Okay. So, here we are.

Krzywonos: Exactly, so here we are.

Charlie's search isn't urgent.

Mango: In the future they'll certainly be a time when I'm looking for a new associate/partner, to join me.

Krzywonos: Geeta, on the other hand, has a search that's a bit more pressing.

Lalwani: I have expanded to three different locations, and because of that, I've come to the point that I absolutely need to take on a partner, probably in the next year.

Krzywonos: Geeta framed the search for a partner in rather funny terms, when we spoke to her last year.

Lalwani: It's like a marriage, you know? And, and ... I'm starting to date. I'm a little apprehensive about it. (laughs) But, I am starting to date, you know? Or, at least say that I'm available. Um, but I look at taking on a partner very much the same way.

Krzywonos: That's right, it's time to date.

Announcer : In color, it's The Dating Game. (applause) And here's the star of our show, and you're host Jim Lange.

Jaraha: Things are about to heat up.

Lange : Rather than the dynamic duo, we have the terrific trio, primed and ready to meet our first lovely, young lady. Let's meet them, and here they are. (applause)

Jaraha: But, there aren't any T.V. shows for retina docs who are looking for a new practice partner, or even an app they can use, like, I don't know, Tinder. (laughs)

Krzywonos: (laughs)

Jaraha: They don't have anywhere to get answers to all of the questions they have.

Krzywonos: Like, are you even ready to date and do you find someone your age, or someone older? Someone younger?

Jaraha: Yeah, I mean, the list of questions goes on. And, we're going to answer them, or at least we hope, in this episode. Geeta and Charlie will be our guides to the dating world of Retina, specifically, these four areas of focus.

Jaraha: How do I find a potential partners? How do I know if I need something serious versus something casual? How do I find a partner who brings out the best in me? How do I take my relationship to the next level?

Krzywonos: So, let's get this show started.

Krzywonos: Ranna, where do we begin?

Jaraha: Well Scott, let's take a look at question one.

Jaraha: How do I find potential partners?

Krzywonos: Our guests had plenty of ideas. We'll start with Charlie, who pointed to some traditional routes.

Mango: Both the AAO and the ASRS, I believe, have traditional print ads, and online ads.

Krzywonos: Okay, so there's your old-school ways of finding a candidate.

Jaraha: Right. The kind of ad that reads, "Single retina doctor seeking single retina doctor-"

Krzywonos: (laughs)

Jaraha: "Who likes piña coladas and getting caught in the rain." (laughs)

Krzywonos: (laughs) Exactly, and the modern version asks those piña colada enthusiasts to go online. Now, Charlie said he would have other options, if he didn't take the online route.

Mango: I'd probably have to hire a head hunter. Uh, which is difficult, because that takes a commission.

Krzywonos: It's easy to see why someone would use a head hunter, or some offline method. If you're like Geeta, online sites offer a degree of uncertainty.

Lalwani: I have say, I'm a little bit apprehensive. I'm glad that I don't have to go that route, not that it's right or wrong. I'm just ... I'm not comfortable as much, with the idea.

Krzywonos: She said some sites are more reliable than others, and she's likely to use those ones first.

Lalwani: I would probably use the more, you know, um, well known uh, job site such as the Academy website or maybe ASRS job site search. I think those have been very helpful. Those are what I used when I was looking for jobs.

Jaraha: If the online thing, like, the online dating scene as it were, doesn't work, can you just go through a friend? I mean, there are plenty of relationships, whether they're business, romantic, or platonic that come from knowing a mutual friend.

Lalwani: For me, dating, quote-unquote, a friend of a friend is the ideal. So, that's why talking to friends in academic programs who are training these fellows, or like I said, know of people who are looking for in tran ... Transitions, they know me. And so, they can help at least weed out what we think will be a good first choice to start, you know, at a starting point.

Krzywonos: Charlie agreed. Direct references are ideal, and rather than go through your Rolodex, you can go to where everyone knows your name: a professional society.

Mango: Pretty much, going to your society would be the best way to do it. I think VBS in particular, is a superb way because we're in touch with all the residency and fellowship directors here. Which, most of them are members of VBS.

Krzywonos: Colleagues act as filters for potential partners who aren't a right fit.

Lalwani: So, they can help at least weed out what we think will be a good first choice to start, you know ... At a starting point and say here's somebody. They're well trained. They have good personality. Um, they're ... They're very ethical. This is a good starting point, for you to, you know, begin having conversations.

