Eagle Lake, Maine

Small town offers beauty and the chance to practice a full spectrum of primary care.

By By Marcia Travelstead | Practice Extreme | Spring 2013

 

WHO:  Paul Pelletier, M.D., a native of Wallagrass, Maine, was recruited to Eagle Lake Health Center in 1990. Pelletier is the medical director and is board certified in family practice. He graduated from Tulane University Medical School in 1986 and completed his residency at the University of Kentucky in 1990.

The beauty of Northern Maine contributes to the area’s quality of life. Madawaska Lake (above), east of Eagle Lake, is proof of the scenic landscape.

WHERE:  Eagle Lake, Maine, is in Aroostook County in northern Maine. It is 247 miles north of Portland, Maine, 345 miles north of Boston and just 16 miles south of the Canadian border. As well as its beauty characterized by rugged, sloping terrain, it offers an exceptional quality of life. There are four seasons of recreational opportunities, a low crime rate and abundant natural resources.

What is the history of the Eagle Lake Health Center?
There was a hospital opened by the Franciscan Nuns in 1930. In fact, there was a book written about the practice in the 50s called Green Wood and Chloroform (by Anthony Betts, M.D.; published in 1998). It is about a young English doctor who settled in rural Maine. It has a lot of stories about the town of Eagle Lake. The history of the Eagle Lake Health Center begins around 1978 as a nonprofit. It’s been here ever since.
We do more than just medical care. We have dental care, mental health, podiatry and home visitation services, which is a support program for expectant mothers and mothers of young children. It comes close to 30 people. Rural health care and education are big employers, not just in Eagle Lake. However, we no longer have a hospital here. The original hospital that started in the 30s is now a nursing home.

What’s the community like?
It has a population of 1,000 people. It’s small, but there are smaller towns in the area. The major industries are tourism and logging. It’s primarily Franco-American. There are a number of French-speaking people.
The hospital is 20 miles away, which is in Fort Kent, a town of 5,000 people. The nearest specialty care is in Bangor, 180 miles away.
As a community health center, it serves the underserved. That is its primary role. However, being the only health facility in town, it serves the entire town, which would otherwise be underserved. Patients would have to travel 20 miles to the nearest primary care physician.

Are you currently recruiting?
We are; however we have not been successful. The biggest draw for physicians would be the ability to practice to your full potential. You can practice the scope of family medicine. The other niche that would be interesting for a recruit is that in this area we see multi-generational families. Not just parents and children, but grandparents and great-grandparents. On occasion, even great-great-grandparents. We have up to five generations that use the facility, which is probably pretty unique.

What would be advantages to physicians who might be interested in coming here?
A full spectrum of medical practice for primary care. A rural environment and a good relationship with patients who really appreciate your services. Also, there are great people to work with in the health care community as well as the community in general. There are rural outdoor activities including the biathlon and dogsledding.

What is it like to work in your position?
There’s really no average day. Eight hours in the office and then maybe the hospital or nursing home. Perhaps doing deliveries or taking care of sick children. I live between Fort Kent and Eagle Lake. However, it’s gotten much easier now that there’s a hospitalist at Fort Kent. I miss more of the hospital practice but at this point in my career, I’m fine with giving up the adult inpatient medicine. I do, however, still do hospital practice for obstetrics and pediatrics.

Is there anything else you’d like to mention?
There are a lot of towns and communities around here that are unique. Another thing that attracts some people is the ability to practice a full range of medicine such as cardiology, minor surgery, adult medicine, ICU to nursing home. You can do as much as you feel comfortable doing. The need is here. The relative remoteness of the practice attracts some people; it also discourages some people. The best part of the practice is dealing with the patients. I like the interaction with the patients and their families.

 

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Lt. Col. Jennifer Marrast Host, M.D.

Snapshot | Spring 2013

 

WORK: Vice President of Medical Affairs-Georgia, Hospital Physician Partners

EDUCATION/TRAINING:
Medical school: University of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical School
Residency: Emergency Medicine, St. Luke’s-Roosevelt Hospital Center, New York City.

IN PRACTICE SINCE: 2000

Host has been married to her high school sweetheart, Chris Host, for 20 years. Their son, Justin, is 2. Host is on her fourth deployment as a Lt. Col. in the Army, which she joined after medical school. She enjoys traveling and getting to know other cultures, running, and family time.

