It takes two: your spouse’s role in the job search

Starting early and speaking up can help physicians and their partners choose a career—and a location—that both can love.

By Karen Edwards | Feature Articles | Spring 2019

 

Stephanie Benjamin, M.D., is an emergency medicine resident and author of “Love, Sanity, or Medical School: A Memoir.” – Photo by Derek Lapsley

Starting the post-residency job search can be daunting. You’re working long hours, studying for boards and trying to have some semblance of a personal life. How are you supposed to add anything to your schedule, let alone a job search? The solution is to take things one step at a time. And if you’re married or in a committed relationship, the good news is that you’re not tackling this journey alone.

Just don’t forget to start early. “It depends on your specialty and where you would like to work, but most residents should start their search 12 to 18 months from their completion date,” says Jen Kambies, FASPR, director of special initiatives at the Cleveland Clinic. It’s the one job-search mistake she sees most often. “Applicants can underestimate the time it takes to get licenses and complete the credentialing process,” she explains.

Wendy Barr, M.D., MPH, residency program director of Lawrence Family Medicine Residency in Massachusetts, agrees. “I hear residents tell me they’re too busy to start their job search,” she says. “But I remind them, the whole point of residency is to get a job. If the search is delayed, they can go a month or two without a paycheck while they wait for the paperwork to be done.”

So here’s a rough roadmap to make getting a head start easy. Read on for the steps you should be taking—and how your spouse or significant other can help:

Getting ready for the search together

Physician

“Medical school and residency are so regimented. A job search marks the first time new physicians have the freedom to choose their path. It’s scary and exciting at the same time,” says Barr.

Before you begin your search, sit down and decide what you’re looking for in a job. Do you want to stay where you are or move? And if you’re moving, what kinds of job opportunities does your spouse need to find in the area? What salary range do you expect to earn?

You need to answer these questions even if you plan to stay put in your current location, so it’s best to start making decisions early. “Lack of clarity is one of the biggest reasons for procrastination,” says Kenneth Hertz, FACMPE, principal consultant with the MGMA Consulting Group. He says that once you’ve set goals and made some decisions, you’ll be better able to focus your search.

John Rodriguez, M.D., an orthopedic surgeon at Texas Orthopedics in Austin, says job applicants need to think beyond salary requirements. He recommends considering other important factors, such as job freedom and flexibility.

Stephanie Benjamin, M.D., a fourth-year emergency medicine resident at UCSF Fresno and author of Love, Sanity, or Medical School: A Memoir says not to pigeonhole yourself. “Determine your priorities and think every decision through so you are building the career that you—and not someone else—want,” she says.

That’s what Sasha Thomas, M.D., did when a job opportunity in Kansas came up unexpectedly. At the time, he was practicing in North Carolina as an executive health physician. “My wife and I sat down with legal pads and made lists of the pros and cons of staying where we were or moving to Kansas,” he says. “We took everything into consideration.” Ultimately, the pair decided to move.

Spouse

“You should be having ongoing conversations with your spouse about lifestyle, location and career goals throughout residency and throughout your lives,” says Lara McElderry, creator and host of the Married to Doctors podcast. When you do talk, she says it’s important to “be honest with your feelings, and keep an open mind.”

Stephanie Benjamin’s husband, Alex Angeli, says he asks his wife questions to ensure she’s making decisions that will truly make her happy. “I’ll ask her what move makes more sense to her in terms of what she wants to accomplish professionally,” he explains. “What location will help toward that goal?”

Doing the preliminaries (residency, years 1-3)

Physician

“The first thing you should do before a job search, if you haven’t already, is pull together your curriculum vitae or update it,” says Kambies. “It’s the first thing you’ll be asked for when you contact anyone for a job.”

Matt Wilson, M.D., a hospitalist and clinical assistant professor at the University of Kansas Medical Center, says he used free online resources to help with writing and formatting his resume. “I also asked a couple of residents a year ahead of me to send copies of their CVs for me to look at,” he says.

Don’t forget to check your social media presence. “We address this from day one,” says Barr, explaining that your public persona may prevent you from getting a license in certain states. “All social media accounts should be set to private—only visible to family and friends,” advises Wilson. And Benjamin says that even though she uses only her first and middle name on media sites, she’s still careful about what she posts.

Now is also the time to research potential locations and make other preliminary preparations. “Handle the process like it’s a job,” says Hertz. “Take notes on paper or online. Hone your interview skills. Spend time researching jobs. Sign up for PracticeLink.”

Faculty can be great resources during this time since many of them have developed a wide network of professional connections. “One of our residents had to narrow his search to Texas and North Carolina because those were the best places for his wife to find work,” recalls Barr. “He asked if any of the faculty had connections to either of those places. It turned out we did.”

Spouse

As a physician’s spouse, there’s a lot you can do to take the weight off your partner during this phase of the search. For instance, you can help with his or her CV. McElderry says, “Most physicians will take care of the writing themselves,” but if you’re skilled at communication, you might be able to pitch in.

Even if you don’t help draft your spouse’s CV, you should give it a once-over before it goes to an employer. Angeli did exactly that for his wife during her job hunt. He proofed her CV and helped organize it. “I also made sure it had her voice,” he says. “It highlighted what she wanted in a job and what she can offer.”

If you have time, you can also help research locations and job opportunities. “In your initial conversation with your spouse, choose the top three geographic areas where you want to live and work and expand from there,” advises Kambies.

“It helps to build a spreadsheet,” adds McElderry. “Organizing prospects will help you both better determine the best jobs and areas to explore.” Once you’ve narrowed the field, she says you should learn as much as you can about the area. She explains, “I researched everything: climate, schools, cost of living, neighborhoods and commute times.”

Kavitha Thomas, Sasha Thomas’ wife, took a less structured approach to her research. “My husband’s a data person; he made spreadsheets,” she remembers. “I’m a feelings person. I researched the area and tried to imagine what it would be like to live there.”

Lara McElderry created and hosts the Married to Doctors podcast. “Be honest with your feeling and keep an open mind,” she says when helping a physician spouse through their job search. – Photo Zayne Williams

Starting your active search (residency, summer of year 3)

Physician

This is the point where physicians can fall behind, according to Kambies. “They become extremely busy and the search for a job can fall off their radar. On occasion, they will wait until after their boards to start the search, but that is the time when they most need to be reaching out to recruiters and prospective employers.

“Starting early doesn’t hurt,” advises Kambies. “We don’t know what our needs will be two years out, but if this is a place you want to work, you can contact us if nothing else and form a relationship.”

That’s exactly what Wilson did. “At the end of my second year, I emailed the head of the hospitalist program at my medical school since I wanted to work there,” he says. “They told me to contact them around September when they were ready to start hiring for the next year.”

After reaching out to an employer, it’s a good idea to let the organization’s contact guide you through the process, according to Debbie Gleason, director of physician recruitment for The University of Kansas Health System. “This person is often an in-house recruiting professional who will be adept at road-mapping the process and provide guidance for the timing of the next steps,” she explains.

Spouse

This part of the process is a good time to play the role of motivator and coordinator, says Gleason. “Spouses and significant others could be helpful in gathering documents that will be needed for updating CVs, completing applications and other paperwork that will be necessary once a decision is made about what position will be accepted,” she explains.

You should also plan to go with your spouse on site visits. “Many hospitals will set up realtors for you and school tours—and may even connect working spouses to contacts in their field,” says McElderry.

“It’s not unusual for in-house recruiters to offer to visit with spouses to answer their questions about the community or professional options,” adds Gleason. If this resource is available through an employer, she recommends taking advantage of it.

Conducting interviews and site visits (residency, autumn of year 3)

Physician

At this point, you should have your interviews and site visits arranged. Before any interview, Gleason says it’s a good idea for physicians to research potential employers. “It can be a way to show they’re serious about the position and the community as well as enhance the research they started at the time they launched their job search,” she explains.

When it comes to the interview itself, Hertz says small stuff matters. “Be professional, dress appropriately, remember basic social skills,” he recommends. And Rodriguez says it’s worthwhile to imagine yourself on the other side of the table. “I changed how I thought about the job search,” he says. “I try to see it from the other side, to think about the employer’s needs. Would I be a good hire for them? I want to make sure I’m what they’re looking for.”

Thomas says he goes into every interview with a list of questions. “The employer’s responses will help you make a better decision about the position because you’ve raised points that are important to you,” he explains.

And while you’re thinking about what’s important to you, Barr says to remember that employers are not allowed to bring up your family unless you do. Depending on your situation, you may choose not to. “There can be discrimination with regard to physicians and families,” she says. That’s true whether the applicant is male or female, so if this is something that concerns you, keep your family out of the interview.

Once you’ve finished the interview, your contact at the employer will likely give you a timeline for the decision. Follow-up emails and calls are appropriate. “The timing can vary, but I would say an email every week or two is likely appropriate,” Gleason says.

Spouse

Since a job decision will affect both of you, it’s a good idea to join your spouse for on-site visits. “Alex comes to every potential job site to help check out the city and to ensure the location would provide professional opportunities for him as well,” says Benjamin.

“The site visit was helpful,” agrees Kavitha Thomas. “No matter how much research you do, you don’t know how things really are until you experience the place for yourself.”

If you have kids, consider their interests and needs as you tour the area. For example, during her site visit, McElderry wanted to learn about the orchestras and sports teams at local schools because she knew those would be important to her children.

