Your job-search timeline

Learning of other physicians’ job-search journeys can help you anticipate, plan and execute your own.

By Marcia Layton Turner | Feature Articles | Spring 2018

 

“Much of the education on searching for jobs was acquired in passing while talking with those ahead of us in training and through each other as we went through process,” says Sunny Jha, M.D. Photo by Dawn Bowery Photography

“Much of the education on searching for jobs was acquired in passing while talking with those ahead of us in training and through each other as we went through process,” says Sunny Jha, M.D. Photo by Dawn Bowery Photography

Until you get to your job search, the path to a career in medicine is quite regimented: Study a pre-med curriculum. Apply to medical school, then to a residency program. After residency, you either apply for a fellowship or begin looking for a job. And that’s when the systematic, methodical process vanishes, leaving some physicians unsure of how exactly, or when, to begin their job search.

“The search process lacks any sort of formal structure, so it is unlike anything most young physicians have ever experienced,” explains Sachin “Sunny” Jha, M.D., MS, assistant clinical professor of anesthesiology at the University of Southern California (USC) in Los Angeles. “I had an idea that the job process would be a long exercise with varying degrees of uncertainty and unpredictability,” he says. “Prior to this point in medicine, everything more or less had a process.”

The path to a new opportunity doesn’t come with a pre-written map or compass. So it can help to hear what other physicians’ job searches looked like as you chart your own course.

“Like many aspects of medical education, this is one of the things that you don’t formally ‘learn,’” says Jha.

The success of your search, and the order in which you uncover and pursue opportunities and resources, is largely dependent on timing. Allow yourself ample time to explore all the jobs that may be available to you so you can negotiate from a position of strength, rather than being rushed and under pressure to accept anything that’s offered.

Design your plan

Zachary Liner, M.D., started his job search 17 months before he would be available. Photo by Michael Caswell Photography

Zachary Liner, M.D., started his job search 17 months before he would be available. Photo by Michael Caswell Photography

When it comes to looking for your first or next job, “Start early,” advises Zachary Liner, M.D., an interventional radiologist with North Oaks Imaging Associates in Hammond, Louisiana. Liner began his job search in the middle of his first fellowship after residency and before he had even started his second fellowship—17 months before he knew he’d be available to start.

According to the 2017 Survey of Final-Year Medical Residents conducted by Merritt Hawkins, a national health care search and consulting firm, 72 percent of medical residents start their job search within or before a year of finishing residency; 28 percent wait until they are six months from completing their training before beginning their job search in earnest.

Patty Shipton, physician recruiter with Penn State Health in Hershey, Pennsylvania, says that a year is just about right for a physician’s job-search process. Physicians in their last year of residency or fellowship generally start looking for a position in early fall, she says. That’s when recruiters begin attending career fairs and conferences armed with a general idea of upcoming openings that will need to be filled. Shipton also collects CVs for unexpected openings that occur from time to time.

Chris Mason, D.O., MS, is regional medical director for the Western region of American Physician Partners and is based in Albuquerque.

Mason points out that, thanks to the fact that there are “far more physician jobs than there are candidates…it’s a resident’s market.” (He’s quick to point out that this varies by specialty and location, however.)

The earliest a resident can commit to a job is right after their intern year. And while that’s not typical, it’s possible, he points out. To entice physicians to sign as soon as they’re eligible, employers may offer incentives including sign-on bonuses, stipends and loan forgiveness.

The major downside to signing a contract so early in the job-search process is that you’re committed to work somewhere long before you’re finished with residency. During that time, you may make all sorts of decisions that could interfere with that employment arrangement. For example, you might decide you want to live elsewhere in the country, you might get married to someone who wants to live somewhere else, or you might decide you want to work for a specific practice or even switch specialties. A lot can happen over the course of several years of training.

Zero in on desirable locations

By early fall, most physicians usually know where they want to be geographically, says Shipton. She finds that they often they want to move to be closer to family. Or they’re clear about whether they want a big city or small, urban or rural setting, mountain or beach, or a specific region of the country.

Many have also started to research which hospital systems or practices have openings in their specialty—or are likely to soon.

Liner’s medical specialty of neurointerventional radiology is what he calls a “super subspecialty.” “There aren’t a lot of people who do what I do,” he explains, which means that there aren’t as many programs or spots available, and “once spots are filled, they’re filled,” he says. “I had to start early to have a chance of getting one of those openings.”

Making his job search even more challenging was that not only was Liner looking for a position in a field with very few openings each year, but he also had a very small geographic target area. Most interventional radiology jobs exist in major cities, he explains, but he and his wife had decided that after living in New Orleans, Texas, San Francisco, and Rochester, New York, they wanted to make southern Louisiana home—where he and his wife had grown up. He knew that his odds of finding an interventional radiology opening in southern Louisiana were slim, so he wanted to start introducing himself to anyone in Louisiana who might have a need for a physician with his skillset.

“It was constantly on my mind that the job I wanted wasn’t open—that I had to create it,” he says. Few programs were looking for a doctor with training in both body and neurointerventional radiology. “It’s a unique skillset that sets me apart,” says Liner, but with so few hospitals and practices actively looking for someone with such unique training, he was aware that his job search could be difficult. It was likely he would need to convince a practice that he would be a valuable addition, and work with them to create a new role rather than take over an existing position.

Be aware of established milestones

Depending on your specialty, there may be opportunities at specific times of the year, such as at educational conferences and medical association meetings, to be considered for upcoming openings.

Jha, who was looking for a position in academic medicine, discovered after the fact that many academic departments interview graduating residents at the ASA (American Society of Anesthesiologists) annual meeting in October. Looking back, he says he should have started earlier and taken advantage of this interview opportunity.

Ask your colleagues if your own specialty’s conference has a similar setup. If so, try to attend.

Mason recommends networking through various local and national chapters of your specialty’s professional organizations. Take advantage of residency events and physician groups that provide opportunities for residents to mix and mingle with health care representatives. “Get involved,” Mason advises, to get to know attending physicians who can serve as referral sources and connectors to your dream practice.

Take a proactive approach

Don’t hesitate to be proactive.

“If there’s a place you’re interested in, don’t be afraid to reach out to the recruiter,” Shipton says. “They may know of a future opening coming up.” Most in-house physician recruiters serve specific departments, so it’s useful to identify which recruiters are responsible for hiring physicians in your specialty at the employers you’re targeting. In-house physician recruiters are uniquely qualified to represent the opportunity and community for which they’re recruiting, as they are directly employed by the facility. It’s their friends and family whom you’ll be treating.

Another option is to retain the help of an agency or staffing firm in your search. An agency may be able to alert you to jobs at multiple specialties through one point of contact.

Liner decided that he needed the support of a professional adviser to help track down a potential employer that would meet all of his criteria. He chose Jeff Hinds, MHA, of Premier Physician Agency in April 2016.

Liner worked on a cover letter and updated his CV to be sent out to prospective employers. He then sent out “feeler emails” to about 40 practices that Hinds had identified in cities and towns in Louisiana, Texas, Alabama and Mississippi to see what kind of interest there might be in a doctor with his training and experience. He also checked physician job boards and applied to a few opportunities.

Almost immediately, Liner began receiving phone calls in response to his campaign. Although most recruiters said, “We don’t have a place for someone with your skill set,” they also told him they would keep his materials on file in case something opened up later. Liner then followed up later with those that had expressed an interest to check in. Back-and-forth phone calls from the feeler emails continued for about six months, says Liner.

Among the many “we don’t have a spot for you” phone calls were six calls from practices that were interested in speaking with Liner, three of which were in Louisiana.

Jha describes his initial job search activities as passive, as he applied and interviewed “broadly” for jobs in both academic medicine and the private sector. “I had been passively searching for jobs in both environments, collecting contacts within different departments,” says Jha.

Then at around the midpoint of his fellowship year, he began directly reaching out to different departments and groups he was interested in. “The department where I did my fellowship kept a list of key contacts within groups around the country, which was instrumental in securing many of my interviews,” he says. In addition, some physician job boards and physician recruitment agencies also provided outreach ideas.

His proactive approach worked. “I actually got my job by directly emailing the chair of my department,” he says.

You can be proactive even without having a name provided. On PracticeLink.com, for example, you can search by specialty, zip or employer, and reach out directly to the in-house recruiter representing the opportunity or organization.

Schedule site visits

For the next five months, from August 2016 to January 2017, Liner flew out to interview with six different groups. He had one interview in August, three in September, one in November, and one in January. Many took weeks to schedule because he had to travel from his fellowship in San Francisco to the south during times he wasn’t required at the hospital. Finding common schedule availability was challenging.

Liner had a strong sense that practices that initially said “no” because they didn’t have any openings at the time might eventually turn into a “yes” if a partner decided to move or retire. So he made a habit of staying in touch with all the practices and hospitals in his geographic search area.

As he scheduled first visits with some groups, he was also scheduling second visits to two practices that had made offers following the initial site visit. He completed those two visits in January.

After reviewing CVs gathered at conferences in September and October, Shipton’s next step is to schedule on-site visits to see if there may be a fit. During October and November, she typically invites the top in for a first on-site visit. Based on those in-person interviews, the interview team and department leadership collectively decide whom to invite back for a second visit, often with their families. Those generally occur in November and December. Offers are then made between December and February, she explains.

Liner made it known to the practices he was considering that he was going to take his time in making a decision. Because he had started his job search so early, he had the luxury of time to thoroughly research each practice and speak with different people and departments within each practice.

While there is a standard recruitment process and timeline, Shipton says, there are factors that can slow it down or speed it up. For example, the availability of a physician to start work can drive how quickly the process concludes. If he or she finishes residency on June 30, the earliest possible date they could start would be July 1. “But many people want to take some time off [after residency], to move and get settled,” says Shipton, “and that can affect when they start.”

Likewise, candidates who are especially responsive can move the process along faster than normal.

Negotiate a contract

As his second site visits were underway in January 2017, Liner began receiving offers. Over the next two months, he began negotiating with three practices. Most contract negotiations don’t take two months, says Liner, “but we were all cautious,” he says. “No one wanted to make any snap decisions.”

