5 tips for marketing your website

Feature Articles | Spring 2013


1 Know your audience.

Tailor patient content for patients, physician content for physicians.

2 Consider SEO.

It’s not enough to have a good looking site; people have to be able to find it. And it must be updated on an ongoing basis to maintain strong search rankings. Consider keeping your site fresh by adding a blog, or working with an SEO consultant, or both.

3 Update your content regularly.

When hiring a firm to build your website, request that they build it in a content management system so you can update it regularly. Being able to update your site with current information yourself helps you meet patient information needs without phone calls, which saves you and your staff time.

4 Get the right partner.

If you’re hiring help to build your site, tinker with your SEO, or manage your web ads, keep trying until you find the right match. Make time to review reports and manage your service providers to keep them producing results.

5 Measure your traffic.

Google Analytics offers detailed reports of how users navigate your site, and it’s free. Learn what draws people in and what pages they exit from.



The 5 job-search mistakes you can’t afford to make

By Susan Sarver | Feature Articles | Spring 2013


Even the most conscientious physician can make a job-search mistake.  A misstep in the process can lead to choosing the wrong opportunity, which can prove costly both financially and professionally. Don’t let these trip-ups lead to job-search mistakes you can’t afford to make.

Mistake 1
Getting a late start

Tony Stajduhar, president, Jackson & Coker

“The first mistake is that people wait too long to start interviewing and considering opportunities,” says Tony Stajduhar, president of the physician recruitment firm Jackson & Coker. “Most hospitals are instructed to start interviewing at least a year in advance of when they believe the need is going to be,” he says. The goal is to fill those positions as quickly as possible. Delaying your search can result in fewer available jobs.

“The mistake I made was I kind of pushed everything off to the side and just focused on the things we had to do for work and for the program, and so finding a job took a back seat,” says Julie Taylor, D.O., an OB/GYN at Highland Community Hospital in Picayune, Miss.

She served as chief resident her final year of training, but figured there would be plenty of time for job hunting. However, the year only got busier. In addition to time constraints, Taylor says some programs are not as open to residents taking time off here and there to go on interviews. Ultimately, she figured out a way to make up for lost time. “I used my vacation to interview,” she says. Taylor packed in as many interviews as possible throughout two weeks. Though it might not be an ideal way to spend a vacation, it got the job search done.

Mistake 2
Problems with priorities

Stajduhar says that starting a job search too late can sometimes spark a feeling of panic and lead residents and fellows to stay put by default and find a position in the same place they trained.

But in addition to limiting options and forgoing great opportunities elsewhere, physicians who put location first often end up unhappy with their jobs, says Stajduhar.

Related: Your ultimate job search guide ow.ly/heSOc

In a study of 500 physicians released in July 2012, Jackson & Coker found those who spent fewer than five years in their first job were more likely to cite location as the top priority. Physicians who remained more than 10 years in a first job cited quality of the practice as the most important factor driving the decision. To help physicians avoid making job decisions for the wrong reasons, Stajduhar says his group talks to candidates about four important areas: geographic location, practice type and needs, family needs and money.

Allowing money to drive the job decision can prompt physicians to eliminate rewarding career opportunities for which they might be well suited.

“I think the money itself can be a pitfall,” says Cecilia Gambala, M.D., assistant professor of obstetrics and gynecology at Tulane Medical Center. “It’s so hard not to always talk about the bottom line, which ends up being the dollar sign.” She has seen physicians accept positions because of money and end up unhappy with the job. Ultimately, the money didn’t matter as much as they thought.

Related: Love where you land ow.ly/heSVk

According to Gambala, determining whether you want to pursue private practice, hospital employment or academia is one of the biggest job-search decisions.

Instead of putting money at the forefront of your job search, Cecilia Gambala, M.D., suggests asking where you see yourself 10 years from now. Make your decision about where to practice now with your answer in mind.

She offers one simple suggestion—ask the question: “Where do you see yourself 10 years from now?”

But some physicians who are good at teaching and enjoy it eliminate academia as an option because of lower compensation rates compared to the private sector. According to MGMA’s Academic Practice Compensation and Production Survey for Faculty and Management: 2012 Report Based on 2011 Data, salaries for those in academic settings continue to trail those of physicians in private practice.

For instance, median compensation for family practitioners in academia was $173,801 compared to $189,402 in private practice. Specialists, such as anesthesiologists, received median compensation of $326,000 in academia compared to $407,292 in private practice.

“We all go to medical school because we want to help people,” says Gambala, “and in the end, we also want to feel like we’re being compensated and not being taken advantage of.” However, she says, you have to look at the big picture when making career decisions and ask yourself if your life will be fulfilled in ways other than money. “It depends on what you value,” she says. Though she interviewed for positions in both academia and private practice following her fellowship, “In the end, I was able to say, ‘I want to stay in academics.’”

Mistake 3
Insufficient research

Not doing your homework regarding the customary salary range for the region and specialty in which you are interviewing could be a big mistake. Inadequate research on the organization and its needs is another oversight that can cost time and money.

Ben Wycherly, M.D., recommends having a good handle on what the practice is looking for in a new hire before making a visit.

Ben Wycherly, M.D., an otolaryngologist with the Connecticut Sinus Institute in Farmington, Conn., launched his job search by sending letters to carefully targeted practices. During a professional meeting, he had an opportunity to meet members of one of the practices that had expressed interest in him. He told the group he’d like to visit the practice. They responded warmly and invited him for a visit—but didn’t offer to pay his way. Wycherly made the trip, but throughout his visit, it became increasingly clear that they were more interested in a general otolaryngologist rather than someone with Wycherly’s expertise in ears.

“I didn’t really fully appreciate that until I started talking to the other physicians,” he says. “My mistake was really not to figure out what they were looking for and how interested they were in me.” He says that if a practice is not offering to pay for your trip to visit them, they probably are not that interested in you. In the end, Wycherly was not troubled by paying his own way as it allowed him and his wife to learn about a new geographic area, one they discovered did not appeal to them as much as anticipated.

According to Stajduhar, going on too many interviews is a mistake that not only costs time and money but also causes confusion. He recalls a physician who was looking at 12 practices over three months. That’s far outside of most physicians’ comfort level or need, says Stajduhar. “Don’t get caught up in numbers or have a pre-conceived number in your mind.” He tries to get physicians to take a more studious approach to the job search. It can be as simple as making a spreadsheet of the things you’re looking for in a practice. Then list those things that are critically important to you. “Before you commit to an interview be sure that you’re checking to make sure those things are in place,” Stajduhar says.

When recruiters contacted Taylor about a position, she asked them as many questions as she could over the phone. Then she followed up with research online to decide whether or not to move forward with a specific opportunity.

 Mistake 4
Interview Errors

Some of the more common mistakes physicians make on interviews are not knowing enough about the institution or practice, not asking enough questions, and not asking the right questions, says Jon Appino, founder of NewCloud Medical, a full-service recruitment firm. Part of the problem is that physicians don’t always know what questions to ask, says Appino; the other part of it is that people are selling you on the job.

Questions not posed during the interview process can lead to unhappy surprises on the job. One basic question to ask when looking at a position is what the turnover is like, says Kennedy Cosgrove, M.D., MPH, a psychiatrist with Kaiser Permanente in Oakland, Calif. If turnover is high or there is a big demand for locum tenens physicians, Cosgrove says that could be a red flag.

Cosgrove, who has held positions in a variety of practice settings, including academia and locum tenens, also advises asking questions about administrative structure, such as whether your prospective boss is a physician or non-physician.

“There’s one common theme that really determined whether the job ended up being good or not; it was how the leadership of the job was structured,” says Cosgrove.

Not getting to know the supervisor well enough before signing on for the job can also be a mistake. Cosgrove has experienced settings in which toxic leadership caused major physician retention problems. In one of those positions, Cosgrove recalls, “they probably went through 10 doctors in the year after I left.”

To avoid such a scenario, Cosgrove suggests keeping an old adage in mind: “You’re interviewing them as much as they’re interviewing you.” He suggests paying close attention to the prospective supervisor and asking enough questions to learn something about that individual’s personality and how you might get along in a work environment. “If you don’t have a good feeling about it,” says Cosgrove, “it’s hard to imagine that it would work out very well down the road.”

Neglecting to ask questions about workload and on-call responsibilities can also result in unfortunate surprises on the job. In one of Cosgrove’s positions, there were three physicians covering an inpatient unit of 25 beds. Though eight patients per physician was a manageable load, Cosgrove soon discovered that each physician was gone about one-third of the time for vacation, educational leave and sick time.

Related: Site visit savvy  ow.ly/heT48

During those times, the workload increased by 50 percent—12 patients per day. Suddenly, it felt like a very different job, says Cosgrove. “That’s not one [question] you always think to ask in a job interview,” says Cosgrove. “I would definitely ask how it works for sick leave and vacation time.”

Taylor points out that interviewing for a job is different from a residency. In a residency interview, you want to convey a willingness to work hard, so you avoid posing questions about call schedules. “You know as a resident you’re going to be on call all the time. That’s just how it is,” she says. But when interviewing for a job, says Taylor, “You want to know exactly what the call schedule is.”

Such details may seem like trivial matters to question during an interview, but Cosgrove explains that those are the things that define what your working life is like. “We all, hopefully, know how to do the doctoring part. It’s more the structure of the place that often ends up being a big deal,” he says.

Other aspects of the interview process where faux pas can occur include making the trip without your spouse.

“My wife went with me everywhere, which was huge,” says Wycherly. It was important to him to get her perspective.

Perhaps everyone’s worst fear during an interview is saying the wrong thing. For instance, “The time to negotiate money is not during the interview,” says Stajduhar. And if you have a bad feeling about something you’ve said, make sure you take some time to get together with that person again and say, “Look, I want to clear something up with you,” he says. Just be very honest and straightforward.

Related: How your spouse can help you with your job search  ow.ly/heTgg

Mistake 5
Contract mishaps

Unfortunately, contract mistakes can be expensive. “You really want to have a lawyer review your contract before you sign it,” says Taylor. She recalls a colleague who did not do so prior to signing on for a first job only to discover later that the salary was not guaranteed; instead, it was based on production.

Though a lot of physicians look at contracts from a compensation perspective, there are many other issues addressed in a contract that are often more important than the dollar figure, Appino points out. He advises physicians to have a lawyer with appropriate expertise review their contracts.

It’s important to make sure you have an out in your contract. Appino has seen instances where departures were extraordinarily expensive. One physician lost $80,000 in bonus money by quitting a position on a Monday instead of on a Friday, Appino recalls, and another had to write a check for $93,000 for a tail policy. If you are not happy with your job or not happy with your boss, there is nothing in a contract that can fix that, says Appino. But if you want to quit, it is important to know what your contract looks like and how much it will cost you to get out. It is far better to evaluate those issues before signing the contract.

However, Stajduhar cautions against taking too long to have a contract reviewed, “Because time will kill deals…” He also advises against major rewriting of contracts. “No hospital or group is going to want their contract torn to pieces,” he says.

The cost of mistakes

Mistakes made during the job search process can cause you to miss out on golden opportunities. They can also lead to making the wrong job choice. Getting out of a position and finding another one can be costly. According to Stajduhar, it can take a good 18 months to get a practice up and running. So, if you’ve made the wrong job choice and have to move somewhere else, you have to start the process all over again. There are also plenty of expenses associated with uprooting your family.

But choosing the wrong job takes a toll beyond money. If someone has been changing jobs frequently, says Appino, “Employers are very hesitant to hire or even interview somebody who has been job hopping.”
However, Stajduhar says that if you work hard at the beginning of the job search, find the right position, and make the decision for the right reason, you could be there for decades. It still happens.

Susan Sarver is a registered nurse and freelance writer.



Job Search 101

Your month-by-month guide to your job search

By Chris Hinz | Feature Articles | Spring 2013


Erin Roe, M.D., knew that staying in Dallas after finishing her three-year endocrinology fellowship would be a challenge. The metropolitan area has an abundance of good physicians, including those in her specialty.