Krzywonos: We seem to have addressed question number one-

Jaraha: Yep.

Krzywonos: Which was, remind us Ranna.

Jaraha: How do I find potential partners?

Krzywonos: And, it's time for question two.

Jaraha: How do I know if I need something serious versus something casual?

Krzywonos: And, just to be clear, by something serious versus something casual, we mean something long-term versus something short-term. There are some relationships that are cemented and others that aren't, and both of those are just fine.

Mango: When most people hire someone, they hire them as an associate and not a partner.

Jaraha: So, what's the difference between associate, and partner?

Krzywonos: A couple of things.

Mango: There's a whole host of ways to divvy this up.

Krzywonos: But, generally ...

Mango: Sharing profits ...

Krzywonos: And ...

Mango: Sharing decision making.

Krzywonos: And, how you're paid differs.

Mango: An associate that's starting out with your practice, pretty much makes a salary and a bonus, uh, structure, based on that but doesn't have the decision making capabilities of a partner.

Jaraha: So, if I'm understanding correctly, the search for someone, be it an associate or a partner is like going on dates?

Krzywonos: Mm-hmm (affirmative).

Jaraha: And then, signing for an associate is like I don't know ... Going steady? (laughs)

Krzywonos: Sure.

Jaraha: Um, then finally, signing a partner is a full-blown marriage commitment.

Krzywonos: Right.

Lalwani: There's no point in marrying somebody just for the sake of getting married. It's just, it's not going to work out.

Krzywonos: Associates stick around for a bit ...

Mango: Usually, it's anywhere from one year to a couple of years.

Krzywonos: The partner and the associate see if it's the right mix.

Mango: And, if it is, you make it a formal partnership.

Krzywonos: And, if it isn't the right mix ...

Mango: If it isn't, again nobody wants this, but you break off and it's better in that position than if you break up as partners later on, where there's a lot more invested in each other.

Krzywonos: It's important to remember that Charlie's practice and Geeta's practice have different dynamics.

Mango: I'm in a two partner practice, and uh, I've been there for ten years.

Jaraha: So, a pretty small group?

Krzywonos: Yeah, and the timeline for finding a new partner hinges on two things. His current partner's decision to retire and his office's physical space limitations.

Mango: Well, if you're in a particular, confined space you need to sort of wait until your senior partner is ready to go.

Jaraha: And, if you're not limited by space or by a partner's behavior?

Mango: In an expandable space, it's more of when you're, pretty much, at the patient load that you can ... That both of you can handle and a little bit more. And, at that point, you say, "You know what? We're over-busy and now is the time to bring in a new partner and keep this trajectory going." And, that's a good spot to be in, if you are.

Krzywonos: Which is, sort of, like Geeta's situation. Which means, to some extent she has to get moving.

Lalwani: I'm going from a solo practice to growing larger. There is more pressure, because … my point ... My practice is growing to such an extent that, as alone, I won't be able to maintain it. Or at least, maintain it as well as I would like.

Krzywonos: Yeah, it's time to get going.

Lalwani: There is a little bit of a ticking clock on this.

Krzywonos: Still, even with that clock, Geeta preaches that you have to stay calm. Don't just find a partner for the sake of finding a partner.

Lalwani: I will still wait for the, uh, the right match.

Jaraha: Well Scott, looks like we've answered questions one and two. And now, on to question three.

Krzywonos: That sounds like an interesting ... Uh oh! You know what that means.

Jaraha: That's right, listeners. Time for a break. We'll be back with more dating game after these words from our sponsors. Don't change the channel, friends. We'll be back in two and two.

[Commercial break]

Krzywonos: Welcome back, I'm Scott.

Jaraha: And I'm Ranna.

Krzywonos: Let's get back to The Dating Game! Ranna, remind me where we were.

Jaraha: Okay so, so far we answered two questions. How do I find potential partners, and, how do I know if I need something serious versus something casual?

Krzywonos: And, what is up next?

Jaraha: We have question three. How do I find a partner who brings out the best in me?

Krzywonos: That's something to consider, for sure. Retina doctors are always looking to improve and finding a partner that improves you is a great chance to make a positive move. Geeta said she wants a partner who could expand her horizons.

Lalwani: I look at characteristics that are complementary.

Krzywonos: The business aspect of retina can important.

Lalwani: How you relate to other referring doctors, and patients, that's perhaps different from me, is a, is a benefit.

