QUESTIONS FAMILY PHYSICIANS SHOULD ASK BEFORE JOINING A PRACTICE

Choosing where to practice is one of the most important decisions in a family physician’s career, but it’s also one of the hardest to evaluate from the outside.

Compensation models, patient volumes, and location are often the most obvious factors. But they rarely tell the full story of what it’s actually like to work in a clinic day-to-day and whether that environment will support you over the long term.

Organizations like the Canadian Medical Association (CMA) offer helpful baseline checklists for evaluating opportunities. In our experience, there are additional — and often overlooked — questions that can make a meaningful difference in your experience as a physician.

The classic advice of trying a practice via a locum is reasonable, but locum opportunities are not always available and may not align with your career timing.

Therefore, at Magenta Health, we encourage physicians to ask these questions openly and to expect clear, transparent answers. Any clinic worth joining should be willing to do the same.

Below, we’ve outlined key questions to consider, along with why they matter in practice. You can also explore the FAQs about practicing with us to learn more.

1. ARE YOUR INCENTIVES AND GOALS ALIGNED?

Before anything else, it’s essential to understand whether your goals as a physician are aligned with the clinic’s business model — and whether that model supports long-term success.

Questions to ask:

  • What is the clinic’s long-term vision?

  • How does the clinic make money? If it’s non-profit, how does it generate revenue to cover its operating costs? 

  • What percentage of revenue comes from publicly funded primary care?

  • Is primary care the core focus, or a means to support other services?

  • How does the clinic benefit financially from having me work here (e.g., referrals to affiliated or co-located services)?

It’s equally important to understand how responsibilities are structured within the clinic and what might be expected of you in practice.

Key areas to explore include:

  • Conflicts of interest (e.g., financial ties to pharmacies, labs, or other services)

  • Restrictions on your mobility (e.g., non-compete clauses, ownership of patients and medical records)

  • How physician responsibilities are shared (e.g., vacation coverage, after-hours or walk-in shifts, seeing colleagues’ patients)

  • Expectations around billing and referrals (e.g., aggressive billing, alignment with professional standards)

  • If primary care is treated as a “loss leader” rather than the core of the business, there may be pressure to prioritize volume, referrals, or ancillary services over quality patient care. In these environments, primary care is treated as a side service rather than a priority, with limited investment in the systems and support needed to deliver strong clinical outcomes. 

    Over time, that misalignment can affect your clinical autonomy, job satisfaction, and overall ability to practice medicine the way you intend.

    Asking these questions helps clarify whether your priorities are actually reflected in the clinic’s operations.

2. WHO ARE YOU ACTUALLY WORKING WITH?

Credit: Luis Melendez

At any clinic, you’re working with a team made up of ownership, management, staff, and fellow physicians — all of whom shape your day-to-day experience.

Staff need to be recruited, trained, onboarded, supported, and at times transitioned out, while systems and priorities continue to evolve.

These moving parts directly impact how your practice runs and the environment you work in.

Questions to ask:

  • Who owns the clinic? Is there physician or non-physician ownership?

  • Who is responsible for day-to-day management, staff oversight, and decision-making?

  • Who is responsible for training staff, improving operations, and managing technology?

  • How many staff are there, and what are their roles, backgrounds, and compensation ranges?

  • What is the physician culture like? How do colleagues interact (e.g., shared spaces, peer consultations, steps taken to promote collegiality)?

  • Strong leadership, well-supported staff, and a collaborative physician group can significantly improve both clinical care and workflow.

    Conversely, gaps in leadership, high staff turnover, or poor communication can create friction and additional administrative burden for physicians.

    Clinics that invest across all of these areas create smoother day-to-day experiences for every stakeholder.

3. WHAT SUPPORT EXISTS BEYOND THE BASICS?

Most clinics offer some level of administrative support. But the depth, structure, and quality of that support can vary widely.

Questions to ask:

  • What does onboarding and training look like (e.g., timeline, documentation, responsibilities)?

  • Is there formal mentorship? Is it ongoing or occasional?

  • What support exists for recruiting and managing locums?

  • Who helps with complex medical-legal situations (e.g., CPSO complaints, medical mistakes)? What is their background and role?

  • What is the expected effective income per hour, and how does that compare across physicians?

  • Is there guidance on billing optimization and financial performance?

  • Will the clinic support patient recruitment and roster building (e.g., advertising costs, support for MOH quotas)?

  • Starting or joining a practice involves far more than seeing patients. Family physicians navigate clinical, operational, and regulatory challenges, often simultaneously.