No matter what you hope to learn while you’re visiting, make sure you remain professional throughout the stay. Hertz warns, “You don’t want to say anything negative about your spouse that could get back to the employer.”

After a site visit, Hertz recommends offering to write thank-you notes to employers. It’s an easy way to take something off your spouse’s plate. You should also sit down with your spouse and discuss expectations for the typical work/call schedule and vacations.

“Be part of the conversation,” says Kambies. You’ll want to provide your feedback before a job offer is accepted and contract negotiations begin. “We had these conversations early on,” remembers Wilson. “That made the whole process relatively smooth.”

Making your decision (residency, winter of year 3)

Physician

If you started your job search a year in advance, you should have an offer by January at the latest, says Barr. But before you can accept a job, you have some decisions to make—especially if you’ve received multiple offers.

“Most in-house recruiting professionals would expect that candidates are looking at other opportunities,” says Gleason. “It’s perfectly acceptable to let organizations know you’re looking at other opportunities and to ask for their timeline.” This will let you know how long you can safely delay your decision.

But organizations have their own timelines for considering candidates for positions, which means you may or may not have as much time as you think. Effective communication and long-term decision-making may be better tools for negotiating offers than pitting employers against each other.

According to Gleason, if physicians falter at the finish line, it’s typically because of one of two reasons: compensation expectations or contract negotiation parameters. “A physician going into a job search should research what factors play into their particular personal family needs and practice setting type and location,” she says. “Understanding a potential compensation model for a future position and what is reasonable for their geographic setting and practice type is highly important.”

She adds that many organizations have standardized contacts. “It’s not uncommon for only a few components of the agreement to actually be negotiable,” she explains. “An interviewing physician would do well to understand this aspect as he or she begins discussions.”

When you’re presented with a contract, Rodriguez says, “The first person you negotiate with is yourself. Are you happy with the terms? Then sit down with your spouse and discuss it together.” Only after these steps should you negotiate with an employer.

Spouse

As your spouse makes career decisions, it’s reasonable for you to weigh in. “You’re in a partnership with your spouse, but the job will be just as much a partner in your relationship,” explains Angeli. “This is something you need to be involved in.”

McElderry says asking your spouse questions can help him or her make a decision. For example: Are there good mentorship possibilities at the facility? Does the workplace culture seem like a good fit? Will he or she enjoy the coworkers? How is the salary structured?

“I think it’s helpful to talk with the spouses of physicians who work there,” she adds. “They may give you a better idea of what kind of relationship your spouse plans to enter into.”

Your own career may affect your spouse’s choices. “My wife’s biggest priorities were location and job opportunities,” recalls Wilson. “Thinking back to medical school, there was a particular residency program that I loved but ranked low because I knew my wife wouldn’t be able to easily find a job there.”

However, according to Barr, these roles are often reversed. In a two-career marriage, the non-physician spouse often makes the professional sacrifices during residency because of the match. “When it comes time to finding a job, that’s where I think the physician spouse might want to give the non-medical member of the marriage a bit of an edge,” she recommends.

No matter where you land, you and your spouse should base your decision on the jobs and lifestyle you feel are right for your family. And if you end up relocating, Gleason says it’s best to have all hands on deck. Help your spouse with relocation planning and transitioning your children to a new community and school.

Throughout the job-search process, a spouse is often part of the decision-making. And that’s as it should be. That’s why Gleason recommends that physicians include partners in their research, thought processes and decision-making from the very beginning. “This will reduce any additional delays in deciding on an offer,” she says.

“Talk to each other even when you’ve made the move,” adds Kavitha Thomas. “Know things will change. If that happens, begin the process again—knowing you can make it work.”

“I hear residents tell me they’re too busy to start their job search. But I remind them, the whole point of residency is to get a job. If the search is delayed, they can go a month or two without a paycheck while they wait for the paperwork to be done.”

“Lack of clarity is one of the biggest reasons for procrastination,” he says, adding that once you’ve set goals and made some decisions, you’ll be better able to focus your search.

“You’re in a partnership with your spouse, but the job will be just as much a partner in your relationship.”

 

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Alexander M. Luer, M.D.

Snapshot | Spring 2019

 

“If it weren’t for PracticeLink, I wouldn’t have found my dream job,” says Alexander Luer, M.D.

Employer: Utah Regional Hospitalist (Aguirre Healthcare), West Jordan, Utah

Med school: Loyola Stritch School of Medicine (2014)

Residency: Medicine-Pediatrics at University of Arizona Phoenix (2018)

Luer enjoys hiking, skiing, piano, spending time with his family, and cooking (and eating!) delicious food.

What surprised you about your job search? It was hard to know where to start, as we didn’t receive any career advice from our residency program. However, simply typing “physician careers” into a search engine and talking to residency graduates led to several starting places.

What’s your advice for residents beginning their job search? Start early! Arranging phone calls and on-site interviews takes a long time—months.

Stay strong and optimistic in your search. I applied for about 20 jobs and interviewed at four places before deciding on one.

What was the most important factor in your search for a new job? Location. I exclusively looked at places near Salt Lake City or Portland.

How did you find your job? I uploaded my CV on PracticeLink and had several emails with offers hours later. I was also able to search for specialty and location, and happened to find the perfect match.

How did PracticeLink help you in your job search? PracticeLink connected me to several physician recruiters and allowed me to search by specialty and location. If it weren’t for PracticeLink, I wouldn’t have found my dream job.

 

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Live & Practice: Small Towns 2019

By Liz Funk | Live & Practice | Spring 2019

 

Small towns and rural areas are often characterized by their natural beauty and genuinely friendly neighbors, but they aren’t lacking in culture or history, either. In fact, they are brimming with it. With care centers that boast big-city amenities and multispeciality practices, these towns and regions fuse professional opportunity with great work/life balance. They could be called the best-kept secrets, but locals take such pride in their communities that there is simply no chance of that.

Gallipolis, Ohio

Small towns are known for neighbors and acquaintances who go the extra mile for each other, and Gallipolis, Ohio, is no different. The town sits on the scenic Ohio River, with the main medical facility positioned on the town’s rolling hills. History, culture and agriculture are all important to the people of Gallipolis, and the thriving hospital network serves the small, tight-knit community.

Joshua Bryant, D.O., grew up in Pittsburgh— so he knew living and working in a small town would be an adjustment. After earning his degree at the Ohio University Heritage College of Osteopathic Medicine, Bryant began residency at the Holzer Family Medicine Residency Program. Now in his third year, Bryant likes Gallipolis and Holzer so much that he has decided to stay.

“Holzer has a fantastic teaching and mentorship program that really helps to educate future doctors,” says Bryant. “I feel like I am where I am supposed to be.”

As a family medicine specialist, building relationships with patients is part of Bryant’s job. That is especially compelling work in a small town, where doctors have the opportunity to get to know their patients in the community, too. When he is not at work, Bryant teaches exercise and dance classes at the Holzer Therapy and Wellness Center.

“Our physicians feel appreciated and respected while wearing a white coat at the clinic or wearing a little league T-shirt while coaching a T-ball game,” says Ginger Canaday-Thompson, physician recruiter at Holzer Health System.

And when they are at work, physicians experience a similar tight-knit, supportive environment. As a nonprofit, physician-owned, community-led organization, Holzer Health System is focused on improving quality of life for its patients and physicians alike.

“Holzer takes care of their physicians,” says Joshua Bryant, D.O. He decided to stay with the group after doing his residency there. – Photo by Chris Jackson

“Our community will continue to receive the very best health care in their own backyard,” says Canaday-Thompson. The phrase, “the patient is the center of all we do” was coined in 1909 by the organization’s founders, she says, and it still stands true over 100 years later.

Holzer operates a main hospital in Gallipolis with 266 beds, plus a critical access hospital in nearby Jackson with 24 beds. There is also the Holzer Center for Cancer Care, the new Holzer Therapy and Wellness Center, and 13 outpatient clinics, to name just some of the many care centers. A new wound care center will be built soon, and physicians also have access to a new linear accelerator in the cancer center and a da Vinci robot. Across its facilities, the system employs over 160 providers in over 30 areas of expertise.

The health system is currently recruiting physicians for endocrinology, family medicine/internal medicine, gastroenterology, hematology/oncology, neurology, OB-GYN, plastic surgery, urgent care and urology.

“We practice big city medicine in a small town,” says Todd Miller, vice president of satellite operations. Because of the organization’s multi-specialty focus, physicians can pick up the phone and ask other providers within the health system for assistance. “Working together and emphasizing a teamwork approach is highly valued inside the system,” adds Canaday-Thompson.

There are also numerous teaching opportunities available to providers, thanks to the organization’s GME program, which accepts medical students from both the West Virginia School of Osteopathic Medicine and the Ohio University Heritage College of Osteopathic Medicine.

There are also teaching opportunities in the Family Medicine Residency Program, which opened its doors three years ago. Four of the current family medicine residents, including Bryant, have signed on to begin permanent employment at Holzer once their residencies are complete, which is a testament to their positive experiences.

“Holzer takes care of their physicians,” says Bryant. “They’re very kind and supportive. There are some amazing teachers that have really helped me become the physician that I am today. They really want you to succeed.”