Krzywonos: But, it's also important to have a skilled surgeon, who you trust but whose style might be different from yours.

Lalwani: I was just having this conversation with one of my colleagues and she sometimes proctors new physicians as they come into her practice. And, she like me, trained at Bascom Palmer, and so when you train at an institution, most of us tend to do, you know, what we did when we were young. You know, when we were babies in the world of retina we learned to do things a certain way.

Krzywonos: Some things might have changed.

Lalwani: Sure, we might have made small changes but for the most part, we do things the same way.

Krzywonos: Learning how others do things might be a good idea.

Lalwani: It's very nice to see how people do it, at other locations, and I think it's um ... It's a huge learning, uh, opportunity for myself, as well, to learn how to do things a different way.

Krzywonos: But, how do you know if they are a good surgeon? There isn't a try out, or anything.

Lalwani: I think, that's for me, is why I rely on the word of mouth route.

Jaraha: As we learned in question two ...

Lalwani: They're coming from institutions where they've been recently proctored and their, you know, surgical skills are well known.

Krzywonos: Charlie agrees that a fresh mind can help his practice. For him, freshness correlates with experience.

Mango: So, what you're looking for, I think, is someone preferably right out of fellowship, that is well trained in an excellent fellowship. And that is open-minded to the point where they're not set yet in their skill set. They're open to new ideas. They're open to a different way of practicing that might be better in, in our certain area than maybe, where they did their fellowship. So, I'm looking for, I guess, a younger person who is well trained and has an open mind.

Jaraha: Hiring a retina surgeon that's fresh out of fellowship comes with both its risks and rewards.

Krzywonos: There are a lot more questions, for one.

Lalwani: When you take somebody who's already been out, for several years, you, you know, obviously, always think about why they are unhappy about the place they are. Are they going to be unhappy in this location? Why do they want to move?

Krzywonos: But an experienced retina doctor comes with knowledge that you can't learn in fellowship.

Lalwani: On the bright side, they know how to function in private practice by themselves. They know, um, how to, uh, deal with referring doctors. They know how to take care of patients. They understand the business side of retina perhaps a little bit better.

Jaraha: Let's go back to this idea of a fresh mind for a minute. Of, expanding your horizons. Shouldn't a partner be able to do things you can't? So, you can make a good team. Like, I do this, you do that?

Krzywonos: Sort of, but it depends on the scale of the practice. If you're a small practice, like Geeta or Charlie, then not quite yet.

Mango: In a smaller group, four or five and under, you're looking for a general retina surgeon, uh, that's quite accomplished, who's done, quite accomplished in their residency and fellowship. Um, but not necessarily, they may have a separate skill set, where they may do ROP, or they may do tumors and they can find a niche to utilize that in, especially, in a practice such as mine. However, it wouldn't be a prerequisite.

Krzywonos: Geeta doesn't need something like a uveitis specialist, at this point.

Lalwani: The point that I am in my practice, I want someone who is very comfortable with medical and surgical retina. That is the bulk of the practice that we have. Uveitis would be beneficial, but I don't think that it would be enough to make that, for me to make that commitment in a specialist yet.

Jaraha: What about location? Is that a factor?

Krzywonos: Yeah, you know, Geeta brought this up actually. She said that location was important and sometimes it's more important than we think.

Lalwani: As a fellow, when you look at your job search, only half of it is the job you take. Half of it is clearly location. You know, and whatever location means to you. Is that a place that you want to be?

Jaraha: Right. Maybe a candidate will want to be close to home.

Lalwani: For me, I'm in Colorado. Boulder is my home town. I grew up there, from a young age.

Krzywonos: Or at the very least, close to a support structure.

Lalwani: Ideally, someone who wants to come to Colorado, either who has family ties or um, has a spouse who has family ties.

Krzywonos: Because guess what's coming up?

Lalwani: As you come out of fellowship, is when you sort of become, when you start your family life, or start having kids, or you get married, and, and, things that require, I think, not require, but are very helpful if you have family support.

Krzywonos: It's a long way to get here, but basically, uh, you know what? We'll let Geeta sum it up.

Lalwani: So, it's balancing. I think it comes down honestly, to chemistry.

Krzywonos: And what you want in a partner?

Lalwani: You have similar philosophies. You have similar ethics. You have uh, similar values that mean a lot to you. For me you know, obviously, I want a partner, whoever it is, to be very hard working. I want them to be very ethical, but also for me, words that trigger in my mind are, "integrity," "loyalty," and um, I would say "availability." It's not exactly a characteristic but understanding, uh, the nature of the business of retina.

