Register for the free call 14 April at 6pm central here

In this episode, Dr. Amy Vertrees and healthcare attorney Amanda Hill announce the return of Season 4 of the 90 Day Notice program, launching April 14th.

Originally created after a wave of unexpected physician layoffs, 90 Day Notice was designed to help doctors protect their careers, navigate workplace challenges, and regain professional agency. Today, the stakes feel even higher.

Across the country, physicians are reporting:

This episode explains why doctors need a proactive strategy before problems escalate — and how physicians can learn to advocate for themselves without immediately resorting to lawyers, job changes, or burnout-driven decisions.

Medical training teaches clinical excellence — but rarely teaches:

Through her work with the BOSS Business of Surgery Series, Dr. Vertrees focuses on closing these hidden gaps in physician professional development.

Meanwhile, Amanda Hill brings insight from representing over 1,000 physicians nationwide, offering real-world legal patterns doctors rarely recognize until they are already in crisis.

Their combined perspective reveals an important truth:

👉 When doctors feel something is wrong at work — they are usually right.

Amanda shares recent client experiences, including:

Rather than reacting defensively, the program teaches physicians how to:

Dr. Vertrees explores the emotional impact of complications — particularly how they often occur in clusters and trigger:

Many surgeons don’t realize how workplace narratives form around them — or how much influence they actually have over those narratives.

90 Day Notice focuses on expanding emotional capacity, communication skill, and professional authority so physicians can lead their careers intentionally.

Amanda explains when legal counsel helps — and when expensive legal consultations may actually reduce a physician’s leverage.

Instead, doctors learn how to:

Success stories include physicians who went from feeling targeted to receiving retention offers after transforming how they showed up professionally.

This program may be right for you if:

Rather than immediately changing jobs, participants learn how to first transform their existing situation — often avoiding the significant financial costs of transition, including tail coverage, relocation, and legal fees.

Participants receive:

Accessible nationwide, the program blends real-world legal strategy with mindset and leadership coaching tailored specifically for physicians.

✅ Register for the free kickoff call beginning April 14
👉 Visit Guard My Practice or 90 Day Notice

✅ Learn more about physician professional development
👉 Explore the BOSS Business of Surgery Series

Register for the free call 14 April at 6pm central here

Episode Description:
What is the real cost of hospital employment for surgeons—and is it as “safe” as it seems?

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrens sits down with plastic surgeon Dr. Mark Shashikant to explore his journey from military medicine at Walter Reed to civilian practice, and ultimately toward greater autonomy and entrepreneurial thinking.

Dr. Shashikant shares a candid look at the transition out of the military, including the dramatic increase in compensation—and how high salaries and signing bonuses can create “golden handcuffs” that keep physicians stuck in misaligned roles. He also breaks down the realities of hospital-employed practice, from intense trauma call schedules to the hidden expectations of unpaid administrative work.

This conversation dives deep into the business of medicine, including how surgeons generate far more value than they are often credited for—especially through downstream revenue that hospitals rarely acknowledge.

The COVID-19 pandemic became a pivotal moment, exposing the imbalance in employed physician contracts and challenging the assumption that hospitals carry all the risk. From there, Dr. Shashikant began rethinking everything—from compensation models to long-term career strategy.

You’ll also hear how his practice evolved toward cosmetic surgery, why reimbursement changes are reshaping the future of surgical specialties, and what physicians should consider if they’re thinking about private practice or ownership.

In this episode, we cover:

If you’re a surgeon or physician navigating early or mid-career decisions, this episode will give you a clearer understanding of your value—and how to take control of your career.

What does it really take to build a successful career as a woman in surgery?

In this episode of BOSS Business of Surgery, host Dr. Amy Vertrees sits down with the editors of the new book Women in Surgery: Navigating Challenges and Triumphs to discuss the real stories behind surgical careers.

Instead of theoretical advice, this book shares honest experiences from surgeons across generations—covering imposter syndrome, mentorship, leadership, motherhood, advocacy, and resilience.