That same sense of support exists outside the hospital, too. Holzer Family Practice Medical Director Lance Broy, M.D., notes Gallipolis seems to embrace young families with open arms. When Canaday-Thompson talks to candidates, the family-friendly culture is something she emphasizes.

If you happen to be coming to the area on your own, do not fear. Your neighbors, who will often be willing to go out of their way for you, can become like family.

There is plenty to do in Gallipolis, especially around the holidays, when the Gallipolis In Lights event “takes you back to days goneby,” says Canaday-Thompson. There are also classic car shows, fairs and festivals, some of which celebrate the region’s farming culture.

Venues for the arts and history include the French Art Colony, the Bob Evans Farm and Homestead Museum, and the Ohio Valley Symphony at the Ariel Theatre. An undercurrent of history also runs through the town, with the fleur-de-lis adorning downtown architecture and serving as a reminder of the French and Welsh populations that settled the region in the 1790s.

Locals and visitors who want outdoor recreation do not have to go far at all. With just a quick drive, you can find “some of the best skiing and whitewater rafting in the eastern United States,” says Canaday-Thompson. The region also has opportunities for camping, kayaking, hiking, cycling, hunting and mountain biking.

Bryant says he particularly enjoys learning about the agricultural aspect of the community. He interacts with farmers and livestock owners and appreciates how knowledgeable they are.

Futhermore, he enjoys hearing the local lingo and being affectionately called “Bub.” He has gotten to know people in the community not only through the hospital and his dance and fitness classes, but also his church group. For Bryant, Gallipolis was the right place to do his residency, and now, it is the right place for him to live and work. He has a sense of purpose as a physician at Holzer.

“I feel that I can make a difference, and I am part of something special,” he says.

Asheville, North Carolina

A picturesque small city situated in the Blue Ridge Mountains, Asheville, North Carolina, is a draw for outdoor enthusiasts. With just under 90,000 inhabitants, its patient populations are both city-dwellers and residents of the surrounding counties. People flock to Asheville not only for the outdoors, but also for the burgeoning entrepreneurship opportunities, the farm-to-table food and the cultural offerings.

Asheville, North Carolina, was not a place Adam Kaufman, M.D., just ended up. Instead, it was a place he sought.

After attending medical school at Harvard University, Kaufman went on to do his residency at Duke University. Durham and Asheville are over three hours away from each other, but Kaufman says he and his wife spent a fair amount of time exploring the smaller city.

“Given the amazing access to outdoors, fantastic people and wonderful environment, we knew it was an ideal place to settle and raise a family,” he says.

Adam Kaufman, M.D., came to Asheville for the outdoors lifestyle it offered. In his off hours, he enjoys hiking, fishing, running, camping and more. – Photo by Derek DiLuzio

An orthopedic trauma surgeon, Kaufman also completed an orthopedic trauma residency at the University of Maryland. Throughout his training, he was always drawn to the technical aspects of orthopedics; he likes the variety of patients he sees and the acuity of the problems.

“It is sometimes daunting to meet patients after a major injury, but it provides an amazing opportunity to help them reach their fullest potential for recovery,” he says.

Kaufman is employed by Mission Health, the state’s sixth largest health system. According to Misti Dixon, senior physician recruiter at Mission Health, Mission operates six hospitals, the region’s only dedicated Level II trauma center, and numerous outpatient and surgery centers, among other services. It has the distinction of being the only North Carolina hospital to be named one of the nation’s “Top 15 Health Systems” by IBM Watson.

Kaufman says he feels fortunate to be at a place like Mission, and that the people are “outstanding.”

According to Dixon, Mission’s ability to grow, thrive, and continue to serve the people of western North Carolina is what makes it attractive to candidates. There’s a new tower dedicated to advanced medicine that’s under construction, and she sees this as an emblem of Mission’s role in the community.

“I think providers are not only interested, but encouraged by this construction as this is a reflection of growth, stability, need and commitment,” she says. “All of these things make our health system even more attractive to the physician and advanced practitioner population.”

Mission Health is currently recruiting for community medicine, cardiology, anesthesia, trauma, pulmonology and critical care, emergency services, behavioral health and oncology, among others.

“The list goes on, which is another reflection of growth,” says Dixon.

Providers at Mission also have the opportunity to see a wide variety of patients from both rural and urban populations, given that the organization serves a wide geographic area. Mission’s size means that providers and their patients get the best of both worlds.

“Providers are able to work within a medical community that is patient-centric and sophisticated enough to handle all complexities of care, yet small enough to maintain that personal touch,” says Dixon.

Often, she does not have to do much convincing when she meets with candidates; they are already sold on Asheville. The city’s reputation as a great place to enjoy the outdoors precedes itself, but she likes to convey to candidates that Asheville has a lot to offer in addition to its natural beauty.

“We place a lot of emphasis on our schools, which have an excellent reputation,” she says. “We have quite a few breweries in town, which is fun for beer enthusiasts. Asheville is lively and it’s thriving, and there’s a lot of really good energy in this town.”

There is also an exciting culinary scene, thanks to a growing interest in the community around food, says Erin Leonard, director of communications at Asheville Area Chamber of Commerce. “We have a lot of small independent restaurants that have embraced farm-to-table,” she says.

Overall, the ability to have work/life balance in Asheville draws people to the area. And, says Leonard, when at play, you can easily explore both cultural and outdoor opportunities. “We have the city and all the great things it has to offer, plus easy access to hikes and outdoor activities in the mountains of North Carolina,” she says. Plus, with a river that flows through town, residents find recreational opportunities just footsteps away on the multi-use greenways.

Destinations within the city include the Folk Arts Center and Shindig on the Green, a folk festival that had its 52nd season this summer.

Asheville’s entrepreneurial spirit is another important aspect of the region. “People decide to move here and say, ‘let me figure out how to create a job,’” says Leonard. Because the city is an attractive place for multiple reasons, there is a mix of people who live there. That dynamic results in varied cultural opportunities with something for just about everyone.

Kaufman, who came to Asheville for the outdoors, says he has not been disappointed, nor has his wife or two sons. “Everything you could want to do, from whitewater kayaking to rock climbing, is all right here.” When he is not working, he enjoys hiking, fishing, trail running, camping and “tiring out my boys off the beaten path.” He and his family are also very involved in the religious community in Asheville, and he regularly volunteers at the Western Carolina Rescue Ministry.

Above all, he is happy he landed in Asheville and at a place like Mission Health.

“The road of medical training is long and brings a trainee to a number of different hospitals and clinics,” he says. “I have been extremely fortunate to work in great institutions with very talented staff. I can honestly say I have never been at a place where people are as caring as at Mission Hospital. I am privileged to be a part of this team.”

Walla Walla, Washington

Scenic Walla Walla, Washington, is known for its wine production, an aspect of the region that has been booming over the past couple of decades. Walla Walla is situated in a largely rural area, so you might not know about the robustness of the medical community or its higher education opportunities. Small town friendliness is a way of life here, and residents enjoy the area’s laid-back vibe while never running out of things to do.

While it might not look like a regional hub at first glance, Walla Walla was at one point the largest community in the territory of Washington. The gold rush brought many settlers to the area during the mid 1800s, and the Walla Walla of today reflects the historical significance it had over a century ago. It is a small city of approximately 32,000, but the cultural and professional opportunities are considerable.

“What struck me regarding the job here is that though Walla Walla is quite rural, it really had a rather remarkable medical community,” says Timothy Davidson, M.D., chief executive of physician services at Providence St. Mary Medical Center.

A Portland native, Davidson attended medical school at Oregon Health & Science University before completing his residency in internal medicine at University of Colorado Denver, when he decided to specialize in pulmonary and critical care. He then did a fellowship at the University of Washington. Though he was not set on a specific location for a permanent position, his wife, a California native, had some ideas. Seattle felt too gray, and when they moved back to Portland for a short time, that did not feel perfectly right for them either.

“In that time, I really developed a better understanding of what I wanted in a practice,” he says. “I was working at a multispecialty clinic owned by an outside, for-profit entity, and there were some aspects of the job that didn’t seem optimal. Likewise, we were looking for a little different type of lifestyle to raise our family.”

He found Providence Health & Services and Walla Walla, and he knew it was a fit.

“There is a very robust medical community here. It serves as a referral center for northwest Oregon and southwest Washington,” he says. “That attracted me, coming from bigger cities where I was used to having a lot of subspecialties around me. I was struck by that.”

In Walla Walla, Providence Health & Services operates the 142-bed St. Mary’s Hospital, which also has a 14-bed ICU and eight beds for in-patient rehab. There are also primary care and specialty clinics throughout Walla Walla, says Providence Provider Recruiter Amy Knoup.

The mission of Providence Health & Services is to care for the poor and vulnerable. Knoup says that the organization deploys system-wide initiatives to meet the needs of those demographics, and Davidson adds that Providence strives to make decisions based on values that support those populations. In addition to serving migrant workers in the wine industry and agricultural sector, the hospital also sees patients who are family members or loved ones visiting the nearby prison.

Davidson spent the first part of his career at Providence working as a pulmonary critical care doctor. He then transitioned into a leadership role, and for the past dozen years has led the medical group.

“As you talk to new providers, we strive to create an environment in which we want to partner with the physician to best support them so they can have a fulfilling professional career and an enjoyable life outside of medicine,” he says. “What I’m trying to get at is, some places, how you work is pretty well-defined. Here, we’re much more likely to say, ‘What fits your lifestyle?’”