But because her husband was already a gainfully employed attorney, Roe was up for the task. She knew, however, that she’d have to do more than rely on recruiter leads, job postings or classified ads, since there wouldn’t be many in a saturated market. So her strategy was to find jobs that weren’t yet posted or didn’t even exist by networking with every faculty member, former fellow and other physicians who might know someone who needed a new associate.

Erin Roe, M.D., focused on networking to land her position at the Baylor Endocrine Center in Dallas. “It just took some time for the right opportunity to come along.”

After exploring 12 possible work situations over the next nine months, Roe landed several offers, including a position at the Baylor Endocrine Center in Dallas. By merging clinical work and diabetes research, it fits her to a “T.” “I definitely did my due diligence,” she says. “Many of the positions didn’t exist until I asked. But I kept my fingers crossed that it would work out. It just took some time for the right opportunity to come along.”

Whether you’re staying in the same community or moving across the country, searching for the right position can be a time-consuming task in an already jam-packed schedule. The rule of thumb is that you should secure your job six months prior to June graduation. (Statistics suggest that 90 percent of residents and fellows have a position nailed down by December with 75 percent of them settling as early as October.)

That means initiating your search at the beginning of your final training year (or earlier). Although most physicians find 12 to 18 months ample time, you may need longer, depending on your specialty.

Developing a timeline can help you accomplish every task of your hunt: soul-searching, identifying potential employers, interviewing, negotiating a deal, signing a contract and securing your license plus credentials—not to mention house hunting. By starting early and planning well, you’ll not only avoid the inevitable time crunch at the end of training, but you won’t miss that great match!

“The reality is that the best positions are usually taken quickly,” says Brett Walker, M.S., FASPR, director of physician/provider recruitment for Indiana University Health. “So if you’re waiting to start your job search until that final six months of training, you could miss out on some excellent career options.”

July (at the latest)
Get organized

The first task on your training-to-job timeline is to identify what’s most important to you! By knowing yourself, being honest about your priorities and listing your “must haves,” you can create an effective road map for your search. Whether you spend 30 minutes a day or two hours a weekend, you need to allow enough time for clarifying your goals and creating a hunt strategy. That includes updating your CV, adding a cover letter, and organizing the questions you want to pose to potential employers.

When Leon C. Adelman, M.D., launched his emergency medicine job search in August, 2010—11 months prior to his residency graduation—he focused on narrowing his choice between a community-based practice and academic medicine. Even though Adelman was drawn to the latter during training at Boston’s Beth Israel Deaconess Medical Center, he determined, by talking to former residents and seasoned ER doctors, that community physicians demonstrated near-universal enthusiasm about their choice while their academic colleagues offered mixed reviews.

“My sense from talking to physicians in community emergency medicine was that by and large they had a positive sense of their lives,” says Adelman. “They were excited about their work and home life. They had found a nice balance and wouldn’t change anything.”

Before joining Philadelphia’s Fairmount Behavioral Health System, Kurt P. Miceli, M.D., had spent nine months as a civilian psychiatrist at West Point. Although working with deploying soldiers was gratifying, Miceli knew that his opportunities as a civilian were limited at the military academy. So when the engagement that brought him to upstate New York ended, he focused on finding a job that would parlay the business degree he earned after graduating from residency in 2008 into an administrative position leading to bigger things. Miceli found that springboard as Fairmount’s medical director for admissions and needs assessments.

Get connected

Once you’ve established your priorities, you’re ready to identify potential opportunities and make contact. Whether you’re focused on a single region of the country or looking far and wide:

• Search the ads. You’ll find a plethora of job opportunities here in PracticeLink Magazine, online at PracticeLink.com and in the career pages of your specialty’s website and journal. Don’t just assume that interested recruiters will contact you—reach out to the facilities and jobs that interest you, too.

• Contact physician recruiters. Because they may work closely with all the facilities and specialties at their organization, recruiters are great resources who can help you learn where the openings are.

• Attend career fairs. Search for fairs attached to your professional society’s national or regional meeting or that occur as stand-alone events.

• Network. Contacting former residents and fellows plus present colleagues and others (nurses, family members, etc.) is a smart tactic for a variety of reasons, not the least of which is that they may be aware of hidden opportunities.

“Doctors in training are often leery of networking because they have the misperception that it’s glad-handing,” Roe says. “But calling up friends who have a feel for what you’re going through can be very helpful. You’re selling yourself short if you don’t take advantage of that.”

When Veronica M. Jow, M.D., first contemplated a move from Connecticut to San Francisco after completing a sports medicine fellowship in 2009, she focused her initial energy on an internet search for contacts in the Bay area. Although she met potential colleagues by her follow-up networking, Jow actually found her orthopedic position at Kaiser Permanente Oakland through a sports medicine society website ad. It was definitely personal contact, however, that led to a recent job switch. She was volunteering at the University of California Berkeley when a team and student health physician position opened that better fit her priorities. She interviewed and accepted the offer.

As a born-and-bred North Carolinian, Adelman was eager to return to his southern roots after training for years in Boston. So he put into place an elaborate game plan that included networking for emergency medicine options in the Washington, D.C., area. During his professional society’s job fair, he talked with recruiters and department chairs from several hospitals and followed up with on-site interviews. Yet despite the effort, Adelman switched gears when he and his new fiancée decided the move would not be best. Fortunately, by staying in Boston, Adelman could refocus quickly on his contacts, including his residency program director, and identified the perfect job. Within weeks, Adelman interviewed and accepted an offer at another Beth Israel Deaconess System hospital in nearby Milton.

With the help of a network he built while in residency, Leon Adelman, M.D., was able to switch gears and refocus his job search to identify practice opportunities in Boston. “The most important thing is to start early.”

“The most important thing is to start early,” he says. “It helped me tremendously to be one of the first people out of the gate. They hadn’t started talking to too many people, so I was fresh on their minds. They could tell I was motivated and would probably be a good worker because I called early. That was huge.”

Recommending references

It’s always beneficial to get your references committed in advance of your first interviews. Since your clinical skills are paramount, you’ll want to tap the teachers, mentors or other colleagues who know you best. Most employers want three to five names, starting with your residency program director or fellowship coordinator. (Your references are good sources for finding out about jobs, too.)

Your references will be asked questions that will help the employer verify that you’re qualified for the position, match the job description and will do well in your new role. They want to know if you’re everything you say you are in terms of your clinical skills, work ethic and ability to be part of a team.

“Administrators are looking for candidates who will add value,” says Jane E. Born, CEO of the Coconut Creek, Fla.-based physician recruiting firm Born & Bicknell, Inc. “They want to make sure that this person doesn’t undermine the organization’s sense of purpose, but will complement the staff, fit into the culture and help them move forward.”

Related: Will you do me the honor? ow.ly/hVAhM

Interview with zeal

There are many reasons to allow enough time for interviewing, not the least of which is that each on-site visit may require 48 hours away from home base. Since time is of the essence, take advantage of the fact that most recruiters and practice administrators request a phone (or even Skype) interview first. It’s a great way for you to find out if the job meets your needs.

Whenever you talk, make sure you’re as inquisitive about the situation as the interviewer will be about you. Probing can help you cut through the clutter to determine which places are worth a visit—or an acceptance.

“A face-to-face interview should be a verification, not a discovery,” says Rochelle Woods, president of Mountain Medical Group, a Boulder, Colo., recruiting firm. “If you’re able to have one or two lengthy conversations over the phone with a recruiter or a physician, you can get a strong sense early on as to whether this is a fit for you.”

Recruiters suggest aiming for three to four potential places to compare and contrast opportunities. Once you’ve narrowed your search, group your on-site interviews as closely together as possible. By keeping the timeline tight, you can weigh your options simultaneously without missing out on a really good job. Although variations abound, August and September are standard months for interviewing while October is when many deals are done.

“Many young physicians operate under the misconception that the timeline is up to them,” says Born. “But once you start interviewing you may have to make a decision more quickly than you anticipated. You can’t expect an opportunity to be there later while you’re interviewing somewhere else.”

Related: Ace your interview ow.ly/heQrm

Although Hamad Husainy, D.O., knew he’d be happy practicing emergency medicine anywhere, he and his wife focused on the Pacific Northwest for its lifestyle possibilities and the fact that their three children would be close to grandparents.

Six weeks after interviewing with Tacoma, Wash.-based St. Joseph’s Medical Center’s emergency medicine group, he accepted an offer that included his top criteria. “Sometimes I felt like I was a little overbearing in doing my search,” he says. “But I gave myself enough time to step back and objectively look at each place with a magnifying glass to determine if it was right or wrong for my family and me. This was the best call for us.”

Related: Ask the right questions  ow.ly/heQuy

Close the deal

Once you’ve navigated the interviews and have an offer, you’re ready to negotiate a deal. In theory, it should take no longer than several weeks for lawyers on both sides to fashion a final document. But it’s probably safer to allow a month, given the slow pace of attorneys and legal departments.

Your offer should include terms that you discussed first during the interview. Part of your due diligence—and that of the employer—is to clarify expectations as to what the job will entail and how you’ll be compensated for it. By the time you receive a preliminary letter of agreement and contract, you should be familiar with the terms, confident there are no surprises, and ready to negotiate minor details.

Related: A physician’s guide to employment contracts ow.ly/heQDp

“If something has been lost in the conversation, you need to see if it can be corrected,” says Carrie Galbraith, director of recruitment at Illinois Critical Access Hospital Network in Princeton, Ill. “You don’t want to blow a great opportunity if you can work out any differences. So it’s worth checking back before you move on.”

Recruiters and candidates alike suggest getting a boilerplate or sample contract to ensure there’s not a deal breaker in the fine print. Roe made sure that the contract she’d eventually sign for Baylor fit any verbal promises. “You can have terrific warm and fuzzy feelings for a practice,” she says, “but if the contract is heavily skewed or contains a deal breaker, you want to know sooner rather than later. Since there’s not a whole lot of customization, especially with new graduates, it’s helpful to have that information upfront.”

  How do you bow out of an interview or offer if it’s not a good match?   
Whether it’s the contract or the chemistry—or even a misunderstanding that might be cleared up later—you want to leave as a desirable candidate, even if your paths never cross again. That means being gracious, honest, specific and fairly quick in severing your ties with a potential employer. Hopefully it will be as early as a pre-screening interview, when both of you have a minimal investment.

Should you leave an on-site interview early?
Although the hiring doctors may welcome your forthrightness, they also might see such a move as unprofessional. When in doubt, finish the visit and politely inform them from home that you want to look further.

Whatever you do, don’t avoid the difficult conversation. Even if you’ve been emailing, call your contact personally. Galbraith recalls a group who had started planning for a physician after being assured that he was on board. Admittedly, administrators had taken a bit too long to complete the contract, but they also had invested time and lawyer fees in someone they believed was committed. So imagine their surprise after forwarding the paperwork that he had signed with another group. “If he had just said a month earlier, ‘Hey, I’m really considering this other position,’” she says, “it would have been better for everyone.”

Adds Sharee K. Selah, MBA, director of physician recruitment services for the University of Maryland Medical System, “Honesty really is the best policy. Certainly if you find a red flag that’s uncomfortable, you don’t want to waste people’s time. But you also don’t want to burn any bridges. You never know when you may need to come back this way again.”

Before joining Philadelphia’s Fairmount Behavioral Health System in May of 2011, Miceli had cast his job hunting net wide, interviewing with six hospitals including one that offered but rescinded a position as chief medical officer. Although Miceli was ready to sign the contract, much to his surprise, someone higher-up in the system than the CEO who negotiated the deal nixed the offer, believing he wasn’t ready for it. The good news was that the same week Miceli lost the offer, Fairmount emailed him. The two sides agreed on contract terms quickly since they had talked general numbers in the past.

