Neda Nikpoor, MD: What was it like being first a newly added partner and then bringing someone else into the partnership?
Neda Shamie, MD: Becoming part of a partnership initially felt like a journey of self-discovery and alignment. Early in my career, I experienced multiple practice settings—from academic private practice to traditional academia—before joining Robert K. Maloney, MD, MA. I wondered if the frequent changes meant something was wrong with me but came to realize that finding the right practice is much like a marriage; it’s about compatibility, timing, and mutual respect.
Joining Robert was transformative because, at that point in my career, I clearly knew what I wanted and had something valuable to offer, which allowed me to negotiate effectively and take on a substantial role. Robert, who had previously had only associates and not partners, immediately treated me as an equal.
A defining moment was when we did a photo shoot for our practice website; Robert purposely positioned me front and center, symbolizing his confidence in me and his willingness to elevate my presence in the practice. This small gesture taught me an essential lesson: when you bring on a new partner, you must endorse and elevate them, allow them to flourish rather than dim their spark. When it was my turn to bring on a new partner, Arjan Hura, MD, I adhered to this principle. Recognizing his talent and value to our practice, Robert and I intentionally placed him prominently on our website—even before he was officially named a partner.
I also learned that being a senior partner requires thoughtful planning and transparency. Our search for Arjan began 2.5 years before he joined our practice. Our approach to recruitment allowed us to choose the right person and wholeheartedly support his integration and growth.
The dynamic between partners can vary based on age, career stage, and goals. My partnership with Robert involved transferring responsibilities and roles as he planned for more personal freedom. In contrast, my partnership with Arjan is about mutual expansion and growth because we are both committed to the long-term development of our practice. This difference shapes how we support and collaborate with each other.
THE ART OF EARLY PARTNERSHIP
By Neda Nikpoor, MD
BE OPEN FROM THE OUTSET
When negotiating your first position as a young surgeon, it is essential to be clear and transparent from the outset about what matters most to you professionally and personally.
Based on my own experience, openly communicating potential life changes—such as possibly starting a family—can initially feel daunting but is incredibly valuable. When I shared with my senior partners that my husband and I had started considering a family after initially presenting myself as someone dedicated primarily to travel and career, their supportive and reassuring response was hugely liberating. It reinforced to me the importance of choosing senior partners who genuinely have your best interests at heart, beyond just practice productivity.
SUPPORT YOUR PARTNER’S HAPPINESS
John P. Berdahl, MD, shared a valuable piece of advice with me that has shaped my perspective on being a good new partner. He emphasized that new partners should always ask themselves, “How am I making my senior partner’s life better? What can I do to support their happiness, not just in the practice but also in their life outside of it?” When both partners approach the partnership with a genuine interest in each other’s happiness, it creates a deeply supportive and fulfilling dynamic.
For example, my senior partner, Tyrie Jenkins, MD, has goals around expanding her involvement in global ophthalmology, doing outreach trips, and even taking extended skiing trips. Knowing this, I willingly take on more responsibilities or shifts in workload during the times she is away, facilitating her ability to achieve those personal dreams. My other partner, Jeffrey Peterson, MD, PhD, prioritizes spending time with his young children, sometimes coming to work later or leaving earlier. By flexibly adjusting my own clinic schedule, I can help him realize these important personal goals.
This approach has also made me mindful of how dynamics in a partnership can vary depending on each person’s age, experience, and personal goals. My partnership with Jeff, who is closer to me in age, has evolved into a relationship of mutual growth, collaboration, and shared experiences even beyond work—bodyboarding with his family, for example—making our partnership more collaborative and less hierarchical.
THE PATH TO A SUSTAINABLE PARTNERSHIP
Overall, my advice to those early in partnership is this: invest the time up front to understand your senior partners not only as professionals but as people. Being open, transparent, and genuinely supportive fosters a partnership where both your professional ambitions and personal well-being are mutually prioritized, ultimately creating a fulfilling and sustainable relationship.
Ultimately, the keys to a successful partnership are clear communication, thoughtful strategic planning, genuine enthusiasm, and mutual support—always ensuring your new partner’s growth and happiness are aligned with your own and with your long-term vision for the practice.
(Editors’ note: For Dr. Nikpoor’s perspective, see The Art of Early Partnership.)
Dr. Nikpoor: Do you think senior partners are always considering what the newer partner might want?
Dr. Shamie: Not always. Senior partners sometimes think primarily from their own perspective—what they need or want at that moment—rather than fully consider what a new partner is looking for. I’ve seen senior partners decide to bring someone on out of urgency or to off-load less desirable parts of their practice rather than with shared intentions that align with their colleague’s professional goals and aspirations.
A thoughtful senior partner starts recruitment early, clearly articulates their intentions, and remains flexible enough to adjust the practice to accommodate and support the new partner’s development and ambitions. Most mutually beneficial is to keep the big picture in focus—to foster the growth and sustainability of the practice as a whole rather than approach recruitment in a self-serving way.
For instance, a senior partner engaged in succession planning might aim to scale back while intentionally facilitating the transfer of patient goodwill and referral relationships. A senior partner who plans to stay on might recruit a new partner to expand the scope or reach of the practice. In both scenarios, the approach aligns with the new partner’s goals of professional growth and integration within the practice.
The successful onboarding of a new partner requires the senior partner’s (1) introspection and transparency about their true timeline and willingness to let go of responsibilities and (2) dedication to ensuring the new partner feels fully integrated, valued, and empowered.
Dr. Nikpoor: Can you share any advice for surgeons early in their careers or those who might be negotiating their first position? What should they should ask for or think about early on?
Dr. Shamie: It’s critical to clearly communicate your personal and professional values, goals, and expectations from the outset. Be honest about what matters most to you—whether it’s your clinical role, your schedule, family considerations, or opportunities for professional growth. Ask yourself questions such as, “What do I need to feel satisfied and valued in this position?” and “Am I comfortable openly sharing these expectations now to avoid future resentment?”
When you’re negotiating, be specific about practical things, such as clinic start times, flexibility for family or personal obligations, and opportunities for mentorship and career development. It’s also important to remain flexible early in your career but to be clear about your top priorities. For example, you might express a goal to transition to a shorter workweek after 3 to 5 years and outline how you intend to help the practice achieve the efficiency required to accommodate that goal. Similarly, if medical mission work is important to you, ask how that could be integrated into your schedule without negatively affecting the practice.
My philosophy is not to hesitate to discuss up front if you anticipate life changes (for example, starting a family) that could affect your role. These discussions are neither expected nor required, but I believe transparency fosters trust. Trust and mutual respect are the two most important pillars of a healthy partnership. Having these conversations early helps set clear expectations and ensures you enter a partnership where both you and your senior partner are aligned, ultimately promoting a healthy, supportive environment and avoiding misunderstandings later.
(Editor’s note: This article was adapted from an episode of Neda Squared, a series on CRST: The Podcast. Click here to listen to their conversation in full.)
