What Recruiters Need to Know About You

PracticeLink Tips | Summer 2017

 

My experience working with hospitals and practices has allowed me to understand what physician recruiters in these facilities need from the candidates they’re considering in order to make the best hiring decisions. Here’s what you need to provide recruiters to help the process along.

Your Contact Information

It is crucial to include your contact information when you contact a recruiter about a position. Include an easily reachable phone number like a cell phone number.

For the recruitment process to work smoothly, both physicians and recruiters should make themselves available to each other. Each must be willing to return phone calls promptly.

Provide a professional email address that you check often. Avoid making your email address something too personal hotdoctor@email.com. Reserve that for family and friends, not potential employers.

In addition, personal information (think marital status, interests and hobbies, citizenship and visa status, and whether you have children) is something you may also want to share with the recruiter and employer to help them understand your personal situation.

Your Geography and Lifestyle Preferences

Next, make sure to discuss your geographic considerations. These can include not only where you want to practice but also factors such as community size, climate, proximity to family and friends, proximity to an airport, daily commute preferences, and schools and activities needed for your children. One thing to remember: When looking for opportunities in particular areas, research the supply and demand in that market. If the physician supply is great in the area, there could be less demand, which could have a negative effect on compensation.

Lifestyle considerations are also important when talking to a recruiter. Discuss the area’s cost of living, opportunities for your spouse, recreational activities, religious opportunities—even access to entertainment, dining and shopping if these are important to you. Ask about the types of benefits the practice offers. Another lifestyle consideration is your schedule. Do you want to work full-time or part-time? Make this clear and also ask about call requirements and the hours you’d be working.

Your Practice Preference and Career Path

The practice setting that interests you is also important to share. This may mean being employed—or becoming a partner—in a single- or multispecialty group, working in solo practice, being employed at an academic/teaching hospital, working as a locum tenens physician or being a hospital employee. Make your preferences clear.

Other important considerations about the practice setting include staff and technology. What types of relationships will you have with the other physicians in the group? Is this the type of practice you can see taking care of your family? Are there nurse practitioners or physician assistants in the practice? How would you be expected to work with them? Does the practice have an EHR? Which system is it, and how does it interface with the billing system? If you have preferences about any of these issues, make them clear to the recruiter.

Make sure the recruiter or employer understands how you see your career path. Do you want to settle in one location for most of your career? Will you want to do administrative or executive work? Do you want to teach or research? Remember, career advancement can come in the form of greater responsibilities or could require more experience and education.

Once you start in your new practice, you will continue to develop your skills and practice style, and your personal priorities may shift. Remember this when you look for a position. Try to determine if it will be a good fit for more than three years.

To make sure a potential employer knows what is most important to you in your job search, please reach out to PracticeLink’s Physician Relations team at (800) 776-8383 or PhysicianRelations@PracticeLink.com.

Our team can work with you to create a free profile that includes all of the information recruiters and employers need, helping you in turn find your first or next job.

Tammy Hager is director of PracticeLink’s physician and client relations teams.

 

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Shannon Clark, M.D.

Snapshot | Summer 2017

 

Shannon Clark, M.D.

Shannon Clark, M.D., found her new job in Virginia Beach through PracticeLink!

Specialty: Neurosurgery

Employer: Sentara Medical Group

Medical school: University of South Florida (2010)

Residency: Thomas Jefferson University Hospitals (2017)

Clark enjoys watching movies and spending time with her husband and daughter.

What surprised you about your first post-residency job search? Neurosurgery has very few graduating each year, so I thought I could take a pick of jobs in even a very desirable location. But the reality is most of the openings, even in neurosurgery, are in out-of-the-way, smaller locations. Because of this, looking early and carefully for what you like is very important. I’m very happy I found a job in a wonderful location—Virginia Beach.

What’s your advice for residents who are beginning their job search? Start early, and gather advice from the residents who graduated before you with multiple interview experiences.

They gave me tons of info including the good hospital systems to interview with, the whole process, and even the exact number of their salaries and sign-on bonuses.

What was the most important factor in your search for a new job? Location. For neurosurgery, building a practice is possible in most locations, even in competitive areas, with about five years of investment. Finding a place that you and your family can be happy with is the most important thing.