Before Husainy landed in Tacoma, he rejected two other places that couldn’t promise a leadership role for at least five or six years, even though it was a priority for him. Moreover, one of the offers existed in a town that was both too small and remote for the Husainys, who love to travel and wanted immediate access to a major airport.

Although the job he ultimately took fulfilled both criteria, Husainy was careful in letting down the other contenders, especially since one involved his wife’s hometown. He thanked the first doctor for the offer but added that they were opting for a bigger hospital with more opportunities. The second hiring physician not only spoke highly of the position Husainy was taking, but has since become a close colleague. “I very much wanted to be open and not burn any bridges,” Husainy says. “I may be in this position today but you never know what tomorrow holds.”

December and forward
Tie up any loose ends

If you’ve signed your contract by December, you should have the required 90 to 120 days to be licensed and credentialed. By giving yourself a six-month window before graduation, you’ll be ready immediately to treat and admit patients, prescribe medications and bill Medicare, Medicaid and private insurers.

Related: State licensing board resources  ow.ly/hVHus

Be prepared for variations, however. It can take up to a year in some states to obtain a new medical license. (You may even have to apply prior to interviewing or navigate a two-step process.) Then again it may be shorter if you’re staying in the same state where you trained. When you start your job search, register with the FCVS so that if you a choose to practice in a state where registration is required, you’ll be ahead of the game.

Also, if you’re a foreign national who wants to stay in this country, you definitely want to secure your job quickly. The faster you have proof of employment, the better your chances of snatching a coveted J-1 or H-1B visa waiver that allows you to stay here beyond training. You need to have your search completed well in advance of the application deadlines.

Related: Coming to—and staying in—America  ow.ly/hVHqd

As soon as you’ve targeted your location, make sure your file is spick-and-span and your references on top of things. Because items get lost and people don’t reply, be ready to intervene if necessary. Jow knew she had to apply for her California medical license months in advance of her August start date. Although she was on the case as early as February, when the license didn’t arrive, Jow took three trips to Sacramento to fill in the missing pieces with the state licensing board. But the delay pushed her start date into September, temporarily costing Jow and her husband, who was still looking for work, an immediate salary plus health coverage. “I was just hoping that nothing happened to us in the meantime,” she says.

One final note
By allowing adequate time for your search, you’ll be ready to field every possible contingency. Remember, a successful hunt takes strategizing, effort and a realistic timeline. As Selah notes: “The message I try to get across to physicians is that what you put into this is what you’re going to get out of it. If you spend the necessary time and energy, the likelihood of landing the right practice opportunity will be far greater than if you don’t invest the effort.”

Even though Roe admits she was probably exceptionally thorough in her hunt, she still advises other candidates to double and even triple the time they assign to it. “Spending enough time, especially on the front end of your search, is definitely worth it.”

Chris Hinz is a frequent contributor to PracticeLink Magazine.



New practice? Now patients!

After your job search is over, the challenge becomes marketing your new practice.

By Laurie Morgan | Feature Articles | Spring 2013


You’ve made the big decision: joined a health system, hired on at an established practice, or hung out your shingle. What’s left? Attracting patients—and that means marketing.

Until relatively recently, many physicians were reluctant to even talk about marketing, much less embrace it. “Even 10 years ago, advertising in any capacity was considered taboo,” says Eric Chang, M.D., a plastic surgeon in private practice in Columbia, Md. In today’s fast-changing market, Chang notes, newly graduating physicians may be more aware of the need for marketing, but they also must take responsibility for learning the marketing ropes. “Because there are so many local differences,” Chang adds, “you can’t just read a book” to know what will work. Employed physicians will also find that practices and health systems have different preferences, policies and expectations.

Plastic surgeon Eric Chang, M.D., advises that physicians market themselves as a way to build confidence and awareness among patients and other practitioners.

Employed? Learn what’s expected

If you’ve been hired into a practice that’s overflowing with new patients and urgently needs you to fill in the gap, you might assume that drumming up interest in your services would be a low priority. But even if your new practice was previously overbooked, the excess is probably insufficient to completely fill your schedule. What’s more, if you’re relying solely on overflow from others in your practice to keep busy, you won’t establish a flow of new patients to keep your practice productive in the future.

“I think an employee joining a practice may feel, ‘The practice markets itself, why do I need to market myself?’” says Chang. “But the truth is, referral patterns have to be solidified for you as a new practitioner. The referring doctor has to feel confident in your skills—not just those of your boss.”

Large health systems with sophisticated marketing programs also count on their physician employees to make personal connections with the community and reinforce local ties.

Nick Crespo, a physician recruiter with Sutter Health in Northern California, agrees. “Participating in local activities in the communities where they’ll be living is key for our physicians, especially in our more rural locations. Radio interviews, tree plantings, health fairs—all of these sorts of activities help build the trust of our local communities.”

On the plus side, it’s easier to figure out what to do in a large organization, because marketing professionals are usually readily available to help newly employed physicians understand what’s expected and promote their practices. “My one word of advice, for almost any health system, is that there’s going to be at least one point person in PR or marketing,” says Sally Foister, director of marketing at Greenville Hospital System (GHS) in Greenville, S.C., who is responsible for guiding newly hired physicians through GHS’s marketing programs. “Talk to them before you do anything because they are there to help you achieve your goals.” Working with internal marketing professionals also helps to avoid unintentional missteps, such as violating the organization’s social media policies or inadvertently contradicting the marketing team’s messages.

What if you’re joining a practice that is too small to have full-time marketers on staff? Outside consultants can fill the gap and help you learn the basics.

“I was lucky that my practice had brought in a consultant to start marketing my practice before I even arrived,” says Ella Lindwall, M.D., a rheumatologist with Advanced Rheumatology in Thousand Oaks, Calif. “When I went with the owner of my practice to meet the physicians at the local hospital, fliers had already been distributed telling everyone about me. I was also already being promoted to the practice’s patients.” Lindwall advises asking for this support if your new practice doesn’t have marketing expertise in-house. “I think it is important to have someone with experience guide you on marketing and take the lead initially because we don’t learn anything about marketing ourselves in med school.”

Buddy up

If you’ve decided to set up a solo practice or have joined a small group and have no marketing department to rely on, figuring out what to do first can be daunting. Connecting with other local physicians at the same career stage can be a great way to accelerate your learning, build your referral network, and identify trustworthy resources like consultants and web developers. Plus, you’ll gain invaluable moral support.

“When I first started out, I called family practitioners and internal medicine doctors, showed up to their offices with lunch and hoped that they would send me patients. I did it for five months before I realized I got almost nothing,” says David Ghozland, M.D., an OB/GYN who set up his private practice in Santa Monica, Calif., in 2007. The problem: Ghozland was newly affiliated at two hospitals where more than 200 established OB/GYNs were already well-connected with the local primary care physicians—and absorbing all of their referrals. Ghozland’s creative solution: He formed his own networking group. He invited other young physicians from a variety of subspecialties to join the group, and they agreed to meet weekly over dinner. Over the next few years, they helped each other build their practices—sharing referrals, inviting new members to join and exchanging ideas.

When Eric Chang left employment with a mid-sized practice to start out on his own, he sought support from a friend, a dermatologist who had set up her private practice just a few years before. “She was not a competitor to me; my presence in the community could actually be helpful to her,” Chang says, noting that dermatologists and plastic surgeons frequently cross-refer. Ultimately, Chang’s friend didn’t just connect him with the community of dermatologists in his area; she became a trusted confidante he could bounce ideas off of as he built his practice. “Knowing that she’d done it herself made me confident that I could do it, too.”

David Ghozland, M.D., dedicates a day each week to running the business of his practice. “I go into the office. I have a to-do list. Every month, I have a goal.” While revenue may be lost in the short term, Ghozland is investing in his practice for the future. “I may lose money that day by not seeing patients, but in the long run, it’s better for my practice.”

Build your network

For most specialties, building your network in order to attract referrals from other physicians is critical for attracting patients. If you’re not comfortable with reaching out the way Ghozland and Chang did, take heart. Educational events provide some of the best—and most natural—ways to connect with other physicians. “Rheumatology has been revolutionized in the last decade with new, highly effective treatments for diseases like rheumatoid arthritis, psoriatic arthritis, vasculitis, and osteoporosis,” says Lindwall. Part of Lindwall’s outreach to local PCPs, geriatricians and dermatologists and other adjacent specialists is to give talks to help them stay abreast of continuing advances in care she can offer patients. These presentations allow her to offer valuable information to other physicians, helping her earn their support.

Attending seminars and presentations for your own education is another relatively painless way to meet more colleagues who could refer you.

“Sometimes people are reluctant to spend $1,000 on a conference—but it’s a write-off, and you never know who you’re going to meet,” says Ghozland.

Attending events can also spark your creativity, helping you think differently about your practice and how to promote it. “If you’re in a room with people who are a little outside the box, your wheels start turning, and you’re suddenly thinking outside the box, too,” adds Ghozland. Even pharmaceutical presentations, notes Lindwall, are opportunities to meet other physicians from a variety of specialties.

“I was lucky that my practice had brought in a consultant to start marketing my practice before I even arrived,” says Ella Lindwall, M.D. “When I went with the owner of my practice to meet the physicians at the local hospital, fliers had already been distributed telling everyone about me.”

Personal interests and non-medical talents can help you make connections, too. For example, Lindwall plans to join a networking group for women doctors in her new community in Southern California. And Ghozland found that he could gain a few referrals from local consulates for emergency care by letting them know he spoke French and Hebrew in addition to English.

Public presence: Start with the web

Referrals from other physicians are still the leading source of patients for most specialists, but even specialists need to communicate directly with the public in some fashion. Today’s educated patient will frequently turn to the internet for more information about a physician before following up to make an appointment. And for primary care physicians—the top of the referral funnel—attracting patients directly is essential. For specialists and primary care alike, a website is usually the best place to start.

“If you’re 25, 30 years old, coming into the market as a physician and trying to attract a patient base, you have to have a web presence,” says Chang. “It’s almost like you don’t exist if you don’t have a site.”

Jamie Cesaretti, M.D., a radiation oncologist with Orlando Physician Specialists in Winter Park, Fla., learned firsthand how marketing to patients online could help build his prostate cancer practice. When he moved into the market a few years ago, Cesaretti learned that even patients who had already been offered treatment somewhere else were still going online to learn more about local radiation oncology practices, and that they carefully considered the information they found on his site. “They were concerned with very specific problems and were going online to explore their options,” Cesaretti says. When patients found his site, many were attracted to Cesaretti’s practice because the site educated them about his local group’s specific expertise in prostate cancer.

Cesaretti’s experience underscores the importance of not just having a site with the information patients need for decision-making, but also having one that ranks highly in search results for your specialty. He and his partners frequently refresh their site’s content and post articles elsewhere online to bring traffic back.

Chang agrees, noting that aesthetics are just one component of a good site. “It’s one thing to make a site that looks nice; it’s another to make a site that looks nice that people can actually find.” He advises colleagues to spend a bit more to get a site that has been designed to rank well for search terms related to your practice. “Everyone wants a site for $300, but when you invest $3,000, you’re paying for expertise behind the design to get the site found.”

The process of making your site rank well on Google and other search engines, known as search engine optimization (SEO), depends heavily on how well your site content meshes with search terms patients use to find your specialty in your area. Regularly updating your site with high-quality content helps ensure your search engine rankings remain high.

Creating at least some original content (for example, by adding a blog to your site) is the best way to ensure the content is personalized and high quality. Says Cesaretti, “Marketing groups write content for practices, but Google has gotten better at discerning which posts are ‘vanilla’ marketing. If it’s genuine content by a real, local doctor, it will show up higher.”

In a large organization, you may not have a separate website for your practice, but you’ll usually have a page or even a multi-page profile on your employer’s main site. Often, there are opportunities to add personal touches that will help you express your care philosophy and connect with prospective patients. At Greenville Hospital System, for example, each physician’s website profile includes several pages with background information, a picture, and an introductory video that is also posted on YouTube.

