The who, what and when of contract negotiations

Your first employment contract may look like it’s written in a foreign language. Here’s a guide to help you know what to look for and what to negotiate.

By Jeff Hinds, MHA | Fall 2016 | Job Doctor


Most physicians, particularly those finishing training and looking toward their first practices, have had years of medical training but almost no training about how to find a job—and, once they’ve been offered one, how to determine if contract terms are fair. Here’s some advice on what to look for in a contract and what to know as you head into negotiations.

The Parties Involved

The first step to navigate the negotiation process successfully is to understand who will be involved in the process. From the employer’s perspective, the exact title or role of the individual who handles negotiations will vary by organization—it may be an in-house recruiter, practice administrator, CFO, CEO, attorney or someone else entirely. Regardless of the title or role, it goes without saying that the employer will likely be better versed than you when it comes to the contractual terms within their agreement. It is also worth noting that the agreement was written by an attorney to help protect the interests of the employer. There is too much at risk professionally and personally for you not to ensure the same. Because of this, it is highly advisable that physicians also seek outside assistance from an attorney to help with contract review and negotiation. The investment is minimal when compared to the potential ramifications.

The Proper Timing

It is equally important to know when the actual negotiation process begins. Though certain contractual terms may be introduced early in the process, such as during phone interviews or site visits, formal negotiation of terms should occur later in the process after a contract offer has been made. There may be instances in which employers ask for your feedback on particular terms (e.g., compensation), but it is in your best interest simply to collect the information shared by the employer at that point and hold off on all negotiations until an offer is in hand. Otherwise, you run the risk of being too aggressive and losing a potential offer before it has even been made. Waiting until later in the process will also allow you ample time to collect or research market data, gain feedback from peers or advisers on questionable terms, and assess your overall leverage before determining what to negotiate and how aggressive you can actually be in negotiations.

The Negotiable Terms

Knowledge of which contractual items are actually negotiable is paramount heading into the negotiation process. Though most physician contracts nationwide are similar from a structural standpoint, there are some key provisions/terms that vary by organization and affect the overall quality of the offer. Below are examples of some key items that may be negotiable in any given contract. But again, it is highly advisable to obtain a qualified health care contract attorney to fully assess all terms and determine the most appropriate revisions to seek based on your unique situation.

Base Salary. How does the salary offered compare to published salary surveys and benchmarking data both nationally and regionally for the given specialty? What competing offers exist within the immediate area to determine market value and provide leverage?

Pre-Employment Compensation. What are standard signing bonus and relocation reimbursement amounts for the specialty and region? What is standard when it comes to student loan reimbursement and educational stipends?

Productivity Compensation. What are the metrics used to calculate productivity compensation, and are they reasonably attainable based on the market data available? Will a base salary remain in place for the duration of the contract term, or will compensation transition to productivity-only?

Termination Language. What termination with cause and termination without cause provisions exist, and are they adequately defined? Is there a notice and cure period in place that provides the physician with added protection from termination with cause?

Restrictive Covenant. Does the contract possess noncompete language, and are the time and distance restrictions reasonable? Do the restrictions apply to areas surrounding a single location or to areas surrounding multiple locations that are part of the employer’s network?

Professional Liability Insurance. What type of professional liability insurance will be provided—a claims-made or an occurrence policy? And if applicable, will the employer or the physician be responsible for the full (or partial) expense of acquiring tail coverage?

Scrutinizing your contract, even with a lawyer’s assistance, may seem laborious at first, but it’s time well spent. By negotiating contract terms before you sign, you will reap the benefits of a more advantageous agreement for years to come.

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



Creating your desired first impression

Looking to move forward as a candidate? Improve your chances with these tips.

By Jeff Hinds, MHA | Job Doctor | Winter 2017


In the absence of any pre-established relationship, the content of your CV and other application materials are all an employer knows about you before deciding whether to consider you as a candidate for their job opening. The reality is that you may be filtered out as a viable candidate for your dream job before you even have the opportunity to sell yourself via a phone interview or on-site visit.

There will likely be competition for any position you decide to pursue, so how you market yourself as a candidate should not be taken lightly. Though the content of your CV and other application materials may appear very basic on the surface, it is the minor details that can set you apart and differentiate you from the competition when all else is equal.

Create a strong CV

The first document that will be required by all employers is your curriculum vitae (CV). Employers use the CV as a screening mechanism to filter out candidates who don’t seem like the right fit before proceeding to phone interviews.

To determine fit and qualification, they look for obvious items like medical training and education, work history, certifications, licensure, professional associations, honors and awards, research and publications. Your goal is to include all the pertinent information that will set you apart as a candidate.

Conversely, do not add what could be construed as irrelevant content just to make your CV longer. The length of your CV is not indicative of your quality as a candidate. Simply adding content to increase length will dilute the meaningful substance of your CV and make it more difficult for potential employers to navigate.

Employers need to be able to navigate through your CV quickly to find the information they are looking for. Beyond the content itself, you can also help accomplish this through proper formatting, consistent spacing and listing activities in reverse chronological order. Employers are most interested in what you are doing now and shouldn’t have to dig too far to find that information.

Again, a strong CV will not win you the job necessarily, but one that is disorganized and difficult to navigate can certainly eliminate you from consideration earlier in the process.

Sell yourself in your cover letter

It is to your advantage to submit a cover letter along with your CV. Your CV may show how you’re qualified, but your cover letter will show why you’re a great fit.

If there is a job posting or advertisement for the opening, take the specific qualifications, skills or attributes being sought and elaborate further in the letter on how you are a match. In addition, indicate any pre-existing relationships you have in the organization or area to show that your commitment to the opportunity will be long-lasting.

