Physician contracts in the age of COVID-19

Health care—and job-seeking physicians—didn’t emerge from the pandemic unscathed.

By Therese Karsten | Fall 2020 | Job Doctor

 

In May 2020, the American Hospital Association released a report estimating that between March 1 and June 30, 2020, hospitals and health systems across the country will experience over $200 billion in losses because of COVID-19 expenses and lost revenue.

How will that impact physician job seekers?

Throughout this time, I’ve been on conference calls with in-house physician recruiters from hospital systems and large medical groups all over the country. We gather in national, regional and specialty professional groups on virtual meeting platforms like WebEx and Zoom to share best practices. Every call starts with a check in to share what is going on in our facilities and groups.

A handful of hospitals in unaffected areas are operating and hiring as usual, with just a pause in onsite interviews due to travel disruptions. Some health care systems in hard-hit areas closed practices and laid off physicians and staff. A lot of recruiters reported furloughs and pay reductions for physicians and staff as well as temporary shutdowns for clinical and administrative offices. Every single recruiter reported that their hospitals revisited their 2020 budget and revised physician recruitment planned expenditures for the remainder of the year and began adjustments to 2021. Even facilities that have not admitted a single COVID patient are preparing for the lost revenue and expenses they would experience if the virus spreads in their community at some point over the next year or so.

That said, we are all confident that physician hiring will recover long before other parts of the economy.

How job searches have been affected

Here are a few of the impacts we saw as our health care systems’ leadership teams wrestled with the pandemic.

COVID Cancel was a quick end to positions tied to new site expansions, new service lines or recruitments requiring major capital investments. Not “never,” just not this year, not early 2021.

Hold was a continuum—hold this one for 60 days. Revisit that one in 90 days. Look at this again at 120 days. Facilities want to fill positions, but they don’t want to start new physicians until they know volumes are rebounding and patient confidence is strong.

Push it Back was the directive for many retirement backfills. Whenever late career physicians’ 401(k)s suffer, they second guess retirement timing, preferring to wait until retirement accounts recover before hanging up the white coat. This was bad news for 2020 residents and fellows who had interviewed and were working on contracts when the pandemic hit the community they hoped to join.

Reduce It was one tactic to move forward within a drastically slashed budget. Full-blown hospital system income guarantee packages were reduced significantly. Large, established private practices helped reduce the burden on the hospital. Practice partners agreed to sacrifice perks like CME travel. Groups deferred bonuses in order to cover their new physician salaries during ramp up. Many graduating residents lost sign-on bonuses to the virus.

Proceed as Planned was the welcome directive to continue with contract development for physicians recruited to practices with volumes unaffected by the pandemic.

The AHA number bears repeating: $200 billion in losses due to lost revenue and COVID expenses between March and June 2020. Going forward, hospitals and private practices are proceeding very, very cautiously. Will a rush to reopen local economies bring about new hotspots, new surges? Will there be another wave in the fall? Will patients return to pre-COVID health care utilization patterns? Will the payer mix recover as Americans return to work and health care coverage?

Some thoughts for physician job seekers in the pandemic physician job market:

If you can, consider another year of fellowship, or stay in the job you have until we are firmly in recovery. Any time employers are experiencing uncertainty, they react by tightening reigns on sign-on bonuses and starting salaries. Your negotiating position will improve when the economic indicators are strong and patients once again feel safe in hospitals and medical offices.

Don’t leave a job without signing a contract for your next job. Pre-COVID, physicians in high-demand specialties were accustomed to leaving a job if they got mad at administration or just were not as happy as they thought they should be. “I’ll do locums or work PRN,” they thought. When locums demand drops off and nobody is hiring PRN, those physicians are unemployed and ineligible for unemployment benefits.

Keep multiple irons in the fire until you have a contract. In this hiring environment, it may not matter how fabulously you interview or how great your references are. If patient volumes are not recovering quickly enough in the market where you interviewed, administration will hit the brakes.

Defer the gratification of buying the biggest house, the nicest car in your price range. There will be a time to stretch, but this is not that time.

A contract might not be what you hoped, heard or thought it would say. In times of financial uncertainty, employers are more conservative. Have a health care attorney review the formal draft so that you thoroughly understand if, when and how the contract could be rescinded or terminated.

Understand that the starting salary, sign-on bonus and education loan repayment deal your senior residents and fellows got pre-COVID is not relevant to what employers will be offering today. Candidates in 2020 are competing with a much larger than normal pool of displaced mid- and later-career physicians who lost jobs or are moving for personal reasons. With some positions pushed out as long as two years into the future, there will be more physician candidates competing for a smaller pool of jobs.

Despite disruption today, our country still needs many more physicians than we have in the pipeline. The challenges and disappointments for this year’s job seekers will eventually be a blip in a successful career. And with all this experience interviewing virtually, I predict that the survivors of the physician candidate pool of 2020/2021 will be our next media stars!