Krzywonos: All right, I think we're done.

Jaraha: Me, too.

Okay, so there goes question three. How do I find a partner who brings out the best in me?

Krzywonos: Moving on in the new Retina Radio dating game ... Renna, what is our final question?

Jaraha: It's a good one, Scott. Question four: How do I take my relationship to the next level?

Krzywonos: Remember how you were always told to have an honest discussion about anything big like, finances, big purchases?

Jaraha: Oh, yeah. Oh, yeah. The same must apply to a business partner, whether they're incoming or outgoing.

Krzywonos: Exactly, Charlie for instance has a business partner who maybe retiring, in the coming years.

Mango: What I'd shoot for, is having an open and honest discussion, uh, when, say, if it was next year, to then start looking to try to bring someone on to meet that demand as soon as the other partner were to leave.

Krzywonos: You want a smooth transition.

Mango: If you want to stay sane, you'd want to coordinate it so that you do have a new partner joining you, uh, pretty much as a hand-off when your, when your former partner leaves you. I mean, you can take the burden of two doctors, but that's going to wear on your psyche and you're going to be pounded with patients. Your social life is going to disappear.

Krzywonos: Timing can be key, here.

Mango: You also are pigeonholed by the fact that, if you're looking for a junior partner right out of their fellowship, you have to wait until they finish their fellowship in July. So that, and then, you probably want to hire in August, September. They're going to want a month off to travel, I would think, and relax. And, I'd want them to have that month off, too. Just so they can come to you with a fresh head, and they're not just moving and starting up in their new position, right away.

Krzywonos: Like any healthy relationship, you need to be honest in your expectations and you also need to empathize with your incoming partner.

Lalwani: I try to look at it from their side, coming in. What are they looking at me for? If I can understand and appreciate that, um, then this will be a more real relationship, if you will.

Krzywonos: Set yourself up with honesty, and you don't risk disappointing your future partner because of blown expectations.

Lalwani: I'm very honest and open about what my practice is, so that I can have your expectations fulfilled.

Krzywonos: And make sure your prospective partner knows what they're getting into.

Lalwani: From my perspective, hiring a partner, I want someone who comes in understanding fully well what it is. What they're getting into. What my expectations are, in terms of us growing this partnership together and to understand that I am truly looking for a partner. Um, and, that I am very respectful, you know, to the Nth degree, in the way I treat people, and I expect that, vice versa.

Krzywonos: Not being clear in your expectations can lead to something worse than unmet expectations.

Mango: Now, if you're at the point where you actually hire them, and then it doesn't work out, then it's a bigger deal. Um, nobody wants to be in that position, both the employee and the employer because it's bad for everyone. But, those things do happen.

Krzywonos: Things sometimes go sour. Again, it's a lot like dating. Even if something looks great on paper, it might not be perfect for you.

Jaraha: Mmm.

Lalwani: I think the hardest thing, in dating, you think you're marrying, or, you're going out with a woman who's, in your opinion, you know, whatever. Beautiful. Ambitious or smart, intelligent and then finding out she's very different. You know? Whether or not it's right or wrong, it's very disappointing.

Krzywonos: To thine own self be true. Stick to honesty and you'll likely have a positive result.

So, that seems to answer question four, right?

Jaraha: Yeah, there we have it.

Krzywonos: Ah, you know what that music means.

Jaraha: Mmm, yep. Time to wrap things up, here. Special thanks to Geeta Lalwani and Charlie Mango, for this episode.

Krzywonos: I'm Scott Krzywonos.

Jaraha: And, I'm Ranna Jaraha.

Krzywonos: See you next time!

Jaraha: Bye!

Krzywonos: Bye-bye.

Nothstein: New Retina radio is a production of Bryn Mwar Communications and New Retina MD. This show is produced by Scott Krzywonos, with help from Jaraha Jaraha and Rachael[Kagan. This show was recorded, mixed and edited by Greg Nothstein.

Our staff includes Dave Levine, Megan Beisser, Elisa D’Amato, Laura Geise, Julie Kassab, Kyra Mazurek, Meredith Pollock, and MJ Stewart. Our publisher is Janet Burk. For advertising questions, contact us at newretinareadio@bmctoday.com. That's all for now. Take care, folks.