As a result, many providers in Walla Walla work less than full-time. This flexibility, says Davidson, is part of the organization’s core beliefs.

In Walla Walla, Providence is currently recruiting hospitalists, as well as physicians specializing in primary care and internal medicine, hematology, oncology and neurology.

When Knoup talks to candidates, she emphasizes the importance of Providence being a mission-driven organization. “We want all the providers to be fully invested in that,” she says. She also underscores the amazing location, access to outdoor activities, unique dining options and phenomenal wineries, not to mention the work/life balance that is possible at an organization like Providence and in a setting like Walla Walla.

For a small town, Walla Walla gets its fair share of tourism, too, thanks in great part to the wine industry. “When we moved here in 2000, there were 25 to 30 wineries,” says Davidson. “Now there are approximately 150. It’s been interesting to watch the growth of the wine industry and with it, fine dining options and elegant hotels and bed and breakfasts.”

For those thinking about relocating to Walla Walla with their families, Davidson says he has been very happy with the school system. “Both of our kids were educated in the public school system and had opportunities for acceleration,” he says. Plus, Walla Walla also has three colleges, which brings differing perspectives into the town. “The colleges provide a broader base and views and consideration about topics,” he adds.

When physicians are looking for permanent employment, Davidson encourages them to think about their lifestyle as a whole—not only what they really enjoy about medicine, but what they really enjoy outside of medicine, too. “Our training leads us to believe that medicine should be done a certain way and we’re so immersed in that environment that we don’t really ask ourselves, ‘So what about the other things beyond work that are important to us?’”

“If you can go through that exercise then I think you are more likely to get something that’s probably going to be a better long-term fit.” For Davidson, Walla Walla was just that.

Staunton, Virginia

With a Main Street that was recently named by Architectural Digest as one of the 30 most beautiful main streets across America, Staunton, Virginia, epitomizes small-town life. Situated between the Blue Ridge and Allegheny mountains, the small city of 24,000 is in the heart of the Shenandoah Valley. The outdoors are a vital part of the culture here, but equally so are heritage, the arts and a sense of community.

Working in a rural, community hospital, Frank Johnson, Jr., M.D., began his career in family medicine practicing just about every kind of care. As he puts it, he enjoys managing a wide variety of medical conditions in a variety of age groups, and in the early years, he was even delivering babies.

As a physician with Augusta Health, which operates a 255-bed hospital along with numerous primary care offices and specialty practices, Johnson’s areas of practice have developed over time.

For the past 20 years, he has specialized in geriatric medicine and preventive medicine with an emphasis on managing lipids in complex patients. In addition to being certified in family practice and geriatric medicine, he has also earned board certification in hospice and palliative medicine.

Johnson trained at the Medical College of Georgia and completed his residency at Spartanburg Regional Medical Center in South Carolina. He chose to practice at Augusta Health due to both the quality of care, and the opportunities present in Staunton and the surrounding areas.

“Augusta Health offered a vibrant medical community with excellent specialty coverage,” he says. “It’s located in a beautiful setting with great proximity to surrounding major universities, while still having the benefits of a smaller town lifestyle.”

“It’s a very collegial group of physicians,” says Dawn Funkhouser, physician recruiter at Augusta Health. The organization is currently recruiting for an interventional cardiologist, a critical care pulmonologist, an advanced gastroenterologist, a neurologist, and physicians specializing in primary care, rheumatology and urgent care. According to Funkhouser, the hospital is doubling the size of its emergency department and just opened its third cardiac catheterization lab.

The hospital’s state-of-the-art equipment includes the da Vinci robot. As Funkhouser puts it, “we have a lot of the amenities that you would find at a larger hospital.” The Augusta Health Cancer Center has an affiliation with Duke Cancer Network, a partnership that allows the hospital to provide a broad range of cancer services for Staunton’s population.

When Funkhouser talks to physician candidates, she emphasizes the highly livable quality of the area. “You can live in a not-so-densely populated area but have that small, tight-knit experience of community,” she says.

City of Staunton Director of Tourism Sheryl Wagner says that Staunton’s location in the heart of the Shenandoah Valley allows for a meeting of recreation and culture. “It’s the perfect base for hiking, biking, golfing, horseback riding and fishing,” she says. “After a big day in the big outdoors, come back to civilization, great restaurants, wine bars and craft breweries.”

Originally founded in 1747, Staunton has a rich heritage, too. According to Wagner, the Frontier Culture Museum displays a series of authentic historic farms, each moved from their country of origin and reconstructed at the museum site. It’s a living-history museum, so visitors interact with costumed interpreters while viewing a blacksmith’s forge, period crop-raising methods and more.

In the downtown, you will also experience something you can only otherwise see in London: an authentic recreation of Shakespeare’s playhouse. Since 1988, The American Shakespeare Center “has worked to create an atmosphere that closely recreates the theatrical experience of Shakespeare’s time,” says Funkhouser.

Staunton also has two city parks that are loved by locals. Among the two parks, facilities include a public golf course, football and baseball stadiums, a public swimming pool, a bandstand, a dog park, a disc golf course, a soccer complex, and fitness, mountain biking trails and more.

When in doubt, simply walking through downtown and enjoying the city’s historic districts and beautiful, varied architecture can make for a lovely afternoon or evening, especially when paired with a musical event, a dinner at a new restaurant or a night of theater.

“I personally enjoy golfing, going to the Augusta Health Fitness Center, which is truly outstanding, or taking a nice walk after dining with my wife,” says Johnson.

It is a similar sentiment to how he feels about his time at Augusta Health, where he enjoys establishing long-term relationships with his patients and working alongside excellent colleagues.

“Augusta Health focuses on health care for the community, with a focus on quality of care,” he says. Equally as important, they are “passionate about training tomorrow’s health care providers.”

 

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What to ask during your interview

The interview is a time for you to get to know the employer as much as it is for the employer to get to know you. Here’s how to do it.

By Debbie Swanson | Feature Articles | Spring 2019

 

Looking for the real scoop on a health system you’re considering? Google it—and check social media for public opinion, says Janet Gersten, M.D. – Photo by Rodrigo Velera

There’s a lot to do when you’re preparing for an interview: research the employer, think about what you might be asked, formulate your answers and even rehearse your responses. Don’t overlook the equally important task of preparing questions of your own.

Asking the right questions shows that you’re a prepared, educated candidate. It also ensures you’ll have the information you need to evaluate the opportunity and steer your career in the right direction.

So, you might wonder, what exactly are you supposed to ask? The following guidelines will help you identify what matters to you and prepare your list. Write your questions down, prioritize them, and then on the big day, tuck the list into your pocket for a quick once-over before you head inside.

Why is this job open?

An interview is usually a good sign that an employer is doing well enough financially to take on more staff, but that’s not always the case. “[Ask] why the practice is hiring. This can give you an idea of the health of the group,” recommends Eric Rey Amador, M.D., business manager at Anesthesia Medical Group of Santa Barbara in California.

Your recruiter should be able to provide some insight prior to the interview, but it’s smart to ask in person as well. According to Amador, you want to hear positive indicators, such as “economic growth, retirement of a physician, the addition of a new line of services.”

Few companies will directly voice negative issues, so you’ll have to listen for clues: employee turnover, a lengthy recruitment process (with the exception of a highly skilled or specialized field), negative comments about past employees, recent changes in management or corporate shuffling. Trust your instincts if something seems questionable.

You should also do your own research to learn why a company is hiring. See if anyone in your network has connections with this company—and what people are saying about it online. “Google the practice and see how social media likes them,” suggests Janet Gersten, M.D., an OB-GYN with TopLine MD Health Alliance in Miami. “Nurses at the local hospitals will generally give you the established opinion.”

What kind of malpractice coverage is offered?

As a doctor, malpractice insurance is an obvious necessity. Without adequate coverage, a claim of negligence or wrongful treatment could have devastating effects on your finances and your future. But it’s not enough to make sure your employer offers it and check that question off the list. Dig deeper to find out everything you need to know.

“Many new doctors will hear that the job offers malpractice coverage, and that’s it. But ask for details: What type is it, and who is paying?” urges Adeeti Gupta, M.D., an OB-GYN and founder of Walk IN GYN Care in New York City.

There are two common types of policies: claims-made and occurrence-based. With a claims-made policy, your coverage only lasts as long as you remain with your employer. Occurrence-based policies offer coverage for any claims made against you during the covered timeframe—even after you leave the company.

“If it is just claims-made, when you leave, you have to buy tail coverage,” Gupta says. “It is costly. Some doctors get stuck with a job because they can’t afford the tail coverage, especially in OB-GYN.” Formally called an extended reporting endorsement (ERE), tail insurance is an add-on provision that extends coverage to any claims raised after you’ve left the employer.

Don’t be afraid to negotiate with your prospective employer regarding tail coverage, Gupta adds. Some employers will split the cost or pay a percentage. If so, inquire carefully about the terms. Some arrangements may involve withholding your portion of payment from your final paychecks.

Malpractice insurance policies and regulations vary by state and by carrier, so do your research. Talk to seasoned colleagues before you interview to learn key factors to consider in the area.

What is required in terms of call hours?

Some type of call responsibility is part of the workload for most physician positions. But what this means varies greatly based on many factors: the type and size of practice, physician seniority, holiday schedules and more.

