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 AMA-assn.org 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 Pipl.com 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 (patrice.streicher@vistastaff.com) 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 (patrice.streicher@vistastaff.com) 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.



Interview Rx

Five keys for boosting your candidacy during the interview process.

By Michael Scott, Health care futurist | Job Doctor | Summer 2013 | Uncategorized


Several years ago, while director of human resources for a small Midwestern hospital, I led our search for a new anesthesiologist. One of the candidates who agreed to interview with us was a physician from Missouri whose general anesthetic and epidural background made him an ideal match for our surgery department. After a series of initial conversations by phone, he and his wife agreed to an in-person visit to further assess the opportunity.

Over the course of their two-day visit I found myself deeply impressed with their depth of preparation in terms of evaluating the opportunity. It was clear that they had given a great deal of thought regarding their professional and lifestyle desires and were determined to leave no stone unturned. In the end, we offered him the job.

These days, on the backdrop of changing economic conditions as well as an uncertain reimbursement future tied to Obamacare, interviewing for new physician practice opportunities have now reached a deeper level of complexity. Moreover, medical model shifts have led to a mass exodus of physicians from private practice to hospital employment opportunities, leading to an even more ominous job search environment.

Here are five key essentials for physicians seeking to boost their candidacy for new opportunities.

1. Be clear in your intent.
As a physician, you know about the importance of clarity and focus. In fact, it was likely a key factor in terms of your successfully completing medical school. But sometimes we unknowingly lose site of the importance of this in pursuing professional opportunities that will represent a good match.

Clarity about your direction in an interview may be the most important key to your success in landing your desired opportunity. What this involves is asking critical questions, which allow you to better define your “ideal picture” end result. Here are among the questions to ask as a part of this process.

• What are the physician call arrangements? Does this impact my personal lifestyle desires?

• What is my preferred geographic location? Am I more comfortable in an urban, suburban or rural setting?

• What variables are important to my family and I in terms of cost of living, diversity, recreational and sports opportunities, and raising a family?

• Will the work offer meaning and fulfillment as well as a sustainable compensation package?

• Is my preferred option a hospital/medical center, private physician practice or community health center?

• What is the state malpractice environment like?

Getting clear about what you really want will prevent both you and potential employers from wasting valuable time engaging in interview discussions that have no chance of gaining traction.

2. Research and prepare well.
Achieving extraordinary results in an interview process requires a thoughtful assessment of the practice opportunity. Therefore it is vital that you never walk into an interview without having done your homework.

In preparing for your interview, there are a number of key pieces of information that you ideally should have researched. Included here is a thorough understanding of the mission, vision and financial performance of the hospital or physician practice for which you are seeking to work. This information is particularly important because it allows you to gauge the extent to which your purpose and future direction are aligned with this potential employer.

The internet is obviously an invaluable tool in terms of your pre-interview research. But beyond online research, don’t discount the importance of reviewing written collateral materials such as annual reports and brochures that may offer you an in-depth perspective on the current culture and future of the organization. Also ask to speak with other physicians in the interview discussion or off the record to get their take on the professional climate.

3. Maximize your value positioning.
Conveying your professional value in an interview is paramount for a successful outcome. This is where you articulate what you can bring to the table with factors such as care quality, productivity and financial returns. Your ability to successfully demonstrate your return on investment proposition can give you a huge competitive advantage in the job market. The ideal value proposition is clear, concise and resonates to those with the highest levels of decision-making influence.

Let’s return briefly to the physician scenario at the beginning of this article. What made this doctor such an attractive candidate for our hospital was that his value proposition was clearly aligned with the anesthesiology needs of our rural hospital. In particular, willingness to share call with our existing nurse anesthetist was a huge plus. And his experience with epidurals resolved a major issue we were facing in terms of patient demands for this procedure.

What all of this suggests is the importance of being able to summarize key points with respect to those competencies of yours that speak to the added value you can offer. At the end of the day, interviewers are seeking to determine whether what you have to offer addresses any and all value gaps necessary for the delivery of cost-effective patient care.

4. Pay attention to credentialing.
As a physician, you are well aware of the process called “credentialing,” which hospitals and medical practice undertake to verify the employment history, educational qualifications, licensure and references of medical providers. This process is designed to protect patient safety, reduce medical mistakes and enhance the quality of delivered services.