How did you find your job? I applied via PracticeLink. I started out very early (May of 2016 for a starting date around August 2017). I also tried to put in an enthusiastic message about the job rather than just sending my CV.

How did PracticeLink help you in your job search? It’s one of the posts I saw on PracticeLink that I applied to. The job description is exactly what I wanted. I’m very happy I looked through PracticeLink diligently!

 

 

 

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Medical Missions Physician

Career Move | Summer 2017

 

Wael Hakmeh, D.O., FACEP, has served on multiple mission trips with the Syrian American Medical Society (SAMS), a nonpolitical organization that does medical relief work in Syria and around the world. He has arranged his schedule as a locum tenens physician in a way that enables him to make trips several times a year. Prior to arriving in Syria, he taught an emergency medicine/critical care course to Syrian health care workers in Turkey, preparing them to treat the traumatic injuries commonly seen there. Hakmeh was honored for his volunteer work with the 2016 MedicalMissions.org Physician of the Year Award.

What do you like best about being a medical missions physician? Medical mission work gives me a chance to practice medicine for the reasons that many of us went into medicine: to help those who need it the most. In Syria, over 95 percent of the physicians who were once there have been imprisoned, fled the country or were killed. A lot of health care providers get killed from indiscriminate government bombings. The Syrian patients I met are some of the warmest and kindest people I’ve ever met, so to be able to practice medicine there is the most rewarding thing I’ve ever done professionally.

Did you specifically request to go to Syria? Yes, a couple of my colleagues shared with me their experiences from working there—I’m very grateful to them. Several times I planned on going into Syria, but for different reasons, of the five times I planned to go, I was only able to twice. While I’m confident working there helped patients, I always left there feeling I benefit the most personally. The strength and perseverance of the people there is uplifting and difficult to put into words without doing injustice. The presence of volunteers lets them know they are not there alone and that the world has not forgotten them even though in reality, it has. So I think what I and the other physicians provided was as much of a psychological boost as any life-saving procedure we could perform.

Wael Hakmeh, D.O.

Medical mission work gives Wael Hakmeh, D.O., a chance to help those who need it most.

How long do you spend there? It was a short time, usually about a week. You have to factor in that you can get stuck at the border, and there’s a lot of uncertainty with the bombing. The roads can be closed. At the time I was last there, there was only one road in and out of Aleppo, dubbed ‘the road of death,’ and now that road is cut off [before the siege against the entire city ended]. There’s a lot that has to be taken into account. If I could have stayed longer, I would have. We spent the greater part of a week training Syrian physicians and medics in emergency medicine and ICU training courses in Turkey prior to my work in Syria. My whole trip is usually 2 1/2 weeks.

How many trips have you made? I’ve been to southern Turkey seven times, where we had the training courses. I was able to go into Syria twice. For a number of different reasons, I wasn’t able to go into Syria. One time, the border was closed and they would not let any health care professionals cross. … Another time, I tore my ACL a few days before playing basketball.

What don’t you like about medical missions? There wasn’t much that I didn’t like about it. The biggest thing that bothered me was the amount of preventable deaths and injuries that didn’t have to happen. For example, my first day there, a barrel bomb was dropped on an open market as people were shopping with their kids. Fifty people were killed that day for no reason. These aren’t people on battlefields, just people shopping for fruits and vegetables trying to figure out what to cook for dinner. This part of it was frustrating. The lack of news coverage about the deaths and injuries was, too. One night, 40 people were killed and the bodies were lined up … a lot of horrific scenes. I went online that night to different news outlets, and there was no mention of the incident. That’s why the people feel that the world has turned their backs on them. Medical missions expose its participants to uncomfortable truths of grave injustices.

What surprised you most? The limitation of resources. The destruction is beyond anything that Hollywood could produce—the oldest civilized city in the world with a population of 3 million, reduced to rubble. It’s an unbelievable level of deprivation. It surprised me that the surgical room had a bug zapper in it, particularly in a country that had an excellent health care system 10 years ago. What appeared to be a soda machine was actually a blood bank. There are shortages of all medicines. Bringing narcotics across the border is not possible. I had to put a chest tube in a man with no analgesics at all. He begged me to let him die. Pain medication has to be rationed. This should never have to happen.