Understanding these factors will help ensure this job fits your vision of work/life balance. For example, if you have young children at home and live far from family, extensive call responsibilities can become a strain.

Ask questions,” recommends Darria Long Gillespie, M.D., MBA. “How often do you have to cover, including holidays? How many different locations do you have to cover? That’s particularly crucial if you may have to drive between them.”

Also ask about the logistics: Will you be required to remain on site while you’re on call or within a certain geographic radius? What is your expected response time? Are there any transportation requirements you must adhere to, particularly if you live in a big city?

How will you establish a panel?

As a new face in the crowd, it can take a little time to build up your patient base. Find out how patients are distributed. Does the organization have policies to ensure even distribution? Are you expected to attract your own patients? Are you encouraged to market your services—or prohibited from doing so?

This can also be a good question to raise with potential colleagues. Ask them how quickly their patient populations grew and whether they faced any challenges when it came to building a patient base.

How does the organization support personal growth?

Your immediate focus may be landing a job, but don’t lose sight of your future aspirations. An interview is a good opportunity to determine if the company aligns with your long-term goals.

“Get a feel for if the practice supports your individual growth,” Gupta says. “Is mentoring available? Do they support an entrepreneurial mindset? Are they welcoming of doctors bringing in new ideas or suggesting new equipment?”

Gupta suggests listening carefully to employers’ answers and evaluating their motivations: “Are they bringing you in just because they need labor, or are they genuinely interested in [your professional] growth?”

Another area to consider is continued education and training. Most organizations encourage physicians to continue learning, but not all offer financial assistance or scheduling accommodations for continuing medical education (CME), medical conferences or memberships in medical organizations and societies.

What is the company culture like?

A job is more than just a means of employment. It’s also an opportunity to form friendships and grow socially. Every company has its own culture. Your interviewers will likely give you an overview of the social atmosphere, including informal after-work gatherings, community events, annual outings or sports leagues and recreational activities. That’s good information, but you should try to learn more.

“You really should be allowed the opportunity to speak with several members of the practice privately, even if only on the phone after the interview,” says Amador. “That is the best time to ask about the culture of the group and what social aspects do or don’t exist.” He adds that if the company discourages you from speaking with current staff, it may be a red flag.

Because you’re an outsider, employers may not readily open up about the true culture of a workplace, and it can be difficult to ask directly. However, indirect questions can still shed light on the company’s true culture.

For instance, you can ask how the company celebrates employee achievements, how long most employees have been with the company, and what the company has done recently in terms of community involvements and employee events. Researching the employer online and on social media can also be helpful, as these types of events tend to attract media coverage.

How will this job impact my future employment?

In an ideal world, you’d never have to job hunt again. But even if you find a fulfilling position, it’s likely that you’ll eventually look for another job. So it’s important to understand the restrictive covenant—more commonly known as a non-compete clause.

A restrictive covenant limits where you can work after leaving your employer. For example, you may be prohibited from working at a similar type of practice within a 10-mile radius for three years after terminating your employment. Gersten recommends reviewing this carefully, saying, “[Find out] about any geographic distance or specific prohibitions with the non-compete.”

The length and geographic area will be carefully spelled out in your contract, but it’s still a good idea to discuss it ahead of time—especially if you have ties to a specific region and plan to stay there even after you leave your employer. You should also research what kind of restrictions are specific to your region, as some states enforce restrictive covenants more so than others.

Press for details when presented with an offer, encourages Adeeti Gupta, M.D. “Many new doctors will hear that the job offers malpractice coverage, and that’s it. But ask for details: What type is it, and who is paying?” – Photo by IHNY

Is partnership an option?

Traditionally, physicians in private practices aspired to become partners. But today’s changing economic trends have shifted that focus. Now many physicians avoid the cost and headaches of partnership in order to focus on clinical practice. Regardless of your future goals, you should use the interview to discuss partnership potential, as well as the duties and benefits involved.

Don’t hesitate to ask for details, says Gersten. She lists some good questions to include: “When can you become a partner? How close are some of the senior partners to retiring? What is the buy-in at that time?” Find out if anyone has ever been turned down for partnership—and if so, why.

Be sure to ask about financial arrangements and pay close attention, especially if something sound too good to be true. As with most parts of your contract, you should ask an attorney to review the details in writing.

What is the management structure?

An amicable, mutually respectful relationship with management is key to success at any job. So it’s important to understand the managerial style and hierarchy at any prospective employer. This will give you a sense of how much autonomy and influence you’ll have on decisions.

Ask some basic questions: Do managers come from a medical or business background? Are all M.D.s involved in decision-making or sitting on committees? How much interaction is there with senior management? What is the procedure for feedback—both positive and negative?

Can you assist with ______ ?

It’s best to put any important issues on the table before going too deep into the process. Whether you need special accommodations for a family member, a visa to work in the U.S., or a job for a spouse/partner, an interested employer will usually try to assist you or connect you with someone who can.

It’s no fun to waste your time or the company’s, so be honest about any obstacles you’re grappling with.

Says Paula Johnson, administrative director of physician recruitment at CoxHealth in Springfield, Missouri: “…We don’t want to find out when we’re making an offer that your wife is also an M.D. or is in another profession and needs a job.”

What does a typical day look like?

Don’t go home without getting a sense of your day-to-day responsibilities, patient demographics and typical case load. “You may or may not want to do certain types of cases or patients,” Amador explains. He suggests asking: “What are the types of cases I will be expected to do, and rough percentages of case type and patient type?”

This question will help you visualize yourself working for this employer. And it may also reveal less-than-favorable arrangements. “Sometimes, more interesting or lucrative opportunities [are] reserved for full or senior partners,” Amador adds, referring to a phenomenon called economic carve-outs. “An example would be a group that has a very lucrative obstetric anesthesia service where only senior partners can participate on that panel.”

What are my non-clinical duties?

From returning patient phone calls to filing paperwork to training staff, there are always non-clinical duties in a physician’s day. Be sure to understand the expectations of your time outside of the examination room. Ask for a rough breakdown of how much time you’ll spend doing what, how available administrative staff will be, and how you’ll be compensated for duties performed outside of working hours.

What’s it really like to work here?

At some point in the interviewing process, you should be able to meet with a colleague on an informal basis. This is your chance to get a realistic picture of what it’s like working for a particular practice or hospital. Are coworkers supportive or competitive? Are there opportunities to collaborate? Are employees comfortable with management?

Try to gauge the company’s emphasis on work/life balance. Does the company offer outlets for fitness, recreation and wellness? Do physicians feel they work excessive hours or have extensive call duties?

Avoid phrasing your questions in a way that leads to incomplete answers. For example, asking “Do you find it rewarding to work here?” might get you a one-word response or a vague description. Instead, try: “Can you tell me about a case you’re particularly proud of?” to encourage conversation.

What are the company’s mission and values?

An interview is a good opportunity to make sure your employer’s mission aligns with your own values.

Many times, you can find a mission statement, list of core values or faith-based affiliation online. Large groups or hospitals often display these prominently. Others may require you to do a bit of digging through their websites or marketing materials to get a sense of what they stand for.

Use whatever information you’ve found to initiate a conversation about mission and values. Ask what accomplishments they’re proud of, what plans they have for the upcoming year and what may challenge or support their efforts. And if you’ve found no information at all about the organization’s core values, feel free to ask anyway.

How does my role or specialty fit into your future?

Just as an interviewer may ask you where you see yourself in five years, you should ask where they see your career going. That way, you can make sure there’s an ongoing need for your services in their future.

“Ask about the vision for the organization and how your role or specialty fits in,” recommends Johnson. “Every organization has an idea of their plans. Of course, anything can happen, but they should be able to tell you their current plan.”

Some things better left unasked

Questions are typically welcome in an interview, but as with anything, there are a few limits. Don’t ask too much too early about perks, such as compensation, bonuses, time off or working from home. Your recruiter should provide you with information about all of these, but it’s best to wait until later in the interview process before probing for more details.

“When someone asks right away, ‘What are you going to pay?’ or how much time off they’ll get, it can be taken as a red flag. The later [in the process], the better,” says Johnson.

By law, an interviewer can’t ask about certain details, including marital status, age, religious preference, gender identity and other personal issues. Similarly, you shouldn’t ask your interviewers about these things. If family photos or college memorabilia is displayed, you can make polite conversation along the lines of “Lovely children!” or “I’m also a Bulldog!” But don’t cross the line by asking for details, like “Where is your spouse?” or “What year did you graduate?”

Wrapping up the interview

As you conclude each meeting, the interviewer will ask you if you have any final questions. Don’t hesitate to raise any lingering concerns that may have arisen along the way. It’s better to get the information than to head home with an unresolved issue marring your ability to make a decision.

If nothing is outstanding, simply ask: What is the next step? When will I hear further? Is there other information or material you need from me? This adds a note of finality and helps express your interest in the position.

Interviews can be challenging, and each meeting presents a new scenario to assess and respond to. One interviewer may be warm and inviting, while the next one’s aloof attitude may cause you to completely forgo your questions. So get your list of questions ready, but don’t worry too much about remembering every single one.

Simply identifying your areas of inquiry ahead of time is helpful. This way, you’ll not only make a good impression during the interview, but you’ll also be more likely to go home with the details you need to make the right decision.

An amicable, mutually respectful relationship with management is key to success at any job. So it’s important to understand the managerial style and hierarchy at any prospective employer.