Line up references and letters of recommendation

Request letters of recommendation or contact information for your references before or at the onset of your search. Be sure to notify your references if you believe a potential employer will be reaching out to them.

By devoting the necessary time and attention to ensure your application materials reflect your strength as a candidate, your chances of moving forward in the process are only increased. You have worked hard to get this far in your career and do not want to miss out on your dream job for reasons within your control.

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



How to make the most of your CV gaps

A gap in your work history doesn’t have to work against you. These expert tips will help you make the most of your career timeline.

By Anish Majumdar | Job Doctor | Summer 2016


I recently worked with an emergency medicine physician who was wrapping up her residency and hunting for a new opportunity. Her program was among the top 10 percent in the country. Her teaching experience and volunteering background were first-rate. There was just one problem: Her four-year residency had taken five years to complete.

During a phone consultation to discuss her career, I brought it up, half-thinking it might have been just a typo on her CV. No typo.

After a lengthy pause, she explained that a close family member had unexpectedly died during her first year of residency. In the aftermath, it was impossible simply to continue on with training, so she’d opted for a one-year leave of absence. Love of medicine had brought her back.

Do you think an employer is more likely to hire someone who owns this part of her journey or tries to ignore the issue? The truth is, ignoring it never works.

Recruiters and hiring agents aren’t robots—they’re people like you and me. They get that life happens. They’re also trained to spot inconsistencies on someone’s CV and will, if they’re not addressed, assume the worst. “Five years to complete a four-year residency? Probably due to poor performance. Pass.”

This is why it’s critical to control the message you’re putting out there, especially when it comes to vulnerabilities. Abide by the following tips.

Create a “Career Note” within your CV

Inserting a brief one to two line “Career Note” directly within the “Work History” section of your CV is one of the most effective ways to address a gap. By placing it in a reader’s line of sight, you enable him to pick up on the relevant details without getting distracted from the rest of the document.

Work Gap Example #1: Taking time off to deal with a personal loss.

Career Note: Undertook a one-year leave of absence to cope with a loss in the family. Strengthened personal relationships, managed household affairs, and volunteered for monthly community health clinics (April 2014 – April 2015).

Note the last part about health clinics. If you took on anything remotely career-related during your work gap, be sure to mention it. This sends a clear message to hiring agents that you remained “in the mix” and continually developing during this period.

Work Gap Example #2: Taking time off to pursue training in another field.

Career Note: Pursued Master of Health Care Administration Degree at University of XYZ between 2014 and 2016, with a goal of incorporating knowledge into a hospital leadership position.

Answering why you pursued this training is a great way to get a reader to understand your thinking. I would also recommend placing the “Education” section near the start of the CV to showcase this training. If it’s currently in progress, it’s fine to list it as follows:

Master of Health Care Administration – University of XYZ (Expected Graduation December 2016)

Share your story within the cover letter

Great cover letters offer a glimpse of the person behind the qualifications: what inspires, challenges and differentiates them. In other words, it’s a prime opportunity to spin your work gap into a positive differentiator instead of a negative. The trick is to frame it in a way that adds value to your candidacy.

Use the CARB formula when broaching a gap within the cover letter: challenge, action, results and benefits. Here’s what I wrote for my five-year residency client (altered to maintain confidentiality):

“During my second year of residency, I faced a moment that shook me to my core and made me question my commitment to medicine. My mother, on a visit from New Zealand, suddenly passed away. I found myself without an anchor, adrift, and took a one-year leave of absence to recover and keep our family whole. What I discovered was a greater sense of purpose, an unshakeable belief that circumstances would not alter the course of my journey as a doctor. Upon finishing my residency, I will have completed more than 1,000 clinical hours, executed a significant body of research and gained specialized training in medical education and simulation. I am a stronger, more focused physician because of what I’ve gone through, not in spite of it.”

Proactively address it during the interview

Congrats, you’ve made it past the screening process and have received an invitation to the big game. Don’t blow it by being unprepared to address obvious holes in your career!

Try to weave the explanation in naturally during conversation, before you’re asked about it. Here’s how you can broach being laid off at your previous appointment:

“While leaving my last job was challenging on many fronts, both professionally and in terms of the impact to my family, I wouldn’t change a thing. My last position taught me that in order to be an effective physician, you need to be part of an organization that shares your values and is committed to empowering staff to create a truly world-class institution. Sometimes a hard experience can clarify your beliefs, and that’s what happened here.”

Above all, remember this: The seriousness of an employment gap—and how much of a career liability it will be—rests largely on how you feel about it. Come to terms with it personally, and these tips will help take care of the rest.

Anish Majumdar is a career strategist, certified résumé writer and founder of



Why cover letters matter for physician job-seekers

Share your personality—and why you’re a good fit for the position—in your cover letter.

By Anish Majumdar | Job Doctor | Spring 2016


Hate small talk? Is chatting about yourself as appealing as getting a root canal? You’re not alone. Many of the physicians I work with have real trouble expressing themselves if the conversation doesn’t relate to their specialty. Unsurprisingly, they are also often the ones who will question the necessity of a cover letter during the search process: “No one reads them!” “It’s just fluff!” “Why can’t I just send the CV and call it a day?”

Here’s why: When asked what the most important factor was in distinguishing a high-quality physician, 59 percent of Americans said “physician-patient relationships” and “personality.” Only 11 percent said “ability to accurately diagnose and fix a problem.” (The study was done by The Associated Press-NORC Center for Public Affairs Research.)

Your ability to engage on a human level matters to both patients and recruiters. And it’s an element that health care institutions are placing an increasingly heavy emphasis on during the hiring process. This is where a cover letter can help: by offering a glimpse of the person behind the credentials, and encouraging a connection.