Twelve months after he started his job search, Liner accepted a job offer from a practice in Louisiana.

Be prepared for credentialing

In order to prevent any delays in receiving your hospital credentials or medical license, make sure you have quick and easy access to the personal information your employer will need, suggests Jha. That means collecting recommendation letters as soon as possible, keeping accurate and up-to-date procedure logs as you go through training, and scanning personal documents, such as identification, degrees, other licenses and immunization records so that you can send them at a moment’s notice, he recommends.

“Be patient and start early so you can begin working on time,” Jha advises.

Shipton says that credentialing, which can include a background check, review of letters of reference and other documentation, can take anywhere from one to three months depending on the state in which you’re applying.

Make your own timeline

While there are common timelines for finding, considering and accepting a new position, there are also many extenuating circumstances. The typical timeline is just that: typical, but not the rule. Liner was looking for the equivalent of a needle in a haystack in Louisiana, so his timeline was extended. You can take a different approach, or operate at a faster or slower speed. It’s up to you.

You can decide for yourself how much time to invest in identifying potential employers, researching programs, sending out CVs, talking to recruiters, visiting hospitals and practices in person, negotiating a contract, and preparing for your new role.

Based on his job search, Liner recommends holding out for the right job. Don’t rush the process, he says. “You can find the right group; you just have to allow yourself the time to find it.”

You’ll also make a better decision if you do your own due diligence before signing any contracts. Ask lots of questions—“you can’t ask too many,” Liner says—to ensure you’re making the best decision for you.

Marcia Layton Turner is a frequent contributor to PracticeLink Magazine.

 

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Is your tail covered?

What you need to know about malpractice insurance.

By Ryan Rekieta | Legal Matters | Spring 2018

 

Wooden gavel on table. Attorney working in courtroom.

For many physicians new to practice, it may seem like a load off when the practice or system they plan to join offers a contract that includes picking up the tab for their malpractice insurance. That’s just one less thing to worry about, right?

Unfortunately, even those physicians may wind up with sticker shock a few years down the road when they leave for another practice opportunity. That’s because they didn’t know about, or fully consider, the importance or huge cost of the tail coverage necessary when making a practice change. Yet it’s an expense that can be avoided if negotiated into an employment contract before signing.

Claims-made malpractice insurance and tail coverage

The most common and widely used malpractice insurance is claims-made malpractice coverage. Claims-made insurance covers a physician for any alleged act of malpractice that takes place and is made with the insurance carrier while the policy is in effect.

This type of malpractice insurance is especially popular with physicians new to practice because of the pricing model.

“All the malpractice insurance carriers extend a new-to-practice discount, which reduces the premium significantly in the first, second and third year a new physician is with the carrier as they build their patient load,” explains Andrew Hawkins, a medical malpractice insurance broker with nearly 30 years of experience. After five or six years of practice, premiums level out.

However, since malpractice claims often are not made until years after the alleged instance of malpractice occurred, if a physician with claims-made coverage switches insurance carriers due to a practice change (or for any reason), the physician will not be covered if a claim is filed against his or her previous carrier, leaving a gap.

There are two options to address this gap in insurance: purchasing tail coverage or transferring “prior acts” to a new policy. Tail coverage will typically cost 200 to 300 percent of the underlying premium and is purchased from the carrier a physician is leaving. Having prior acts (aka “nose coverage”) covered by the carrier a physician is changing to is typically the better choice.

“It’s always a cheaper option to have prior acts transferred to a new policy and avoid the cost of tail,” says Hawkins. “Physicians should just make sure their contract with their group allows that transfer.” Occasionally, group employment contracts stipulate that a physician must purchase tail coverage if he or she leaves the practice—something physicians should seek to negotiate out in favor of a transfer.

The best option when it comes to claims-made insurance is to negotiate it into the employment contract to have the practice pick up the cost of tail coverage in the event of separation.

Other types of malpractice coverage

In addition to claims-made malpractice insurance, occurrence-based malpractice insurance is another option. Occurrence-based insurance covers a physician whenever the alleged act of malpractice occurred, regardless of when the claim is actually filed, meaning there is no need for tail or prior acts coverage. “Occurrence has a built-in tail policy, but it’s much more expensive and only available in a limited number of markets,” says Hawkins.

Some medical trusts operate claims-paid malpractice insurance coverage, which sets premiums based on malpractice claim payouts from the previous year and anticipated payouts in the coming year. As with claims-made insurance, tail coverage is necessary—and often hugely expensive—when ending a claims-paid policy. Additional drawbacks of this type of policy include premiums that may fluctuate unpredictably, strict rules on what is covered and what is not, and difficulty switching to a new carrier.

A plan of action

Every practice situation is different. When navigating your employment contract, make sure there is an answer to the question of who pays for malpractice insurance premiums while with the practice and tail coverage in the event of separation.

For the individual physician, the ideal situation is, of course, having the practice foot the bill. While it probably shouldn’t be a deal breaker if the practice does not pay for that coverage, knowing that tail or prior acts malpractice coverage will be necessary is the first step in planning for an almost certain big expense in every modern physician’s career.

Ryan Rekieta provides executive leadership for the Career Services team at Afferent Provider Solutions

 

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An update on the opioid epidemic

As record numbers of Americans die, projects (and prosecutions) emerge.

By Jeff Atkinson | Reform Recap | Spring 2018

 

Opioid pain killers

Approximately 64,000 people died in the U.S. in 2016 from opioid overdoses—a four-fold increase from 2000. That compares with 40,000 deaths in motor vehicle accidents in 2016. Drug overdoses are the leading cause of death of Americans under age 50.

The rate of deaths from opioid overdose has increased so much that it is responsible for a 2.5-month reduction of average life expectancy for Americans between 2000 and 2015 after several years in which average life expectancy was increasing.

According to data from the Centers for Disease Control and Prevention (CDC), the states with the highest death rates from opioids are in Appalachia, New England and the Southwest.

Precise, current data on drug overdoses is not possible to obtain because of the delays by medical examiners in determining the cause of death and submitting data to the CDC. Toxicology reports often take several months to process.

Blame for the crisis

Drug companies and the insurance industries have received part of the blame for the opioid crisis. Beginning in the 1990s, drug companies increased funding for organizations and CME programs to encourage the expanded use of opioids. Spending on opioids increased by more than 40 percent between 2006 and 2010.

Insurance companies often preferred to pay for comparatively cheap drugs rather than alternate therapies and interdisciplinary pain clinics.

Murder conviction for physician

In egregious cases, a physician’s involvement in opioid abuse can lead to criminal penalties. In 2016, a California general practitioner, Hsiu-Ying “Lisa” Tseng, was sentenced to 30 years to life in prison following her conviction for second-degree murder in the deaths of three patients. She also was found guilty on more than 12 counts of illegally prescribing drugs.

One of the patients who died of an overdose of drugs prescribed by Tseng traveled more than 300 miles with friends to obtain prescriptions from the physician.

The federal government is stepping up its effort to punish over-prescription of painkillers. In 2017, Attorney General Jeff Sessions announced funding for 12 experienced Assistant United States Attorneys who, for three years, will focus exclusively on fraud issues related to opioid prescriptions.

Law enforcement officials will examine whether physicians prescribe opioids far in excess of their peers.

Government initiatives

Federal and state governments have launched initiatives to combat abuse of opioids. Among the initiatives:

  • The federal 21st Century Cures Act has provided $1 billion in funding over two years to fight opioid abuse. More than $140 million is for opioid treatment medication (particularly Naloxone/Narcan) and training of first responders; $200 million will go to community health centers
  • The FDA is requiring drug companies to develop more post-market data on long-term impact of opioid use
  • In August 2017, President Trump declared that opioid addiction was “a national emergency,” though the statement was not promptly followed by a formal declaration and specific emergency actions
  • Approximately 20 states require physicians to check a prescription drug monitoring database before prescribing painkillers to a new patient
  • Some state licensing boards require physicians to receive training on controlled substance guidelines if the physician prescribes controlled substances

Medicaid coverage

State Medicaid programs provide coverage to more than 650,000 non-elderly adults with opioid addiction. The coverage is mostly likely to be available in the 32 states that expanded Medicaid coverage under the Affordable Care Act (Obamacare).

Jeff Atkinson is a professor for the Illinois Judicial Conference and has taught health care law at DePaul University College of Law in Chicago.

 

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4 free apps to download today

A long-overdue addition to the app store—and a good example of how a practice can develop an app of great value.

By Iltifat Husain, M.D. | Spring 2018 | Tech Notes

 

Young hipster using a mobile phone

These four great medical apps have all recently been developed and released. They’re all free to download, and they all come from great sources. One application in particular has long been overdue to make an entrance in the app store, and you’re sure to be excited to download it and give it a try.

Choosing Wisely

Price: Free. Apple: apple.co/2tYQfVK. Android: Not available at this time.

Price: Free. Apple: apple.co/2tYQfVK. Android: Not available at this time.

The Choosing Wisely app is a collaboration between the American Board of Internal Medicine (ABIM) and Consumer Reports—and finally brings the popular Choosing Wisely recommendations to mobile form via a smartphone app.

Most physicians are aware of Choosing Wisely, a campaign created in collaboration between ABIM, other medical societies and Consumer Reports to help promote conversations between clinicians and their patients when it comes to ordering tests and procedures. The crux of the campaign is to reduce unnecessary medical testing and procedures, while also improving health outcomes.

The Choosing Wisely campaign has gotten a lot of attention in the media because of the number of medical societies involved, the evidence behind the recommendations, and how the recommendations are easily presented in one easy-to-access area not only for clinicians, but also for patients.

This ease of access is why I have been puzzling that it took this long for the campaign to make it to mobile form—but it’s better late than never, and the app is a welcome addition to the medical app store.

When you open the Choosing Wisely app, you are immediately prompted to select “For Patients” or “For Clinicians.” In the physician section, along with key recommendations and literature citations, the app has patient-specific handouts and sharing functions that make it easier to explain to patients why a certain test or procedure isn’t recommended at the time.