Do you have any advice for physicians considering medical missions? The first thing to do is to find something you feel passionate about. Look for a credible and trustworthy organization to work with. Preferably, find something you can benefit from in whatever field you are in. Working as an emergency physician meant working in Aleppo made more sense than on the periphery where people by definition are stable. Talk to other physicians and learn from their experiences. Insight into which medical missions are good is generally [gathered] through word of mouth. If you decide to go somewhere where you could be in danger, you really need to give it a lot of thought. Pray and make sure you are 100 percent mentally and psychologically onboard.

Is there anything else you’d like to add? As I just mentioned, pray about it. Make sure it’s what you want to do, particularly if it’s a dangerous venue. Once you are there, fear should not drive or dictate anything you do. Take a lot of stuffed animals as kids really love that. A lot of times, it’s not the medical work that we do; it’s your actions and genuine caring that people notice. It’s very meaningful and uplifting that somebody came thousands of miles across the ocean to care for them. That will do more good a lot of times than any application of medical knowledge will. Do your homework. Learn about the culture of those you will be serving as provision—culturally sensitive care maximizes your effectiveness as a physician.

 

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Moving for work? Read this first

Physicians looking to relocate for a new practice have even more to do throughout their job search. This guide breaks it down.

By Karen Edwards | Feature Articles | Summer 2017

 

Janet Young, M.D.

Janet Young, M.D., relocated twice in four years—once from California to Chicago, and once back.

For Janet Young, M.D., an emergency medicine physician, it made sense to relocate. The large group practice where she worked had offered her an opportunity at its Chicago location that she knew would benefit her professionally in the long term. So in 2008, she packed her bags, and along with her two preschool-aged children and an au pair, moved from Oakland, California, to Chicago. Her husband remained in California a while longer.

“I didn’t know anyone in the Midwest. I’d never even been there,” Young says.

The move would not be a long-term engagement. Less than four years later, Young and her family relocated again, back to Oakland.

Young is hardly alone in this relocation exercise. New physicians who train far from family and friends often return home once their training is complete. And more and more physicians are choosing to relocate even after a few years in practice. A 2016 report issued by health care data analysts SK&A found that nearly 14 percent of health care providers made some type of professional move within the past 12 months—keeping pace with what the U.S. Census Bureau says is the percentage of Americans who relocate each year.

It’s possible that new physicians relocate in even higher numbers. In 2011, Today’s Hospitalist stated that as many as 70 percent of physicians change jobs within their first two years. Jeff Hinds, president of the physician consulting firm Premier Physician Agency, believes this trend may be because, “early in their careers, most young physicians do not know how to fully evaluate their job options, nor at that point, even know which practice settings or locations are most conducive to meeting their professional and personal goals.” But relocating closer to family, or even moving for more opportunity, like Young, can also explain the frequent exoduses.

As anyone who has ever moved can tell you, however, relocating is not easy. That’s why it deserves careful consideration. Your experience, of course, will be unique, but their suggestions may provide you with a road map to make your relocation a bit easier.

1. Know your contract

Alexander Zaslavsky, M.D.

Alexander Zaslavsky, M.D., recommends applying for a license in your new state as soon as a relocation is in your future. It’s a process that “can take up to four months or longer,” he says. “Start early.”

First, understand the consequences of leaving your current job. “Physicians need an adequate exit strategy before making the decision to relocate,” says Hinds. “They need to review their contracts to fully understand the termination process and potential risks.”

It’s possible you’ll have to return at least a portion (if not all) of any signing bonus if you leave before your contract term is up. “Responsibility for purchasing malpractice tail coverage could also be tied to completion of the full contract term,” Hinds adds.

Any of these factors may play a part in your decision to leave—or at least in your timeline to relocate. “Seeking legal advice to help determine your ideal exit strategy is very important,” says Hinds.

2. Visit before you decide

In other words, “Don’t Skype the interview,” says Edie Webber, owner of Pinnacle Relocation Services. “You really have to go and visit in person.”

That’s the only way you will pick up on what Webber calls intangibles—the feel and culture of a place and the people who live and work there. “A place should make you feel welcomed and wanted,” says Webber, and that’s especially true of your potential workplace. “You’re going to spend a lot of time here with these people, so make sure you’ll feel comfortable before you choose to relocate,” she says.

A visit is also the best way to learn about the community where you hope to live. “Learn about the schools, about any work opportunities for your spouse if he or she will also be looking for a position, and seek out information about any cultural or recreational activities that you and your family enjoy,” says Hinds.