The exploratory letter

Having gone through the med school and residency application process, you’re probably familiar with the rigid structure of CVs. Throw all of that out the window for your cover letter! Consider it a blank canvas on which to create a fantastic first impression. This goes double for those situations when you’re not applying for a specific position, but rather initiating a dialogue.

Here are some questions to ask yourself as you begin to write:

  • What appeals to me about this institution?
  • Why, specifically, do I want to work there, and what will help me to succeed?
  • With whom am I connected at this institution? An easy way to answer this question is to go to LinkedIn, search for the institution name in the search bar, and check out the “How You’re Connected” section on the top-right corner of the page.
  • Why am I a good fit with the culture of this institution?
  • Why do I practice medicine? How does my personal history relate to the work that I do?

Now that you’ve got some great information for the letter, let’s take a look at a general structure you can customize:

Dear Dr. Doe [use a first name if “Dr.” is not applicable]:

I am currently completing my [insert level of training and experience] and believe that [institution name]’s forward thinking in [areas you’ve identified through research] would make for an excellent fit. I received my [degree] from [institution name] and am highly experienced in [insert a few key procedural details or specific areas of interest].

Key qualifications:

Working with [insert patient population] to improve their lives and foster meaningful change is at the heart of what I do. During my [previous position or appointment] I faced a unique set of challenges in [what successes are you most proud of?]. I’d like to bring this experience to your institution, and know that I can be an asset to furthering the goals of the [specialty] department.

In researching [institution name], I realized that we share a connection with [person you’re connected to]. I had a chance to [mention any history you have with this person] and am confident that he can provide more insight into who I am.

Growing up in [mention hometown] I had an experience that opened my eyes to the immense potential we have as healers to effect positive change. [Mention aspects of your personal story that made you want to become a physician here, and why it continues to inspire you today.] I wish to continue to learn alongside leaders in the field, and serve as a mentor to the next generation of physicians.

Beyond the excellent reputation enjoyed by [institution name], I [mention lifestyle reason that appeals to you based on research]. A copy of my current CV is enclosed. I look forward to hearing from you to further discuss. Thank you in advance for your consideration.

Sincerely, [Your name]

The position-specific letter

Cover letters for a specific position need to explicitly communicate fit. With that in mind, it’s important to evaluate the job posting to identify the top one to two qualifications that are essential for success.

For example, a high-level academic position could hinge on demonstrating excellence in medical education and organizational development.

Here’s a general structure you can use:


Dear Dr. Doe [use a first name if “Dr.” is not applicable]:

How can we [directly address the long-term priorities of the institution based on research] and succeed within a rapidly changing health care environment? Answering these questions have been at the heart of my career to date, and is the primary reason behind my desire to join your institution. I am [mention your most impressive credentials].

A leader in [Insert number-one qualification necessary for success]

My areas of interest in [mention key aspects of your experience] have been shaped through a range of academic and clinical appointments. At [mention specific position], my duties included [describe aspects of the job that tie into number-one qualification]. Prior to this, I [mention other work and training that helps to establish credibility for number-one qualification].

Broad experience in [Insert number-two qualification necessary for success]

[Use the same approach as previous paragraph. If you lack experience in this area, use this space to talk about your strong interest, and how exactly you’re planning to bolster your capabilities.]

My roots in medicine began [mention personal history], and my progressive experience over the past few years have done much to illuminate the way forward. In the following years, I see myself as [describe your biggest dream for the future, and how this position is integral to it].

My CV is attached. Thanks for your consideration, and I look forward to continuing this discussion in person.

Sincerely, [Your name]

Anish Majumdar is a career strategist, certified résumé writer and founder of He specializes in helping physicians land dream positions in less time.



CV vs. Resume: Do you know the difference?

It’s up to you to connect the dots for employers and show how you’re a fit for the opportunity.

By Anish Majumdar, CPRW | Job Doctor | Winter 2016


The question I’m most frequently asked by physicians who are about to embark on a job search is, “Do I need a CV or a resume?” It’s usually followed up a moment later by, “What’s the difference, anyway?”

The confusion is understandable. After all, if you’re hunting for a position in Europe or other parts of the world, resumes and CVs alike are all referred to as CVs. Even here in the United States, where significant differences have emerged between the two documents, it is by no means uncommon to hear the two terms used interchangeably. Let’s talk about the major differences between CVs and resumes, and how to develop either in a manner that gets noticed by employers.

Layout: Comprehensive vs. Strategic

Lay a curriculum vitae and a resume side-by-side and the first big difference becomes apparent: length.

While most resumes stop around the two-page mark, a CV can easily stretch to three, four, even five pages. Ever wonder why? Inspecting the layout of each document reveals some important clues. Here are the general headings for each:


  • Opening section
  • Education
  • Licensure & certifications
  • Postdoctoral training
  • Professional experience
  • Teaching experience
  • Research experience
  • Publications & presentations
  • Community involvement
  • Professional affiliations


  • Opening section
  • Professional experience (with teaching and research experience usually integrated)
  • Education
  • Community involvement
  • Professional affiliations
  • Special interests (optional)

CVs are sticklers for detail and leave very little wiggle room for interpretation. It’s what you’ll need to pursue clinical and academic positions, and because of the life-and-death stakes, it’s how you’ll communicate that you have the specific knowledge base and experience required for success. Use the following question to guide your CV writing efforts: Have I made it crystal clear that I can handle every one of the major responsibilities required by this position?

A resume is what you’ll need for non-clinical positions, everything from hospital administration to technology/informatics (serving as chief medical information officer, for example), pharma/biotech R&D and management consulting.