Therese Karsten is the division director for physician recruitment for the Continental Division of HCA Healthcare.

 

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Interviewing on video? Follow these guidelines

Physician recruiters weigh in on how to have a great virtual interview.

By Therese Karsten | Job Doctor | Summer 2020

 

In 2020, physician job interviews shifted temporarily to video platforms as hospital systems and medical practices adapted recruiting processes to meet the challenges of the COVID-19 environment.

As shelter-in-place orders locked down the United States, employers adapted to a new normal. Offers were made and contracts negotiated before physicians had met administrators and peers face to face. We got pretty good at virtual hospital tours and realtor virtual community tours, and candidate video interviews are now here to stay.

If you do not present well in a video interview, the employer may not invest the time and money on a full site visit. Here are a few tips from HCA Healthcare recruiters on making sure your video interview scores are strong.

Do a trial tech run well before the interview

Make sure you have the interviewing software loaded and tested on your device. Preparing your device is just like mapping out your drive to an in-person interview. When you join the interview on time, visible and audible and ready to go, you are setting the right tone.

Pay attention to your appearance

Use the best device camera you have for the interview. You may be surprised that your older laptop has a better video camera than your newest device. Prepare for less-than-optimal video quality. Don’t wear white; it often looks dingy and gray. Avoid stripes, which can “wobble” on a lower-resolution feed. Watch any lip liner pencil under lipstick, which can appear clown-like on camera. …And if you’re not wearing pants, don’t stand up to adjust the blinds!

Do a sound and lighting check

The most common problem on video interviews is poor audio. Only a sound check will show you that your device is too close to electrical interference or your laptop microphone is damaged. If your best video quality is on a laptop but the sound is not great, try earbuds or a headset, or dial in to the number provided on your phone. If you are using phone for audio and laptop for video, mute the laptop.

The most flattering light is indirect and comes from several sources. Move lamps, open blinds, change angles of your device and chair to test the effect. Particularly at nighttime, avoid having the glow from the screen light your face. Interviewers are looking for your professional presence—and nobody looks healthy and rested hunched over a screen and lit with an eerie blue/gray glow.

Frame your shot

This issue got the most feedback from HCA Healthcare recruiters. They recommend putting your device close to eye level by propping it on top of a printer, a box, a bookshelf…anything that will get the device off desktop level to avoid having the interviewer looking up your nose.

Do not be afraid to have personal items in the background. A completely blank background is boring. A typical home or physician office setting behind you is great. Pictures, awards, books, a guitar on a stand, sports memorabilia and plants are all fine. Move things that may be distracting or misinterpreted out of camera range. Odd items like a huge preserved frog, a cremation urn or a toy collection will have the interviewer wondering. There is a lot of potential for unusual backgrounds to detract rather than add to the overall impression.

Be sure to hide clutter completely. It is not uncommon for a camera to be jostled slightly in the course of an interview. A messy pile of bills, trash and a day’s worth of beverages are not a good surprise peek into your lifestyle if that camera pivots an inch.

Eliminate distractions

Distractions are the number-one pet peeve of interviewers. Let family or roommates know you are in an interview. Help them avoid interrupting by taping a reminder to the door that lists the the start and end times you are not to be disturbed.

Be sure to turn off the TV in the interview room. Muting is not enough; it’s not flattering to see movement on a screen in the background or flickering light reflecting off the side of your face.

Make sure pets are in another room and distracted by another human or a new toy. Positioning yourself outdoors or near an open window is risky during a video interview because you have even less control of noise. The neighbor’s lawn mower, the garbage truck arriving on your street, even chirping birds can disrupt interviews. Earbuds or a headset will also reduce ambient noise.

Put your phone on “do not disturb” so that it does not ring or audibly vibrate. If you are paged, apologize and reschedule.

Be mindful of the camera

Smile when you introduce yourself! Human brains are wired to interpret a smiling face as friendly and relatable. Know where the camera is on your device. You can look at the interviewer’s face when they are talking, but look at the camera when you are responding to a question.

Check yourself periodically to make sure you are still in frame. We see candidates drifting off to the left or right as they get comfortable in their chair.

Don’t chew gum, and don’t eat. It’s fine to have water or coffee to sip. We would offer it to you in a face-to-face interview, so behave just as you would if sitting in our office.

Resist the urge to move around with your phone the way you might do with friends or family. Movement is very distracting and interviewers can’t help but wonder where you’re going and why. (And thanks to that now-infamous viral video of a conference call attendee using the toilet…we’re worried when you walk.)