It’s great to have an application to help patients understand the guidelines their physician is using. It’s important that patients realize that following guidelines and evidence-based care is how tests and procedures should be ordered—not in a haphazard manner that can cause unintended consequences.

My biggest issue with the app is that it’s not available on the Android platform yet. That will hopefully change soon.

Pneumonia Guide

Pneumonia Guide is by the prolific physician app developer Joshua Steinberg, M.D., whom we’ve featured before. His medical apps are truly created “by physicians, for physicians,” and they are simple and easy to use.

Though Steinberg’s Pneumonia Guide app has been around for years, it has undergone a significant update centered around recent changes in pneumonia guidelines by the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA).

Once you select the type of pneumonia (the app has pediatric pneumonia recommendations as well), you are presented with a page that lists diagnostic testing that should and shouldn’t be considered, antibiotic choices, assessing clinical response, and recommendations on management of overall care.

The app makes distinctions between IV and PO antibiotics and outpatient and inpatient settings. There is a calculator section as well to help physicians with risk stratification.

Price: Free. Apple: apple.co/2BaINPc. Android: Not available.

Pregnancy Passport from P&M

Price: Free. Apple: apple.co/2iQGANR. Android: bit.ly/2BCugwg

Price: Free. Apple: apple.co/2iQGANR. Android: bit.ly/2BCugwg

Pregnancy Passport was developed by the Physicians and Midwives Collaborative Practice, a team of OB/GYNs and midwives who practice across five centers across Northern Virginia. The app is a great example of how a practice can promote itself by providing a great smartphone app experience that’s not only for their patients, but for patients in general.

Though the app itself does have specific features made just for patients of the Physicians and Midwives practice, it’s packed full of great patient education content that any pregnant patient would find useful.

There are sections related to many chief complaints encountered in pregnancy. Key timers included in the app are kick counts and a contractions timer. A great feature of this app that many other patient-centered pregnancy apps don’t include is a postpartum and newborn care section.

Practice-specific apps rarely have patient portals and simply include information on the medical practice, which don’t make them useful. However, this app does a great job of promoting their practice by creating a medical application that provides real value.

If you’re thinking of making a practice-specific app, look at the Pregnancy Passport app as a model application.

CKD Care

The CKD Care app by the National Kidney Foundation calculates eGFR, adjusted eGFR, and other related information.

The app allows you to enter in key demographic information, insert key lab values, and get eGFR and adjusted eGFR values. Interestingly, while you are entering in the data, you are at times prompted with pop-ups that explain why the patient should see a nephrologist based on the values that you enter.

You are given a differential diagnosis as well as the actual values, which is one of the main features that separates this app from those that have come before.

Click through the differential list to get a nice condensed version of the condition. Some of the content within the differentials can also link out to UpToDate.

Overall, this medical app is a nice addition by the National Kidney Foundation into the app store and provides value by providing a great differential list based on the values that you get for eGFR and adjusted eGFR.

Price: Free. Apple: apple.co/2BSRyK8. Android: bit.ly/2juOGzT

Iltifat Husain, M.D., is editor-in-chief and founder of iMedicalApps.com, the leading physician publication on digital medicine. He’s also assistant professor of emergency medicine and director of medical app curriculum at Wake Forest School of Medicine.

 

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Navigating your job-search expense reports

Don’t let a seemingly routine exercise cost you a job offer.

By Therese Karsten | Job Doctor | Spring 2018

 

Close up pen on paperwork and woman hand calculate finance.

Expense report gaffes after an interview can cost you a job offer or damage your reputation in a new job before you even see your first patient. Employers know from history that the way a candidate handles the expense report process correlates closely with the physician’s administrative style. Bad behavior on an interview or relocation expense report is a pretty good clue about what’s to come regarding that physician’s scheduling, contracts and general behavior with other members of the medical staff. Conversely, reasonable, responsible, professional behavior with expenses reinforces the positive impression you have been working so hard to cultivate.

The best defense against committing an expense report gaffe is to ask yourself, “is this reasonable?” before you submit a receipt for reimbursement. The examples below are all real… Names and specialties redacted to protect the guilty!

Interview expense reports

A typical site visit runs approximately $1,000 to $2,000. Although that’s a drop in the bucket of a hospital or group practice operating budget, it’s an opportunity to demonstrate the type of reasonable employee you will be.

Flights: OK

  • Upgrading to business or premier economy if you are really tall (note this on the expense report) or if you’re recovering from an injury and really need a bit more room.
  • Arranging an interview that will dovetail with a conference, incurring slightly higher airfare than roundtrip from your home airport would have cost but saving you travel time and CME expense.
  • Baggage fees for checked or carry-on baggage.

Flights: Not OK

  • Upgrading to first class because you felt uncomfortable and claustrophobic in the assigned seat.
  • Upgrading to business class because you and your spouse weren’t able to sit together in the assigned coach seats.
  • Insisting that the only time you can interview is during spring break (so you can bring your family on vacation).
  • Building in an extra day to “see the area” when you are actually interviewing with another employer.
  • Incurring a heavy bag (more than 50 pounds) fee for a two-day interview trip preceding a vacation.

Ground transportation: OK

  • Taking a train, subway, Lyft, Uber or car service from your home to the departure airport.
  • Asking to use Lyft, Uber or taxis instead of a rental car (particularly for a short stay).
  • Driving your personal vehicle at the IRS business mileage reimbursement rate of 53.5 cents per mile instead of flying so that you can bring your kids.
  • Requesting an upgrade on a rental car if you are really tall so the seat can be adjusted for comfortable and normal knee and headroom.

Ground transportation: NOT OK

  • Requesting to fly out of a hub airport to avoid changing planes, then submitting a receipt for a $300 town car for the 90-minute trip to the airport.
  • Submitting hundreds of dollars worth of Lyft Premier receipts for shopping and dinner out with friends.
  • Submitting absurdly high restaurant, valet and baggage handling tips for reimbursement. (Feel free to add some dollars at your expense if you receive over-and-above service you would like to personally recognize.)
  • Submitting the mileage for your entire trip, including vacation days and mileage driven on days you were interviewing with another employer.

Hotel: OK

  • Ordering room service in lieu of a meal at a restaurant.
  • Submitting receipts for reasonable tips for bag storage, room service and housekeeping.

Hotel: NOT OK

  • Submitting receipts for alcohol, candy, ice cream or over-the-counter medications from the hotel gift shop.
  • Adding a second hotel room to the bill because your partner snores, and you need your sleep before the interview day.
  • Parking with the valet at twice the cost of self-park.
  • Leaving your personal belongings in your hotel room until you leave in the afternoon, incurring an unnecessary additional night room expense.

Meals: OK

The employer will typically present you with the guidelines of what expenses they reimburse. Alcohol policies vary; ask first, as many employers do not cover alcohol on meal expense reimbursement.

  • Purchasing some food at the grocery store instead of at a restaurant.
  • Asking your travel coordinator about the guidelines for taking your hosts out for a meal if your host is saving the employer hundreds of dollars in lodging costs.

Meals: NOT OK

  • Submitting grocery receipts that include toys, magazines and personal toiletries. Only submit grocery purchases that are in lieu of a restaurant meal.
  • Submitting grocery receipts for snacks, ice cream or dessert purchases. Don’t submit Starbucks stops unless it’s in context of a meal, like breakfast.

Other: Not OK

  • Submitting ski lift tickets, gambling expenses, movie tickets, zoo and water park admissions or spa services. If an employer has invited your spouse and family and intends to entertain them, the employer will let you know.
  • Submitting clothing, makeup or hair appliance purchases due to lost baggage. If the airline doesn’t deliver the luggage to your hotel (which happens in only 2 percent of lost luggage), they have their own process for reimbursement.
  • Submitting insurance copays, over-the-counter medication, or charges for a hotel concierge physician, urgent care or emergency room visit.
  • Expecting reimbursement for kennel fees or pet-sitting fees in your home. The majority of employers consider this your personal expense.

Relocation expense reports

Your moving van may be set up to directly invoice the hospital or practice, but there are a lot of ancillary expenses that can cause problems. Read the relocation policy and have your significant other read it, too. Many relocation dramas unfold due to assumptions made. When in doubt, get pre-approval on the expense.

Relocation: OK

  • Using a friend or relative in the moving business to move, as long as they are a registered, tax-paying business with a website and appropriate insurances. (Get bids from other movers to document that your cousin’s invoice is in line.)
  • Staying in a reasonable, mid-range hotel en route to your destination.

Relocation: NOT OK

  • Submitting a $1,500 for movers. (Tips are usually not covered by employers.)
  • Submitting a handwritten invoice for a cash payment to a mover with no business license, no tax ID and no searchable identity.
  • Instructing movers to disassemble play structures in the old yard and rebuild them in the new yard at the employer’s expense.
  • Detouring to a resort where nightly rates are double what hotels on your route would have been.
  • Submitting grocery, drug store or clothing purchases because the closing for your new house was delayed.
  • Submitting relocation expenses a month after the deadline.

Before you submit that expense report, hit “save” and do something else for a few hours. Ask yourself if your reimbursement requests sound reasonable, sensible and fair. If so, you most likely have done a great job and reinforced your terrific reputation with your new employer!

Therese Karsten is Director of Physician Recruitment for HCA’s Continental Division and a frequent contributor to PracticeLink Magazine.

 

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What’s your retirement plan?

When it comes to retirement, you either outlive your assets or they outlive you. The deciding factor is whether you have a formal, comprehensive plan.

By James McNaughton | Financial Fitness | Spring 2018

 

Glasses and clock on the business paper. Report chart

When it comes to retirement, you either outlive your assets or they outlive you. The deciding factor is whether you have a formal, comprehensive plan.

Depending on your specialty, you just spent the last 12 to 15 years of your life preparing for your “real job.” While your friends from undergrad have been in the workforce for 10 years, you have been increasing your debt load during medical school while working for a fraction of your worth during residency. You have given up one of the most important components of investing: time.