The conversation explores how women surgeons support each other, challenge broken systems, and continue shaping the future of the profession.

• Why surgical careers rarely follow a smooth path
• How imposter syndrome shows up at every career stage
• Why mentorship and sponsorship are essential in surgery
• The reality of balancing surgical careers and family life
• What it means to advocate for patients—even when it's difficult
• How resilience evolves from early career to senior leadership

The book includes stories from a wide range of contributors—from surgical pioneers to modern leaders.

One powerful chapter by breast surgeon Beth Dupree describes becoming a whistleblower after discovering missed cancer diagnoses at her institution, demonstrating the courage sometimes required to advocate for patients.

Another chapter highlights pioneering burn surgeon Mary Lou Patton, representing the generation of women who helped open the doors for those who followed.

Each editor shares personal experiences reflected in the book.

Dr. Kahyun Yoon-Flannery discusses the emotional experience of losing a patient who had become a close connection during treatment.

Dr. Maureen Moore reflects on raising four children while building a surgical career and the importance of a supportive partner.

Dr. Asanthi Ratnasekara explores the importance of surgical partnerships and how finding supportive colleagues can make or break a career.

Imposter syndrome affects surgeons at every level

There is no perfect balance between career and life

Women surgeons often succeed through strong professional networks

Difficult conversations and disagreements are part of meaningful collaboration

Sharing stories helps future surgeons navigate their careers

Find the book here.

Guest: Dr. Claudia Emami

Starting your first job as an attending physician involves navigating systems that residency rarely teaches you about. In this episode, Dr. Claudia Emami joins the BOSS Business of Surgery Series to explain how hospital credentialing works, how peer review actually functions, and what physicians should understand to protect their careers.

Dr. Emami walks through the credentialing process required for physicians who want to practice in hospitals, including verification of training, licensure, malpractice history, and case logs. For surgeons and proceduralists, documenting recent cases is essential, and when case volume is insufficient, hospitals may require proctoring before granting full privileges.

A key point discussed in the episode is that having a job contract does not guarantee hospital privileges. Credentialing is a separate process that must be approved by the hospital’s credentialing committee and medical staff leadership.

The conversation also explores Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE)—the systems hospitals use to review complications, outcomes, and performance trends. These processes feed into broader reporting systems, including the National Practitioner Data Bank.

Dr. Emami explains how peer review works when complications occur and outlines how concerns may escalate through departmental review, quality committees, and medical staff leadership. In more serious situations, physicians may face additional proctoring, monitoring, or privilege restrictions.

The episode also addresses professional realities that new attendings often overlook—such as the importance of building relationships throughout the hospital. Developing strong connections with the chair of surgery, chief medical officer, medical staff office, and OR teams can be critical to navigating complex situations.

Finally, Dr. Emami emphasizes professional resilience. Career challenges, complications, and difficult reviews happen to nearly every surgeon at some point. Understanding the systems, participating in peer review, and maintaining perspective can help physicians recover from setbacks and continue to build successful careers.

A signed job contract does not guarantee hospital privileges

Surgeons must maintain accurate case logs and documentation

Proctoring is common and often required when privileges are new

Physicians should understand peer review, OPPE, and FPPE processes

Strong professional relationships within the hospital are essential

Setbacks in credentialing or peer review are challenging but not career-ending

With Dr. Andrew Schlussel

In this episode of the BOSS Business of Surgery Series, Dr. Amy Vertrees interviews Andrew Schlussel, colorectal surgeon, Army veteran, and co-editor of The SAGES Manual for Navigating a Successful Military Surgical Career.

Dr.Schlussel  shares insights from his 15 years on active duty in the U.S. Army, his transition to the reserves, and his experience building a fulfilling and dynamic military surgical career. This conversation is both practical and deeply personal — covering everything from surgical volume and research opportunities to LGBTQ+ service and retirement planning.