Remember that this is an interview, not a screening call

Prepare for the call just as you would have done if you were flying in. Visit the organization’s website. Google your interviewer in advance, and have some questions prepared. Be ready for icebreaker chitchat, like how your training program is participating with your facility’s emergency response, or what you’ve been binge watching during COVID-19 lockdown.

Relax

It’s hard, we know…but we have to get to know you in a compressed amount of time. That’s difficult if you look defensive. We love our physicians, and we hope you will soon be one of them.

Therese Karsten is the division director for physician recruitment for the Continental Division of HCA Healthcare.

 

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5 ways to overcome job-search stress

Career changes can be overwhelming. Cope with these tips.

By Jennifer L. Brown, M.D. | Job Doctor | Spring 2020

 

Life changes in general can be stressful—especially when the change involves getting a new job. Whether you’re fresh out of residency or just seeking an improved work/life balance, physicians face many challenges once they make the decision to explore new employment opportunities.

I personally have dealt with the stress related to changing jobs in the medical field. Many negative emotions can surface: uncertainty about the future, fear of making a wrong decision, disappointment, anxiety, and guilt over leaving your current practice, just to name a few.

Luckily, there are ways to help mitigate stress associated with the job search.

1. Start with clarity

A significant amount of job-search stress can be related to uncertainty and indecisiveness. Take time before beginning the job search to consider what would constitute your ideal practice. What exactly do you not like about your current job? What did you love or hate about previous jobs? Are you interested in serving a specific community? Are you passionate about teaching or research? Do you want administrative responsibilities? Are you interested in a physician leadership role? Also consider alternative practice models, such as direct patient care or telemedicine. Once you have a clear picture of your future practice, it becomes much easier to focus your search.

2. Make a list

Once you have gained clarity regarding the overall vibe of the practice you are looking for, it’s time to hone in on the details.

It helps to make a list up front of what’s important to you in a new practice, in order from most to least significant. Consider location, compensation, call schedule, patient load, administrative duties, teaching responsibilities, staffing ratio, IT support, electronic health records, benefits package, work/life balance and practice culture. Also consider whether you prefer a multispecialty group, hospital-based practice, community health clinic, solo office or other arrangement.

Writing down and ranking what’s most important to you can help further focus your search. You’ll be able to spend your time considering only those jobs that match well with your list. The practices that score poorly on your list can be quickly nixed.

3. Allow plenty of time

Many physicians underestimate the amount of time it takes to get through the job-change process. It can easily take six months to a year to transition between jobs in the medical field. It’s a good idea to set aside dedicated time in your regular work schedule for tasks related to the job search.

Use the dedicated time to explore job opportunities, prepare or update your CV, participate in phone interviews and schedule site visits. It’s also important to allow time to research communities and specific employers online. Plan to visit promising communities more than once prior to making a final decision. Remember, once you make a decision, it can still take several months to obtain a state license and get through the credentialing process before you are actually ready to make the move.

4. Let your spouse help

Family and friends can be a huge asset when it comes to overcoming job-search stress. People close to you can help you weigh the pros and cons of various opportunities. Spouses in particular are an integral part of helping you manage job-search stress. Spouses can help with many non-medical related tasks, such as evaluating local school systems, researching communities, exploring housing options and arranging the details of site visits.

Have your spouse weigh in on your list of must-haves. It’s easy to get bogged down in the fine details, such as patient loads or staffing ratios, and neglect the importance of work/life balance. Your spouse can help remind you there’s life outside of medicine.

5. Work closely with recruiters

Physician recruiters are valuable resources. Most hospitals or large group practices have in-house recruiters who are knowledgeable about the practice’s culture and needs and can help you through the job-search process. If you are flexible about your eventual location or practice model, consider an independent recruiter to help you network and research opportunities. Make sure to be completely upfront with any recruiter with regards to what you are looking for.

The search for new employment can be overwhelming, but much of the related pressure can be overcome by following these tips. Remember, new opportunities can bring fulfillment and improved career satisfaction. Happy hunting!

Jennifer L. Brown, M.D., is a board-certified family medicine physician with almost 20 years of experience in traditional family medicine. She has also spent time on the administrative side as medical director of a multispecialty clinic. Most recently, she has switched gears into urgent care telemedicine. Her areas of interest include physician work/life balance, alternate physician practices and physician mental health/substance abuse.

 

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How to discover a practice’s true culture

These examples of different practice cultures show how varied—and important—the heart of a workplace can be.

By Therese Karsten | Job Doctor | Winter 2020

 

By this point in your training, you have worked in enough environments to spot signs of a toxic culture. Unfortunately, there isn’t a universal checklist for how to identify a healthy practice culture. But seeing how culture plays out in both clinical and personal decisions at a variety of organizations like in the examples following can help you identify cultures where you are most likely to thrive and grow.

Emotional vs. financial connections

How important to you is a strong emotional connection with your colleagues? Consider these two approaches, and see where you’re most comfortable.