Due to the significant career pivot necessary for jobs like this, emphasizing the right details is far more important than being comprehensive. Ask yourself the following question when crafting a resume: Have I elaborated upon those aspects of my experience and training that support a move to the targeted position?

Branding: Expert vs. Visionary

In a hiring environment that is growing ever more complex and data-driven, it is essential to do the heavy lifting when it comes to branding yourself. Never rely on someone else to connect the dots between what’s on the page and why you’re a great candidate. Take control of the message to get a significant leg up on the competition.

I usually begin CVs with an opening paragraph designed to establish credibility and professional stature. This is where you’ll want to include details such as being board certified and fellowship trained, the Level I Trauma Center you’re working at, and the strong EMR experience you’ve gained. Everything needs to be tied down to specifics. Show an unbroken timeline of your work history. Avoid fluff.

For the resume, think in terms of an “elevator pitch.” If you only had the time it takes for an elevator to go between floors to convince an employer to hire you, what would you say? Wouldn’t it behoove you to communicate your passion, and perhaps back it up with one or two career accomplishments that demonstrate transferable skills? Remember: It’s only considered bragging if done badly!

Keywords: Hard vs. Soft Skills

The use of Applicant Tracking Systems (ATS), software designed to serve as the first pair of “eyes” when it comes to evaluating candidates for a job, is a hiring practice that is ubiquitous outside the health care industry. Up until recently, physicians could rest easy knowing that their CVs would be evaluated by an actual person, not rejected by an ATS system for insufficient keywords. Times have changed, and it may surprise you to know that physician Applicant Tracking Systems are being increasingly used to identify high-quality professionals. Here are the strategies I use to address ATS systems and get documents seen by those who matter.

CV keywords are all about hard (read: quantifiable) skills. Think about including a boldfaced section near the start of the document that calls out procedures and emerging/established areas of expertise. Here’s a keyword section I developed for a nephrologist who had recently completed his training and was on the hunt for a clinical-heavy role:

Procedures: Peritoneal Dialysis (PD), Central Line and Arterial Line Placement, Lumbar Punctures, Paracentesis, Conventional Hemodialysis, CVVH/CVVHD/SLED, Home Hemodialysis, Thoracentesis, Arthrocentesis, ICU Care and Ventilator Care

Resume keywords can focus more on soft (read: big picture) capabilities. The goal is to move beyond current skills and into the realm of potential. Here’s a keyword section I developed for a board-certified pediatrician in search of a program development/consulting role:

Core Competencies: Health Care Management, Program Development, Community Outreach, Health Care Information Technology, Quality Improvement, Patient-Centered Medical Home, Public Health, Critical Care, Health Care Reform

Expert tip: Searching on LinkedIn for professionals who currently have the job you’re after is a fantastic way to get keyword ideas. Insert the exact job title into the search bar, click on the first few member profiles that come up, and scroll down to the “Skills” section for a rundown of keyword ideas. Of course, be sure they’re based in your reality. Be prepared to defend the keywords included within your resume or CV in an interview.

Anish Majumdar is a Certified Professional Resume Writer (CPRW) and founder of He works one-on-one with physicians and health care leaders in developing optimized CVs and resumes, LinkedIn presences, and other tools for rapid job placement. He can be reached at



Specialize your CV for better results

Connect the dots to show recruiters how you’d be an asset to their organization.

By Anish Majumdar, CPRW | Fall 2015 | Job Doctor


Though it’s great to see yourself as a Renaissance man or woman in terms of career options, someone who can succeed in a wide range of roles and settings, for the purposes of a job search this approach can be counterproductive.

At the stage of the hiring process where CVs are involved, it’s all about match-up: How precisely does your experience align with the position that needs to be filled?

By thinking like a specialist and communicating the right details in your CV, you will see an uptick in the amount and quality of responses received from employers. Answer the “Why me?” question

I recently worked with a board-certified cardiologist who was concerned about the lack of attention his CV was getting. I took a look and quickly ruled out qualifications as the culprit. Prestigious fellowships in interventional cardiology and advanced heart failure and transplantation, solid teaching experience, numerous awards, a huge publication list…it went on and on. In fact, the more I read the more I found myself asking the questions, “Where does he go from here? What are his priorities?” This is the main problem with a jack-of-all-trades CV: If you don’t explicitly communicate what you’re after, an employer will rarely connect the dots for you.

My solution was to develop two separate versions of the CV inline with the types of jobs he was targeting: the first toward interventional cardiology positions, the second toward advanced heart failure and transplant cardiology roles.

I recommend creating an opening statement at the start of the CV that establishes your suitability. Here are the first few lines of the interventional cardiologist-oriented CV:

Board-certified interventional cardiologist with a track record of excellence in advanced heart failure and transplantation, cardiovascular disease management and interventional training. Adept in the management of mechanical circulatory support devices, including IABP and Impella LVAD. Able to guide interdisciplinary teams in enhancing quality of care standards.

And now here are the first few lines of the advanced heart failure and transplant cardiologist-oriented CV:

Board-certified cardiologist specializing in the management of advanced heart failure (inpatient, outpatient, consultative), mechanical circulatory support devices (LVAD, TAH, ECMO) and cardiac transplantation. Skilled in the management of critically ill patients after cardiothoracic surgery, cardiogenic shock and inotrope dependent end stage heart failure. Distinguished clinical research background.

Both statements are describing the same person. But because we’re thinking now about what aspects of his background are most relevant to the job being targeted, the initial impression is stronger. Stronger is good!