What’s your advice for residents who are beginning their job search?
Pick the state you would like to live in. Think about where you want to be. What does that state have that makes you want to be there? If you’re someone who likes the city, then you’ll want a state that has a big city. If you like the country, you’re not going to pick New York City. Figuring out what it is you like and finding a place that offers those things to you is a good place to start.

What do you wish they had taught in med school but didn’t?
The administration aspect of medicine. Medicine has changed a lot since I started out. There’s a lot more administrative oversight. I think they should teach things such as medical director leadership, peer reviews and patient-physician relations.

What was unique about your job search?
I joined the Army after medical school. I saw the sign and thought, “Oh, that looks like a good thing to do—I think I’ll join.” Fourteen years later, here I am. For me, it has really been very enjoyable, very rewarding, just very satisfying. It’s always great to work with people who have the same mission, and everyone is working toward the same goal. You have a lot of rewards for being in the military. You can have your physician career and retire from that, and you can have your military career and retire from that. And it’s not taking much more out of your life than having a civilian career. For me, it has worked out quite well.

Any other advice?
Figure out where you’re going to work, then pick your home close to that. In a state like Georgia, you could have a job that’s an hour and a half away. It’s not like New York City, where you jump on the subway and you’re there.

We were renting and then realized that where I was going to be working was not close at all to where we decided to rent. When you’re looking at hospitals, look at the hospital and the city that’s around the hospital and figure out if you want to be there. It seems like it all has to be done concurrently. I was so used to New York in that everything was close, or you jump on the subway and you’re there. But other states aren’t like that.

 

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Airline Medicine

Emergency medicine with a twist provides care to those in the air.

By Marcia Travelstead | Career Move | Spring 2013

 

NAME:  David Streitwieser, M.D.

TITLE:  Emergency medicine physician; Medical director for MedAire, Inc. at Banner Good Samaritan Medical Center, Phoenix

EDUCATION/TRAINING:
Medical school: University of California, San Diego
Residency: Valley Medical Center of Fresno

What happens if someone has a medical emergency while on a flight? It used to be that this call was made throughout the cabin: “Is there a doctor on board?” Now, that call is likely to be made to a company like MedAire, who through their MedLink service provides in-flight telemedicine services to airline personnel through emergency medicine physicians and support staff.
David Streitwieser, M.D., started with MedAire 25 years ago. “We have a lot of experience, we’ve seen a lot of situations, and we’re comfortable at handling anything from a telemedicine standpoint,” he says.

What is your typical day like?
There are two ways we staff the call center. Monday through Friday for eight hours a day, we have a doctor who is dedicated to that call center. He or she basically stays in that call center taking as many calls as possible while on duty. After those hours, the calls are taken by the doctors who are on duty in the emergency department. The doctor may be seeing patients when a call comes in, or may be able to break away from charting or whatever else and take the call.

Are all of your calls from airlines?
The majority are commercial airlines but there are other clients, including some companies with their own aviation departments. We handle their needs whether they are in the air or on the ground when they are traveling. We also handle some private yachts that could be anywhere in the world who may have a medical event. There are also some commercial vessel tankers for which we handle medical emergencies.

What do you like best about your job?
It’s interesting because you get to apply your medical knowledge, especially your knowledge of emergency medicine, to situations outside of the emergency department.
For instance, somebody in an aircraft could be having chest pain. We know how to handle that in the emergency department. We know what things we are worried about and we know what things are available to treat chest pain. On the aircraft, we find out what symptoms the patient is having, what diagnostic capabilities and what treatment modalities are available and tailor it to fit the individual interaction. It’s a unique type of practice and the more you do it, the better you get at it.

Does it take a lot of experience to become a physician with your group?
We hire new doctors every year for our practice and we have to train them how to take the calls. They are monitored for their first year or so with me reviewing their patches or calls. There is always another doctor around to help them if they run into trouble. They are never alone. That seems to work fairly well.

How does the schedule work?
The shift where the doctor is dedicated to the MedLink calls—those are fixed hours. That schedule is run separately from the work schedule of the emergency department. So the days the physician is not scheduled to work in the emergency department, he or she can sign up to work those MedLink shifts. It’s only the experienced doctors that get to work the MedLink shifts.
When a physician works in the emergency department, he or she is expected to take calls while on duty. That’s part of the job. The physician who is the dedicated MedLink physician is in a voluntary extra work situation.