Practice A is a thriving group where physicians talk to each other throughout the day, often stopping to ask a question or get a colleague’s thoughts. Everybody eats together several days a week. The whole practice gets together with their families a few times a year, and mandatory physician meetings are lively breakfast events with everyone participating in the debate over proposed changes. Everyone from front desk to the last remaining original partner describes the practice as a “work family.”

Practice B is just as successful. They also earn above market, have a very good reputation and great patient satisfaction scores, but the practice culture is very different. Physicians interact primarily with staff and advanced practice providers (APPs) they personally interviewed and selected for their own “pod.” They like and respect colleague physicians, but don’t interact much beyond “how was your weekend?” at the Keurig machine. They describe their group as a successful medical business, talking about ancillary revenue sources and good strategic decisions.

Shared cultural driver

When interviewing with smaller groups, look for common denominators that drive culture. It may be something obvious, like Group C, founded by physicians coming out of Air Force medicine.

The founding partners loved the camaraderie they experienced in squadron life and essentially replicated the elements they believed contributed to a great culture in the Air Force. It works wonderfully for them and has stood the test of time, but adjustment to this culture hasn’t been smooth for all. Spouses of candidates travel with the physician for the first interview and are often surprised to realize that the other spouses are not selling the group, but rather interviewing them for fit. Selected candidates and their spouses get fully indoctrinated from the day they say “yes.” The spouse group ensures that the new family has everything they need: babysitters on move-in day, the website for the best pediatric dentist, the behind-the-scenes scoop on each school. None of the physicians recruited over more than 10 years has left or failed to be offered partnership. The practice chose well, and the physician families “opted in” to a culture that fits them.

When religion comes into play

Interviewers are not supposed to ask you questions about your faith because asking is a slippery slope. But you, as the candidate, can initiate discussions. I personally think you should, because faith shapes so many aspects of leadership decisions, and that power is amplified when all of the partners are voting on practice issues based on shared values. Take this example into account.

Practice D is led by physicians who are evangelical Christians. They interviewed a candidate who had listed Christian Medical Dental Association membership on her CV. Clinically, the new practice was a great fit. Practice meetings opened with a prayer. Partners’ vacation travel consisted primarily of mission trips, and they expected her to use most of her PTO days the same way.

Then, a pregnant patient was referred by a Catholic OB/GYN practice. Her partners warned that she was not to mention pregnancy termination as an option with the patient. The new hire, however, believed that she had a responsibility to discuss all options so that the patient could make an informed decision. The partners operated differently. Not only did life begin at conception, they reminded, but also…the lucrative and exclusive referral relationship from the OB/GYN practice would be at risk if this patient reported termination was discussed as an option. The physician started her job search.

Group E consciously made religious diversity a new pillar of their practice culture. The group was founded by Jewish physicians from the Northeast. The community wasn’t quite large enough to arrange call sharing, so one of them was on call for every High Holy Day. The next new hire was Christian, and she happily introduced herself as “the only triple-boarded intensivist educated and trained at top 10 institutions ever hired entirely because I’m a Shiksa (non-Jewish female) who will work on Jewish High Holy Days.” The intro always got a laugh (because it obviously wasn’t true). Religious humor became their “thing.” No one was surprised when subsequent hires were from Hindu and Muslim backgrounds, respectively. The themes common to all of their faiths—caring for the most vulnerable, kindness, loyalty and respect for human life—bound them together as a group.

Politics play a role

Not surprising that politics has surfaced as a divisive issue in physician cultures, just as it does at family reunions and neighborhood block parties across the country. If you are interviewing with a small practice, this should come up if either you or the practice is strongly in one camp or the other. (Indifferent or dispassionately independent physicians need not focus too much.)

If you have a collection of MAGA or LGTBQ Pride stickers on your bumper, the first glimmer of your deeply held convictions should not come as a surprise to the practice on the first day you park your car in the physician parking lot.

Be relentless in your asking

Questions, questions and follow-up questions are your best tools to uncover practice culture. There is no universal template for “good” practice culture, but asking a lot of questions about what makes the practice tick will help you know if a practice you are considering has a culture in which you can thrive and grow.

Therese Karsten, MBA, FASPR, is division director of physician recruitment for HCA Healthcare’s Continental Division.

 

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What recruiters want you to know before talking money

Follow, don’t lead the conversation—and do your homework first.

By Therese Karsten | Fall 2019 | Job Doctor

 

Recruiters understand that you have very little, if any, education about compensation packages as you enter the job search. Even if this is not your first job out of training, chances are still high that you are looking at an entirely different set of circumstances from the last contract you signed.