 

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Building a CV that works

Even sought-after physicians need to create a CV that sells.

By Chris Hinz | Feature Articles | Spring 2019

 

Adding a bit of color in your email or cover letter can help your CV stand out. “These are the first words they read that are not in a robotic format, so they give the employer a flavor of who you are,” says Alexander Hamling, M.D. – Photo by Erin Schedler

No matter how confident you are in your job-search package or presentation, you won’t win an interview unless people have an initial sense of who you are, what you might bring to the table, and if you’re a potential fit.

Obviously, it’s up to you to eventually make the sale. Your profile and personality will carry significant weight when it comes to whether or not you get the job—but it’s your CV that opens doors.

Everybody says you only get one chance to make a first impression,” says Kip Aitken, director of physician recruitment for Sterling, Illinois-based CGH Medical Center. “Your CV is often that first impression. It’s critically important.”

So, how to make your CV work for you? Focus on organization, formatting and a few other basics.

Organizational basics

Your CV should convey your education and experience in such a well-defined way that recruiters and managing physicians can quickly determine who you are, what specialty you’ve pursued, and why your background merits a closer look. You want to give anyone in the hiring food chain a distinct picture to determine if you check off all of the boxes related to a given job.

“If it’s disorganized, not legible or just doesn’t look right, that’s a red flag,” says Jana Mastandrea, FASPR, senior provider recruiter for Seattle-based Provider Solutions + Development, Providence St. Joseph’s Health. “If you don’t look good on paper, you’re not going to get a call back. It needs to be professional.”

Despite the plethora of templates available to accomplish that goal, there still is no one format for a winning CV. The information you need to provide—training, work experience, certifications and other credentials plus unique skills—is pretty cut and dried. How you arrange it, however, is not necessarily so.

“I honestly don’t think that there’s one size fits all,” Misty Daniels, FASPR, director of physician recruitment for Charleston-based Medical University of South Carolina, says of the format. “But reverse chronological order is the easiest because I can see where you are and what you’re doing right now.”

Whatever the structure, you want to make sure that your CV doesn’t meander. “I want to see a logical layout in a time-oriented way that makes sense to me so that I can easily, without undue hassle or undue time, figure it out,” says Bruce Guyant, systems director of provider recruiting and retention for Tewksbury, Massachusetts-based Covenant Health.

You’ll need to keep these key components in your crosshairs:

Contact information. Make it front and center. Top the document with your formal name, M.D. or D.O., home address, telephone number and email address. Also placing your specialty and board certification under your name gives recruiters an instant heads-up as to two major qualifications.

Training. If you’re a physician just leaving training, your education—fellowship or residency, followed by internships and medical school—will constitute the first section. Within that structure, list correct dates, formal names of institutions, programs and your field of study along with other relevant information. Ditto on similar information for any advanced degree you’ve undertaken or any undergraduate major you’ve pursued.

Work experience. If you’re already in the workforce, your initial block should focus on that experience, leading with your latest position. Make sure to include titles, roles and any other pertinent parts of the job, such as academic, hospital or other clinical appointments and privileges. Keep your fellowship and residency in training, not in this section. “I don’t consider candidates to have work experience until they get out of their residency or fellowships,” says Marshall Poole, FASPR, physician recruiter for Northeast Georgia Health System.

Licensure/certifications. Start with every medical license you hold or have held and every specialty board and other certification you’ve achieved. Even if you’re “eligible,” let people know.

Research. If you’ve collaborated on a project during training, obviously that information is ripe for here. But if this is an ongoing part of your career, threading through current and past positions, separate the details into another block. Note the name and focus of your studies and that of any principle investigator with whom you’ve collaborated. Details count, so pay attention to proper names of places plus start and end dates.

Publications/presentations. You may have enough material for a section drawing attention to those peer-reviewed journal articles, book chapters or other periodicals that bear your name as a lead author or contributor. If you’ve given talks or participated in clinical panels or roundtables, make sure you list them too. Although the information might not strike a chord with a recruiter, hiring physicians may want to know more. Also, any scholarships, awards or other honors that you’ve lassoed along the way or organization or committee memberships that you’ve held deserve individual section notes.

Other skills and proficiencies. Identifying any special procedural skills or unique qualifications can be important. For instance, if you can converse in a second language, make it known on your CV. But only offer languages for which you can have a meaningful dialogue about someone’s medical issues. “I wouldn’t mention that you’re conversational in German or Japanese if you don’t feel comfortable conducting an interview in that language,” says Alexander Hamling, M.D., MBA, FAAP, a pediatrician for Seattle-based Pacific Medical Centers.

Formatting basics

You can’t achieve an aesthetically-pleasing, easy-to-navigate CV if the margins are uneven, the spacing is awkward and you’ve used difficult-to-read typefaces. When you don’t have unanimity, you’re sending a message that you’re not good with particulars, say recruiters. As Aitken notes: “The lack of attention to detail makes me wonder how good this physician’s documentation will be and how much attention will be given to patient care. If the only thing I have to judge is a CV, it better look like someone is attentive.”

To create a clean, consistent and visually-balanced document, consider these starting points:

Think typeface. Select a typeface that not only displays your accomplishments, but also invites recruiters to continue reading. When in doubt, Times New Roman or Arial are tried-and-true workhorses. Make sure what you select is crisp, clean and computer compatible.

Structure counts. A pleasing-to-the-eye CV depends on balance, and balance depends on how you align the words and utilize white space. If you’re using a template, you won’t have to worry about parameters since they’ll be built in. It’s still to your benefit to know, however, that standard margins usually call for one inch on all sides.

Make sure your CV covers your career highlights. “They won’t magically know, and they may not ask,” reminds Lenore DePagter, D.O. – Photo by Cheko Tapia

Other need-to-know CV basics

Length. It depends on where you are in your career and what type of opportunity you’ve targeted. If you’re looking for an academic appointment and already have significant research, teaching and clinical years in your wheelhouse, the page count could be well into the double digits. (You might even need an appendix.) But if you’re just out of residency or fellowship with an eye on a clinical slot, you’ll be able to make your case in short order. Two to four pages may be enough to cover the basics. Whatever your background, you’re actually creating your CV for two audiences: The recruiter who’s interested in a quick evaluation of your qualifications, and the hiring physicians who may relish delving into the granular parts.

References. Naming people on your CV means that they can be contacted without delay. Depending on their reputations, they may even add credence to your candidacy before a word is exchanged about you. “Just seeing the name,” says Guyant, “sometimes adds a level of assurance.” By keeping them close until asked, however, you can help your choices tailor a more effective response.

Something personal. Recruiters are mixed as to the advisability of listing hobbies or interests on a professional bio. Purists who want a document devoted solely to your medical skills say the information is superfluous. But for someone who likes seeing candidates in a broader context, getting personal can help define a candidate in differing ways. For instance, Aitken reviews half a dozen bios every day and welcomes a few lines tucked into a CV revealing why an applicant is interested in his medical center. “I’m looking at each CV to see if there’s some tie to a small town in the Midwest or some reason why I should take up the candidate’s time and my time with a phone call to learn a little bit more,” Aitken says.

Roberta Gebhard, D.O., president-elect of the American Medical Women’s Association, counts among her friends an adventure medicine enthusiast who splits time between her jobs as an emergency medicine physician and a whitewater rafting guide. Would that intrigue a prospective boss? Absolutely, she says, noting anything that fosters interest, leads to common talking points, and links you with potential colleagues can be helpful. “You want to offer something that sparks a connection with you or that gets you into the door,” Gebhard says.

Updates and versions. Given that physicians often have multiple aspects to their careers—and recruiters like seeing CVs and cover letters targeted to their openings—there are plenty of reasons to have more than one version of your CV. Kennedy Ganti, M.D., FAAFP, assistant professor of medicine for New Jersey-based Cooper Medical School of Rowan University, for instance, is boarded both in family medicine and clinical informatics. If he’s asked to speak at a clinical workshop or conference, not surprisingly he forwards a CV calibrated to those experiences. If someone wants to tap his extensive work in health IT and clinical informatics, however, he offers a bio that speaks directly to those skills. “I typically advise my residents and students as they move forward to be very, very specific about what they want and very specific with their CVs,” Ganti says. “You need to generate various iterations for the different opportunities that you’re deciding.”

The finishing touch

Creating a great CV won’t get you anywhere unless you have a polished end product. To put a bow on the package, consider these points.

Get outside help. If your CV-writing skills are wanting, it’s smart to invest in professional help. “Whatever you need to do to have a good high-quality professional-looking CV, you need to do it,” says Aitken.

Daniels recalls a friend who wasn’t getting any job bites with his current CV. She realized immediately that the bio he had created didn’t reflect what she knew about him—that he was a great physician, beloved by his patients. Daniels suggested working with an outside firm to revise the document. Once he had a new CV fully demonstrating his talents, he quickly snagged his next job. “If you recognize that this is not a skill set of yours, I would certainly encourage you to work with people who can help you—particularly if you’re in training and you haven’t done this before,” says Daniels.

Edit and edit again. Even if you don’t hire a pro to craft your CV, you want an extra set of eyes to take a serious look. “It doesn’t hurt to get a second opinion,” says Jennifer Feddersen, FASPR, director executive of physician and advanced practice providers recruitment for Detroit-based Henry Ford Health System. “It’s even better if you have a friend in HR or a recruiter who can look for common misspellings and mistakes.”