Be strategic about what you highlight

Using the opening statement as the theme for the rest of the CV, elaborate upon those aspects that support your standing as a specialist. For my cardiologist client, that meant making the following changes and additions:

Integration of an “Interventional & endovascular skills” section divided into three categories: coronary, peripheral and structural. A section like this that highlights procedures is a great way to back up the assertions of an opening paragraph with concrete details.

Inclusion of both current and in-progress licenses and certificationsTo add an upcoming certification, list it along with a note on when it will be completed. Here’s an example: ABVM Endovascular Certification (anticipated 2016)

Highlighting useful information within work history and postdoctoral training. In my client’s case, we emphasized details such as how a recently completed fellowship in interventional cardiology had a focus on cardiac catheterization, as well as coronary and endovascular interventions. At other points we drew attention to his extensive experience with lab-based clinical services, as well as some of the distinguished faculty he has learned from. Avoid mentioning responsibilities that are taken for granted at your level, such as patient history taking.

Use closing sections to your advantage

How often have you seen CVs that end with a laundry list of publication and presentation credits but offer little in the way of additional insight?

The first thing I do when presented with a CV is scan the opening and evaluate education and work history. The second thing I do is skip to the bottom for a glimpse of the person beyond the credentials. This is a prime opportunity to highlight relevant soft skills. For example, if you want to communicate your ability to work well with people from different cultures and backgrounds, and have performed humanitarian work in another country, including this information is a great way to do just that. I would recommend inserting additional sections with information in any (or all) of the following areas:

  • Committees
  • Professional Development (courses, training, etc.)
  • Volunteer Experience
  • Community Involvement
  • Professional Affiliations

Coming across as a specialist within your CV can give you an edge during the job search. State your fit for the job, back it up with concrete qualifications and highlights, and remember to stay on-message from the moment you send out that CV to when you accept that great new position.

Anish Majumdar is a Certified Professional Resume Writer (CPRW) and Founder of He is passionate about helping physicians increase their marketability and achieve excellent job search results through new CVs, cover letters, online profiles and other tools.



5 phrases not to say during your job search

Rephrase these statements to get your point across with grace.

By Therese Karsten | Job Doctor | Spring 2015


By this point in the job search cycle, every physician knows some of the phrases they should be uttering regularly: “Thank you for your time.” “What should I expect in terms of next steps?” “I really appreciated your staff’s hospitality.” And “I’m looking forward to learning more.”

But how about those phrases you need to avoid? Here are five things you should never say to a prospective employer.

1. “I shouldn’t say this, but _____ .”

The next words are inevitably negative about your current employer, training program, hospital or city. We will nod our heads sympathetically and agree with how intolerable this must be for you, but we are wondering. Is the gossipy slam you just shared a clue that you are a habitual complainer? Or was it just an inexperienced interviewee gaffe?

Rule of thumb: There is never an upside to negativity in an interview. Interviewers will pick up clues to the thorns in your side in your current world through listening to what excites your enthusiasm and questions. Let your references talk about how certifiably insane the founding partner is, or how budget cuts have systematically destroyed your department. If the information is relevant, turn it around to focus on a positive element you want to experience in your upcoming job.

Rephrase “I shouldn’t say this, _____” to:

“I found I really loved _____. I’m really looking forward to working with a hospital that does a great job with _____ and has committed the resources to support it.”

2. “I don’t know anything about business.”

Employers know how little exposure you have to business operations during training. Unless you’re a second-career physician or an MD/MBA, we aren’t expecting you to walk in the door with balance sheet savvy.

Rephrase “I don’t know anything about business” to:

“I’m looking for a group that has strong practice management support for their clinicians. I’ve had a great clinical education and now I’m excited to develop administrative mentors who can help me learn about the business side of medicine.”

3. “I am impressed by the high quality of _____ services offered at your center.”

Unless you have physician friends inside giving you the scoop, any pronouncement about our quality based on 10 minutes of surfing online or a canned facility tour rings a bit false.

Rephrase “I am impressed by the high quality…” to:

“I reviewed your website and it looks like ______ plays a major role in your practice. Can you tell me about plans for this area going forward?”

4. “We have a certain lifestyle to which we have become accustomed,” or any similar phrase that infers a hedge-fund baron’s standard of living.

It’s perfectly OK to set high income targets for your own reasons, but package income needs to be carefully presented to prospective employers. Listen to how different these two explanations sound:

“My family has a certain lifestyle to which we have become accustomed. I need at least $_00k to make this work.”

Rephrase “We have a certain lifestyle…” to:

“My husband and I have a pretty large education debt load, and we face some additional expenses due to our son’s special needs. I need to focus on positions where I will clear $_00k, and I know we are going to have to make some sacrifices to meet that. Is that going to be feasible with this position?”

5. “I’m not comfortable sharing that.”

There will come a point in negotiations where the employer wants to know where you stand. They want to know who else is at the table with you because it helps them gauge what is driving your decision. They want to know what the competing offer is so they can justify matching or beating it if the move makes business sense. They want to ensure you have relevant information for your pros and cons list assessment.

Employers are also looking for some “buy signs” that justify their continued focus on you. As the comfort level that this is the right fit goes up, they keep piling eggs in your basket. Refusing to discuss your decision process may be taken as a sign that you are no longer interested in this organization.

Don’t be surprised if their tone and pace cool significantly in response to a stonewall answer. One snarky retort can be off-putting enough to move a candidate to the back burner if there are other qualified applicants.

Rephrase “I’m not comfortable sharing that” to:

“I’m looking at one position in Wisconsin that is pretty similar to this position, and I have a formal offer with a higher base salary for a hospital-employed position in Illinois. Neither of those positions includes all of the positive elements of your facility’s position. I am very interested in continuing discussions with you because this may well be the best overall fit for me and my family.”