ROTC beginnings and returning to medicine through HPSP

Training at Tripler Army Medical Center

Deployments to Afghanistan, time in Iraq and Syria

Serving in Korea, Fort Lewis, and Fort Eisenhower

Transitioning from active duty to the reserves

Dr.Schlussel shares how military training provided not just clinical skills, but leadership experience in quality improvement, root cause analysis, and systems-based practice.

The idea for The SAGES Manual came after Dr.Schlussel found his Army Officer’s Guide while cleaning out his closet after leaving active duty. He realized:

Military medicine needed its own playbook.

The book was intentionally developed as a tri-service resource — benefiting Army, Navy, and Air Force surgeons alike — and was created collaboratively with leaders involved in Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) military initiatives.

A common concern: lower surgical volume.

Dr.Schlussel reframes this as opportunity:

Time for research

NIH collaboration

Global health engagement (including the Wilkins Fellowship)

Creative academic and leadership projects

Quality improvement and systems innovation

His key message:
Persistence is everything in the military system.
You may hear “no” repeatedly — but success often comes to those who continue asking the right questions.

Military surgical careers have evolved. Dr.Schlussel explains:

Off-Duty Employment (ODE)

URSAs (utilizing civilian colonoscopy suites)

MTAs (taking acute care call at civilian hospitals)

These opportunities are significantly more available than they were 10–15 years ago — but require understanding military legal frameworks and approval processes.

Current reserve bonuses for surgeons:
💰 $75,000 per year with a two-year minimum commitment

One of the most powerful parts of this episode is Dr.Schlussel's personal experience serving under “Don’t Ask, Don’t Tell.”

ROTC contracts in 2000–2001 included clauses prohibiting identifying as homosexual.

He served closeted for years.

Following repeal, he observed gaps in military physicians’ understanding of LGBTQ+ healthcare — including knowledge of PrEP and inclusive care practices.

As former president of the Association of Gay and Lesbian Surgeons and Allies, he emphasizes:

Inclusive environments require both cultural awareness and clinical competence.

Dr.Schlussel strongly recommends:

Start preparing one year earlier than required

Carefully review your DD-214

Utilize Veteran Service Organizations (VSOs)

Take advantage of transition programs (college courses, certifications, Lean Sigma training)

Once the DD-214 is signed, changes are extremely difficult.

Dr. Schlussel discusses his experience serving at the VA — both as a volunteer and paid staff.

He explains:

Differences between DOD and VA funding models

Communication challenges between systems

The deep fulfillment of caring for veterans

He also highlights:

Priority hiring for veterans

Ability to “buy back” military time toward federal retirement

TSP rollover benefits

After relocating to Jacksonville for his husband’s practice, Dr. Schlussel contacted every colorectal surgeon in the area — demonstrating the same persistence he advocates.

He now:

Works in Jacksonville

Continues reserve service

Plans to coach and mentor military surgeons

The SAGES Manual for Navigating a Successful Military Surgical Career (Springer, 20% discount available; proceeds support SAGES)

Connect with Dr.Schlussel on Instagram: @rainbow_scalpel

Email: [email protected] 

Attend the annual Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting

Free for active duty personnel

Reduced membership ($60–100 for attendings, free for residents)

✔ Military surgical careers offer leadership development far beyond the operating room
✔ Lower volume can create space for innovation and research
✔ Persistence within the military system is critical
✔ Separation planning must begin early
✔ LGBTQ+ inclusion requires both policy change and medical education
✔ Military surgeons develop unique leadership and systems-thinking skills that translate powerfully into civilian careers

After a decade in private practice, Dr. Claudia Emami transitioned from pediatric surgeon to Chief Medical Officer—driven by burnout and a deep curiosity about how healthcare systems function.

In this episode, she shares the behind-the-scenes structure of hospital operations that every surgeon should know but rarely learns in training.