Format for clean effects. Recruiters suggest converting your CV into a PDF to make sure it holds its formatting shape between your computer and that of any recruiter.

Final thoughts

You’ll have many particulars to consider in creating a winning CV. Keep in mind, however, that both you and any potential future employer are working toward the same goal—avoiding buyer’s remorse!

Your challenge is to target the right opportunities with a CV that makes a strong case for you. Since reputation, backed up by evidence, usually wins the day, present yourself in the most complete, compelling light possible.

“Physicians often feel like ‘My CV should speak for itself and I don’t have to change it,’” Lenore DePagter, D.O., MBA, medical director of McAllen, Texas-based Cigna-HealthSpring, says. “But sometimes you really have to tell them, ‘Yes, I’m a physician, but I’ve also worked in academic environments, done research, served on committees and led groups.’ They won’t magically know, and they may not ask.”

“Our role is to help both sides make well-informed decisions so that the hiring manager, medical director or department chair feels great about who’ve they’ve hired,” Daniels says, “and the candidate feels great about the organization they’ve joined.”

Your profile and personality will carry significant weight when it comes to whether or not you get the job, but it’s your CV that opens doors.

Your challenge is to target the right opportunities with a CV that makes a strong case for you.

 

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How tight is the job market in your specialty? Spring 2019 Issue

The PracticeLink Physician Recruitment Index can help you gauge the relative ease or difficulty of your job search.

Spring 2019 | Vital Stats

 

What’s your competition like? For job-seekers of all kinds, it can be hard to know. A simple PracticeLink.com search for opportunities in your specialty will give you an indication of the demand for physicians like you, but without knowing who else is vying for those jobs, it’s hard to get an accurate picture of supply.

How many other candidates in your specialty are actively looking for jobs at the same time? And how does that number correspond to the number of opportunities available?

That’s where the PracticeLink Physician Recruitment Index comes in. The Index is a relative indication of the ease or difficulty of job searches in various specialties based on supply and demand information gathered by the PracticeLink system quarterly. The larger the “jobs per candidate” number for your specialty, the better your potential standing in the market.

The change in rank reflects the specialty’s movement since last quarter.

The Most-Challenging-to-Recruit Specialties are those specialties with the highest demand-to-supply ratio in the PracticeLink system. The specialties on this list likely won’t come as a surprise to candidates; they’re often narrow fields.

The Most-In-Demand Specialties represent the specialties that have the most jobs overall posted on PracticeLink—specialties for which the demand for physicians is highest. For the Index, we then rank those in-demand specialties according to the supply. Those at the top represent specialties with the most jobs available and the fewest candidates per job.

After reading these Indexes, ask yourself: Do these Indexes match my experience of searching for a job in my specialty? Do I need to widen or narrow my job-search parameters as a result?

This PracticeLink Physician Recruitment Index was pulled January 2019. Candidate ratios include physicians who have registered with PracticeLink.com within the past 24 months.

 

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Medical societies win with apps

Two associations release helpful apps—and another that you may want to share with patients.

By Iltifat Husain, M.D. | Spring 2019 | Tech Notes

 

In this edition of Tech Notes, I will cover three recently released medical apps. Two of them are from medical societies and provide great value to their members. Both of those are free to download and critical for their particular specialties.

I’ll also dive into the difference between an FDA “approved” medical app and an FDA “cleared” medical app, and how the FDA has opened up a new regulatory pathway for medical apps that allows them to market their treatment benefits in a way that was not possible before.

Price: Free. iPhone, iPad: apple.co/2Brt7oC. Android: bit.ly/2A5bqeO.

ACOG District II Safe Motherhood Initiative

There has been a lot of unfortunate news recently on how maternal mortality in the United States after childbirth has been increasing. The increase has been dramatic and has been highlighted in many mainstream news publications, with some numbers showing an almost doubling of maternal deaths per 100,000 live births since 1987.

Although the dramatic increase might make researchers think the underlying pathology has changed, it hasn’t. There are still three main causes of maternal mortality worldwide and in the United States: postpartum hemorrhage, severe hypertension of pregnancy, and venous thromboembolism.

The Safe Motherhood Initiative (SMI) is a project of the American College of Obstetricians and Gynecologists (ACOG) District II. SMI started in 2013 and works with over 10,000 health care providers and 118 birthing facilities to help develop a standard approach to handling obstetric emergencies associated with maternal mortality and morbidity.

The application itself contains position statements, guidelines, checklists, algorithms and teaching slides. You are able to highlight and bookmark key bundles and checklists. An interesting feature of the app is the ability to leave feedback. If you click the star icon within a document, you are able to give ratings on the actual content. There is an additional section for leaving detailed text feedback.

My only criticism of the app is in the lack of conversion of the PDF files. The actual content is presented in PDF forms. While the PDFs themselves are relatively easy to read on a mobile device, it would have been much better to convert the PDFs into a native iOS or Android format for reading.

Overall, it’s great to see ACOG’s District II take on such an important task and help standardize management of the main causes of maternal mortality.

Price: Free. iPhone, iPad: apple.co/2A3YOEx. Android: bit.ly/2BBbHWX.

Pedi Crisis 2.0

The Society for Pediatric Anesthesia (SPA) created Pedi Crisis 2.0, a medical app that has peer-reviewed algorithms for treating 26 pediatric crisis situations. Not only is there specific treatment advice, but the application also contains checklists and differentials.

Pedi Crisis allows you to enter the weight of the pediatric patient you’re taking care of, then gives you specific dosing advice throughout the app. The application has a really interesting user interface, with a host of hyperlinks throughout that allow you to jump around the pediatric crisis situations.

A lot of thought went into the user interface, shown in the “phone numbers” section. Instead of just having a blank screen for providers to input key numbers, the application gives you specific sections and categories for the phone numbers, such as “code team,” “blood bank,” “ECMO” and more.

Almost all medical societies have algorithms and treatment plans they give guidance on, and it would be great to see more of them getting into the mobile space by providing value add mobile apps such as Pedi Crisis.

Price: $79.99 billed annually, or $9.99 per month billed monthly. iPhone, iPad: apple.co/2USSUiD. Android: bit.ly/2Ciuesz.

Natural Cycles

Natural Cycles is the first FDA-cleared mobile medical application that can be used as a method of contraception to prevent pregnancy. It’s important to note the mobile application isn’t “approved,” but “cleared.” This means the FDA is allowing the application to market this specific medical use.

Why does the FDA stamp matter here? The story is actually pretty interesting. The FDA reviewed the Natural Cycles app through the new de novo premarket review pathway. This is a regulatory pathway for novel, low-to-moderate risk devices of a new type.

This now allows mobile medical apps to go through the FDA’s 510(k) process, allowing them to obtain marketing authorization for their claims.

Natural Cycles contains an algorithm that calculates the days of the month a woman is likely to be fertile based on daily body temperature readings and menstrual cycle information. This is a type of contraception referred to as fertility awareness. The daily body temperature reading is based on a basal body temperature, which is the lowest body temperature attained during rest (immediately after awakening).

The Natural Cycles app algorithm was originally created by nuclear physicist Elina Berglund Scherwitzl, a Nobel Prize winner. The app launched in 2014, and there have been several studies performed that test the efficacy of the application and algorithm. Overall, this is definitely an interesting medical application with solid research to back it up. The app claims to be 93 percent effective under typical use, meaning that 7 out of 100 women get pregnant during one year of use—so there are definitely several cases of unintended pregnancy.

There is a subset of women who are interested in non-hormonal methods of contraception, and this app could be appealing to them, as long as it’s made clear to patients that it’s not superior to traditional methods and that unintended pregnancy can occur.

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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The challenges of medical marijuana laws

State laws have become more liberal while federal laws are strict. Physicians should be aware of professional guidelines for prescribing marijuana.

By Jeff Atkinson | Reform Recap | Spring 2019

 

Within the last year, 12 or more states have revised their marijuana laws or are considering doing so. As of 2018, 31 states, as well as the District of Columbia, Guam and Puerto Rico, had “comprehensive public medical marijuana cannabis programs.” The criteria for a comprehensive program, as specified by the National Conference of State Legislatures and other organizations, are:

  1. Protection from criminal penalties for using marijuana for a medical purpose
  2. Access to marijuana through home cultivation, dispensaries or some other system that is likely to be implemented
  3. Allowing access to a variety of strains, including those more than “low THC”
  4. Allowing either smoking or vaporization of some kind of marijuana products, plant material or extract

In addition, 15 states allow use of low THC, high cannabidiol (CBD) products for medical reasons or allow limited defenses. These 15 states are not considered to have “comprehensive” programs.

Recreational use

Nine states and the District of Columbia have legalized recreational use of marijuana: Alaska, California, Colorado, Massachusetts, Maine, Nevada, Oregon, Vermont and Washington.

The liberalization of state marijuana laws corresponds with public opinion. A 2018 poll by Quinnipiac University indicates that 93 percent of American voters favored legalization of marijuana for medical purposes, and 63 percent favored legalization of marijuana without additional restraints.