Related: Medicine 3.0 ow.ly/hgZPg

Embrace directories and ratings sites

When patients search on a specialty in a state or city, it’s not unusual for the top results not to be physician sites at all. Listings from Google Places and the biggest physician directory and rating sites (Healthgrades, Vitals) often appear in search results higher even than the major health systems and payers in the area. But because these directories rely on public databases that may not have current data, it’s not unusual for a physician’s information to be incorrect, causing hassles for patients that rely on the data and undermining physician marketing efforts.

Fortunately, these directories make it easy for physicians to claim their listings and correct erroneous contact information and other problems. Claiming and updating your directory listings also allows you to spiff up your listing with a photo and even add a link back to your web page (an excellent SEO boost). And claiming and updating your directory listings is free, so it’s something every physician should do.

Another advantage of claiming your listings: many of the sites will use your registration information to notify you if patients have added new ratings or comments. For those that don’t—and to monitor what’s posted about you elsewhere on the web—sign up for the free Google Alerts service, which tracks keywords you select and alerts you via email when related postings appear.

When medical rating sites first appeared on the web a few years back, many doctors were nervous about the prospect of patients reviewing them and publishing their opinions online. The prevailing attitude among many doctors was to ignore the sites and hope they’d go away. But that view has shifted as the ratings sites gained popularity. Now, physicians are starting to see the benefits of embracing patient ratings. Positive ratings can be a real boon for referrals.

“Patient feedback is one of the most cost-effective ways of advertising these days,” says Chang. “Directory sites are becoming more useful and more targeted.” Chang encourages his patients to review his practice online, especially on a directory called RealSelf, which is focused on plastic surgery.

Give a little bit

Getting patients to talk about you and your practice positively online or to their friends is perhaps the most powerful way to expand your patient base. But in a 15-minute visit, it can be a challenge to make an impression worth talking about.

One way to be memorable: Establish a personal connection. “I knew a doctor who said that in the first 60 seconds of the visit, he can make the patient feel like they’ve been with me for 15 minutes,” recalls Ghozland. “He did it by remembering little details about the patient, and taking chart notes to ask them about at their next visit.” Ghozland applied the ideas to his own practice. “It’s about really making your patients enjoy coming to you, making yourself open. That’s how you get referrals.”

Charitable opportunities can also lead to new patients and more procedure revenue, and they can be found at organizations of all sizes. For example, free screenings are a way to give back to patients who might otherwise not get tested for disease. And in some cases, testing will lead to a need for treatment and new revenue for the physicians who donate their time. “Our practice is working with one of our hospitals to create a free prostate cancer screening test program,” says Raul Hernandez, urologist and partner in Golden Gate Urology in San Francisco. The NFL and American Urological Association’s “Know Your Stats” program provided the template for their efforts and has made it possible for urology practices and hospitals of all sizes to piggyback on the program’s publicity and provide free screenings to thousands of men who might otherwise go untested.

Going social

By some estimates, nearly 70 percent of Americans have a Facebook page and nearly 15 percent of American internet users use Twitter. So it’s no surprise that physicians are exploring social media as a tool for connecting with patients. “They hold almost limitless potential,” says Chang about Twitter and Facebook. “It’s a matter of spending the time and energy and making sure that you’re addressing the correct market.”

The time and energy required, though, are no small matters—especially for private practice physicians. It’s important to know what you’ll be getting into if you decide to connect with patients via the social web. “Facebook and Twitter are extremely time consuming and can put you at risk because you may not seem caring if you don’t answer a post fast enough,” says Hernandez. Information you post may also be interpreted as medical advice, so it’s imperative to have clear guidelines about what can be posted on your practice’s page and to monitor patient postings to be sure none unintentionally breach their privacy.

Theresa Varughese, practice liaison with Carolina Cardiology Consultants, a wholly-owned practice of Greenville Hospital System, found that a team approach enables her practice to manage the fast-response demands of social media. The team monitors the practice’s page for patient requests or comments that need a response. “We can quickly respond to issues patients post—‘I’m really sorry you had this experience, can I call you to talk about it? I’d like to get your feedback’—and avoid the patient feeling ignored.”

A physician champion, a sports cardiologist whose practice serves many young athletes, is a key member of Carolina Cardiology’s social media team. He is an avid user and early adopter of social media who’s fully comfortable using it every day. “He recently spoke at a national conference, and he tweeted about it the entire time,” says Varughese.

Becoming your practice’s social media champion can help you build your own panel and boost your practice’s profile. Some large organizations even compensate physicians who help with social media. The key is to work with others in your practice, especially marketing professionals, to stay within practice guidelines. “If one of our physicians wants to set up a practice Facebook page, we help them figure out what is appropriate and what isn’t. We have guidelines covering legal issues and things like, ‘don’t have an argument online,’” adds Foister from GHS, who also notes that problems are rare.

Besides establishing content boundaries, just finding enough content can be a challenge, especially for specialty practices. Varughese and her team solved it by supplementing their in-house postings with a purchased stream of cardiology content from UbiCare.


One of the biggest challenges for physicians in marketing their practices—much as with all things business—is maintaining interest and commitment. Too often, physicians set up their websites or hand their marketing programs off to a consultant and think, done. But marketing is never really done. Websites must be repeatedly optimized, directory listings regularly updated, and you must participate in your community continuously to be known to potential patients moving into your area.

Related: Don’t let your next IT project crash your practice ow.ly/iZNvn

“Doctors have trouble following up” on business goals, says Ghozland. “We get busy, hire others to help with marketing, but then fail to follow up and the leads drop off.” He solves the problem by dedicating a day each week to running the business of his practice. “I go into the office. I have a to-do list. Every month, I have a goal.” While revenue may be lost in the short term, Ghozland is investing in his practice for the future. “I may lose money that day by not seeing patients, but in the long run, it’s better for my practice.”

Laurie Morgan, MBA, is a medical practice management and health care industry consultant with Capko & Company.



Finding a practice that fits your life

A myriad of practice options await depending on the kind of lifestyle you’re looking for.

By Karen Childress | Feature Articles | Winter 2013


Whether you’re looking for your first practice opportunity or your fifth, options abound. What constitutes the “perfect job” depends entirely on your practice style, personality, values, and how hard you want to work.

Edgar Bulloch, M.D., provides care to the uninsured, low income or medically underserved. A volunteer experience at a free clinic in med school piqued his interest in this kind of practice opportunity.

It’s no secret that more physicians are opting for employed positions today, viewing them as more secure and having a lower hassle factor. But even within the realm of employed opportunities, there is a wide variety of choices offering greater and lesser degrees of autonomy, security, recognition and income. And each comes with its unique challenges and benefits.
In this article, we profile five physicians working in five very different settings: the military, locum tenens, a rural clinic, correctional medicine, and in a big city clinic caring for underserved patients.

Their stories illustrate just how varied careers in medicine can be and underscore the fact that doctors have plenty of latitude when it comes to how and where to practice.

Serving the underserved
As a medical student, Edgar Bulloch, M.D., volunteered at a free clinic where he treated uninsured patients who might not otherwise have been able to afford medical care. This experience piqued his interest in working with underserved populations. “That’s what initially drew me in. I had very good mentors in that program. They were doing so much for patients, for no compensation,” says Bulloch.

When he completed his OB/GYN residency at Texas Tech University Health Sciences Center in El Paso two years ago, Bulloch, 35, considered an academic career where he would have been both teaching and caring for underserved patients. But as he began exploring practice options, he heard about an opening at Family Health Centers of San Diego (FHCSD). A nonprofit federally qualified health center (the second largest in the country), FHCSD was founded in 1970 and has 33 sites, including 13 primary care clinics, in and around the San Diego area. Their mission includes providing comprehensive care for uninsured, low income, and medically underserved patients.

“It was the first interview I went on and I really enjoyed everyone I met,” Bulloch says.

After going on a few other interviews, Bulloch decided that Family Health Centers was the best fit for how he wanted to practice medicine. “FHCSD has great support staff and I felt that I could do everything needed for the patients,” says Bulloch.

Too often, low-income pregnant women receive little if any prenatal care and simply show up in hospital ERs in active labor—a less-than-desirable situation to be sure. “Here, they’re getting comprehensive visits throughout their pregnancies and we have a better understanding of patients when they go into labor. This means safer deliveries and better outcomes,” says Bulloch.
At FHCSD, patients have access not only to physicians, but also to health educators, nutritionists and social workers. “Each patient has a case manager,” says Bulloch. “If they need help finding insurance or getting on MediCal, they’re not alone. There are so many resources available to patients and I really like that.” Bulloch is fluent in Spanish, which serves him well in caring for a large Hispanic population. Translators are available for caregivers who are less fluent in the wide variety of languages spoken throughout San Diego County.

Due to inflexible work schedules and lack of transportation or childcare, ensuring continuity of care can sometimes be a challenge for doctors working with low-income patient populations. Bulloch says compliance is not a big problem at FHCSD. “We have a young, healthy population of pregnant women and most patients trust you and do what they need to do.” It helps that FHCSD has unique incentive programs for women that encourages them to receive comprehensive prenatal care. Patients receive Baby Bucks when they keep appointments, “money” they use to buy everything from diapers to baby clothes at FHCSD’s Baby Boutiques stocked with items donated by the community. Women also receive a free car seat for their newborn if they attend all of their prenatal appointments.

FHCSD has nine OB/GYNs on staff who rotate through all of the system’s clinics that provide obstetrical services. This allows women to meet each doctor at least once over the course of her pregnancy so that when it’s time to deliver, she is in the capable hands of a physician with whom she’s familiar. Bulloch holds privileges at several area hospitals. His practice is about 75 percent obstetrics and 25 percent gynecology.

Bulloch finds his work so satisfying that he’s helped recruit two OB/GYNs who were a year behind him in training to join FHCSD. Because of the system’s status as a federally qualified health center, professional liability insurance is covered by the government. This allows FHCSD to offer competitive salaries. “I could probably earn a little more working in another group, but that’s not why I went into medicine,” says Bulloch. “The program of care here is so integrated that I don’t have to worry about business and can focus on finding the right diagnosis and treatment for each patient. It’s very rewarding.”

Duty to country
When he’s not serving his country on the other side of the globe, Lt. Col. (Dr.) James Sebesta, M.D., practices general and bariatric surgery at Madigan Army Medical Center in Tacoma, Wash., where he lives with his wife, Janelle, and their six children. Sebesta, 48, always planned to go to medical school, but he didn’t necessarily have his sights set on a military career. “A friend was going to check out the Uniformed Services University of the Health Sciences in Bethesda and I went along, thinking it would be a free trip to D.C. I fell in love with the school,” says Sebesta.

Following medical school, Sebesta did his internship year at Madigan and then went on a two-year tour as a medical officer before returning to Madigan to complete his surgical residency in 2002. He’s been there ever since, but again, this was not necessarily his original plan.

“I thought I’d do my payback time and then figure out what to do next,” he says. But as that juncture neared, Sebesta did some career soul searching. “I broke out a piece of paper and wrote down everything I wanted in a job. I wanted to train residents, do research, and take care of patients how I thought they needed to be taken care of. I realized that I had the perfect job, that I was doing it right now,” says Sebesta. He’s now been a physician officer for 10 years and enjoys caring for members of the military, their families and military retirees.

Sebesta appreciates the fact that, even though there is a certain level of bureaucracy associated with being in the military and budgets are often tight, he doesn’t have to deal with the business side of practice. “I get to focus on medicine,” he says. His schedule is not unlike that of a civilian physician. “We divide call up between partners. There are 10 of us now because no one is deployed. I take call one weekend a month or every other month and three to four weeknights a month,” Sebesta says.