Takeaway thought:

Employers virtually purr when candidates present relevant information in a positive, reflective and cooperative context. They want to like you and feel good about your potential contributions to their team. They want to finish interviewing and get back to work. Give them good reasons to close this search with you as the successful candidate.

Therese Karsten, MBA, FASPR is a senior in-house recruiter assisting HCA affiliated and hospital-employed practices in her markets.



Why aren’t they calling me?

When you’re in full job-search mode, it can be concerning if you don’t hear from recruiters. But do they know you’re in the market?

By Therese Karsten | Job Doctor | Winter 2015


In job-search advisory sessions with residents and fellows, the most urgent questions come from physicians perplexed about why they aren’t getting calls and interview invitations. Graduating physicians’ pipeline of inquiries, phone interviews and site visits should be full in the winter months. If it isn’t, you don’t have time to watch and wait. Run through this checklist to see if any of these issues are reducing the number of calls you are receiving.

Are you on employers’ radar?

If you aren’t getting emails and snail mail about jobs in your specialty, you may not be in the AMA Masterfile or you may have told them not to release your name. Allopathic med schools and most ACGME accredited residencies report physician names and graduation or training status to the AMA’s Masterfile, the foundation of most physician mailing lists. Go to or call (800) 262-3211, press 1, extension 4031, to check your record.

Has your name or email address changed?

If you have married or divorced or deleted email accounts, employers’ communications may not reach you. Check your listings for accuracy. If the AMA, PracticeLink and other resources don’t know you are completing training in a few months, employers can’t include you in notifications.

Are you checking email and voicemail regularly?

Recruiters pose follow-up questions based on your initial online response. If you don’t respond, your candidacy is essentially on hold. We may check back again, but only if we haven’t already filled the position with a candidate who was ready for next steps.

Do you have enough oars in the water?

Recruiters typically post jobs on multiple sites known for good traffic for the specialty and type of candidate we need for that search. Use both broad categories and tightly focused channels to increase your likelihood of connecting with the jobs you might want. Email volume is a short-term problem if you make an email address specifically for the search and delete the account or unlink it from your primary email box once you’ve found your job.

Have you connected the dots for employers?

Recruiters prioritize incoming responses and correspondence according to how closely candidates match the search criteria. After essential training and eligibility criteria, we scan for a connection (family, spouse, friends, history of living or vacationing here). Connect the dots for us and explain why you want to live and work in our community. Unless the tie to the location on your CV is obvious, a “cold” response with no cover message and no clues in your profile is going right to the bottom of our priority list. Did you specify when you are available to begin practice? If you trust someone else to know your specialty’s training duration and do the math, your CV may be erroneously recorded in the database as not available until next year.

Any resemblance to a “buckshot” candidate?

Candidates who don’t have a lot of geographic ties sometimes list 10 or more states of interest or check “open.” Some leave all fields blank. Their job search resembles a buckshot pattern with reponses scattered all over the country. This is irrelevant to some employers but backfires with many more who have observed over time that a candidate who doesn’t care where the job is located doesn’t stay in the job very long.

If you don’t have ties, keep your preference statement general but thoughtful. I liked one that said “Medium-sized city with four seasons, conservative social values, within two-hour drive of a hub airport.” Another said “Cities where soccer is a religion.” Both statements rule out a lot of locations, but these opened doors and caught our attention.

Is your digital footprint free of contradictions?

Take a look at your cover messages, CV and your online profiles on the major job search boards. If the profile you made two years ago says “I’m looking for warm major metro areas in the Southeast,” then the Utah, Colorado and Oregon recruiters will be skeptical of your sudden interest. Proofread your cover letters to avoid copy/paste errors. Every day, recruiters receive messages extolling the wonders of the location —but ending with a statement about an entirely different region.

Are you aiming at jobs that are a fit for your CV?

Job search is not much different from the residency match process. You respond to some jobs where you are competing with graduates of programs more prestigious than yours, several that are likely fits, and some that are safe bets. Your faculty can help you know what this looks like for you personally.

Don’t count on nuanced explanations from the recruiter about why you didn’t get the invitation. Here in PracticeLink Magazine and in job search 101 sessions, we give you the scoop on how employers tend to think and act. When it comes to individual employment process decisions, we have to stick to the HR explanation that decision-makers have “moved on to other candidates who are a better fit for the practice.”

What comes up when we Google your name?

What pops up on or Spokeo? Most candidates are savvy enough to lock down their own Facebook account. Employers still see photos that you would not have chosen because other people have named/tagged you. You and a nephew with your hands posed in what appear to be gang signs. You and a bunch of friends in interesting Halloween costumes. An arrest mug shot from that colorful college spring break fiasco.

Or most commonly: A residency bio and photo calculated to make you sound fun and approachable to the fourth-year med students the residency program is trying to recruit. I’ve seen bios list hobbies like shopping, competitive Call of Duty video gaming, celebrity gossip and binge-watching Netflix seasons of “The Bachelor.”

Those bios were never intended to be read by employers, but that’s what pops up when employers Google you. These mid-to-late-career physicians are looking for serious, dependable physicians ready to carry on the practice’s legacy. So get busy making sure that’s what shows up online.

Have you had your CV checked and edited by a trusted faculty member?

Your mentors have your back, and helping you find the best job is in the institution’s best interest. They will explain that nomination to “America’s Best Doctors” does not belong on your CV because anybody who orders the coffee table book is included. Mentors will help you edit out things like fast food jobs and college committees. They will catch grammar gaffes and word choice errors in your cover letter template. They will correct “advise” to “advice” or replace “site” when you should have used “cite.” Consult them!