Fortunately, physicians can earn a higher paycheck than most. Unfortunately, the temptation to purchase items that were unrealistic during residency (luxury cars, large houses) can be overwhelming.

The good news is that, by exercising some common sense and creating a formal plan, accumulating the assets needed for your “work optional” lifestyle is not as difficult as it seems.

Create a budget beyond student loans

Creating a budget is a great idea for two reasons. First, it will give you an idea of how much you spend on necessities, the things you need to live. Secondly, it will determine your discretionary income, or surplus, after you cover the necessities.

From this discretionary income, you can determine how much you need to invest to achieve your target retirement age. There will be non-investing factors, such as the cost of setting up a practice or running expenses for a clinic. There will also be investing factors to consider, such as contributing to a taxable account vs. retirement accounts.

Start saving early

Once you decide on a “work optional” age, you’ll need to calculate how much to invest each year to accomplish your goal. You will also want to choose a hypothetical rate of return determined by your risk tolerance.

Everyone’s risk tolerance is different. If you are able to tolerate volatility and have a long-time horizon, a portfolio weighted more heavily in equities may be suitable for you. If market volatility gives you sleepless nights or you have a shorter timeline, a balanced portfolio consisting of equities and fixed income may be more suitable. Be sure to consult a financial professional if you are unsure of your risk tolerance.

Inflation is another factor to consider when creating a financial plan. Inflation is the rate at which the general level of prices for goods and services increases over time. Consequently, inflation can erode purchasing power, something to consider when building your portfolio.

Consider Dr. Jones, 30, fresh out of residency. She would like to have a “work-optional” lifestyle at age 66. She desires to withdraw $8,000 per month from her retirement accounts, adjusted for inflation. Using 3 percent inflation, Dr. Jones will need to withdraw roughly $24,000 per month at age 66 to maintain the same purchasing power as today. At a 4 percent withdrawal rate, she would need a retirement account of over $7 million!

Fortunately, time is a great ally for young physicians. What may seem daunting fresh out of residency can be achievable with some planning and discipline.

Don’t get caught up comparing numbers, as everyone’s situation is different. There are many factors that can influence your plan. Social security benefits, pensions, private business interests, liquidating shares of a surgical hospital or selling a practice can all impact your situation. The important thing is to be proactive and work with a qualified financial professional.

Establish an emergency fund

It’s recommended to have three to six months of expenses in a liquid, low-volatility account. If you are the primary income source in your household, six months should be the target. If your spouse is also a high earner, you could reduce your fund to cover three months.

Look for an FDIC-insured, high-yield savings account. As interest rates have gone up, so have the yield on these accounts. It’s best to avoid investments with volatility, such as individual stocks or equity funds. Think of this money as an emergency fund only, not a slush fund for entertainment purposes!

Work with a professional

Similar to the medical profession, the financial industry offers an array of designations. The term “financial advisor” can be used to describe a very diverse field of individuals. It is in your best interest to form a relationship with someone who can represent and work with several companies or investment products. Even as a resident or newly practicing physician, you need to be proactive with your retirement plan. Your financial numbers need to be monitored and reviewed just like your personal health. If you don’t like your current financial situation, it is much easier to make changes in your 30s and 40s than it is in your 60s.

James McNaughton, CFP, is a partner at Siouxland Investment Group, LLP, and financial adviser for Premier Physician Agency, LLC, a national consulting firm specializing in physician job search and contracts.

(Disclosure: James McNaughton is a registered representative and a registered investment adviser of Hilltop Securities Independent Network Inc. a registered broker-dealer and a registered investment adviser that does not provide tax or legal advice. Views and opinions expressed herein are solely the author’s, and not Hilltop Securities Independent Network Inc. member of FINRA and SIPC and a wholly owned subsidiary of Hilltop Holdings, INC. (NYSE: HTH), with headquarters at 1201 Elm Street, Suite 3500, Dallas, TX 75270 (214-859-1800). Premier Physician Agency, LLC is not affiliated with Hilltop Securities Independent Network Inc.)

 

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Where should I work?

Decide what practice setting is right for you by taking a close look at your options.

By Debbie Swanson | Feature Articles | Spring 2018

 

Shoshana Ungerleider, M.D., counts a variety of specialists and continual learning opportunities as benefits of working at a large organization. · Photo by Mischa Photography

Shoshana Ungerleider, M.D., counts a variety of specialists and continual learning opportunities as benefits of working at a large organization. Photo by Mischa Photography

The job search can be all-consuming, with countless criteria to consider. But before you begin to think about location or benefits, you should decide what type of practice you’d like to join. Whether you see yourself at a big city hospital, a specialized clinic or a group practice, evaluating where you fit best will help you make up your mind about other factors.

Throughout your medical journey, you’ve glimpsed many practice settings. Rethinking each is valuable as you begin your career search. This overview of practice settings will help illuminate your options as you start looking for a new practice.

Solo/private practice

Opening a solo practice was once the dream for most aspiring physicians, but it’s now the road less traveled. Between 1983 and 2014, the percentage of physicians practicing solo dropped from 41 to 17 while the percentage of physicians in practices larger than 25 rose from 5 to 20, according to the American Medical Association.

There are many reasons for this drop in private practice. Complying with government regulations can be difficult, and many physicians prefer a setting where they can expect a stable income and steady hours. Additionally, private practice involves more administrative work than some other settings.

However, some physicians are still drawn to the autonomy of private practice. Fayne Frey, M.D., a dermatologist based in West Nyack, New York, chose being a solo practitioner for the control she has over her patients’ care and her own schedule.

“I can see as many or as few patients as I want and adjust my schedule as needed,” Frey says.

But Frey admits there are drawbacks. For instance, she says private practitioners have less leverage when it comes to negotiating with insurance. “They’re not as interested in me as they are a big group,” she says.

Group practices

Physicians opting for group practices find a setting that provides more leverage with insurance companies, greater profitability and improved quality of patient care. Group practices vary in size and scope. Single-specialty groups tend to be smaller, employing an average of eight physicians, while multispecialty groups employ an average of 25 physicians.

Single-specialty groups can be a prime environment for learning more about your specialty and fine-tuning your skills.

However, because every physician in the group practices the same specialty, referrals rarely come from within, and a practice’s existing patients tend to gravitate to whichever physician they have seen before. A new physician may need to be proactive about getting his or her name out and building a client base.

The amount of autonomy varies widely in this setting. At some single-specialty groups, physicians are highly involved in setting standards and procedures. At others, physicians have less say. And while single-specialty groups often have more leverage with insurance companies than solo practitioners do, smaller groups still face similar struggles with insurance agencies and regulatory compliance.

Multispecialty groups tend to employ more physicians than single-specialty groups, and they also offer a wider spectrum of services. Most multispecialty groups are general in focus, but some revolve around a certain area, such as diabetes or cancer care.

“It’s common to see some type of primary or family care included [in a multispecialty group], as well as several other specialties,” says Philip Masters, M.D., FACP, vice president of membership and international programs at the American College of Physicians and an adjunct professor of medicine at the University of Pennsylvania School of Medicine.

Masters believes this diversity benefits physicians. “With several doctors within a group, a multispecialty practice offers built-in support and consultation. It’s easier to send patients to other doctors or to consult with and get guidance yourself,” he says. “Overall, the process is streamlined for patients and easier for the doctor.”

However, multispecialty groups don’t always offer as much autonomy as smaller group practices. With more clinicians, these practices require more protocols for smooth operations. Those protocols may be developed by executive management, not physicians themselves. And as you’d expect, workplace dynamics can sometimes be difficult when multiple specialties are involved.

When interviewing at either type of group practice, consider whether a hospital acquisition is likely and whether that affects your interest in the group. According to the Physicians Advocacy Institute, hospital ownership of group practices increased 86 percent from 2012 to 2015—representing a 50 percent increase in the number of physicians employed by hospitals.

Hospitals

“It gives me a feel good feeling that they’re not just after profits, but to serve and to help,” says Michael Burdi, M.D., of working at a religiously affiliated hospital. · Photo by KLK Photography

“It gives me a feel good feeling that they’re not just after profits, but to serve and to help,” says Michael Burdi, M.D., of working at a religiously affiliated hospital. Photo by KLK Photography

Hospitals remain a popular work setting for physicians. According to Physicians Advocacy Institute, hospital employment of physicians steadily increased between 2012 to 2015, with regional growth rates ranging from 33 to 59 percent across the nation.

Most hospitals offer a complete spectrum of medical and surgical procedures on both inpatient and outpatient bases. But beyond that, hospitals vary greatly in terms of size, affiliation, specialty, patient population, levels of emergency and trauma care, for-profit or nonprofit status and more.

As an employer, a hospital offers physicians some of the same advantages as a large multispecialty group practice. You’re among a large, diverse medical population, and the environment is usually intellectually stimulating and modern.

“Having many different specialists, as well as fellows, available at all times is a benefit of working in a large institution,” says Shoshana Ungerleider, M.D., an internal medicine physician at California Pacific Medical Center in San Francisco. “There are also numerous monthly opportunities for continued learning through lectures, grand rounds, events and conferences.”

With round-the-clock, year-round staffing needs, hospital employment allows physicians to choose shifts that suit their lifestyles. “From early in my residency training, I enjoyed working the night shift. Now as an attending, working nights affords me many days off to do the other things I enjoy outside of medicine,” she says.

Teaching hospitals not only provide hands-on clinical experience to medical students, but also enriching opportunities for practicing physicians.

“Teaching [other] doctors, along with taking care of patients, pushes me to stay up on all of the latest data on diagnostics and treatments for patients,” says Ungerleider, adding that she also enjoys the opportunity to give back.

Faith-based hospitals are also common. MergerWatch reports that the number of Catholic owned or affiliated hospitals in the United States grew by 22 percent between 2001 and 2016, and 14 percent of acute care hospitals in the nation are owned by or affiliated with the Catholic Church.