Having been deployed four times (once to Iraq and three times to Afghanistan), Sebesta says deployment is both the best and the worst part of being a military doctor. “They send you to bad places and you’re in harm’s way, but you get to do amazing things to save lives. Being away from the family is hard, but it’s an adventure, sort of like a six-month camping trip,” he says. Physicians who serve in the Army are not permanently attached to a single unit for deployment. Instead, when they’re needed to go overseas, they’re assigned to a unit for a period of time. Sebesta’s deployments have been between six and eight months in length.

Related: Military careers for physicians ow.ly/e2NYr
Dr. Red, White and Blue ow.ly/e2Ocf

Returning stateside after a deployment is an interesting experience. “The practice side is easy. You just jump back in and start working,” says Sebesta. At home, re-entry can be a bit more challenging. “The family has figured out their own rhythm of doing things. You slowly move yourself back into that and figure out where you fit in,” he says.
Sebesta advises physicians considering a military career to get in touch with a recruiter.

“Based on the needs of the Army, the doctor’s skills, and how long they’ve practiced, they get a rank, go through officer basic training, learn how to put on the uniform, and start practicing medicine,” he says. Basic training? For doctors, it’s not like you’ve seen in the movies. “I stayed at the Holiday Inn,” says Sebesta. “They’re not yelling at you or shaving your head.”

Sebesta is passionate about his career as a military physician. “It has its challenges with deployments and budget issues, but the vast majority of us love being here,” he says. “For me, it’s a great place to practice medicine.”

On the road

Kristen Kent, M.D., works as a locum tenens physician.

Kristen Kent, M.D., is 37, single, enjoys traveling, and is taking full advantage of the fact that at this stage in her life she has the flexibility to practice medicine on her own terms.
Kent completed her emergency medicine residency at the University of Massachusetts Memorial Medical Center in Worcester in 2006. While in training, she moonlighted as a locum tenens physician and enjoyed it enough to go that route full time upon completing her training. “Then I joined a group in Cincinnati and worked with them for a while before going back to locum tenens,” says Kent.

“I feel like I have a lot of flexibility with my schedule,” says Kent. For example, she had no issues taking time off recently to go on a cruise with her dad.

Kent currently works in two locations—one near her home in Ohio and the other on Cape Cod—through LocumTenens.com and Vista. Her assignments generally run for at least three months, and she’s had offers to stay on permanently several times. For now, she’s keeping her options open and continuing to work locums. “I get to practice in different environments and I get to travel,” says Kent, who is hoping to work in Alaska next summer and will likely accept engagements in Illinois in the meantime.

Kent typically works between 100 and 140 hours a month, which is considered full time for emergency medicine. “I still work nights and weekends and holidays, but I have flexibility with my schedule,” she says. “I can fit in other things while I’m working. In Cape Cod, I work for four days and then have four days off.”

The biggest challenge of working locum tenens, says Kent, is getting to know the culture and systems at each new location. “Every place is a little different in how they manage patients. Some have hospitalists and some have private physicians who admit,” says Kent. “And things are not always as they were presented. You have to be flexible.”

RELATED: Will work for travel ow.ly/e2SnQ
Career move: Locum tenens ow.ly/e2S9c

Kent says any physician considering locum tenens should give it a try. “It’s an excellent opportunity. You get to travel wherever you want, even outside the U.S.,” she says. “I moved a lot growing up and I like seeing different places, regions of the country and cultures. My friends joke that I can sit in an airport and guess where people are from based on their accents and shoes.”

Care without judgment
Internist Norman Johnson, M.D., was in private practice in 1994 when he first became acquainted with correctional medicine. “A friend worked in a prison and when he had patients who needed to be hospitalized, I’d admit them,” says Johnson. He quickly recognized that prisons and jails needed better systems for delivering care to their unique patient populations, and in 1995 he co-founded Health Professionals LTD.

In 2002 he founded Advanced Correctional Healthcare, a company that designs programs and provides risk management services for correctional facilities. In the interim, Johnson worked in jails and prisons for 15 years and continues that practice on a part-time basis today.

Johnson says the ideal doctor to work in a correctional facility is a primary care physician who has the ability to demonstrate empathy and also be somewhat parental.

“These patients are less likely to participate in their own care, and we’re charged with giving them everything they need, sometimes whether they want it or not,” says Johnson. “We have to do the right thing, while keeping in mind the cost to taxpayers and governments, both in dollars and in time.” Johnson’s philosophy is that individuals who are incarcerated, regardless of whether or not they’ve been found guilty of a crime, deserve quality medical care and respect.

Caring for incarcerated patients has challenges and rewards. “These patients come in on inappropriate drugs and they’ll want narcotics for minor problems,” says Johnson. “Many of them had doctors on the outside but they may have been non-compliant and not paying attention to their health. We get a shot at educating them. Patients in our jails get healthier. Their diabetes and hypertension improve while they’re inside,” says Johnson, adding that even “frequent flyers” who are released and then return to jail often come back in better health than when they were first seen within the system.

RELATED: Career move: Correctional medicine ow.ly/e2QUu

“As the economy has worsened and states have done away with mental health programs, a lot of mentally ill patients are pouring into jails. Many of these people shouldn’t be there,” says Johnson. In this case, the goal is to get them on an appropriate drug regimen and link them with community services. “We cannot legally advocate for them, but we can work with the legal system to give them mental and medical health parameters so that they can sort things out,” says Johnson.

In the world of correctional medicine, prisons and jails are quite different. “Prisons are large and doctors usually work 40-hour weeks,” says Johnson. “Nurses line everything up, patients are pre-screened, protocols are followed, and if anyone gets really sick they’re sent to a hospital.” Physicians working in prisons do take after-hours call, except in facilities that are large enough to have doctors on duty 24/7.

Most jails are smaller than prisons and a full-time correctional physician might cover several facilities, traveling between as many as 25 over the course of a week checking in on and caring for inmates. “These doctors don’t see as many patients face-to-face because they’re spending time traveling,” says Johnson.

Interestingly, jail doctors tend to earn more than their colleagues who work full time in a single prison. “Correctional doctors earn based on the number of hours they work,” says Johnson. “If they’re in a prison, they’re likely salaried and earning in the range of $120,000 to $170,000 a year. Jail doctors are in the $150,000 to $200,000 range.”

Johnson says burnout among correctional physicians is not as high as one might imagine. Most facilities have nurses on staff and systems in place that make practicing medicine in the setting quite manageable. “You learn how to work with these patients,” says Johnson. “You cannot allow yourself to get hardened and think that everyone you see is manipulating you. You’ll miss something if that happens.”

The rural life

The idyllic setting of Northern Idaho is the perfect location for Troy Geyman, M.D., and his rural practice. Geyman, wife, Luann, and their 12 children enjoy living on their ranch—away from big cities but in close relationship with the people he treats.

Family physician Troy Geyman, M.D., practices medicine in keeping with what your imagination likely conjures up when you hear the term “country doctor.” He covers his own practice in Bonners Ferry, Idaho, 24 hours a day, seven days a week, every day of the year. “It’s part of the job. You just do it,” he says of his practice choice. Geyman has admitting privileges at his local 20-bed critical access hospital and completes rounds each morning. He does get coverage from another local doctor for inpatients when he leaves town, but even then remains available by phone for calls about patients. “I don’t do house visits though. The county’s too large for that,” says Geyman.

Following medical school at the University of Arizona in Tucson, Geyman completed his family medicine residency at Self Memorial Hospital in rural South Carolina and then worked at a community health center in rural Michigan before settling in northern Idaho, about 20 miles from the Canadian border. He’s been there for 10 years. “I like doing the full range of practice,” says Geyman. He typically sees 45 to 50 patients a day, holds places in the schedule for walk-ins, and performs a wide range of procedures. Obstetrics is the one aspect of family medicine Geyman does not offer because the service is not available at his local hospital.

RELATED: Rural medicine: You can go home again ow.ly/e2UDo

Geyman appreciates the community-oriented aspect of practicing medicine in a rural area. He takes care of entire families and everyone in Bonners Ferry pretty much knows everyone else. “In more populated areas most people don’t even know their neighbors, let alone have a lot of relatives in the community,” says Geyman. He sees his patients around town outside the office on a daily basis. “That’s more positive than negative,” says Geyman, who does occasionally get medical questions from patients when he’s out and about. He takes that in stride. “I enjoy seeing patients and having that interaction,” he says.

Rural living suits the entire family. Geyman and his wife, Luann, have 12 children ranging in age from 4 to 22. Luann homeschools the children and everyone pitches in to take care of their sizable mountain ranch that features sheep, cattle and a pond. “The kids have responsibilities and chores and raise animals that depend on them,” says Geyman. “We have the ability to hunt and fish and hike out here. I can work in the morning and be on a mountain peak two hours later.”

“Some people come out here to vacation for a week, but we want to live like this every day,” says Geyman. If he and his wife want to get away to enjoy something that a city offers, they drive a couple of hours to Spokane or Coeur d’Alene. “We look at the big picture of living rural, what that means, like not having easy access to shopping,” says Geyman. “I might have to avoid hitting a deer or elk or moose driving to work, but I’m not fighting traffic and dealing with road rage.”

Karen Childress is an award-winning freelance writer who contributes regularly to PracticeLink Magazine.



Job searching? How to use PracticeLink.com

Feature Articles | Winter 2013


1 Start your job search today at PracticeLink.com. Registration is not required. If you do choose to register, you’ll be able to manage all of your recruiter messages from one central dashboard. We’ll also email you the new openings in your specialty so you never miss an opportunity. Your profile also lets you easily save and respond to the jobs that interest you most.

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The qualities of a winning physician CV

Tailoring a CV toward your employer and lifestyle needs can set you on the fast track to a new position.

By Anish Majumdar | Feature Articles | Winter 2013


A physician seeking a job out of residency or fellowship. A veteran emergency medicine M.D. seeking a locum tenens assignment. A plastic surgeon trying to join an established group.

What do these people have in common? All will, in attempting to develop careers within an industry in flux, come face-to-face with hiring practices that are changing just as rapidly. Nowhere is this more true than in the case of a physician’s CV. Make no mistake: Regardless of specialty or background, the days of simply listing your training and contact information on a sheet of paper, sending it out, and expecting the phone to start ringing are over.

“The factors that go into who to hire have changed as the relationship between physicians and the entities that write their paychecks have changed,” says Tommy Bohannon, divisional VP of hospital-based recruiting for Merritt Hawkins in Dallas. “Now that the industry has moved toward hospital or large group employment of physicians, it has definitely become more of an HR-type corporate vetting process. They’re looking for more of a fit from a personality and culture standpoint.”

In my capacity as a Certified Professional Resume Writer (CPRW) and owner of ResumeOrbit.com, a career development firm, I’ve had the opportunity to work closely with physicians across the United States in developing job search documents that both communicate unique value and present it within a format that’s preferred by recruiters and employers.

It can be a challenging process. For one thing, the gap between possessing experience and successfully presenting it on the page can be large indeed, particularly when dealing with a business document that comes with a daunting set of rules and standards. Oftentimes physicians will contact me after having pulled their hair out for weeks trying to write a CV themselves, shoehorning as many (frequently contradictory) “CV best practices” they could before realizing the document just didn’t hold together.

“There’s no one format,” says Arlene Macellaro, director of physician recruitment at Augusta Health in Orlando. “I’ve seen all lengths and approaches. If the right qualities are there, I’ll be contacting you.”

Quality 1

Sense of self
Richard Sheff, M.D., author of Doctor Confidential: Secrets Behind the Veil, has traveled a unique road over the course of 30-plus years practicing family medicine. In addition to being a published author and former professor at Tufts University School of Medicine in Boston, he is currently serving as chairman and executive director of The Greeley Company, a health care consulting and education firm. Though the particular challenges he’s faced have varied widely, the impetus behind all of them remains the same. “I had

Throughout your entire job search, keep your passion for medicine at the forefront. “It’s not about employment, it’s about being the solution.” — Richard Sheff, M.D.

a moment of clarity back in med school that family medicine was what I needed to do. Everything I’ve done since that point has come out of real love for the specialty and wanting to contribute in a meaningful way.” He urges physicians entering the health care industry to keep that passion at the forefront of their search efforts. “It’s not about employment—there’s a physician shortage on the horizon; you will be employed. It’s about being the solution.”