“Watch and wait” is a sound medical approach to many conditions, but a silent phone for a job-searching physician is not one of them.

Complete this checklist, and you should see a significant uptick in recruiter and employer responses within a few days.

Therese Karsten, MBA, FASPR is a senior in-house recruiter assisting HCA affiliated and hospital-employed practices in her markets.



Minding your interview P’s and Q’s

Etiquette isn’t a lost art. It’s actually an important gauge on which you’ll be judged on your site visit interview.

By Patrice Streicher | Job Doctor | Summer 2014


Making a favorable first impression as a physician on an interview is about more than just showing up on time. Throughout your entire site visit experience, keep job-seeker etiquette at the top of your mind—and follow these helpful tips.

Etiquette refresher 1: Make sure your online profile isn’t built to offend.

Search for your own name online. For better or worse, you should have full knowledge about where, what and how your name is being documented, associated, affiliated and commented on by others. To ensure a proper impression of your professional identity, clean up those social media photographs of yourself and comments you don’t want a potential employer to see.

Etiquette refresher 2: Get to know the potential employer before your interview—and look for conversation builders.

As you begin to collect information about the hiring practice, pay particular attention to their affiliated health and hospital systems. The organization’s national and regional presence may provide insight into referral patterns, marketplace positioning, financial stability and their preparedness for the future of health care.

You’ll likely uncover patient reviews in your research. Remember that reviews are subjective opinions, not necessarily facts. I suggest focusing instead on details found on the clinic’s website about each providers’ education, expertise and medical interests.

Take note of these key facts, as they may serve as nice conversation points during your interview.

For instance, perhaps you discover that a physician in the group is an alumnus from your residency program. Or maybe you identified an area of your skill set that would benefit the practice. These nuggets, when shared in a conversationally appropriate manner during an interview, set you apart as a gem while simultaneously aligning you as an ideal match for the practice.

Etiquette refresher 3: Make sure the town is a place you’d consider living before agreeing to visit.

In addition to collecting facts about the professional aspects of the opportunity, investigate the community’s offerings other than its proximity to the nearest city or international airport.

A reasonable introduction to the community’s shopping, restaurants, schools, tax climate, local businesses and recreational venues can be found on the town’s Chamber of Commerce website. Often overlooked—but critical to a relocation decision—is identifying the major employers in the service area. For a new physician seeking to build a practice, the vitality of the local economy, unemployment rate and financial stability of the community is paramount. Once you are properly prepared with facts about the opportunity, you are now ready for the next step: the on-site interview.

Etiquette refresher 4: Don’t let nerves rule your judgment.

The evening prior to your interview, make sure your attire is pressed and professional. Get plenty of sleep (avoid interviewing post-call), have a succinct list of questions prepared to ask the interviewers, rehearse your answers and practice talking points.

On the day of your interview, ignore those nagging thoughts that give you pause, create doubt or are negative. Know that practice administrators and recruitment directors only extend site interview invitations to candidates with whom they have a sincere interest and hope to employ at their facility.

Take the pressure off yourself by redefining “interviewing.” Think of it not as a formal process in which you are being judged for selection, but as a conversation between individuals to help you both gain a better understanding of a potential partnership.

As you stroll into the entrance of the building, your interview has unofficially started. It is essential to create a positive impression with each person you encounter.

Etiquette refresher 5: Brush up on your table manner know-how.

Make no mistake: Your academic accomplishments, knowledge about the opportunity and interpersonal communication skills should be credited for the invitation to interview on site. But once you’re there, the lasting impression you leave will be the direct result of the way you carry yourself and treat others throughout the interview.

Throughout my recruitment career, post-site interview feedback from clients nearly always includes comments about the interviewing physician’s preparedness, conversational style and table manners. Yes, table manners!

Most site visit itineraries incorporate a social component, such as a dinner with the department’s physicians, the hospital’s executive leadership team or physician spouses.

If fine dining isn’t on your typical to-do list, here’s a helpful tip from the Emily Post Institute: Put your hands out in front of you, palms down. Touch the tips of your index fingers to your thumbs to make a lowercase ‘b’ with your left hand (that’s where your bread and butter go), and a lowercase ‘d’ with your right hand (that’s your drink side).

Etiquette refresher 6: Remember to say thank you.

As the evening concludes, remember to thank your hosts and hostesses for a delightful evening and for their hospitality. Conclude your day with an email to your interviewers offering your sincere gratitude and interest in taking the next step in the process.

Congratulations for a successful site interview day! Now get some well-deserved slumber—you might have a new practice opportunity to consider in the morning.

Patrice Streicher ( has 26 years combined healthcare experience in physician recruitment and patient care delivery systems. She is Associate Director at VISTA and has served on the National Association of Physician Recruiters (NAPR) Board of Directors since 1996.



Making a list, checking it twice

Start your job search by first evaluating your needs and wants.

By Patrice Streicher | Job Doctor | Winter 2014


During my tenure in health care, I have observed physicians who have delivered treatment to patients who had lost hope of ever improving their quality of life. And though medicine has never claimed to be a perfected science, practitioners’ decisions about a course of treatment are universally founded on the evolution of discovery and technology creating recognized practice protocols.

As a provider, your diagnostic and treatment strategies are guided by knowledge, experience, best practices, protocol standards, gut instinct and logic.

Most interesting to me is that, during their search for a new position, some incredibly intelligent and accomplished practitioners voluntarily paralyze themselves by casting such wide nets that they are faced with an unmanageable number of options.

Based on my experiences, I have come to conclude that this approach is derived from a need to tempt the unlikely, daunting curiosity about possibilities, a fear of missing out on the “perfect job” or an anxiety of making the wrong practice choice. And though some have taken an adventurous leap into an unexpected practice in a “now or never” location, the majority of job seekers lack the time or engery to stray from their recognized reality.