Hospital employment contracts are very different from private practice employment, and the differences among markets can mean that the vocabulary you need for one city is useless for a market with a markedly different payer mix. Stark Law throws a unique set of handcuffs into contract construction if hospital financial support is involved. The growth of large national employers now drives alignment of local contract structure and verbiage with national physician services agreements. Bottom line…There really isn’t any point in reading up on every type of structure you might encounter. So what can you do to prepare?

1 Determine if you can live there

First, control one element that only you can control: Determining whether or not the community is a viable fit for you and your household.

Have an idea of the compensation range for your specialty in the area.

Ask your program coordinator for names of physicians from your program who have settled in this market in recent years. Reach out to them and ask for an appointment to ask what they see happening in the area. Ask recruiters the same questions. Even if it is too early to ask about salary and sign-on bonus for the job you clicked through, it’s never too early to ask questions about the market compensation.

  • What do you the think is the compensation range is going to look like in the market in 2020?
  • Have recent recruits ramped up quickly? Are they on track to earn bonuses as projected?
  • What factors explain the low- and high-end outliers?
  • Where does this metro area fall relative to Medical Group Management Association (MGMA) benchmarks?
  • Are base salaries increasing or decreasing?
  • Are sign-on bonuses typical? If so, how much?
  • Do you have an education loan payback program?

Research the cost of living in the area.

Enter “cost of living calculators” in any search engine and compare that market with one you know, like where you grew up or where you are training. Talk with your spouse about his/her absolute must-haves so that you are on the same page about minimum number of bedrooms, size of lot and commute time.

Do you have a special needs child? Will you need to budget for private school for a gifted/talented child if the group puts you in site A, but there is a great magnet public school convenient to site B? Perhaps the realtor’s pre-qualification process projects that you will need $20,000 for a down payment and you will need that money at closing, several weeks before your start date. The recruiter needs to know that before any draft contracts are developed. Be ready to discuss your progress in assessing how your needs fit with your household’s projected cost of getting settled in the community during the compensation discussion.

Know what your monthly education loan payment will be.

You do not need to share this with the recruiter, but your realtor needs to know. That number is not what you hope it will be after you get it restructured, or what you dream it might be after a generous loan repayment deal, or what your spouse thinks it will be based on original paperwork you completed years ago. Use realistic numbers.

These activities will give you a general idea of whether or not you can afford to live in a particular market. That is an important step in narrowing your focus to the one or two offers that make sense.

Physicians withdraw from discussions all the time, at whatever point they feel certain there will not be a meeting of the minds. Withdrawals are a perfectly normal part of the process. Employers do not stop interviewing and do not expect you to stop exploring until there is a mutual decision to move forward. The scenario everyone wants to avoid is the heartbreaking realization that you, the physician, have burned interview days and spent many hours of precious time negotiating a contract that you cannot sign because you and your spouse will never have peace of mind with the tradeoffs that will have to be made. By then, the employer has lost other candidates and may lose patients and miss budget targets if they were counting on the start date for which you were interviewing.

2 Talk compensation

Good questions are the key to a productive compensation talk . “What is the pay?” is not going to get you disqualified, but it does not cast you in a flattering light. The conversation will naturally lead to discussion of the potential range of first-year compensation and a better understanding of how compensation is structured. Follow, rather than lead, the discussion.

Ask how the compensation structure reflects the employer’s values.

The explanation will help you understand what the group prioritizes. Hundreds of management and physician leadership hours have been expended on developing and tweaking the compensation structure. Let them explain how it works. Ask how long the structure has been in place and ask them if they and the physicians feel it is working for the practice. Are any major changes coming soon?

Ask where they expect you to be in year one in terms of production.

Year two? Year three? In order to hit those targets, how many patients a day will you be seeing? Ask physicians when they typically arrive and leave. Is a day off really a day off, or do physicians use half of it to catch up on calls and charting? How many PTO days will you have, and how do they calculate holidays? What happens if you underperform?

If you intend to work part time or need more PTO than normal due to mission trips, introduce this parameter early in the talk.

Employers feel manipulated when they learn about limitations after compensation for a full-time, full-bore position is on the table.

The answers to these will help you know if this job is going to be the right fit in terms of practice style and pace. If getting to the expected threshold to support the salary level is going to entail a lot more hours per week or a pace much faster than is comfortable for you, this job is simply going to be too stressful to be sustainable. If the practice is slower paced or more of a “lifestyle-focused” group of physicians, it won’t be long before you’re chafing at carrying more than your fair share of the load.

Your recruiter’s job is to consult, educate and explore the fit with you. Asking questions is your most important job as a candidate. The more you ask, the better we understand your situation and can help you get into the right fit for you and your family. 

Therese Karsten is director of physician recruitment for HCA Physician Services Group-Continental Divison.

 

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Your secret job-search weapon

In-house recruiters help physicians through the interview process—and into the best job for them.