Michael Burdi, M.D., an orthopedic spine surgeon at Mission Hospital Regional Medical Center in Mission Viejo, California, enjoys the altruistic mindset of his religiously-affiliated hospital. “I do get a sense of service to the community. It gives me a feel-good feeling that they’re not just after profits but to serve and to help,” Burdi says.

While working for Mission, Burdi has been able to spend time treating underserved populations. “Years ago, I took trauma calls at the Camino Health Center, a clinic which provided care to those who couldn’t otherwise afford it,” he says. “To me, that’s an example of what a faith-based hospital does.”

Stephen Tocci, M.D., chair of the orthopedics department at Mission Hospital, adds that religiously-affiliated board members keep the hospital grounded in their mission. “We have nuns serving on the board who bring a great deal of experience and provide a balance of humanitarianism and compassion,” he says. “Having them present at the leadership level provides an ongoing sense of service and upholds the hospital’s defense of the underserved.”

Some faith-based hospitals restrict care and referrals for certain types of services, such as reproductive and end-of-life services. If you’re considering employment at one, make sure you’re informed about their policies.

Government

Many sectors of the government employ physicians as well. For example, the Veterans Health Administration is the largest integrated health care system in the United States, providing care at 1,245 facilities and serving more than 9 million enrolled veterans each year.

Physicians who work for the VA find it rewarding to care for patients who have served our country. “These are some of the best patients in the world,” says Shereef Elnahal, M.D., Assistant Deputy Under Secretary for Health for Quality, Safety and Value. “I’ll never forget some of the patients I have treated.”

Jennifer MacDonald, M.D., Director of Clinical Innovations and Education in the Office of Connected Care, agrees. She says, “The vets are extremely grateful for their care. …They have a lot of pride, and that makes it very rewarding as a provider.”

Because many of their patients have undergone physical or psychological trauma, VA physicians are trained to take a holistic approach. They screen for mental health, lifestyle issues and substance abuse among other health concerns.

The VA is also highly focused on research and innovation. In 2017, the Department of Veterans Affairs ranked 17th on Reuters’ list of the world’s most innovative research institutions.

MacDonald says the VA also provides telehealth. “To follow up on someone who was discharged, I can call up a video visit, [which easily] fits into my day and doesn’t require the vet to drive in to see us,” MacDonald says, adding that in FY 2016, more than 2 million patient visits were conducted via telehealth.

Correctional medicine

Correctional health care is another growing opportunity for physicians. It may sound like a difficult work environment, but Mohammad Khan, a board-certified psychiatrist in Dallas, says that providing medical care in correctional facilities offers variety and new challenges.

“It was quite rewarding to diagnose and treat them,” he says. “The combination of personality disorders with mental illness was quite high in adults. In the juvenile facilities, the biggest problems were lacking a stable home structure.”

Khan found correctional services to be vigilant when it came to ensuring physician safety, and he enjoyed working alongside other medical professionals, such as counselors and therapists.

Federally Qualified Health Centers

Physicians can also find enriching government opportunities at Federally Qualified Health Centers (FQHCs). These clinics and health centers provide comprehensive care to uninsured and underserved populations. And because it is often financially and logistically difficult for their patients to access medical care, FQHC doctors quickly learn to wear many hats.

“From a professional perspective, [you’ll encounter] many medical and psychosocial issues that may be less commonly seen in other practice settings,” says Masters, who worked at an urban FQHC setting early in his career. “Since centers are required to provide comprehensive care, you’ll work closely with other medical professionals.” He adds: “It is [also] nice to know that you are helping in a place where good care may be difficult to find.”

Locum tenens

Medical practices have extensive staffing requirements—and physicians sometimes get ill or go on leave. That’s when locum tenens physicians step in. Locum tenens physicians take over when a doctor is unavailable for as briefly as a day or for as long as several months.

What it lacks in job permanence and stability, it makes up for in variety. Physicians are attracted to locum tenens work because it allows them to explore different practice settings and locations.

Planning your next move

Identifying your preferred setting can help with your job search, but it’s also smart to remain flexible. You never know how a practice might surprise you. For example, you may find a small group practice where management determines procedures or a large practice where physicians have a lot of say. Remain open to possibilities.

Like most major decisions, the practice setting where you’ll fit the best often comes down to a gut feeling. The environment that appeals most to one physician may sound completely unappealing to another. So do your research, talk with your advisors, and reflect on your goals. In the end, you’ll find the answer by listening to your true calling.

 

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6 Questions you must ask in your job search

A physician’s job search is full of questions. Asking yourself these along the way will help you find your dream practice.

By Chris Hinz | Feature Articles | Spring 2018

 

Job Search Chart with keywords and icons Flat Design

The job interview process involves a lot of questions. You’re trying to find the best match for your experience, work style and skills. Meanwhile, your future employer is trying to find the best match for its culture and staffing needs. But the most important questions you ask throughout the process may be the ones that you ask of yourself. In a job market flush with opportunities, it’s important to direct your job search, narrow your options and quickly determine what setting is best for you.

David Hass, M.D., is course director for the Young Physician Leadership Curriculum for Connecticut State Medical Society/Yale New Haven Hospital and a physician with Gastroenterology Center of Connecticut. He explains, “You can’t cast a wide net and hope that every opportunity that draws you in is going to be the perfect opportunity. Instead, you need to set parameters for yourself as to what you think will really make you happy both personally and professionally.”

Start with these six questions to help clarify—then achieve—your goals.

Question 1: What do I want out of my job?

The culture of the community and practice was an important factor for Michael Antolini, D.O., in his job search.

The culture of the community and practice was an important factor for Michael Antolini, D.O., in his job search.

As you start looking for opportunities, consider who you are personally as well as where you’re headed professionally. Focus not just on your strengths and weaknesses, but also on your personality and preferences. That will help you define what practice type, size, configuration and culture will work best for you.

Ask yourself: What do I want my work and private life to look like? Would I thrive as an employee or as an independent practitioner? Do I prefer working with other specialties or just my own? What would make me happy, confident and energetic at work?

“I tell residents, ‘It’s both a good and bad [thing] that you basically can go anywhere because there are so many job options,’” says Heather Gavitt, provider recruiter for AtlantiCare in Atlantic City, New Jersey. Zeroing in on a practice type can narrow the virtually unlimited choices. “It can help you cut down on the places that you’re looking at so that you have a manageable pool before you move further and overwhelm yourself.”

When Joshua Cohen, M.D., wanted a career change, he took inventory of his skills and asked colleagues and friends for input. They told him he had a knack for taking charge and would thrive in a leadership role.

Cohen came up with two goals: 1) to help a lot of people, and 2) to tackle a variety of challenges in his day-to-day work. “I wanted something that was going to be different every day,” he says. “I wanted a challenge or project that I’d have to learn how to do and then integrate into my job.”

He found the perfect opportunity at Teva Pharmaceuticals in Frazer, Pennsylvania, as global medical director and medical lead for migraine and headache.

This role allows Cohen to be involved in leadership and tackle new challenges every day. Most importantly, he can focus on his passion: improving the lives of migraine sufferers. “I really wanted to do something that would be meaningful to the patients I had treated for all of these years,” he says.

Question 2: Is the work environment at this practice right for me?

Your search isn’t over once you find a practice that matches your criteria. You need to evaluate the offer—beginning with the work environment. Do administrators foster a supportive environment? Will you be able to flourish as a physician and maintain a healthy work-life balance? You can get a sense of the workplace dynamic from your interactions and observations throughout the interview process. If prospective colleagues are genuinely content, you’ll feel, see and hear it.

You can ask a few questions to help assess the environment. For starters, why is the practice hiring? Longevity speaks volumes about the practice leadership, as does high turnover.

“Sometimes physicians are blinded by the things that look good,” says Wanda Parker of The HealthField Alliance in Danbury, Connecticut. “But why have six people, for instance, left this practice? There could be some red flags.”

You should also ask about workload and policies. How much time will you be spending at the office, and will you have enough time left over to enjoy your personal life? Is it a democratic environment where everyone has a say, or is the decision making top-down? And what about the management style? Whatever the case, you want to know that the structures and environment will suit you.

Michael Antolini, D.O., asked these sorts of questions before accepting an offer for a family practice position with Access Health in Lochgelly, West Virginia. Lochgelly is near Beckley, where Antolini had completed medical school rotations and had family. Antolini enjoyed the practice’s collegial atmosphere, and he had met several of its physicians during his rotations. “It’s always been nice to walk down the hall and bounce ideas off of people who you know and trust because they taught you what you know,” he says. “I now participate in training other residents the same way.”

Parin Patel, M.D., is targeting her job search by looking for an academic or hospital setting. She’s now a fourth-year obstetrics and gynecology resident at The University of Texas Medical Branch in Galveston. She’s excited to merge clinical duties with teaching, and she also wants to motivate younger doctors to become leaders in their specialties. As president of the American Medical Women’s Association resident division and an active participant in American College of Obstetrics and Gynecology, Patel enjoys being a voice for the profession.

Wherever she ends up, Patel hopes to find a practice with colleagues who share her commitment to the underserved. “I want to work with people who understand and are supportive of someone who wants to provide care to patients potentially not able to find it anywhere else,” she says.

Question 3: Can I be professionally successful here?

For a profitable, satisfying career, you need to find a position where your skills are in demand. Consider the local community and its patient population. You’ll want to know not only how your competition stacks up, but also basic information about the local economy. Will it support a stream of patients for your specialty?

Examine the professional opportunity at the practice itself. If you’re replacing another physician, you’ll likely have a patient base ready when you arrive. But if administrators plan to use your skills to grow the practice, you’ll likely have to start building your patient base from scratch.

In either case, make sure you understand how the group intends to launch you, and if they’re willing to invest in equipment and support services. If you’re a surgeon with expertise in robotics, for instance, you don’t need to bother with a practice that won’t purchase the equipment for you to do your job. “You have your skills,” explains Jane Born, CEO of Born & Bicknell in Boca Raton, Florida. “You want to bring them to a facility that truly wants and needs them.”

You should also ask about travel. If you’ll be practicing at more than one facility, consider how that travel time might affect your ability to see patients. Productivity impacts compensation, and splitting your time among several locations might reduce your efficiency.