RELATED: CV essentials ow.ly/e2B1D

Develop an opening paragraph
Creating a succinct and focused opening paragraph at the start of a CV is an excellent way to establish a framework for the document and communicate what sets you apart.

“Start with the basics: specialty, subspecialty and training,” advises Macellaro. “Also, if you have a work visa issue or won’t be available until a certain date, I need to know that too as soon as possible.”

Beyond the basics, it’s a good idea to highlight three to four key areas of excellence that can then be expanded upon within the work history section of the document. For candidates with a limited work history, it is perfectly acceptable to offer a quick rundown of particular areas of interest. Here’s an example of an effective opening paragraph for a physician seeking a Non-Invasive Cardiologist position:

Board-certified Non-Invasive Cardiologist with 7 years’ experience launching successful Cardiac MRI and Cardiac CTA programs, recruiting physicians and medical staff, and implementing viable protocols and Standard Operating Procedures (SOPs). Specialist in deploying a multidisciplinary approach to addressing patient needs such as heart disease, diabetes and metabolic disorders. Internal Medicine Residency: University of Alabama. M.D.: University of Oklahoma. Available 4/13.

Be bold in expressing accomplishments
“I should be able to look at a CV and tell, at a glance, what the distinguishing characteristics of a physician are,” says Macellaro. “The easier it is for me to pick out these details, the more time I’m likely to spend evaluating it.”

Making strategic use of bullet points throughout your work history detailing noteworthy accomplishments is an effective way to differentiate yourself from the competition. Even without a lengthy work history, taking the time to highlight a special project you completed or a professional experience that had a profound impact sends a clear message that you’re a candidate on the rise. Here are three examples:

• Founded full-service anatomic laboratory within highly competitive market through developing physician referral network, delivering excellent patient care, and offering 24-hour turnaround time for test results versus 72-hour regional average.
 • Served in clinical supervisory capacity for implementation of 320 slice Toshiba scanner at ancillary hospital as part of overall cardiac CTA program.
• Developed focus on outcomes-based, resource-conscious medicine and received specialized training in outpatient minimally invasive gynecologic surgery.

Personal interests have a place
“I have definitely seen physicians land jobs because one of the key decision makers in the hiring process was a fellow member of an organization they’d listed on the CV, or else they shared a passion for a particular sport or activity,” says Bohannon. Though non-professional details should never constitute the bulk of a CV, including a “personal interests” or similar section at the tail end of the document can be a shortcut to making a connection, particularly when your candidacy relies heavily on perceived potential (read: limited work history). “One or two interesting details can make having a follow-up conversation that much more natural,” says Bohannon.

RELATED: Is your CV helping you? ow.ly/e2Bed

Quality 2

The oftentimes complex credentialing process a new physician hire must undergo necessitates full accountability on a CV. “Our credentialing process takes six months,” says Sharon McCleary, physician recruiter at Summit Health in Harrisburg, Pa., who recommends that residents and fellows allow themselves at least a year for the job search. “The more upfront a candidate is within their CV, particularly with regards to their career timeline, the easier the process becomes.”

List professional experience in reverse chronological order
Structuring your work history in reverse chronological order (most recent to least) is a proven way to quickly establish legitimacy. Think of every position as its own mini-section and include the following information:

√ Name of employer
√ Location (City, state)
√ Employment dates (Month/Year – Month/Year)
√ Approximately three to six lines describing unique responsibilities. An expert strategy is to expand upon some of the areas of excellence outlined in the opening paragraph.
√ Accomplishments (If available)

Address all work gaps longer than one month
“Any breaks in employment or training that aren’t addressed raises an immediate red flag,” says McCleary. “The truth is, leaving an uncomfortable incident off the CV doesn’t mean it disappears. It just means you’re giving up the opportunity to control its impact.”

Inserting a one or two-line “Career Note” directly within the work history or “Education” section of your CV is a simple way to address gaps. Here are three examples:

Career Note: Addressed family responsibilities while maintaining current knowledge of industry standards and practices (9/12-12/12).

Career Note: Completed rigorous physical training for Ironman Triathalon and attained personal goal of finishing (9/12-12/12).

Career Note: Traveled throughout Brazil and
Argentina, developing new friendships and expanding worldview (9/12-12/12).

Quality 3

Aligned with employer’s needs
Mark Friedman, M.D., cofounder and chief medical officer at First Stop Health, an online and telephonic health concierge service, is a master at projecting the right professional image to secure both clinical and non-clinical positions.

In addition to the above, Friedman is assistant clinical professor of emergency medicine at Quinnipiac University’s Frank Netter School of Medicine in Connecticut and actively pursuing locum tenens assignments.

Related: 8 quick tips for landing the job you want ow.ly/e2Bnq

He knows from experience just how widely the requirements of business, academic, and clinical roles can vary, and cautions physicians against using a “one size fits all” strategy for their CVs. “I’ve found it very helpful to use an ‘outside-in’ approach,” he says. “What’s the impression you want to leave? Yes, being thorough is important, but how you choose to present that information will set the stage for how you’re perceived.”

Use separate versions of your CV for different job targets

Arlene Macellaro, director of physician recruitment, Augusta Health

“It’s frequently easier for me to evaluate a physician with a limited work history as opposed to someone who’s been practicing for decades, because where the former might send me a two-page document outlining the basics, the latter might send me a 10-page document listing every aspect of every engagement and fellowship,” says Macellaro. “On a typical day I’ll deal with somewhere in the vicinity of 70 calls and 200 emails. Unless you make it clear exactly what you’re going after and why you’re a great fit, I’m probably not going to have the time to discern it.”

When applying for clinical positions, it is essential to emphasize board certifications, clinical qualifications and clinical engagements within the first page of the CV. It is also important to de-emphasize non-clinical experience within the work history section. A good approach here is to use the reverse chronological format for all relevant positions, followed by a “non-clinical experience” or similar section briefly summarizing this work in bullet points.

When applying for non-clinical positions, a candidate has more leeway in terms of what skills he or she chooses to emphasize in the opening paragraph and work history. However, it should be noted that clinical expertise carries weight regardless of the particular position being sought, so it should play a role no matter what opportunity you’re seeking.

“Often what I’ll do is attach my clinical CV to the end of the business résumé when submitting for a non-clinical position,” says Friedman. “That way I feel like all the bases are covered.”

Identify and integrate industry keywords
The key takeaway from a job market that is increasingly reliant on technology is the importance of developing a document that makes it simple for a reader to identify relevant industry terms and facilitates a positive decision about your worthiness as a candidate.

• Gather five to 10 relevant job postings to which you would seriously consider applying. Analyze the job description: Which skills are called out time and time again? At which of these skills are you particularly proficient? Jot down a quick list. For example, a Non-Invasive Cardiologist might end up with a list that looks something like this:

Cardiology program development
Protocol and SOP development
Medical and administrative staff leadership
Multidisciplinary coordination
Cardiovascular diagnostics and therapeutics
Staff recruiting/mentoring
Community partnerships
Patient management

• Insert a “Core competencies” section near the start of the CV that lists the keywords you’ve identified. This simple step both increases the odds of your CV passing a quick scan while enhancing the overall focus of the document.

• Be sure to elaborate on the keywords listed in your “Core Competencies” section within the work history section of your CV. This will provide the context a recruiter or hiring agent will be looking for when they review it for the first time. “If you take the time to ascertain your strengths, then figure out how they mesh with our needs and highlight that, you’re several steps ahead of the competition,” says Bohannon.

“Don’t tie your hopes to any one position. Be flexible. My story isn’t what I imagined it would be when I started as a physician: It’s better.” —Anthony Youn, M.D.

In his memoir, In Stitches (institchesbook.com), renowned plastic surgeon Anthony Youn, M.D., details the good, bad and frequently absurd experience that is medical school.
Like many young physicians, he entered the job market convinced that the hard years were behind him.

“Wrong!” he says during a call from his office at Youn Plastic Surgery in Troy, Mich. “I wanted to work in this area, so I sent my CV out to about 25 different groups. Nothing.” Faced with a nightmare scenario and the looming specter of more than $200,000 in student loans, Youn was forced to find the opportunity in adversity and bootstrap his own practice. Following some lean years that included renting office space from an anesthesiologist to see patients and bringing breakfast to the offices of family doctors for possible referrals, he broke through with an appearance on the reality show “Dr. 90210” in 2004. Appearances on many other shows followed, including “The Rachael Ray Show” and “The CBS Early Show,” resulting in rapid growth and establishing Youn as an expert in the field. “None of it would have happened if I hadn’t been able to find a job,” he says. “Don’t tie your hopes to any one position. Be flexible. My story isn’t what I imagined it would be when I started as a physician: It’s better.”

Anish Majumdar is a Certified Professional Resume Writer (CPRW) and owner of ResumeOrbit.com.



Picking up your life…and moving it!

Nothing influences your quality of life as much as where you choose to live. But how can you relocate with minimal stress?

By By Anayat Durrani | Feature Articles | Winter 2013


Loss of a job. Divorce. Illness. Death of a loved one. All rank high on the list of the most stressful life events.

And then there’s moving.

It’s so stress-inducing, there’s even an “I hate moving” Facebook page to vent about it. YouTube is full of videos of people lamenting about their dreaded move.
Most will agree that moving is no fun. But with every move there are lessons to be learned—lessons that can improve your next one.

Moving wasn’t too bad for David V. Evans, M.D., an assistant professor at the Department of Family Medicine at the University of Washington School of Medicine. Evans spent 15 years practicing family medicine at Madras Medical Group in Madras, Ore., before he, his physician wife and their two kids uprooted and headed for Seattle in April 2012.

“The relocation was as easy as it could be considering we had lived in Madras for almost 15 years. We sold our house without much difficulty. That was fortunate especially given the economy in Madras,” says Evans. “The major challenges were being away from (my wife) Suzy and the kids for two and a half months and finding a house in Seattle.”

Thinking about moving? ‘‘Don’t fly in one day and out the next if you are unfamiliar with a place. Stay for a few days if you can. If you are still unsure, ask for a second interview even if the employer is ready to hire you.’’ — David Evans, M.D.
Evans and his family moved to Seattle from Oregon last year.

Evans says his new employer paid for the bulk of the move. His employer also picked the movers, who “thankfully” packed the family’s boxes. They were given a moving allowance, which Evans says they exceeded, though they were “willing to pay the extra to do less work.”

In his new job, Evans teaches family medicine in the residency program in addition to having a medical practice. Evans says he and his wife feel it was the right decision to move, adding, “so far so good.” He enjoys the challenges of his new job as well as the people with whom he works.

For other physicians facing relocation, Evans recommends taking some time at both the job site and the community to see if the move is right for them. He points out that observing the work environment is important as well.

“Do people seem happy? Is it unnecessarily chaotic? Talk to staff, not just docs. Talk to spouses. Talk to patients. They often have a different insight and can tell you about living in the community,” he says.

He also suggests asking to tour with a realtor as part of the interview. This allows time to discuss and discover community aspects such as schools, churches, activities and other factors that matter in the new location.

“Don’t fly in one day and out the next if you are unfamiliar with a place. Stay for a few days if you can,” says Evans. “If you are still unsure, ask for a second interview even if the employer is ready to hire you. You are interviewing them as much as the other way around.”

More physicians relocating
Of the physicians placed in 2011, 93 percent relocated to a new community for their new job, according to The Medicus Firm. That year, signing bonuses were offered to 88 percent of physicians placed, and relocation allowances increased.

When Julie Zacharias, D.O., was preparing for a move, she packed in a wedding as well. Zacharias moved from North Carolina to Nevada in 2011 to join Touro University Nevada College of Osteopathic Medicine (TUNCOM) as an assistant professor in the primary care department. Zacharias serves as a practicing physician providing on-site care at assisted living facilities, skilled nursing facilities and private homes.