What are the challenges?
There are times when I get really busy in the emergency department and MedLink gets extremely busy. That’s extra stress, another responsibility. If you know emergency medicine, then you know physicians are frequently interrupted by any number of distractions. This is another distraction from the flow of care. However, we are actually working on other ways of handling the calls during those peak times.
Regarding the calls, we have many full-time communication specialists who do a lot of the documentation. There are a surprising amount of phone calls involved with handling an airline medical event. The airport where the flight is going to land needs to be contacted to arrange for emergency medical services. The airline itself may need to be notified regarding that particular flight. We have those calls delegated to the communication specialists. We maximize the efficiency of the physicians by getting the information and making decisions and leaving the rest of the work to the non-physicians. That works out well for our practice regarding patient flow and other responsibilities.

Approximately 45 emergency medicine physicians provide telemedicine care for in-flight emergencies from the ground through MedAire’s MedLink service. Full-time communication specialists help document the calls and maximize physician efficiency.

What advice would you give a physician who would like to do what you’re doing?
The physician will want to do emergency medicine and if he or she has an interest in this type of telemedicine, then he or she will need to work for a group that has this type of capability. There aren’t going to be many of them out there.

There is a website for MedAire and International SOS. The physician could get linked to our group. There is also a chapter in the American College of Emergency Physicians (ACEP). They have a section on airline medicine.

Is there anything that surprised you about working as a MedLink physician?
When I started with MedAire, we didn’t know if the model (MedLink) we chose was even going to work.

There were emergency physicians who were used to directing paramedics or nurses on air ambulances who needed medical advice. However, would this type of model allow the physician to give meaningful advice to airline personnel calling with needs for airline passengers? (By the way, the woman who started MedAire had been a flight nurse.)

Initially, this was a very small operation. We found it was effective. We could give good advice and make reasonable decisions and really help people. The only other alternative for the airline prior to MedLink was if there was a doctor onboard the flight. Some of the airlines had a doctor employed by them who was basically an occupational medical doctor. He or she would do employee physicals and might be on call for emergencies but did not practice emergency medicine and may not be available around the clock. There was nothing like MedLink.

I also think it was a surprise to me how much of a need there was in the airline industry for this kind of service. Having done it, I can see that it is a win-win situation. It’s great for the airlines, their passengers and the physicians taking the calls.

 

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

By Susan Sarver | Feature Articles | Spring 2013

 

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

Mistake 1
Getting a late start

Tony Stajduhar, president, Jackson & Coker

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

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

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

Mistake 2
Problems with priorities

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

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

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

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

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

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

Related: Love where you land ow.ly/heSVk

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

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

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

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

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

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

Mistake 3
Insufficient research

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

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

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

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

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

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

 Mistake 4
Interview Errors

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

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

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

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

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

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

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

Related: Site visit savvy  ow.ly/heT48

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

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

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

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

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

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

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

Mistake 5
Contract mishaps

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

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

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

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

The cost of mistakes

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

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

Susan Sarver is a registered nurse and freelance writer.

 

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Job Search 101

Your month-by-month guide to your job search

By Chris Hinz | Feature Articles | Spring 2013

 

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

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

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

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

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

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

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

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

July (at the latest)
Get organized

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

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

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

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

August
Get connected

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

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

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

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

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

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

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

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

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

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

Recommending references

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

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

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

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

September
Interview with zeal

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

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

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

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

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

Related: Ace your interview ow.ly/heQrm

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

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

Related: Ask the right questions  ow.ly/heQuy

October/November
Close the deal

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

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

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

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

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

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

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

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

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

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

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

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

December and forward
Tie up any loose ends

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

Related: State licensing board resources  ow.ly/hVHus

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

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

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

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

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

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

Chris Hinz is a frequent contributor to PracticeLink Magazine.

 

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New practice? Now patients!

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

By Laurie Morgan | Feature Articles | Spring 2013

 

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

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

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

Employed? Learn what’s expected

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

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

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

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

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

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

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

Buddy up

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

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

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

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

Build your network

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

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

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

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

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

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

Public presence: Start with the web

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

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

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

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

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

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

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

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

Related: Medicine 3.0 ow.ly/hgZPg

Embrace directories and ratings sites

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

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

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

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

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

Give a little bit

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

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

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

Going social

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

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

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

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

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

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

Done?

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

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

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

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

 

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