By Charlene Plotycia | Job Doctor | Summer 2019

 

As a physician, you have spent a lot of your lifetime preparing for the moment when you will start your first “real” job. However, it is highly unlikely that you have had much time or experience actually searching for a job.

But now you are ready to make a commitment to build a practice caring for patients in an organization with values that match your personal values, in a community where you can live, play, raise a family and build a network of friends over a lifetime.

This is more than a temporary assignment with shallow commitments. You are about to embark on a major investment that will involve a lot of other lives. You need some help. You need someone who is an expert at finding jobs for physicians.

You need an in-house physician recruiter.

In-house physician recruiters help physicians find jobs. They work directly for the organizations for which they recruit, and they usually live in the communities to which they are recruiting. That helps them know the integrity, values and culture of their workplace and the personality and amenities of their communities. They’ll likely be one of your first contacts at the organizations you’re considering, and they can help you throughout your career.

What in-house recruiters do

In-house physician recruiters can help you:

  • Discover what you value in a work environment
  • Discover what is important to you in a community
  • Identify the type of practice opportunity you have envisioned for your present
  • Identify what practice goals you have for your future

Now, you may be thinking that you don’t know the answer to those four points—or maybe you do, but you won’t have time to dig deep into them before you have to make a decision. That’s where a great in-house recruiter is going to be your very best resource.

They can help you learn about the area

Your in-house recruiter wants to find an opportunity for you that fits you and their organization and community for the long haul. They want to provide you with information about what it’s like to work in their organization and in their community. They are about to invite you into their family—so, for your sake and theirs, they want to be honest and transparent with you to prove a match.

They dig into your family’s needs

Because in-house recruiters know that a balanced life is critical to a healthy life, they want to find out how you define your balance. What things must be proximal to your home? How long of a commute do you need in order to put work behind you? Do you want to live in a loft, in a gated community or on acres of land?

They help you imagine your next step

What do you envision for your practice? You may have experienced a variety of settings in medical school, residency and fellowship: academic and community, for-profit and not-for-profit, large group practices and maybe even solo practices. What have you experienced in each of those models that you hope to experience in your next practice? Is it present or is it possible with the opportunity you’re considering? Your in-house recruiter can tell you that.

They help you think about your future

What are your goals for the future? If you have something in mind, make it known. You may learn something important about the organization’s culture by the way this information is received.

If you come to an agreement that there may be a match, there is another important service your in-house recruiter will help provide: an excellent site visit that will take all your needs into consideration and help you see the community, facility, leaders and potential colleagues firsthand.

Never underestimate the ability and the willingness of your in-house recruiter to advocate for you, their organization and their community. They are determined to find the right match that will become a long-term relationship for all.

Charlene Plotycia is a physician recruiter at Mercy.

 

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How to choose a contract review attorney

Consider these key factors as you evaluate your attorney options.

By Jeff Hinds, MHA | Job Doctor | Spring 2019

 

You’ve received years of training to become an expert in your field, but little to no training on how to go about finding a job and ensuring that contract terms are fair and equitable.

Though you may be able to successfully navigate the process of finding your first practice on your own, you may not have adequate knowledge of physician contracts to successfully ensure your interests are fully protected. That’s why it’s highly advisable to retain a health care contract attorney when it comes time to review a contract. It is well worth spending a few hundred dollars before signing a contract worth millions of dollars. The employer had the contract drawn up and reviewed by their attorney to protect their interests….there is no reason you shouldn’t do the same.

But with no shortage of attorney options, how do you choose the best option? Here are some key factors to consider as you make your selection.

Look at their specialty

The first thing you should know is that attorneys specialize just like physicians. Just like you don’t want to go to a pediatrician to get a colonoscopy, you don’t want to select an attorney that specializes in family law to review your health care contract.

Without having reviewed a large number of physician contracts previously, nor being up-to-date on the multitude of changes taking place within the health care industry, there is much that can be overlooked.

All too often, we see physicians use their friend/cousin/neighbor who doesn’t specialize in health care contracts just to save a few dollars on the review. Remember: This contract is worth millions of dollars over the course of your career and should be treated as such.

Experience outweighs location

We’re frequently asked if the attorney needs to be located in the area where the physician will practice. The simple answer is no.

The reality is that most physician contracts are standard nationwide with regards to content and structure. The clauses that may vary by state (such as restrictive covenants) can all be researched via case law that’s accessible by any attorney, no matter the location. This recommendation would be different if you were challenging or being challenged by the employer for a contract you had already signed. But for the purpose of simply evaluating a contract before signature, physical location has little bearing. Let experience instead be the deciding factor.

Know what’s included

It is very important to know what actual services will be provided as part of your contract review—specifically how the findings are shared, your access to the attorney, and if you will receive negotiation assistance.