In an interview situation, the importance of being upfront about any potential credentialing-related issues is paramount to your success. Make sure that you also have up-to-date records of your licensure and certification, for this will help speed up the credentialing process if you are offered employment. Most importantly, resist the temptation to gloss over or cover up information that may come up in an interview discussion. With tools like the National Practitioner Data Bank, health care employers have easy access to your records and history.

5. Follow up.
In many respects, this final stage of the recruitment interview process may be the most important because it represents the final opportunity to cement a deal if the opportunity interests you. Unfortunately this is where the post-interview fog often sets in—a factor that can cloud your efforts at following through the finish line tape.

If you are fortunate enough to have been selected as a final candidate for a position and have an interest in pursuing the position further, don’t overlook the importance of formally stating your interest in the position and that you look forward to communicating with them in the immediate days ahead regarding next steps.
Nothing creates a more positive impression in follow-up to a final interview than a personalized, handwritten thank-you note.

The bottom line
At the end of the day, every new job opportunity that you engage can represent an important step in your physician career. So take your interviews seriously. If the opportunity appears to be a good match, then be sure to confidently act as though the position is yours. You never know—it just might be just the right prescription for your long-term success.

Michael Scott is a Denver-based health care futurist, speaker and writer.



Competition is alive and well

These tips from a recruiter can help you secure the job you want.

By By Patrice Streicher, Associate Director VISTA Physician Search and Consulting | Job Doctor | Spring 2013


In the mid-90s, a buzz of excitement vibrated through the walls at Fox Hill Associates, the physician recruitment firm where I was employed at the time.

A new technology called the World Wide Web promised access to physician candidates within just a few key strokes on our newly purchased shared office computer. The days following the grand announcement, I recall daydreaming about how wonderful life was going to be.

Fast forward to 2013. Despite the ongoing conveniences afforded the recruitment process, recruiting physicians is as difficult as ever. The current shallow pool of viable physician candidates creates a paradox in which practice decision makers have become highly selective by requiring candidates to meet specific professional and interpersonal criteria before extending an offer. Recruiting entities regard their recruitment and retention efforts as nearly synonymous.

The investment in recruiting long-term physician candidates with ties to the area, a solid skill set, desirable interpersonal attributes and practice philosophies similar to the incumbent medical staff are key to building and retaining a strong medical community.

Over the course of my more than 25 years of experience in the industry, I have logged a few unspoken and “just shy of traditional” observations that I have been known to share selectively with my physician candidates. Here they are for you.

In building a successful career, keep it simple by abiding by these rules of engagement
√ Never burn a bridge.
√ Always look for the silver lining.
√ Be the answer, not the problem.
√ And perhaps, most importantly, be polite and mind your manners.

1. Know the practice administrator’s mantra.
Even in the midst of a physician shortage, administrators and hospital boards’ recruitment mantra continues to be unwavering: “It is better to not fill a position than hire the wrong candidate.” And though it is seems counterintuitive, practices will wait for the ideal candidate, in some cases for years.

2. Opportunity does not equal employment.
Over the years, I have spoken with physicians who have boasted that opportunities for them are limitless. One family medicine resident recently informed me that he had so many opportunities to choose from that if he were blindfolded, he could point to a spot on a map and be assured a position in that location.

Admittedly, I would agree that jobs for physicians are plentiful. But I would argue that available opportunities equal open positions, not assured employment. Competition, especially in prime locations and for select specialties, is alive and well. Practices with a well-tuned recruitment program interview multiple candidates before choosing a new associate.

3. Make lists.
The most successful practice searches start when the physician begins their job search with a focused conversation with a spouse or significant other involved in their final practice decision.

Devise a “must have” and “wish” list that includes both preferred and realistic location and position attributes. Do this before starting your search. Over the years, I have observed that those with a mutually agreed upon practice search plan experience a streamlined process, alleviate distraction delays, ease expending unnecessary energy and avoid wasting valuable time on empty objectives.

In my opinion, physicians listing as many as 15 state location preferences are either benchmarking the market, shopping opportunities, or fear they will miss out on an opportunity.
Though there is no harm in exploring more than one region, I suggest augmenting your location options incrementally to avoid being overwhelmed and paralyzing your decision-making process.