What’s your reality?
Last spring, I was assisting a Pediatric PGY3 who sought a position near her parents in North Carolina. Following our conversation about an opportunity near Raleigh, she expressed a sincere interest resulting in a site interview. Upon her return, we visited about her trip. She was highly enthusiastic about her prospective colleagues, the hospital and lovely community. Despite the practice’s interest to move forward with a formal offer, she shared that she was not ready to make a final decision. Throughout the next several months, the pediatrician interviewed with another practice in North Carolina, as well as opportunities in Washington, New York, Wisconsin, Ohio and Florida. More than six months post-interview, the group near her family in Raleigh and I received an email from her announcing her decision to move forward with their opportunity.

But as a result of her unresponsiveness to our calls and emails following her visit, she was unaware that the group had interpreted her silence to mean that she had no interest, and they signed another physician.

As a rule, practice searches are rarely a “one and done” proposition. For this pediatrician, her reality was that she was always going to choose a position in North Carolina. Her interviews in Washington, New York and Florida were an excerise in exploring possibilities. The Ohio interview was the outcome of falling prey to a persuasive recruiter who made unattainable promises. Wisconsin beckoned because of the potential of living near a friend from college.
Six months later, jet lagged, stressed, exhausted from juggling site interviews and difficult rotations, she discovered that in the end, her core practice decision had not changed since she began the process. Her final decision was to relocate to a practice near her parents in North Carolina. And though she did accept a position in North Carolina, to her dismay, it was not the job she most wanted.

As someone who has stood on the sidelines of hundreds (and at the risk of aging myself) even thousands of physicians’ practice searches, I have come to conclude that for most people, the reality of practicality and responsibility takes precedence over dreams of possibility.

For those inclined to heed the path less traveled, explore away. However, and at the risk of being a buzz kill, be aware that while you are on your expedition, the interview process halts for no one, and a desired position may close by the time you circle back.

Physicians searching for new positions should follow a similar structure as those they use in the practice of medicine. Diagnosis and treatment follows a structured process. Initially, information is obtained and the situation assessed. A plan is devised and strategies executed seeking a desired objective. This organized approach used in everyday practice is an optimal format when searching for a new practice opportunity. It will also help you streamline your search, have the support of a well-thought-out plan, and ease the stress that comes with making a major decision for you and your family.

Your job-search plan
As we embark on the initial step of your search, I suggest  creating categories vital to your search. Most commonly, that includes geographic location, practice preferences and community offerings. Next, revisit your thoughts about what you envisioned your career and life to be as you pushed through your academic training and residency. Oftentimes, this core truth will serve as the root of your final decision.

Talk it out
The next step is critical to your success: Devise a “needs vs. wants” list under each category. Make a list of both needs and wants that you will later merge with your significant other’s preferences. To that point, before applying for your first position, make sure you have had a face-to-face conversation with your spouse or significant other about their needs and wants. Stop. Read this again. Talk. Do not presume to know what is important to your significant other. Misunderstandings about “must have” versus “would be nice” items, whether yours or a loved one’s, serve as the greatest deal breakers.
Start the conversation with yourself and your loved ones with a common understanding that items listed as needs are essential for survival and wants would be nice but aren’t necessary. Rest assured that needs and wants have been known to migrate back and forth. When you have narrowed your practice choices to a final three, you can allow more flexibility in redefining the needs and wants on your list.

Start with your needs
A fundamental principle in physician recruitment states that physicians’ preferred geographic location almost always relates to some sort of personal tie to the region or state. Oftentimes, the location is within driving distance to family or friends. Additional considerations might include climate preferences or recreational offerings.

Practice considerations should include items such as practice environment (academia, private sector, government, public health service, federally qualified, underserved, hospital, university and/or clinical based); schedule (full time, part time, workdays per week, block scheduling, hours per day/shift); leadership opportunities; financial and benefit package offerings.

Your quality of life
When it comes to devising lists about community, tread cautiously. Your quality of life and overall happiness lie in the hands of the community in which you set roots for your family.

In my experience, one of the top reasons for practicing physicians to relocate is a result of a family member not being happy with where they are currently living. For the sake of conversation, this also applies to picking up roots and relocating to another city or state.

Selling a home, uprooting teenagers or moving away from an established life without the full support of all parties involved many times is a non-starter for a practice search. As a compromise, many physicians successfully secure a new position within 30 to 45 minutes of their home base. Should relocation be in your plan, make sure to include additional items like the proximity to places of worship, shopping, cultural venues and schools.

The interview
As you entered the interview stage, prepare to incorporate your needs list into the conversation in the form of questions. Also during your evaluation of an opportunity, feel free to explore items on your want list with the recruiter—but make sure to position them as such, to avoid misunderstandings about your priorities.

Decision time
After vetting a comfortable number of opportunities, I recommend narrowing down your choices to a final three. As a fan of HGTV, I like to refer to this as the House Hunter Decision phase. At the end of each show, the buyers discuss the pros and cons of each of their three options. They then exclude one, leaving two. For our purposes, this is the point in the process when items on your want list come in handy. Ask if one of the opportunities offers all your needs and more of your wants than the other. Or perhaps there are more wants and fewer needs for one compared to the other.

Whatever you decide, one thing is definite—your deliberate approach resulted in your well-deserved happy ending. Congratulations!

Patrice Streicher ( has 26 years of experience in physician recruitment and patient care delivery systems. She is Associate Director at VISTA and has served on the National Association of Physician Recruiters (NAPR) Board of Directors since 1996.




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