Will the attorney simply review your contract and send over their feedback via notes? Are you responsible for negotiating on you own? Will you have access to the attorney via phone following the review to discuss the findings? Does the attorney also have access to market compensation data to evaluate the offer from a financial perspective?

Avoid hidden fees

Most attorney fee structure options will fall into one of two categories: flat rate or hourly. This is especially important to note considering not only the potential back-and-forth between you and the attorney with regards to contract questions, but also the potential back-and-forth between you and the employer if negotiations ensue.

That’s not to say you should automatically dismiss hourly arrangement options; just be aware that the hours can quickly add up and the rate should be evaluated accordingly. You don’t want to select an attorney and then be dissuaded from using their services to the fullest out of fear of the running clock.

Jeff Hinds, MHA is president of Premier Physician Agency, LLC, a national consulting firm specializing in physician job search and contracts.

 

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Looking for that work/life balance?

Aren’t we all. Here’s how to find it.

By Charlene Plotycia & Terri Houchen | Job Doctor | Winter 2019

 

Work life balance

Yes, a healthy work/life balance is a critical component of your job-search strategy. But it’s also a complex issue with many personal nuances.

So before you get enticed by an opportunity that professes “work/life balance,” first consider what exactly that means to you and your family.

Figure out what you value most in your work and in your home, and how the interplay of those factors should be structured to result in your best overall health. Also consider what your life might look like a couple of years from now, and how your needs might change.

Once you have a grasp on what your best work and life activities look like, find the organization, the community and the practice that will support it.

Start by researching organizations and communities online. Check out websites of the company and the community’s visitors bureau and chamber of commerce.

After you have identified the organizations that may be a fit, create a list of questions that will further disclose an infrastructure that will support it.

These questions can include:

  • What benefits are offered that contribute to work/life balance?
  • What is your work culture like?
  • What are some ways that you set up employees for success?
  • How is the mission of the organization supported through your department?
  • How do you incorporate employee feedback into the day-to-day operations?
  • How is the department’s staffing level? What are the open positions?
  • Is it difficult to recruit to the organization? If so, what contributes to that?
  • Is there any flexibility in hours/shifts?

During the interview process, ask to meet with someone in a similar role or life stage. Learn how the organization or position fits their needs. Ask that person if there have been any big organizational changes, and how they were addressed.

Only you will know the right work/life formula for you and your family.

Charlene Plotycia and Terri Houchen are physician recruiters. Learn more about our contributors on page 20.

 

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Stop before you make one of these errors

A plethora of job-search tools and resources still hasn’t solved these common problems.

By Therese Karsten | Fall 2018 | Job Doctor

 

Worried job candidate waiting hiring decision

We were wrong.

Old guard recruiters and employers predicted that smartphone access to CV and cover letter samples, templates, how-to guides and FAQs would eliminate most of the common CV and cover letter problems. It didn’t occur to us that the older generation’s errors might be replaced by new challenges in the era of digital job search.

Learn what they are so you can avoid them.

Using a file sharing platform and embedding macros

Dropbox, ShareFile, Google Drive, Egnyte and other file-sharing platforms are wonderful for sharing documents and photos with friends and family. They are not optimal for sharing your CV and cover letter.

Recruiters and practices work behind formidable firewalls and may not be able to open the file. I recently asked our information protection and security guru why we are blocked from so many third-party sites. He explained that file-sharing platforms are hit-and-miss on safety standards for protected health information (PHI). These vendors do not intentionally put our information at risk, but sometimes speed and ease-of-use shortcuts provide opportunities for malware.

The fastest way to get your CV and cover letter in front of a decision maker is to stick to PDF or Microsoft Word attachments. To avoid landing in a spam filter, avoid macros and embedded objects. Our firewall is looking for anything similar to malware and will either divert your document to spam or disable the suspicious element.

Not proofreading after the red squiggly lines are gone

We see far fewer misspellings today because spelling and grammar checks catch most. The dangerous downside of these tools is the false sense of security they afford.

Candidates who skip having a spouse, friend or mentor proofread a CV and cover letter run a far greater risk of:

Date errors. Only another human will catch the typo on a year or omission of key dates, such as your anticipated completion of training.

Word choice errors. We see incorrect usage of ensure/insure, accept/except, adopt/adapt frequently because spell check doesn’t see these as wrong.

Subject/verb agreement errors. These are often editing errors. You changed the subject and did not change the verb that modifies it.

Pronoun and preposition errors. We see more dropped or incorrect use of preposition pronouns: “By the end fellowship, I will have performed 50 TAVR procedures.”

Fiancé/fiancée mistakes. A female betrothed is a fiancée; a male is a fiancé.

Not caring about format

A good CV template is designed by someone who’s an expert in the visual presentation of written information. If you just wing it with a bold here or a font change there, your CV looks amateurish and difficult to read next to your competitor’s.