4. Timing is everything.
In the United States, the nonverbal communication of “time” is used as a measure of the importance of one person to another. Specific to recruitment, the expedience or delay in our responding to an email, text or voicemail communicates to the sender—whether real or perceived—their importance.

Upon engaging a practice representative, be prompt and responsive to their emails and calls. Be timely with communicating new developments that arise.

In my tenure in the industry, I have witnessed CEOs and Medical Directors who interpret delayed candidate replies as unprofessional. On occasion, after weeks of unresponsiveness by a candidate, the bad taste experienced by some executives warrants them eliminating the physician from consideration.

Rest assured, these executives understand you have a full plate. However, trust me when I say that in a time when attrition is a prevalent business practice model, everybody is feeling that their cup runneth over.

5. Mind your manners.
Recruitment is a communication proposition that imposes judgments on verbal and nonverbal messaging.

When interviewing candidates, practice executives evaluate prospective physician matches with regards to their incumbent physician culture. Conversational style, approachability and etiquette during an on-site interview undoubtedly make unforgettable impressions on decision makers. Firsthand candidate interactions; word-of-mouth; and advanced networking in physician programs, medical communities and specialty markets have advanced or stifled a physician’s career and ability for promotion.

Patrice Streicher (patrice.streicher@vistastaff.com) has 26 years of combined health care experience in physician recruitment and patient care delivery systems. She has served on the National Association of Physician Recruiters (NAPR) Board of Directors since 1996.



Tactics for finding unadvertised jobs

Most physicians today identify positions based on ads, fliers and online postings. What's the plan when the city you want seems to have no job possibilities?

By Therese Karsten | Job Doctor | Summer 2012


The internet has transformed physician job search. We rarely talk about the “old school” tactics used by the pre-internet generations because so many physicians find jobs just by clicking a response link.

But if you aren’t finding advertised opportunities where you want to live, it’s time to dig deeper in the toolkit.

Message, message, message

Tell everyone in your environment where you want to practice and why you want to live there. You need a Tweet-length message that people hear several times in different contexts:

“Do you have any health care contacts in Denver? My husband has an opportunity to transfer there with his company and we have family and friends there.”

Program director, program coordinator, faculty and a few attendings should all know where you want to practice. Think outside the physician box, too. We learn about candidates through phone calls and emails from parents, in-laws, siblings, neighbors and former med school buddies.

The other residents and fellows should know where you want to go.

One resident found me because she posted notes on her program’s bulletin board saying, “I need Denver!” She changed it regularly, the next month titled “I MUST Get to Denver” and the following month, “Get Me To Denver Task Force Update.”

Fliers had photos of her and family skiing, hiking the Rockies, or attending a Broncos game. The best was a map of metro Denver with a red arrow pointing to “My in-laws live here,” and another red arrow to the other side of town—45 minutes away—labeled “I want to live HERE.”

It was funny, memorable, and it resulted in a resident forwarding an email that led to an interview that ultimately led to a job.

A surgery resident who was dead-set on getting to Kansas City used T-shirts to spread the word. He had a wardrobe of sports team T-shirts and never passed up an opportunity to talk about his sartorial homage to his dream location—his parents’ and siblings’ new home city. His program coordinator connected him with a recruiter who had a newly posted opportunity.

Refresh your message to your network by giving them updates on your search. An outrageous awful interview story, an anecdote about something cool that happened on your rotation in that city, or a thank you for a suggested contact will reinforce that connection of your name with that city in people’s minds.

Set up a rotation, or moonlight

Practices in the most competitive cities are very big on the idea of “try before you buy.”

A rotation often clinches a job offer even if the practice wasn’t actively recruiting. If you are a fit with their culture and practice philosophy, a smart practice will make it happen. You can also try out a facility by moonlighting there. (The extra money isn’t bad, either.)

A founding partner who hadn’t set a retirement date may realize that two years from now is the perfect time to transition. Or maybe the new satellite office the hospital is asking the group to open becomes viable if they add one more physician.

Active, not passive internet search

Some physicians won’t post their CV or profile on internet job search sites or their specialty organization career tab because they don’t want to be contacted about locations other than the target city.

That’s short-sighted. If you’re looking for a job in a highly competitive market, the value of having a lot of oars in the water outweighs the annoyance of spam.