“You need to ask yourself, ‘How much time am I spending in my car or away from the office?’” says Patrice Streicher, associate director and professional development coach at VISTA Staffing Solutions in West Allis, Wisconsin. “How much of my life will be spent doing that compared to what I really love: practicing medicine?”

Zach Lopater, M.D., considered these sorts of questions in his last job hunt. Since radiation oncologists depend on referrals, he wanted to make sure his future employer had enough connections with other providers for him to attract patients. He knew he’d need physicians to send patients his way in order to produce consistent numbers. “The key was: ‘Am I going to have enough patients?’” he says. “‘Was I stepping into a hostile practice that was going down the drain, or was it a strong practice?’”

At Radiation Associates of Macon in Georgia, Lopater found exactly what he was looking for. The practice already had a close relationship with a medical oncology group in the same building, so sharing patients and information was an established routine. “It’s been a very strong practice with very good relationships,” Lopater says. He now enjoys a steady stream of patients and sees a variety of cases, from breast, lung and prostate cancer to head and neck cancer.

Question 4: Is this the right community for my family and me?

It’s natural to focus on your employer during a job search, but you shouldn’t overlook the town you’re moving to. If the area is a total mismatch to your personality or your family’s personality, it can deplete your energy and drive—and make everyone unhappy.

Ask yourself and your significant other how the setting will work for you and your family. Are there professional opportunities for your spouse or partner? Plenty of activities for your children? Do the schools in the area offer what you’re looking for? Finally, does the place offer the lifestyle you want? “One exam room looks just like the next,” Streicher says, “so your questions should be based on what occurs in your life and your loved ones’ lives outside of that room.”

Finding a geographic location that supports her family’s religious needs is an important piece of post-residency planning for Parin Patel, M.D.

Finding a geographic location that supports her family’s religious needs is an important piece of post-residency planning for Parin Patel, M.D.

As Patel and her husband, Nikul, look for their next home, they are prioritizing proximity to a major airport nearby. And while they’re willing to live outside the Northeast, they want visiting family to be relatively easy.

It’s also important for them to be able to worship their Hindu faith as members of a BAPS temple. BAPS congregations are scattered across the country, and Patel is using their locations to direct her search. As a result, she’s expanded her options to cities that she hadn’t previously considered.

Because the denomination is closely knit, Patel anticipates knowing people already or meeting people who are familiar with her temple in New Jersey.

Question 5: What do I want my future to look like?

Think about your job not only in the short-term but also in the future. Having a sense of where the position might take you can help determine if it’s truly the best fit. Will the environment sharpen your skills? Do you expect to stay put, or is it a stepping stone to another place?

“Physicians should ask themselves, ‘Where do I want to be professionally and personally in five and 10 years?’ says Emily Glaccum, recruiting principal at The Medicus Firm. “Then they need to figure out what characteristics of a practice opportunity will most likely help get them to those goals.”

Lopater, for instance, put autonomy and partnership at the top of his wish list. He not only wanted a pleasant work environment, but also some control over business decisions. His biggest must-have was a written guarantee that he’d make partner in two years if he showed his worth. “I wanted a position where I could stay long term and not have to uproot my family once I settled in,” he says.

Other opportunities offered higher initial pay, but Lopater believed Radiation Associates had a long-term interest in him. They were willing to make a firm commitment. In turn, he was willing to make a little bit less at first because he was confident he’d be a partner in year three. It was a busy organization, and the practice recently made good on their two-year commitment by making him partner.

Question 6: What’s my fallback plan if this job doesn’t work out?

As you enter the home stretch with any offer, you’ll likely have high hopes for the future. You’ve done your homework and made informed choices. And if your initial vibes are positive, it’s hard to envision everything crashing around you. But what if things don’t unfold as nicely as you envision? Do you have a plan B? It’s smart to anticipate your next steps if your new position doesn’t live up to your expectations.

“Physicians should do what I call ‘fear setting,’” says Streicher. “They should ask themselves, ‘OK, if I take this job and it isn’t what I was told it would be—or the people aren’t what they appeared to be—what would I do? What are my outs?’ I think that’s really a very practical step in making a decision.”

Your backup plan should lay out your options if you leave the position you’re considering. Where would you go next? What sort of practice would you look for?

If you want to remain in the same community even if you leave your job, make sure your contract has a favorable out clause. And if you’re not excited about an opportunity from the get-go, perhaps you should reconsider your acceptance. “Chances are it’s not going to work for whatever reason if you already have those feelings,” says Parker.

Even if you love your job and don’t plan to look elsewhere, it’s smart to have a contingency plan. Since starting his job, Antolini has sought additional leadership roles. As medical director of four nursing home facilities, he sees 80 elderly individuals each week in addition to his clinic hours. He loves his job and the location, but he wants to have options if his circumstances change. With geriatric medicine on his CV, he’s confident.

“If it all came crashing down tomorrow, I feel good about just presenting what I’m doing,” he says.

 

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Live & Practice

By Liz Funk | Live & Practice | Spring 2018

 

A small population size can mean a tight-knit community, even if residents hail from far-flung places. Locals from the communities on this list pride themselves on being welcoming to others, ready to share in the abundant natural wonders and cultural offerings that epitomize their corners of the world. If you explore any of these gems, know that many a tourist have visited and declared, “I never want to leave!”

Sedona, Arizona

In Sedona, Arizona, locals are surrounded by spectacular natural beauty, including the iconic red rock formations often featured on postcards from the area. Physicians in Sedona often have opportunities to establish relationships with their patients. The patient population is comprised of residents (many of whom enjoy active lifestyles year-round, thanks to Sedona’s mild climate), as well as tourists and outdoor adventurists drawn to the region.

Many residents of Sedona are transplants from other parts of the country. Blame “red rock fever” for this: People come for vacation, fall in love with the area’s stunning natural beauty and opportunities for outdoor recreation, and decide to make Sedona home.

Ed Eppler, M.D., an emergency medicine physician who attended the University of Washington School of Medicine and completed his residency at Indiana University School of Medicine, landed in the small city of Sedona after deciding to become a traveling locum tenens physician. In addition to working on his own, Eppler also worked with the staffing agency Envision Physician Services, which placed him in Sedona for one of his first assignments.

“It has been over-the-top awesome,” says Eppler. “Envision has tremendous opportunities, and they make it relatively easy for physicians to navigate through licensing, credentialing and scheduling.”

In Sedona, Envision Physician Services operates Verde Valley Medical Center, a free-standing emergency department. The Cottonwood campus of Verde Valley Medical Center, also operated by Envision, is just a short distance away, and is a Level IV trauma center. On the Sedona campus, which has laboratory, radiology, orthopedics and primary care outpatient clinics, in addition to the emergency department, physicians also have access to a TeleStroke program, through which patients can be remotely “seen” by a neurologist from the Mayo Clinic.

Though the Sedona campus emergency department has only four treatment rooms with five beds, according to Envision Physician Services Recruiter Anthony Martinez, there is no shortage of excellent care at the facility. In the category of overall quality of care, the facility “consistently ranks above the 90th percentile from Professional Research Consultants, Inc.”

There is also no shortage of exciting employment opportunities. Envision actively recruits board-certified or board-eligible physicians in emergency medicine, family practice and internal medicine for the emergency department on the Sedona campus. According to Martinez, the staffing agency offers a variety of opportunities across more than 1,000 centers, including full-time employment, independent contracting, and locums capabilities, which is how Eppler found Envision, and subsequently, Sedona.

When Martinez speaks to prospective candidates for the Sedona campus, he emphasizes that the lower-volume environment (in comparison to highly trafficked urban medical centers) allows for stronger relationships between physicians and their patients—not to mention the high quality of care physicians can provide to each person who walks through the medical center’s doors.

With a median age of 57 among the core population, plus an estimated 3 million tourists exploring the area each year, physicians play a critical role in keeping both local and visiting populations healthy and safe.

Staying healthy is important to residents and visitors alike, who take every opportunity to explore the outdoor splendor Sedona offers. “There is so much to do on the land,” says Jennifer Wesselhoff, President/CEO of the Sedona Chamber of Commerce and Tourism Bureau. “Hiking, biking, mountain biking, meditation. We joke that God made the Grand Canyon, but he lives in Sedona. It’s true!”

While many people visit the Grand Canyon’s rim to check it off their bucket list, Wesselhoff says Sedona is more accessible for exploring. “You can get into the rocks and land pretty easily and be immediately hiking and biking.”

Many people also gravitate to Sedona to experience its mediation and spiritual offerings, as Sedona was considered sacred land for Native Americans, according to Wesselhoff. The town offers meditation and spiritual retreats and world-class wellness spas quietly tucked alongside institutions steeped in small-town charm. The most meditative activity is sometimes as simple as stepping outdoors for a few moments.

“When you’re surrounded by beauty and nature, it puts everything in perspective,” says Wesselhoff.

In addition to attracting top medical talent, the area also has a vibrant community of entrepreneurs and other professionals who have made a conscious decision to move to Sedona. “People who live here absolutely want to be here and love it,” says Wesselhoff, nodding to the sense of community and sense of place that are both vital aspects of the Sedona experience. “You can really create that here,” she says. “It’s hard to do in a big place. It’s easy to get lost. But in Sedona, it’s easy to make a difference. That’s what I love about it. One person in Sedona can make a tremendous impact.”

Eppler, for his part, has found a rewarding professional experience at Verde Valley Medical Center, while also enjoying the richness of opportunities in the area. “Sedona and the surrounding area has too many wonderful outdoor opportunities to list,” he says. “It’s simply amazing.” He says he loves biking and running, in addition to skiing in the nearby town of Flagstaff, and enjoying the incredible scenery, culture and restaurants.

To put it simply, Eppler says, “What’s not to love?”

Traverse City, Michigan

Traverse City, Michigan, isn’t on the way to anywhere—and that is why people love it. The small city, which has a year-round population of 15,000, boasts an undeniable sense of community. Residents take pride in the area’s stunning beaches, green vineyards, charming downtown district and ample cultural activities. Physicians will find a state-of-the-art nonprofit regional referral center, and families will be welcomed into a friendly, thriving community.