How did her move go?

“Overall it was OK. I did not expect my belongings to take as long as it did to move out from North Carolina to Nevada—approximately two and a half weeks. It worked out OK because I had an extended stay in Texas,” Zacharias says. “I got married in between moving from North Carolina to Nevada. I also was lucky to have someone on the receiving end to let the movers in. My fiancé had already settled into our new house and was available to sign for my belongings.”

RELATED: Site visit savvy ow.ly/e0Yhi

Zacharias had planned to move to Las Vegas because her then-fiancé (now husband), who is in the military, was assigned there. She visited with a few of the faculty of Touro prior to interviewing and connected well with two physicians she met. She then set up an interview. Next was the move. She researched several different moving companies online, then arranged to have all her belongings shipped from North Carolina to Las Vegas.

“I had packed most of my belongings the week before the movers were supposed to arrive and placed all the boxes in my extra bedroom. I did have the movers pack dishes and picture frames,” she says. “The actual move was pretty painless with movers. My fiancé flew out to North Carolina to help drive.”

But like most moves, sometimes things don’t always go smoothly. She suggests letting movers pack most belongings. “It turns out that I am not the best packer, and a few things I packed ended up broken,” she says.

She notes that even if the movers pack all your things, she would still recommend packing and transporting your important documents and jewelry yourself.

RELATED: How to avoid a relocation nightmare ow.ly/e11dr

She also wishes she had hired someone to professionally clean the townhome she was renting in North Carolina. “My fiancé and I spent several hours cleaning after the movers left, before an 11-hour drive,” Zacharias says.

The total cost of her move was $1,100. She highly recommends that physicians do their research and compare prices when planning a move, adding, “It makes a big difference.”

Prepping for the move

Caroline Steffen, physician recruiter for DuPage Medical Group

Physician recruiter Caroline Steffen, with DuPage Medical Group in Illinois, says physicians should call at least three moving companies before deciding which to use. Request estimates and references, and make sure they are bonded.

“A typical moving allowance is $7,500 to $10,000 to cover the cost of the move,” Steffen says. “True costs can vary depending on how far you are moving and to what region of the country.”

Steffen says that, in many cases, practices and hospitals in metropolitan areas will not provide physicians a relocation allowance. Nor if the physician is already living in the area, or if the relocation is because of a spouse’s new position. Rural and medium-sized communities, she says, are more likely to have a relocation allowance in their standard employment offer.

“Physicians who are moving to join a new employer need to remember that their move is the second transaction they are having with their employer; the first is negotiating the employment agreement,” says Steffen. “How a physician handles the move with the employer can set the tone of the first few days at work.”

Yes, moving can be stressful. But, Steffen says, physicians who are demanding, spend too much on their move, or have excessive special requests “can put a bad taste in an employer’s mouth and make them question if they hired the right individual.”

Physicians with unique needs when moving should not expect their new employer to cover moving expenses of a sailboat, antique car or pool table, for example. Any special requests, she advises, should be brought up during the contract negotiation process so that it’s clear what will and won’t be covered in the moving allowance.

“Many employers have moving polices. Ask for a copy during contract negotiations so you have a clear understanding of what you are being offered in your moving allowance, and any restrictions there may be as well,” Steffen says.

Fawaz Ahmad, M.D., just relocated from Baltimore to Chicago in July 2012 to join DuPage Medical Group as a hospitalist. His start date was a month later, following completion of his boards. Ahmad received a relocation stipend and picked his own movers. However, he realized after talking to several moving companies that many were unable to accommodate the dates he needed, despite his scheduling a month in advance, due to high demand during the end of the month. Ahmad used Yelp and other online reviews to research moving companies but ended up with a few that could accommodate his schedule.

“From a previous personal bad experience with in-town moves, I would highly recommend using an online review to research the movers you are hiring,” Ahmad says. “I only packed our valuables and the few items that we would need through the month before we could move into our apartment. Everything else was packed by the movers.”
Ahmad says it’s “very difficult to have a completely hectic-free relocation experience.” His biggest unexpected surprise was that he was not able to find an apartment that he liked for the move date that he wanted because the rental market in Chicago was so competitive.

“And because we had to give two months’ notice with our current landlord, they had already leased our apartment and could not extend our lease,” he says. “We ended up having a month overlap between our move-out and move-in date. This resulted in having to find temp housing for a month as well as having to negotiate storage costs for a month with our movers.”

Expect the unexpected
When moving, anything can happen.

Sharon Dionne, a physician recruiter for St. Joseph Hospital in New Hampshire, has heard her share of moving horror stories from physicians. She recalls one physician who had extensive damage during a move. Another had water damage on items in storage. These events, however, happened years before the hospital entered into a national moving agreement. Now they work with United Van Lines through local carrier Diggins & Rose.

“They provide us with a discount and allow the physician to have them direct bill us to their max benefit,” says Dionne. “The most important factor is to deal with a reputable mover, as mistakes can happen that can really be a problem, such as damaged goods and delays in schedules.”

Sometimes things arrive broken or don’t go according to plan. She recommends that physicians purchase protection as part of the cost of their move to cover any damages.
“We have that automatically included in our agreement with United Van Lines. Normal packing and moving are included along with a car carrier, temporary housing, storage, etc., as long as they do not exceed their total benefit,” Dionne says.

With so much focused on moving and unpacking, little time is often left for physicians to get settled in and acquainted with their new location. Ahmad had the advantage of already being familiar with Chicago, but says, “because of the boards, I haven’t had much time to enjoy Chicago or get settled in yet.”

Evans, who moved with his wife and kids to Seattle, says they are still exploring the area. From previous experience, he says, “It takes about a year to really get settled into a new town.”
Zacharias planned ahead so that she would have time to relax before she jumped into her new job in Las Vegas. “After I had officially moved in, I had planned to have about three weeks off prior to starting my new job, which helped quite a bit,” she says. “Also, my husband had been in Las Vegas for several months already, which was great. In regards to work, Touro was great having the first few weeks be a settling-in period. I met with HR and had a few sessions learning the EMR, which helped when clinic started.”

Adriana Tobar, M.D., has moved from Ecuador to New Jersey to Illinois, where she now calls home. Finding a support system in your new town, she says, is a huge benefit.

Moving with family
Adriana Tobar, M.D., is a family medicine physician who lives in Illinois and commutes to her job at Dean Health System in Wisconsin. She originally moved with her husband and then-3-year-old daughter from Ecuador to New Jersey in 2001 to study for the boards. They lived in New Jersey for two years, then moved to Illinois in 2003. Though she did get a bonus when they moved to Illinois, they decided to pack themselves to save money and shipped a few items they had from New Jersey.

Moving was not entirely easy on her family.

“For physicians or residents who move, I think there are several stressors the family members struggle with that tend to be overlooked,” Tobar says. “My husband helped quite a bit with exploring around, but it was very difficult initially for him. I was at work as a first-year resident, my daughter was at school, and he couldn’t work or study for six months until the visa was approved.”

A support network helped them ease into their new location.

Often, joining activities and clubs, church groups, sports and cultural centers can help smooth a transition into a new town.

“When we arrived, there were three doctors—one from Dominican Republic, one from Venezuela and one from Argentina—who really helped us to not feel so alone and to settle down,” Tobar says. “They were like family. I think it is extremely important to find a support system to help with the transition: church, sports, etc.”

Moving can sometimes be tough on the family. That’s a topic “Jane” has blogged about on her anonymous blog, “From a Doctor’s Wife.”
She started the blog during her husband’s fifth year of residency as a way to reach out to other wives and significant others who don’t have support networks, and also “as a way to scream into my pillow.”

RELATED: How to avoid relocation shock ow.ly/e1aE5

Her family recently moved for a fellowship over the summer. She has a countdown clock widget on her website counting down the days, hours, minutes and seconds until the fellowship ends.
“We have moved three times in eight years, with our fourth move coming next summer. For me, the worst part of moving has been driving across the country. Packing and unpacking is the easy part,” says Jane. “I start the process earlier than most would, but it has proved invaluable every time. More work in the beginning means less work at the end.”

For her last move, they sold their house a few months before they needed to relocate. Her husband stayed in student housing and she and their four kids went out of state to stay with family. The hospital for fellowship didn’t cover moving expenses, so they used PODS. They were provided a container to load and unload. She and her husband packed their own boxes and saved money using spare boxes her husband brought home from the hospital.

RELATED: The trailing family ow.ly/e12W4

“They drop off a box, we fill it over the course of several days, they pick it up, store it, and deliver it when we need it,” Jane says. “For us, this method fit our budget, our storage needs, and meant we didn’t have to drive a truck or move between a storage unit and moving truck. In the end, our moving expenses for storage/transportation of the POD came in at about $3,200. We were very pleased.”

Jane says moving so far has been fairly easy on her kids, ages 1 to 7, because they are still young. When they first arrived in their new city, the family made sure to explore the area and see all the fun things near which they lived.

“We sought out our church community as soon as we arrived, and have made friends there for ourselves and our children. Finding a local network of people to help you navigate a new city is priceless,” says Jane. “We found out the best days to hit the children’s museum, what times to avoid grocery shopping, where to pick up the kids’ school uniforms inexpensively, and info on free things to do around the city.”

Their next move will be for her husband’s first post-training job in summer 2013. Being super-organized has paid off. Having either donated unwanted items or boxed up, labeled and put aside items not in use, Jane doesn’t feel concerned or stressed about the next move.

“We did so much work this last time I think we will be in a position to say, ‘Box it up, it all goes,’” says Jane. “Movers will most likely be included in our offer, but we could easily do it ourselves—and honestly, we probably will. I like knowing what is in the boxes!”

Keeping a positive outlook and sense of humor can help keep the moving woes at bay. So can keeping in mind that moving is a temporary situation that will bring you to your next stage in your career and life. Being well-organized and preparing in advance can go a long way in making the move smoother and less stressful.



Your before, during and after moving guide

Relocating can be overwhelming, but by planning ahead and breaking it down into manageable tasks, you can assure a smooth transition into your new home.

By John Boozer, Nilson Van & Storage/Mayflower Van Lines | Feature Articles | Winter 2013


Part I

Well before your move…
• When getting quotes, show the representative from the moving company everything that will be moved including items in the attic, basement, garages, storage areas, sheds, etc.
• Once you have chosen your carrier, obtain and read the three “pre-move required documents” from your carrier. These documents include your “Rights and Responsibilities” and Ready-to-Move brochures. These are required documents for every interstate shipment.
• Take an objective look at what you own. Decide what must go and what can be left behind. Books you’ve read and will never read again? Do you really need the pan with the broken handle or the children’s long neglected games? Remember: extra weight costs more money.
• Carry valuable jewelry with you. If you’ve hidden any valuables around the house, be sure to collect them before leaving.
• Animals cannot be moved in a moving van. If you’re not taking your pets by car, make other transportation arrangements. Because some states require up-to-date health certificates and rabies inoculations, it’s a good idea to take your pets to the veterinarian prior to the move to ensure that you have the proper documents.
• Leave your plants behind. state laws prohibit the entry of house plants, and most plants will not live through being transported in the moving van. Consider giving your plants to a friend or a local charity if you cannot transport them yourself.
• Send change-of-address cards to national newspapers and magazines. Cancel delivery of local newspapers, and settle your accounts.
• Make final packing decisions. Clean and clear your home, including closets, basements and attics. Check with your carrier representative for a complete list of items not to pack.
• Transfer all current prescriptions to a drugstore in your new town.
• Check your safety deposit boxes. You also should call your bank to find out how to transfer your accounts.
• If you plan to pay for your move by credit card, you must arrange it with your carrier representative because authorization is required prior to loading the van.