Manage response volume with an email account exclusively for job search. Every few days, log in and put the target city name in the “search” field. Set the field to find matches in the entire email, not just the subject line. Recruiters sometimes put the state or suburb name in the subject line, then describe the location as “20 minutes from downtown ______” in the body of the ad. Drag the search results to another folder for follow-up. “Select All,” “delete” the rest.

Some internet sites push new or newly updated profiles out to employers. Your name, desired practice location and summary might land in recruiters’ inboxes even before we post ads for a new search. The “push” alerts also connect you to recruiters working on highly confidential, off-the-grid searches.

Refresh your online CV or profile every couple of months. When you click “update,” your profile could go out to every employer with an open search in the specialty and region. The update may spark a call about a position that has re-opened or expanded parameters since your initial posting.

Opt-in to the “alert” or “notification” feature that emails you when sites post a new or updated job matching your criteria. It’s good to be an early respondent for jobs in competitive locations. The likelihood of an interview invitation is much higher if you respond while the search is still fresh.

Follow-up a week or so after you’ve submitted your CV. Check in a few weeks later with that recruiter to remind her that you are still trying to get to that community. Follow-up is not pestering—it’s our job to communicate with candidates. A physician who is committed to the location is more likely to accept if offered, and stay long-term if hired. That’s a win for us, and a win for you.

Network through alumni programs

One of the most effective networking tools is the commonality of having been educated or trained at the same institution as someone else. You have a shared experience and have been shaped by the same culture and educational process.

Call the alumni coordinator for your college, med school and training institutions and ask if you can be connected with fellow alumni in health care who live in the state and city where you want to practice. You may strike gold and find a university alumni club chapter in the target city.

Some alumni coordinators will build a query, search their database and share the Excel spreadsheet once you’ve given the secret alma mater handshake and showed them what you’re going to send out. Others will send an email to physicians on your behalf. Alumni staff can walk you through tips for mining the alumni website yourself.

Many universities have a filter that allows you to inform an alumnus that you would like to connect—but blinds their personal data in case they don’t want to communicate. Why? Universities that help alumni network benefit because graduates who feel connected to their alma mater donate and help future graduates.

If all you have is a name, search on LinkedIn, Facebook, Twitter or search engines. Be expansive and don’t limit just to alumni in your own specialty or recent grads. All it takes is one or two contacts to make the effort worthwhile. In addition to possible job contacts, physicians where you hope to practice will help develop your understanding of what’s going on in the local medical community. They might even share rumors of group mergers and acquisitions or gossip and history behind a practice implosion that no employee of the hospital system or practice would dare relate to a candidate.

Six degrees of separation

You may not get to Kevin Bacon, but the one-off connections may get your CV forwarded into the hands of someone who has a job for you.

Contact in-house recruiters who have jobs posted in other specialties in the right location. Call hospitals in the suburb where you want to live and work, saying “This is Dr. Smith, and I’m looking to relocate to the south side of your metro area and find a hospital-employed or private practice opportunity in my specialty. Who do I need to talk to in your facility?”

You can also ask hospital recruiters if they know of any needs at any other groups in the area.

Use search engines to identify private practices in the zip codes that you want. Email or fax in your CV with a cover letter. State what you are looking for, when and why you plan to live in that community. The recipient of your CV usually does not have a job for you—but he or she knows someone who does.

Perseverance pays off

Start your search for the unadvertised job early, and expect to spend more time on the search than peers who are kicking tires in multiple states. It’s worth the effort, though. Physicians who truly love where they live tend to have more stable career paths and seem happier than those who just “ended up” somewhere! l

Therese Karsten, MBA, CMSR (therese.karsten@hcahealthcare.com) has been recruiting physicians into hospitals, managed care and private practice groups for more than two decades. She is a senior in-house recruiter with HCA.



8 quick tips for landing the job you want

Throughout your search, remember that email is forever, politeness counts, and a thank you is always appreciated!

By Sharee K. Selah | Job Doctor


A quick review of the following career search tips can help you land that perfect practice opportunity. As a rule of thumb, mind your manners, pay attention to your communications, and do not forget that you are always being evaluated.

1. Be careful with the “send” button.
E-mail is forever. Research supports that 76 percent of physician hires originate with email. Your candidacy starts with the first email you send.