Federal laws are more restrictive

Although state laws regarding marijuana use have become more permissive, federal laws have not. The federal Controlled Substances Act, passed in 1970, is still on the books. That law was passed as part of President Richard Nixon’s War on Drugs. Under the law, marijuana is a Schedule I drug, which means, from the perspective of the federal government, marijuana “has a high potential for abuse” and “the drug or other substance has no currently accepted medical use in treatment in the United States.”

For a period during the Obama administration, however, the federal government relaxed enforcement of marijuana laws.

President Obama’s Deputy Attorney General, James Cole, wrote a “guidance” memo to United States Attorneys noting the changes in state laws and directing a more hands-off approach by the federal government “[i]n jurisdictions that have enacted laws legalizing marijuana in some form and that have also implemented strong and effective regulatory and enforcement systems to control the cultivation, distribution, sale and possession of marijuana.”

Cole said, “[E]nforcement of state law by state and local law enforcement and regulatory bodies should remain the primary means of addressing marijuana-related activity.”

Return to the rule of law

In early 2018, Attorney General Jeff Sessions issued his own memo, rescinding the Cole Memo.

The Department of Justice said it was “announcing a return to the rule of law,” adding that “Congress has generally prohibited the cultivation, distribution and possession of marijuana.” U.S. Attorneys were directed “to enforce the laws enacted by Congress and to follow well-established principles when pursuing prosecutions related to marijuana activities.”

Although Sessions has followed the Trump administration’s approach of undoing initiatives of the Obama administration, the federal government is not expected to markedly increase prosecutions of marijuana offenses.

IOM Report

The Institute of Medicine, part of the National Academies of Sciences, Engineering and Medicine, issued a report in 2017 on “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research.”

The report stated there was evidence to support use of cannabis or cannabinoids for treating multiple conditions.

On the negative side, the report said evidence suggested “cannabis use is likely to increase the risk of developing schizophrenia, other psychoses, and social anxiety disorders, and to a lesser extent depression.”

Guidelines for recommending marijuana

Among the organizations issuing guidelines to physicians on the topic is the Federation of State Medical Boards. These guidelines were adopted in 2016 and have much in common with general medical standards:

  • Document an appropriate physician-patient relationship
  • Collect and document relevant medical history, including substance abuse and addiction
  • Discuss risks and benefits of marijuana treatment
  • Review other measures attempted to ease suffering
  • Make recommendations for marijuana consistent with current standards of practice as well as with state laws and regulations
  • Set a specific duration of treatment not longer than 12 months
  • Where available or required, register with appropriate oversight agency and check state Prescription Drug Monitoring Program
  • Make referrals, as needed, for substance abuse disorders or mental health issues
  • Do not have an office in a dispensary or have a compensation arrangement with a dispensary or cultivation center

Physicians should consult licensing boards and professional organizations for standards that may be applicable to them.

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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Curious about the jobs out there?

PracticeLink.com lets you conduct even a confidential job search.

By Chris Scites | PracticeLink Tips | Spring 2019

 

There comes a time in every physician’s life when, even though they might be fine in their current position, they would like to see what other opportunities are available.

This might be due to any number of reasons: curiosity about what else is available, a desire to relocate, wanting more diversity in cases, looking for more compensation, or dissatisfaction in their current role.

Problem is, you probably don’t want your current employer to know that you are looking until you’re ready to disclose it. And at the same time, your employer is likely combing physician recruitment sites, looking to hire more providers to your practice. Fortunately, with PracticeLink, it’s easy to look for opportunities and keep your search confidential from your current employer.

Browse confidentially

You don’t have to register with PracticeLink in order to see the jobs that are available. If you’re truly just curious to see what’s available in your specialty and location, simply browse the job profiles employers have posted on PracticeLink.com without registering.

Set your status to passively looking

If a job search is in your future, you’ll want to register for PracticeLink. When registering, set your job search status to “passively looking” if your search is confidential. You can choose this option while you’re setting up your profile. If you’ve already registered, you can change your status at any time in your account settings. From your dashboard, simply go to “My Account” and use the radio button near the bottom of the page to select the job search status that’s right for you.

Choosing “passively looking” will allow you to apply to jobs on PracticeLink, but will limit your profile visibility to only employers with jobs to which you’ve applied. Choosing “passively looking” will also let you receive PracticeLink’s Job Messenger email alerts, which notify you of new opportunities that match the criteria you’ve selected.

Hide your profile from specific employers

If you are interested in a more active job search (but would rather your current employer not know about it), another option is to hide your profile from specific employers.

In this case, switch your account’s job-search status to “active.” This will enable any in-house recruiter on PracticeLink to view your profile. Directly above that account setting, in the section labeled “Hide from specific employers,” there are two selection fields. The block on the left lists the employers that have opportunities posted on PracticeLink. Simply highlight the ones you don’t want to see your profile, and use the arrow buttons to move them to the right. Any employer in the block on the right will be unable to see your profile.

Pro tip: if you are looking for an opportunity with only one specific employer, use the double arrow to move everyone to the field on the right, then from that field select the employer or employers that you want to see your information. Use the single arrow to move them back to the left.

Even if you’re engaged in a confidential job search, PracticeLink can still help.

Chris Scites is PracticeLink’s physician relations manager. Reach his team for free job-search advice at (800) 776-8383.

 

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An insurance primer for young physicians

From life to malpractice, the ins and outs of insurance are important for new physicians to know.

By Bruce Armon & Jay Weinberg | Legal Matters | Spring 2019

 

Physicians generally think insurance—life, disability and professional liability—is too expensive or will never be needed. But it’s critical to understand what insurance policies do and don’t cover, the potential benefits and the actual cost of each kind.

Life insurance

Your employment setting typically dictates whether life insurance is part of your benefits package. For physicians who are employed by a hospital, hospital affiliate or a larger group (more than 20 employees), it is likely that group life insurance will be part of the benefits package. With respect to a group life insurance policy, a physician should focus on these items:

Eligibility. How long do you have to work for that employer to become eligible for this benefit?

Coverage amounts. Often times, the amount of insurance is a multiple of your annual salary and includes a maximum cap on the amount payable. For example, a policy could state “3x the physician’s salary with a maximum benefit of $500,000.” These caps are typically far less than one’s actual insurance needs.

Additional “buy ups.” You may be able to purchase additional life insurance coverage than what is offered in the original group policy. It is important for you to know, in advance, if the buy up policy can follow you to another job, or if it makes more sense to purchase an individual policy from the outset.

Cost. Do you, your employer or some combination pay for life insurance?

Portability. If you leave the job, is it possible to continue the policy? (Generally, there is a low probability that you can transfer a substantial group life insurance policy into an individual policy even if you agree to continue to pay the annual premiums.)

Conversion. Are you able to extend your coverage amount at a later date without having to answer any medical questions?

Medical underwriting. Does the life insurance policy require, as a precondition, that you answer questions with respect to your health history?

Depending on your individual circumstances, you may elect to receive the employer’s group life insurance policy “free of charge” and then purchase an individual policy catered to your specific needs.

Professional liability insurance

Most states and hospitals require a minimum amount of professional liability insurance. One of the key issues is making sure you know what type of coverage is provided, and confirm your responsibilities when you’re no longer employed by that organization.

There are two main types of professional liability insurance: claims-made and occurrence. A claims-made policy generally covers you for any negligent activity that occurs while you’re employed by that organization. Upon the end of your employment, in most circumstances, a “tail” policy will need to be purchased.

Assuming a tail policy is required, confirm before signing a new employment agreement whether you, your employer or some combination of both is responsible for paying for the tail policy.

An occurrence policy generally covers you for any liability action regardless of whether the action is brought during or after (but within the state’s statute of limitations) your employment. A tail is not required for an occurrence policy—and for that reason, an occurrence policy is typically more expensive than a claims-made policy.

Physicians who are moonlighting or working second jobs should confirm whether their primary employer’s professional liability coverage extends to the secondary employment setting. (In most circumstances, it will not.)

Disability insurance

There is no “one size fits all” disability insurance policy.

Unlike life insurance, where a physician can essentially purchase as much as is desired, there are strict limits on the amount of disability insurance a physician can maintain. Disability insurance companies do not want physicians to be “over-insured” because there would be no incentive to return to work if you were on disability with a very generous policy.

With disability coverage, there is a direct relationship between income and allowable coverage amounts. These items are important to understand when it comes to group disability insurance policies:

Definition of total disability. This determines if the physician is eligible to collect on a policy should there be an adverse change in health.

Elimination period. This is the number of days a physician must be out of work in order to qualify for a claim.

Mental/nervous/substance/psychiatric claims. In most group insurance policies, claims that fall into this arena are limited to 24 months.

Partial/residual claims. The vast majority of disability claims either start or end as a partial claim.

Pre-existing conditions. The vast majority of group disability policies have a provision that states the insurer will not pay benefits due to “pre-existing” medical conditions.

Taxation. Benefits received from the majority of employer-paid group disability policies are taxable.

Portability. Most group policies end when employment ends.

Who pays. Often times, the costs associated with group long-term disability insurance are covered by the employer.

The benefits and exclusions in each life, professional liability and disability policy are critical to understand. A benefit offered by an employer may not be as generous as it initially seems, and you may elect or need to supplement a policy individually to ensure you have adequate coverage in place if the unforeseen or unexpected occurs.

Bruce Armon, Esquire, is chair of the health care group at Saul Ewing Arnstein & Lehr, LLP. Jay Weinberg is an independent financial planner with 18 years of experience.

 

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