Download and share this
helpful article at ow.ly/g4T4d


Part II

RIGHT Before your move…
______ Schedule to have your utilities (electric, gas, phone, etc.) disconnected or transferred to the new owner the day after your scheduled move-out.
______ Empty, defrost and clean your refrigerator and freezer and clean your stove—all at least 24 hours before moving to let them air out.
______ Prepare a “Trip Kit” for moving day. This kit should contain the things you’ll need before your belongings arrive at your new home. Some suggested items are soap, toilet paper, travel alarm clock, snacks, bottled water and a first aid kit.
______ On move-out day, be on hand when the movers arrive. If you are not able to be there, it’s important to have a trusted adult on hand who will authorize decisions about your move. Let your carrier representative know the name of the person who will be there on the day of your move. Be sure that the spokesperson you have chosen knows exactly what to do.
______ Provide your new phone number and make sure to bring your carrier representative’s contact information. The driver will contact you 24 hours prior to their expected arrival.

On move-in day…
• Be sure you are there when the movers arrive. You or an adult representative will need to be there to accept the delivery and pay the charges. You will be asked to note any changes in the condition of you goods indicated on the inventory at the time of loading and to note any missing items at the time of delivery.

√ Plan to sign the following paperwork:

Inventory of Goods: This document is a description of the condition of your belongings. You’ll be asked to sign it to acknowledge receipt of your goods upon unloading.
Bill of Lading: This is the shipping document that establishes the legal terms of your moving service.
Additional Services Performed: This is used to verify the services the carrier performed other than loading and transporting your things. Please examine it carefully before you sign, making sure that you understand what you’re being charged for.

John Boozer (Jboozer@nilsonvan.com) is director of corporate accounts for Nilson Van & Storage/Mayflower Van Lines.



Till work do we part

Physician couples conducting a simultaneous job search need to be patient, open-minded and willing to compromise.

By Vicki Gerson | Fall 2012 | Feature Articles



The right location is key
Michelle A. Potts-Griesser, M.D., MPT is a Pediatric Physiatrist at Nationwide Children’s Hospital in Columbus, Ohio. Her husband, Michael J. Griesser, M.D., is an Orthopaedic Sports Medicine Surgeon at Clinton Memorial Hospital in Wilmington, Ohio.

“Whether you are seeking a residency position or a job, the couple has to determine who will have a more difficult time finding the position and give that person priority.” —Michael Griesser, M.D., and his wife, Michelle A. Potts-Griesser, M.D., MPT, at Nationwide Children’s Hospital

“We were both looking for a job at the same time,” says Potts-Griesser, “but I knew where I wanted to be. I wanted to stay where my fellowship was, at Nationwide Children’s Hospital.” Potts-Griesser found her dream job and was offered her position in October 2011. Potts-Griesser also has a faculty position at Ohio State University Medical Center.

Griesser started his job search as soon as his July 2011 fellowship started. He went on seven interviews and narrowed it down to three reasonable possibilities within a negotiable distance from the hospital where his wife would work. He had five job offers by February 2012, all within Columbus and surrounding areas. He signed his contract at Clinton Memorial Hospital in April 2012, and will be a hospital employee with an orthopedic practice within the hospital.

How they interviewed

This couple did not tell recruiters they were both looking for jobs. They conducted totally individual job searches within their geographic boundaries. Initially, they didn’t go on joint interviews or send out joint CVs to potential employers. Ultimately, they did two joint interviews, but only after they had gone though the individual search process.

One of the main questions that always comes up in two-person job searches is, “Whose job gets priority? Why?”

In this case, Potts-Griesser’s job search took priority because she is in a more specialized field with fewer jobs available. She had the opportunity to get a job where she was doing her fellowship, so Griesser adjusted his job search accordingly.

“Whether you are seeking a residency position or a job, the couple has to determine who will have a more difficult time finding the position and give that person priority,” he says.

Job-search advice

Potts-Griesser and Griesser advise candidates to be open and honest with potential employers in terms of your family’s location constraints.

“Be patient. Be open. Take your time, and ask questions,” says Griesser.
“Try not to get frustrated or jealous or feel you have to rush to find a job because your spouse has one. Employers may try to rush you because they want an answer, but don’t be rushed.”

On a few occasions, the couple was recruited by the same employer.

Even when this happens, Griesser recommends that physician couples evaluate each opportunity separately.

“What I’m clarifying is that you shouldn’t adjust your opportunity in order to work at the same hospital,” says Griesser. “It’s much better to find the best individual job for you within the location.”

The key point is that you both agree to the location.

“That is the one factor you can’t compromise on,” Griesser says.

Once the couple agreed on the general location where they’d conduct their job search, they were able to canvass one specific area for opportunities.

Griesser ended up selecting a job about 45 minutes from home. That leaves Potts-Griesser with the responsibility of getting the children to daycare and school.

“You may have to accept that, within your geographic limits, you may not find your perfect job…the job you were dreaming of while you were growing up,” Griesser says. “But you will be able to find something pretty darn close. Adjustments are in order to make it work as a couple.”



Small-town living provides a perfect fit

Lindsy Alons, M.D., is an OB/GYN at Ottumwa Regional Health Center in Ottumwa, Iowa; her husband, Sandro Younadam, M.D., is an Internist. Their new practices suit the couple, whose goal was to work together.

Alons is joining the hospital employed OB/GYN group. The group is aging and had been looking for the right fit for a new physician. Younadam will be establishing a group practice in Ottumwa to which the hospital is currently trying to recruit more physicians.

Ottumwa Regional Health Center is a trauma and referral center with 217 beds providing medical care to the residents of southeastern Iowa and northern Missouri. There are 70 physicians representing 30 specialties of medicine. The city is in a family-oriented community with a population of
25,000 in the city and a service area of 125,000.

Initially, the couple focused on practicing medicine in Jacksonville, Fla., where Younadam’s parents live. They soon realized it was important to expand their search due to better job offers and a better call structure elsewhere.

How they interviewed

Alons and Younadam each had three interviews. They always brought their two children to the cities where they interviewed and arranged for family to watch the children during the actual interview time.

The couple informed recruiters and prospective employers that they were searching for work together. They always asked if there was a need for each of their specialties and sent in their CVs at the same time.

“We arranged our interviews to occur on the same day so we would both go together,” says Younadam. “We visited as a family. We felt it was important.”

The couple didn’t have any friends who were physician couples and didn’t ask in-house recruiters for any advice. As a result, “we figured out what we should do on our own,” says Younadam.

The couple started their search in Alons’ last year of residency. “We felt it would be wise to search for both of our jobs at the same time so we could obtain work in the same city,” Younadam says. “Neither of us wanted to commute long distances. We were lucky because we got our jobs at the same time.”

Job-search advice

Alons and Younadam recommend that physician couples start their search with wide parameters. Initially, they limited themselves to a small region. Their philosophy changed when they realized there were numerous opportunities they would be missing if they didn’t expand their search.

Younadam advises to not judge the job before interviewing or visiting the location. After visiting a place, you may realize that you like the area more than you thought you would.

It’s also important to know what is important to you and your family, and know what amenities you need. Do your homework. Research the area so you know what it has to offer.

“Always look for a place that will make you happy in all aspects of life:
work, play, relaxation, family and hobbies,” Younadam says. “It is not just about the job, but rather the whole picture.”



An island job may be the perfect place

“Talk and share the thought process. It’s never healthy to ‘play the martyr’
or to make sacrifices thinking you are making it better for your spouse or the
family. If you’re not happy with your decision, it will likely lead to resentment later.”
—Li-Duen Clark, M.D., on the shores of Oahu with her husband, Jean-Paul Clark, M.D.

Jean-Paul Clark, M.D., and his wife, Li-Duen Clark, M.D., are both OB/GYNs who practice together at Windward Obstetrics and Gynecology LLC in Kaneohe, Hawaii.

How they interviewed
Although the couple graduated in June 2011, they started their job search in the fall of 2010. Focusing exclusively on finding two positions, they either wanted jobs in the same place or geographically suitable so they could at least live in the same house. In addition, they didn’t want a commute that would be more than 30 minutes.

Without any strong geographical ties, Hawaii seemed like the perfect place to live. The couple looked at the other Hawaiian islands, but it became apparent that Oahu, with its denser population, would provide the greatest opportunity.

“When it’s harder for one of you to find a position, then it¹s fine for one of you to have a permanent position while the other takes a temp position and continues the search,” says Li-Duen Clark. “Talk and share the thought process. It’s never healthy to Oplay the martyr” or to make sacrifices thinking you are making it better for your spouse or the family. If you’re not happy with your decision, it will likely lead to resentment later.”

The couple stated their goals to potential employers in a cover letter that introduced both of them. However, they kept their CVs separate. They stayed together for all but one interview. If they weren’t together for the formal interview, they had dinner together with the potential hiring doctor.

“Some recruiters/employers think when a couple is presented, they have reasonable concerns,” she says. “They don’t know if the couple gets along, or what happens if there is a later dispute. Employers wonder, will they lose both of them or create an awkward work situation?”

Private practice was the Clarks’ answer.

The couple spent one week in Hawaii doing interviews. The final interview was the right fit, and from there they moved forward, using hospital assistance to set up a private practice together.

“In a way, we both thought we were crazy for starting a private practice, which we had not experienced or had any training for,” says Jean-Paul Clark.

Their typical agreement consisted of a period of guaranteed income followed by a promise to stay in the area for a certain amount of time while repaying the amount of Castle Hospital assistance. “The hospital had every incentive for us to succeed,” says Jean-Paul Clark. “The hospital was making a judgment in recruiting us, believing it was an opportunity for a win-win situation.”

The couple saw their first patient on Sept. 6, 2011, and have no regrets.

Job-search advice

There is little preparation for simultaneous job searches in residency. Get all the help and advice you can from people who have completed these steps.

Private practice, for example, is not for the faint of heart, but perfectly possible for a couple with strong determination.

Most importantly, don’t underestimate the “feel” of a work environment. It can affect not only your day-to-day life, but also shape your future. Trust your gut and ask around.

When you’re working together, divide and conquer as much as possible. Try to avoid overlapping work, which can reduce friction. “If you feel as if you can each run the clinic without the other, that’s a success,” says Jean-Paul Clark. “The clinic is not dependent on either of you, and you’re not overly dependent on each other.”

“Not everything will go smoothly,” says Li-Duen Clark. “It’s important to keep communication open through the process. It’s hard enough for one job search; it’s harder for simultaneous job searches. Be open and flexible, and be sure to support each other during this stressful process because no one else understands the situation better than the one going through the exact same process.”

Survey says…

“Attracting a newly trained physician also means that the community must meet the needs of his or her family. In an increasing number of cases, that may include another physician.

67%  More than two-thirds of the respondents said that their practice opportunity choices are dependent on the interests of their spouse, significant other or family member.

24%   Nearly one-quarter of respondents have a spouse or significant otherwho is also a physician.”

Source: Cejka Search 2012 Resident and Fellow Survey


Your same-time job search

To find the right or “near perfect” job opportunity for both you and your other half, Erin Wainwright, a physician recruiter at RegionalCare Hospital Partners in Brentwood, Tenn., has this advice.

Couples searching for physician opportunities with different specialties need to make one search the priority and focus on that one first. The priority usually goes to the specialty for which opportunities are harder to find.

“For example, at a facility in Iowa, RegionalCare Hospital Partners was able to successfully recruit an OB/GYN and an Internist. The couple knew the area was looking for both specialties and contacted us, but the OB/GYN was the priority,” she says. “They wanted to make sure that the OB/GYN opportunity was a good fit because there was only one practice to join.

There were several Internist/Hospitalist opportunities in the area for the Internist to select.”  Recruiting couples for physician job opportunities is not much different than recruiting one physician. Typically, recruiting the spouse physician is just as important to the organization. Wainwright’s goal is to find physicians ready to commit to the area and who are looking for a place to call home.

When Wainwright interviews one physician, she often interviews the second physician also seeking employment opportunities. Whenever possible, her organization tries to recruit both. Therefore, both physicians should always submit their CVs when looking for jobs together.




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