2. Be polite, be prudent.
The old saying “you only have one opportunity to make a first impression” has an added nuance. That first impression can be permanently documented in recruiting databases and later read by recruiters, hospital departments or medical groups on staff. more »



How to avoid a relocation nightmare

Seems like everyone has a horror story about moving. Make yours a happier tale.

By Therese Karsten, MBA, CMSR | Job Doctor


Relocation is like childbirth: a) it’s painful, and b) total strangers feel compelled to regale you with their own irrelevant, traumatic and scary stories to make sure you approach the experience with an appropriate level of abject terror.

Sometimes, though, tips from the collective experience of those who’ve run the gauntlet before you can save you time and money. Here are a few thoughts for physicians from my “lessons learned” across hospital, corporate and private practice recruiting environments.

Get a copy of the employer’s relocation policy early in negotiations
Many employers provide an allowance on a “use it or lose it” basis with a deadline for getting your expense report completed. They pay a mover directly (or reimburse you based on receipts) and reimburse you for specific expenses associated with getting you and your belongings from point A to point B. The IRS rules drive most relocation policies.

If you could deduct the expense on your personal income taxes, it’s likely to count as an allowable expense under a physician recruitment relocation allowance. Discuss options with the hospital or group if you think your expenses will be unusually low. During the negotiation phase, they may be open to shifting funds earmarked for relocation toward education loan repayment or sign-on bonus.

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How to Negotiate like a 5 Year Old

Little kids usually have no problems getting what they need. You can too, with these tips for successful employment negotiations.

By Anne Fowler | Fall 2011 | Job Doctor


Have you ever noticed how effortless it is for children to negotiate for their wants and needs? It is as if they come into this world with a magic gift of knowing how to get what they want—and better yet, nibble for even more.

As a mother of three small children, I watch in awe as my kids masterfully maneuver these situations and take note of their skills in an effort to learn from them. So I ask myself—why is it that, as we get older, we lose that comfort level with being direct about our needs and wants and negotiating for the same?

As a physician recruiter with more than 15 years of experience negotiating physician employment agreements, there is a palpable change in a candidate’s voice, behavior and even body language when we move from the pleasantries of exploring a particular opportunity to the negotiation phase of the recruitment process.

Why is this? I believe it has much to do with a candidate’s worry about crossing some invisible boundary in the discussion, appearing too greedy, or having a general discomfort with advocating for their needs. Since the fall is the time of year when many senior residents begin to consider job opportunities, it is an optimal time to put forth some tips on negotiating with an employer.

Come prepared for the discussion.

This is fairly obvious, as you cannot expect modifications from an employer if you don’t know what is already in the agreement. You must review the document and become familiar with the obligations of both parties. Employers and their representatives will be well-versed in the language of the employment agreement, and you don’t want to be left behind as they move from paragraph to paragraph. That said, if there is something that requires clarity, be sure to speak up and ask for an explanation in layman terms.

• Enlist an attorney to review the agreement.

As it may be your first time reviewing an employment agreement, I encourage you to select an attorney who is both in the region where you plan to practice and is well-versed in physician agreements. You will be bound by the provisions of the agreement, so it is important that the document be one you can live with for the duration of the term of employment.

• The figures related to compensation may be negotiable, but more often than not, the methodology for payment is non-negotiable.

Compensation structures have simplified over the years, but there can often be multiple components that make up a total compensation plan, including salary, incentives, bonuses for quality and good citizenship, partnership, etc. Employers devote extensive time and resources to developing the best model for a practice and are typically not inclined to make radical modifications related to their methodology. As a general observation, employers tend to be more inclined within reason to readjust dollar amounts for base salaries, sign-on bonuses or retention bonuses before ever delving into changes in the compensation plan.

• It is perfectly acceptable to request data related to historical incentive/bonus payments.

If the employer is offering an incentive or bonus component, you should feel comfortable requesting not only the specific formula used for calculation, but also historical data related to how much has been paid on average to individuals in the group over a period of time (such as the past three or six months). The employer can do this while still protecting the identities of the individual physicians. If an employer is reluctant to do so, you should consider this a red flag.

• Benefit programs offered by employers are usually standard and universal for the group.

Health, dental, vision and retirement plans are typically non-negotiable. CME allowances and paid time off may be more negotiable, but many employers are reluctant to do so in order to avoid inequities within the group. There is also a greater level of complexity for the employer to administer a plan that differs among group members. more »


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