Locals of Traverse City, which is located on the shores of Lake Michigan’s Grand Traverse Bay, enjoy a four-season paradise that offers something for everyone.

There are opportunities for swimming, boating, fishing, hiking, golfing, skiing and snowshoeing, plus an extraordinary range of dining and wine and beer tasting options. It has a healthy tourism industry that peaks the first week of July, when the National Cherry Festival celebrates Traverse City’s title as Cherry Capital of the World. Traverse City has a small-town vibe with big-city amenities—and residents who care deeply about the area’s heritage, as well as their neighbors.

Kelsey Knaack, D.O., a hospitalist born and raised in Traverse City, recently returned to the area to work at Munson Medical Center through iNDIGO Health Partners. Her husband, Joel, is also a hospitalist, and she recalls they agreed upon the excellence of the Munson Medical Center. “Especially for young physicians, there is nothing more encouraging than to enter into a strong group of practitioners,” she says, adding that her partners have a wide range of backgrounds, from providing care in rural settings to working in practices or outpatient facilities prior to starting hospital medicine. “We have folks who are fresh out of residency and folks who have been practicing for 30 to 40 years,” she says. “I love it.”

Knaack says she has been passionate about medicine since she was young, though she was momentarily sidetracked with plant physiology and ethnobotanical studies while studying at the University of Michigan. After deciding she wanted to pursue medicine and that she was passionate about the osteopathic discipline, she attended the Arizona College of Osteopathic Medicine at Midwestern University. Afterward, she returned to Michigan and completed her residency at Genesys in Grand Blanc. Though she was not home to Traverse City yet, she did meet her husband, Joel, then an internal medicine resident, during residency. They both took jobs within a large hospital system in Saginaw, Michigan, before deciding to return to Traverse City. When the couple started having children, Knaack knew it was where she wanted to be.

“We moved a year and a half ago, and we couldn’t be happier,” she says. During summers, they spend as much time as possible on the beach with their kids, who are 5, 4 and 2. The winter season provides a variety of outdoor activities as well.

“Traverse City is an outdoor paradise,” she says. “It’s absolutely stunning. Everything we do here is wrapped around the beautiful water and the beautiful outdoors.”

Knaack also loves her job in part because of the diversity among patients and cases. “Practicing in this community, we draw from such a wide range of areas, and we have folks coming from far reaches of the state,” she says, adding that some patients have not had any type of medical care for many years. That sometimes means Traverse City physicians see and treat rare pathologies. “Folks are under the impression that you only see those ringer cases in big cities, but that has not been my experience,” she says.

Munson Medical Center is the only verified Level II trauma center and the only neonatal intensive care unit north of Grand Rapids, which is more than two hours away. The center has 439 beds and the region’s largest medical staff, with over 500 physicians representing 57 specialties. According to Tracey Kukla-Aleshire, manager of physician recruitment at Munson Healthcare, the center has received repeated national recognitions, making the list of 100 Top Hospitals 14 times. It is home to an award-winning heart program and the Cowell Family Cancer Center, and is also designated as a Primary Stroke Center by the Joint Commission, says Kukla-Aleshire.

And they are looking for new candidates in dermatology, endocrinology, gastroenterology, neonatology, ophthalmology, psychiatry and more, including subspecialties.

When she introduces candidates to the region, Kukla-Aleshire explains how Traverse City is not only a great place to work, it is also a great place to live—no matter where your recreational interests lie.

“Traverse City offers something for everyone,” she says. “From a safe, welcoming community with excellent schools, to festivals, concerts, recreation and a vibrant foodie scene, Traverse City is a place people visit and never want to leave.”

Even with all its attractions, Jenny Jenness, media relations manager of Traverse City Tourism, acknowledges with pride the best thing about the region is the people who live there. “It’s no secret, Traverse City isn’t on the way to anything,” she says. “The people who are here have chosen to be here, and they’re deeply passionate about caring for this town now and for preserving it for generations to come. Life here is intentional, and you experience that sentiment in everything.”

She also echoes Kukla-Aleshire’s comment about Traverse City offering something for everyone. “I’m amazed that when I say this, I actually mean it. There’s something here for every interest.” Locals and visitors can find year-round adventure and recreation opportunities in Sleeping Bear Dunes National Lakeshore, which was just named the “Most Beautiful Place in America” by Good Morning America. The food and drink scene is not short on accolades, either, having been called one of “America’s Top 5 Foodie Towns” by Bon Appétit. With 40+ wineries and 20 breweries, many featuring craft beers, experiencing the full breadth of Traverse City’s gastronomic delights definitely requires pacing yourself. The ideal growing conditions mean wine and beer offerings proliferate, as do tart cherries, which are featured in the National Cherry Festival, or “the ultimate celebration of Traverse City heritage,” according to Jenness.

“There is no shortage of great stuff to do,” says Knaack, adding that because many of her partners have small children as well, activities with colleagues are always centered around family and are kid-friendly. The area’s strong sense of community permeates the hospital environment, too.

“As a mom in medicine with a busy schedule, it’s comforting to know I can turn to my partners and say, ‘My kid has a Christmas program,’ and they say, ‘Hand me your pager.’ That’s not always a guarantee for parents in medicine because of the hours we put in. This group emphasizes making it happen for each other.”

“It can’t be beat in that regard, as a place to live and raise a family,” Knaack says. “You can also have a very successful, strong medical practice, and it’s amazing to have that duality.”

Pittsfield, Massachusetts

“The Berkshires are a wonderful place to practice osteopathic medicine,” says Amanda Staples Opperman, D.O. “I initially followed a mentor to the Berkshires, and it just felt like home.” Photo by Angela Mia Photography

“The Berkshires are a wonderful place to practice osteopathic medicine,” says Amanda Staples Opperman, D.O. “I initially followed a mentor to the Berkshires, and it just felt like home.” Photo by Angela Mia Photography

Pittsfield, Massachusetts, is located in the heart of Berkshire County, a rural mountain region in western Massachusetts. Outdoor adventure, a vibrant economy and the farm-to-table lifestyle are all accessible in this picturesque area, which also offers a low cost of living in comparison to nearby cities like Boston and New York. Physicians are part of the tight-knit medical community, which is always working to innovate and bring new services to the area.

Amanda Staples Opperman, D.O., now associate program director of internal medicine at the Berkshire Medical Center, drove through western Massachusetts long before she ever relocated there for work. She recalls traveling through the area on her way to Ithaca College, where she earned her undergraduate degree, and thinking there was something beautiful and magical about it. “As you drive west on the Mass Pike, you start climbing, your ears pop, and as you pass over the Appalachian Trail, something seems to change,” she says. “It’s both comforting and exciting at the same time.”

After earning her degree at Ithaca College, Opperman completed additional pre-med classes at the University of New England in Biddeford, Maine before attending medical school at the University of New England College of Osteopathic Medicine in southern Maine. She says she fell into her specialty, which is primary care internal medicine with a focus on lifestyle and integrative medicine for optimal health. Says Opperman, “I was originally interested in women’s health, and through experiences in my training, realized that the best realm for me to do that was in primary care.”

“Women are instrumental agents of change in families, so that was my main focus,” she says. “Then I followed my interests and what came naturally to fit my patients’ needs. I’ve found that integrating nutrition, stress reduction and lifestyle factors, like daily movement, has led to incredible improvements in my patients’ lives, and the lives of their families.”

For Opperman, Berkshire County was the perfect place to nurture and hone her practice. “The osteopathic philosophy really resonated with my own values and view of health, and the Berkshires are a wonderful place to practice osteopathic medicine,” she says. “I initially followed a mentor to the Berkshires, and it just felt like home.”

Liz Mahan, a physician recruiter at Berkshire Medical Center, says a strong sense of community within the health system and beyond contributes to the area’s high quality of care and life. “I think there’s a pretty strong sense for everybody working within Berkshire Health Systems that we are caring for our friends, our family and our neighbors. It’s a tight-knit community within small towns throughout the Berkshires and within Berkshire Health Systems as a whole,” she says. “We frequently receive feedback from prospective job candidates about how much people seem to care, and that speaks a lot to the kind of community we have here.”

Berkshire Health Systems is the parent organization for Berkshire Medical Center in Pittsfield, Fairview Hospital in Great Barrington, the Berkshire Visiting Nurse Association, and numerous Berkshire Medical Center and Fairview physician practices. The practices cover a range of specialties including primary care, orthopedics, surgical services, bariatric surgery, oncology and radiation oncology, endocrinology, gastroenterology, OB-GYN and numerous other disciplines.

The Berkshire Medical Center is licensed for 298 beds, and has outpatient clinics and programs throughout the community, including Operation Better Start, which helps children and families prevent and overcome obesity. Community lectures also bring awareness directly to residents, and topics include wellness, cancer prevention and treatment, orthopedic care and treatment, and more. Among other initiatives, a community outreach team also provides free blood pressure screenings.

According to Michael Leary, director of media relations at Berkshire Health Systems, the organization has “invested significantly in technology,” and facilities now have state-of-the-art imaging and operating suites, hyperbaric oxygen chambers for wound care, da Vinci robotic technology for urology and gynecologic surgery, a MAKO robotic system for knee and hip replacement, high-speed linear accelerators for cancer patients, and advanced therapeutic endoscopy technology. “One of the benefits of working here specifically is that the health system works to innovate, bringing as many services as possible,” adds Mahan.

According to Mahan, Berkshire Medical Center is currently recruiting physicians for its hematology, oncology, orthopedic surgery, internal medicine, rheumatology, dermatology, ER, trauma, acute care surgery and anesthesiology departments. Similar to medical centers across the country, there is also a huge need for internal medicine.

According to Opperman, the Berkshire Medical Center is a rewarding place to work. “Almost all of my mentors from residency are now colleagues and have truly made me feel valued as part of the health system.”