Choose a template that has address, email and phone prominently positioned at the top. Include M.D. or D.O. behind your name to instantly distinguish yourself from other health care professionals.

Once you’re done, save the document with a title that includes your last name and the type of document (CV or cover letter), the month and year.

Trusting Siri, Cortana and Alexa

In the last couple of years, I’ve noticed an uptick in the number of candidates who dictate their cover letters as they respond to online ads from their phones.

This can be an efficient tool when used judiciously: “Here is my CV. My husband just accepted an engineering job in Colorado, and we plan to move to the area in August. I will send you my cover letter tonight.”

Sometimes, though, the dictating physician fails to notice silly autocorrects before hitting send. We get things like: “Please accept my CV for the minimally offensive surgery position,” or “I am interested in hospitalist opportunities with no more than 15 sh*ts per month.”

Copying and pasting poorly

Copy/paste is both the best friend and worst enemy of an online physician job seeker. As long as you customize your response with a few opening words specific to the employer or location, copy/paste allows you to get a lot of responses out very quickly.

The body of your cover letter also can be copied and pasted from one response to the next. It will tell employers when you are available and what you are seeking. All prospective employers want that kind of differentiating detail.

Copy/paste is your worst enemy in two circumstances:

It makes you too generic. If you don’t customize the cover letter to the location, we don’t know why you want to live and work in our community. A generic cover letter comes off as canned and leads the reader to assume you are taking a buckshot approach to your job search. If a glance in my shared database shows that you sent exactly the same cover letter to six of my colleagues in the last six months, then I’m not highly motivated to put you at the top of my to-do list for today. You simply don’t look like an intentional, serious candidate for my city and practice.

It’s wrong. You don’t want to copy/paste another employer’s cover message, complete with the wrong location and/or practice name. If your CV gets forwarded at all, it will probably go to the administrator or lead physician along with your botched cover letter to make sure your lack of detail is not overlooked.

Times have changed. But some old-fashioned proofreading and awareness of these issues can help you make a strong first impression to prospective employers!

Therese Karsten MBA, CMSR, FASPR is the director of physician recruitment for HCA Physician Services Group.

 

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How your partner can help

Your significant other’s research can help you make a smooth transition to a new opportunity.

By Jeff Hinds, MHA | Job Doctor | Summer 2018

 

Stack of hands. Unity and teamwork concept.

I’m both an adviser who has helped hundreds of physicians with their job searches and the spouse of a physician who has gone through the same process.

As such, I’ve seen firsthand how physicians struggle to manage all aspects of their search while simultaneously juggling the heavy demands of their current position or training program responsibilities.

Because of this, one of my biggest pieces of advice for physician job-seekers is to lean on all the resources available to help you maximize your efficiency and minimize your stress. One of those resources? Your spouse or significant other—someone who is equally invested in making sure this is a smooth and successful transition.

There are some key areas where your spouse can help ensure you are fully prepared for your job search.

Before you begin a search

At the onset of your search, you should be gathering and updating all of your application materials, such as your CV, cover letter, reference list, etc.

Don’t underestimate the importance of these materials. They not only help you get a foot in the door, but when all else is equal among candidates, it’s often the seemingly minor details that can make a difference in the end.

Pay attention to those details. Have your spouse proofread all your documents to ensure there are no formatting or grammatical errors. This is also the time to take a step back and, with your spouse, define your job-search parameters. Which geographic locations or regions are the best fits for your family? Your spouse can also help you reflect as you determine which practice types or settings are most conducive to both your personality and your career aspirations.

During your search

As you begin applying to opportunities and receiving invitations to interview, it’s time to conduct further research into each location to determine the potential fit for your family. Your spouse can help you with this research.

Similar to evaluating a practice to determine if it matches your clinical skillset, you’ll need to closely evaluate a community’s amenities, recreational opportunities, schools and other organizations to determine if it can support your family’s interests and aspirations.

Two great resources for learning more about a community include the local convention and visitors bureau and local realtors. Realtors “sell” the community for a living and will be able to highlight its major perks and opportunities.

After your search

Once you have selected a position and accepted an offer, there is much more research your spouse can do to ensure a smooth relocation process.

If you have children, you have likely already given some preliminary considerations to the educational opportunities that exist in the area. Now it’s time to explore further and begin making the decision on where to enroll. Does the area offer a great public school system? What private or parochial options should you consider?

It’s also time to start looking further into interviewing realtors and exploring housing options, selecting banks, exploring churches, and getting plugged into recreational options for your kids. All of this research takes time—and present great opportunities for your spouse to help.

Jeff Hinds, MHA, is president of Premier Physician Agency, LLC, a national consulting firm specializing in personalized physician job search and contract assistance.

 

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