    Without structured support systems in place, much of this responsibility falls directly on the physician. Over time, that can contribute to burnout and a reduced quality of care.

    Ongoing mentorship and guidance are essential to helping physicians grow as clinicians, navigate complexity, and continue improving over time.

    At Magenta Health, we’ve built integrated support systems to assist physicians at every stage of practice. Learn more about how we support our MDs here.

4. HOW DOES THE CLINIC OPERATE?

Day-to-day clinic operations — from workflows and technology to how a clinic identifies and addresses problems — play a major role in how efficiently and safely you can practice.

Questions to ask:

  • Are processes clearly documented (e.g., referrals, urgent results, patient discharge, voicemail triage)? Can I see examples?

  • What written resources are available to help me learn how to work within the clinic?

  • How are mistakes identified, reviewed, and learned from?

  • What is the process for requesting and implementing change, and how often are requests acted on vs. rejected?

  • What systems audit and catch administrative or clinical errors?

  • What technology infrastructure is in place (e.g., patient communication tools, EMR reliability, remote access, ability to complete work from home)?

  • Does the clinic invest in or develop internal tools or software?

  • Will I have transparent access to data on workload, income, patient access, and performance?

  • Well-designed systems reduce errors, improve care, and ease physician workload. 

    Strong clinic operations rely on a combination of technology, professional management, and well-developed workflows — all supported by ongoing quality improvement and continuous iteration. From EMRs to communication and data-management tools, these elements work together to streamline workflows and help practices run without friction.

    In today’s clinics, reliable infrastructure is the foundation for delivering high-quality care.

    At Magenta Health, we actively invest in our <Better/Care> initiative as part of our broader commitment to strengthening clinic systems across Canada. This allows physicians to spend less time navigating processes and more time delivering excellent care.

5. IS THE CLINIC BUILT FOR THE FUTURE?

Credit: Hadija

Healthcare is constantly evolving — and your needs as a physician will evolve too. The right clinic should be able to adapt alongside both. 

By asking about how the clinic has handled challenges in the past, you can get a clearer sense of how it will navigate future risks that might arise throughout your career.

Questions to ask:

  • How stable are the overhead costs and financial structures (e.g., rent, overhead changes)?

  • Do I need to sign on to a lease?

  • Will I be charged HST? If not, why, and who is responsible if that changes?

  • Does the clinic receive subsidies (e.g., Family Health Team funding, co-located services)?

  • How does the clinic handle regulatory compliance, audits, and privacy (e.g., who is responsible, how are privacy breaches or sterilization issues handled)?

  • What flexibility exists in scheduling and practice size (e.g., setting your schedule, making changes, minimum or maximum roster size)?

  • What coverage systems are in place to ensure you can fully disconnect when you’re off?

  • What opportunities exist for career development? Are there opportunities beyond patient care or in funded non-clinical projects?

  • How is the clinic engaging with broader system changes and regional primary care initiatives (e.g., its involvement with Ontario Health Teams, local clinics, and community physician leaders)?

  • Does the clinic have any sustainability or carbon-reduction initiatives (e.g., energy-efficient equipment, paper reduction)?

It’s also important to understand how the clinic responds to uncertainty and change.

One way to assess this is by asking “what if” questions:

  • What if I need to take extended time off or change my schedule?

  • What happens in cases of internal conflict between colleagues (e.g., concerns about unsafe care or situations where working relationships break down)?

  • What if I want to take a vacation? Do I need approval?

  • What happens if an urgent result comes in on a day that I’m not working?

  • What happens if funding models or subsidies change?

  • Many of the most significant challenges in practice don’t appear immediately — they emerge over time. 

    Financial changes, regulatory risk, evolving care models, and personal life shifts can all impact your experience. A clinic that proactively plans for these realities, rather than reacting to them, is better positioned to support physicians long term.

THE BOTTOM LINE

There’s no such thing as the perfect clinic or the perfect answer to every question.

But there is such a thing as an informed decision with clarity.

Asking thoughtful, sometimes difficult questions upfront can help you better understand the structure, expectations, and realities of the clinic you’re joining, and whether it aligns with the kind of physician you want to be.

At Magenta Health, we believe transparency is essential to building strong, long-term partnerships with physicians. We welcome these conversations openly, and we encourage every physician to have them, wherever they choose to practice.

Ultimately, when clinics are built to support physicians — with the right incentives, systems, and transparency — it leads to better care for patients.

If you’re interested in learning more about working with Magenta Health, you can explore our current opportunities here.