Lindsey Schmid, marketing director at 1Berkshire, an economic development organization for Pittsfield and western Massachusetts, cites the high quality of life coupled with the relatively low cost of living as one of the area’s main draws. “You can pay for a house here for what it would cost you to buy a parking spot in New York City,” she says. However, western Massachusetts is still incredibly culturally vibrant, which goes back to the boom it saw during the Gilded Age, when millionaires built their summer homes in the Berkshires.

“Today, people come here to be inspired,” says Schmid. “Writers, photographers, artists—they’ll come here to pick up on that history and that energy.” Entrepreneurs, too, are vital to the creative economy, and it is not just food trucks, according to Schmid. Anyone who wants to be creative and make an impact on the community can leave their mark here.

“Everyone’s story of how they got here is just so interesting,” says Schmid. “I think because 80 percent of the land is undeveloped, it’s easier to access your creative potential without the noise of the city around you.”

Popular attractions include Tanglewood (the summer home of the Boston Symphony Orchestra), the Norman Rockwell Museum, the Massachusetts Museum of Contemporary Art (MASS MoCa), the Gilded Age mansions, and Edith Wharton’s home, the Mount.

Opperman and her husband welcomed their son in the fall of 2016, and they spend time outside during every season, soaking up the quintessential New England feel. “Whether we are in the yard planting flowers, hiking in nearby Kennedy Park, exploring a quaint village for the day, paddleboarding on Stockbridge Bowl, snowshoeing with friends in the winter, or apple picking and pumpkin carving in the fall, there’s always something to do in nature.”

The region also boasts a farm-to-table lifestyle that, thanks to the bounty of working farms in the area, is an authentic part of daily life in the Berkshires. “We are able to get amazing locally grown organic produce at Berkshire Organics Market, but we get out to the farms, too, to meet the farmers and see where our food is grown as often as we can,” says Opperman.

“To this day, I still learn of new things to see and do from patients, and I’ve been here for seven years now,” says Opperman. “The Berkshires has layers, and I haven’t found one I didn’t like.” That includes her experience as a physician working alongside a cadre of dedicated colleagues that care for their patients, and who are also neighbors and friends. Says Opperman, “It has been empowering to grow and develop into the clinician I am today, with such support from the health system and a true focus on patient-centered care.”

Beaufort, South Carolina

“Community oriented, patients first” is how Stephen Larson, M.D., describes the culture at Beaufort Memorial Hospital. Photo by Paul Nurnberg

“Community oriented, patients first” is how Stephen Larson, M.D., describes the culture at Beaufort Memorial Hospital. Photo by Paul Nurnberg

Charleston without the traffic? That’s Beaufort, South Carolina, a charming coastal town located on Port Royal Island, one of the largest Sea Islands. Residents take every chance they can to enjoy the area’s beautiful waterways, and the moderate year-round climate means almost every day can be spent outdoors. Coupled with numerous walking districts, friendly residents and excellent health care, Beaufort is an ideal location for physicians to practice medicine in a patient-first, physician-focused environment, while finding tranquility during off time.

Stephen Larson, M.D., medical director for emergency medicine at Beaufort Memorial Hospital, chose emergency medicine because of his affinity for bringing stability to a situation in chaos. “I like taking something that has fallen apart and restoring order,” he says. One of Larson’s medical school mentors, John Stone, M.D., was an emergency medicine pioneer, shepherding the idea that emergency medicine specialists should be able to treat all emergencies, rather than delaying treatment while waiting for input from consulting specialists.

After training with Stone and others at Emory University, Larson put his education to the test when he completed his emergency medicine residency at Alameda County Medical Center in Oakland, California. At the time of his residency, Larson recalls Oakland was experiencing a tremendous amount of street violence and drug use. “We saw very serious medical conditions,” he says. “It was a four-year emergency medicine training program by fire. That experience had me prepared for everything.”

After his residency, Larson joined a local group at a small practice in Berkeley, California, and after 10 years, started to take on leadership within the group. After that, he took an administration-focused leadership position in St. Louis. Because he was at that point affiliated with TeamHealth, the organization that manages Beaufort Memorial Hospital’s emergency department, he was ultimately able to move to his current leadership role.

Larson says Beaufort Memorial differs from how many other hospitals operate. “It’s administered and operated by a local board, not owned by a big corporate entity or large for-profit system.” he says. “We are truly a standalone community hospital. It’s becoming more and more unique.” While there are financial challenges that come with being board-operated, Larson says “we’re mustering our own course.”

As the largest hospital between Savannah, Georgia, and Charleston, Beaufort Memorial is busy, seeing 55,000 patients each year. “We are two to three times busier than the other local hospitals by the bigger cities, which means we’re able to offer a lot more complex services,” says Larson. Additionally, the hospital is the top employer for physicians in the area, and is very physician-friendly, according to Larson: “Community oriented, patients first.”

Zarina Manwah, senior clinical recruiter for emergency medicine at TeamHealth, adds that despite a challenging health care environment, “our emergency medicine clinicians are ready for each patient that comes through the ER doors.”

“For 35 years, we’ve provided support services, networks of communication and educational resources, and we’ve brought together a community of thousands of emergency medicine professionals to share and shape best practices,” says Manwah. TeamHealth partnered with Beaufort Memorial in January 2013, and Larson joined in connection with that relationship.

When Manwah talks to candidates about life in Beaufort, she is quick to share the variety of cultural offerings, both old and new, that make the small city a wonderful place to live. “Beaufort is filled with many historical mansions,” she says. “Art galleries, antique shops and modern boutiques dot the entire downtown and uptown walking districts, along with fine dining and quick eateries.” Plus, she says, the moderate climate means you can dine al fresco often.

“People find Beaufort very charming, very friendly,” says Robb Wells, vice president of tourism at the Beaufort Regional Chamber of Commerce. “It’s a 300-year-old city and close-knit community. Many of us are not originally from here, but it was inviting enough that we wanted to call it home, and we act like we’ve been here the whole time.”

Beaufort’s proximity to the Beaufort River, an intercoastal waterway, means locals and visitors alike can always be found enjoying the water. “If you don’t find somebody on the water, they’re trying to get to the water as fast as possible,” says Wells. The annual Beaufort Water Festival celebrates the region’s most beloved natural resource with nightly concerts, air shows and raft races. Food festivals, including a shrimp festival, make summer a highlight. The region’s attractions and atmosphere are particularly great for kids, which is why some people relocate to Beaufort from Charleston once they have a family.

Beaufort and Port Royal are also home to three military bases, which train over 20,000 marines each year. While much of the military population is temporarily stationed in the area, others are located there permanently, and Wells says that many military families retire to the area after they transition out of service.

And—no surprise—lots of physicians in cooler climates are ready to call Beaufort home.

“I get calls all the time from doctors in Ohio and the Midwest looking for a way to escape the heavy winters,” says Larson. “South Carolina is definitely a desirable place to practice.”

 

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Physician app cofounder

Jason Reminick, M.D., saw a need—and decided to fix it through technology.

By Marcia Travelstead | Career Move | Spring 2018

 

 Jason Reminick, M.D., cofounded a GME interview management platform after getting stuck in New York City during his own interview process.

Jason Reminick, M.D., cofounded a GME interview management platform after getting stuck in New York City during his own interview process.

Name: Jason Reminick, M.D., MBA, MS

Employer: CEO and cofounder, Thalamus

Education:

Undergraduate: University of Pennsylvania

Postgraduate: University of Rochester (NY) School of Medicine & Dentistry, Simon Graduate School of Business Administration (MBA)

Internship/Residency: Combined Pediatrics and Anesthesiology Residency Program, Stanford University Medical Center; Stanford Children’s Health-Lucile Packard Children’s Hospital

Reminick developed the idea for Thalamus after getting stuck in New York City during Hurricane Sandy. After several of his residency interviews got cancelled, he returned to his medical school and brainstormed with his mentor, now Thalamus cofounder, Suzanne Karan, M.D. Thalamus is the premiere cloud-based interview management platform designed specifically for application to graduate medical education training programs. The software was established by a grassroots collaboration of medical students, residents, fellows, program administrators and GME leadership to provide comprehensive online interview reservation and travel experience via a real-time scheduling system. Thalamus assists over 25,000 applicants and schedules more than 50,000 interviews at over 100 institutions nationally for all medical specialties.

What do you enjoy most about your role? To be clear, I’m not an engineer or coder, but lead our app and product development. What I most enjoy is the fact that we experienced a problem firsthand and then, along with my cofounder, built the solution into our product to best manage and streamline the residency and fellowship interview scheduling process.

It went from an idea to a successful app solving problems for both medical students and administrators. We’re really proud of that, and hopefully it’s making the process easier for all involved.

What’s the most challenging part? I enjoy this a great deal, but remain frustrated by the amount of anxiety that exists on both sides of the interview scheduling process. We are trying to figure out ways to allay that because applicants are applying to more programs than needed, further increasing their application costs. Similarly, programs continue to over recruit the amount of applicants, inviting more applicants than they have available interview positions. All are trying to protect themselves, and yet it’s adding even more anxiety and noise to the process. We are continuing to explore analytic solutions to allay these concerns.

What’s your advice to other physicians with an idea? I think the most important thing is to keep an open mind and be creative. Continue to learn by reading blogs and online publications. Also, connect with people and network.

There’s no unique formula, but seek out physicians in entrepreneurship, be that through Google or other search. It is a matter of networking with them. People are usually pretty forthcoming.

I believe it is important for physicians to be involved with innovation because we have firsthand and front-line knowledge of health care processes and can implement our experience to innovate health care, improve patient care, and benefit the medical profession as a whole.

Medicine is very structured in a lot of ways and often establishes a set path with limited flexibility. If you want to be an internist, an anesthesiologist, a surgeon or otherwise, you have a very set and distinct training path. Conversely, entrepreneurship is in many ways the opposite. It allows you to be creative and often face great uncertainty. It’s a different type of expertise, which at times can be challenging to fit into the paternalistic structure of medicine. It’s a matter of finding your passion and seeing it through. Surround yourself with the people who can help you get there.

 

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