We cover:

The difference between medical staff and hospital administration

Why bylaws are your protection

How credentialing and peer review actually work

Who sits in the C-suite—and what they control

Why surgeons should proactively build relationships with their CMO and chief of staff

How committee participation builds influence and opportunity

Healthcare is becoming increasingly complex. Mergers, acquisitions, and system growth mean that physicians who don’t understand governance risk losing their voice.

This episode is a practical roadmap for surgeons who want to protect their autonomy, navigate hospital politics wisely, and possibly even explore leadership beyond the OR.

As surgeons, we are trained to go big or go home.

And when we can’t do it perfectly?
We often do nothing.

In this week’s episode of the BOSS Business of Surgery Series, I sat down with Dr. Sara Ionescu — family physician, movement coach, mother of five (ages 8 and under), and spouse of a general surgeon.

Her question can change how you think about goals:

“Can you find one minute a day to move?”

That simple question helped her patients transform their health — and helped her rebuild her own consistency after residency and multiple pregnancies.

We discuss:
• Why surgeons fall into “all-or-nothing” thinking
• How 5 minutes a day compounds into real results
• Why accountability matters more than motivation
• What surgeon spouses wish you understood
• And how small communication shifts can protect your marriage

If you’ve been waiting for the “right time” to prioritize your health or your relationship, this episode will challenge that thinking.

You don’t need more time.

You need a realistic starting point that gives compounded results.

Free movement consult: calendly.com/drsaraionescu/30min

Website: drsaraionescu.com

Instagram: @drsaraionescu

YouTube: @DrSaraIonescu

Facebook: facebook.com/drsaraionescu

LinkedIn: linkedin.com/in/drsaraionescu

In this episode of the BOSS Business of Surgery Series, Dr. Vertrees sits down with Dr. Alex Schloe, Air Force veteran, family medicine physician, and host of the Physicians and Properties podcast, for a wide-ranging conversation on financial freedom, real estate, and practicing medicine on your own terms.

Dr. Schloe shares his path through military medicine via the HPSP scholarship, his experience training and serving as the sole physician at an Air Force base, and how that preparation shaped his confidence as both a clinician and leader. From there, the conversation turns to entrepreneurship—starting with his first rental property purchased during intern year using a physician loan and evolving into a diversified real estate portfolio.

A major focus of the episode is residential assisted living—a boutique, high-quality care model that addresses the massive shortage of senior housing while offering strong cash-flow opportunities for physicians. Dr. Schloe breaks down multiple investment strategies, including his lease-to-operator model, which generates consistent income without day-to-day operational burden.

The discussion also dives into direct primary care, healthcare affordability, and how insurance-based systems distort patient care. Dr. Schloe shares a powerful patient case illustrating how cost barriers delay life-saving diagnoses—and why DPC offers a compelling alternative for both doctors and patients.

Finally, Dr. Schloe explains why mastermind communities, coaching, and accountability are critical accelerators for physicians looking to build wealth and optionality outside traditional clinical roles.

This episode is a must-listen for physicians who want more agency, better alignment, and real choices in how they practice medicine and live their lives.

Description:

In this episode of the BOSS Business of Surgery Series, I sit down with Dr. Ronan Elefant, trauma surgeon, entrepreneur, and pilot, to explore a radically different way of delivering surgical care.

Dr. Elefant shares how his background in biomedical engineering shaped his view of surgery, why he believes healthcare insurance should be reserved for catastrophic events, and how transparent, bundled cash pricing can lower costs while paying surgeons more. We discuss his company, ACES National Surgical Team, which leverages underutilized ambulatory surgery centers (ASCs) nationwide—without building hospitals.

We also dive into how aviation allows him to scale surgical access across multiple states, manage complications safely, and maintain quality of life—plus how mid-career surgeons can shift from achievement to mentorship without burning out.

Keywords: surgery entrepreneurship, healthcare economics, cash-pay surgery, ambulatory surgery centers, surgeon business models, physician leadership, nontraditional surgical practice