And just because you have lived in the area before doesn’t mean you can skip this step, says Ron Davis, senior vice president of MD Preferred Services, a website that helps physicians find professionals like realtors, attorneys and accountants. “Even if you lived or grew up there, unless you’ve made recent trips back to the area, don’t assume the place you left will look the same.” As he points out, training can take a while, and if you’ve added a fellowship on top of that, chances are the place has changed. “You need to visit it again if you haven’t seen it in a while,” he says.

Ying Hui Low, M.D., an anesthesiologist who recently moved from North Carolina where she trained to Lebanon, New Hampshire, suggests bringing along the important people in your life to visit a new location. “You want people to visit you, so it lets them become comfortable with the area, too,” she says.

3. Establish a timeline

Relocating involves a lot of moving parts happening simultaneously. Once you have the move scheduled on your calendar, you’ll need to establish a timeline so the transition will be smooth.

“One of the first things to do is apply for your state license,” says Alexander Zaslavsky, M.D., who relocated from a hospitalist job in New York City to a new position in Maryland—then, when his employer opened a new location in New Jersey, he moved again. “The licensure process can take up to four months or longer,” he explains. “That’s lost time and income if you delay the process. Start early.”

This is also a good time to start your paperwork. Eleanor Hertzler, recruitment coordinator for Patient First, says that three months is generally a good rule of thumb for the credentialing process. Credentialing and licensing timing varies from state to state.

“The process is very state-specific, so do some research for the state you’re moving to and plan accordingly,” she says.

“You should also notify your current employer two to three months in advance,” says Jeffrey Tsai, M.D., a regional director with CEP America who has relocated twice—from Chicago to Atlanta and then home to California. “At least let them know you’re thinking about a move.”

Your professional liability carrier will also need to know of your move, and, if you’re currently in practice, don’t forget to notify the Drug Enforcement Agency, any vendors you work with and of course, your patients.

You’ll also need to find a place to live. Allow about a month for this step, Tsai says.

Other factors to include in your timeline: Time to locate a job for a working spouse and time to check out schools. “A lot of this can be done online,” says Debra Phairas, president of Practice & Liability Consultants. “But of course you and your spouse will want to visit any potential employers and schools in person.”

Young offers one more “must” for your timeline if you have children. “I was lucky that my au pair moved with me, but if you’re relocating, establish your childcare option in advance,” she says.

Finally, consult with movers, realtors and recruiters. These experts can help you fine-tune your timeline.

4. Dive into the area

Yes, you’ve visited the area, but now is the time to explore it.

Each time Tsai moved, he took a month of vacation, he says. He used part of that time to travel. “When you’re working, you don’t have time for many vacations,” he says. But that month also allowed him to explore the area thoroughly, to look for a place to live, and to unpack.

Low says she also vacationed in the area prior to relocating. “After all my exams were over, I visited the area and the hospital and took a look around both,” she says. “Check out the amenities, things that are important to your lifestyle.”

By staying in the area, you’ll not only become familiar with various neighborhoods but also gain a better idea of the real estate market and what kind of properties might be available in your budget. “You can [also] determine commute times,” says Low. Just because a house appears to be close to the hospital doesn’t mean you’ll be able to get there faster if traffic in that area is heavy at the times you’ll travel, Low explains.

Hertzler says when she works with relocating physicians, she gives them a list that’s filled with helpful resources. “As recruiters, we don’t endorse any outside business, but we give our physicians referrals for things they may not think about, like mechanics, vets and dentists,” she says. If you’re checking out an area, you might want to put together your own list of frequently used services, then look to see what’s available in the areas where you’ll spend most of your time.

5. Consider living arrangements

Finding somewhere to live, of course, may be the biggest challenge facing the relocating physician.

Zaslavsky suggests renting an apartment or small home for a year. “Make sure this is the place you want to be before buying a house,” he says. “You may find you don’t like the job or the area, then what?”

Hertzler agrees. “If you’re not familiar with the area, it’s a good idea to rent a place for six months to a year to see if this is where you want to live. You may get here and decide you like another part of town better. Unless you know the area, I’d suggest renting when you first arrive.”

One practical, economical option is to follow Young’s path. “I rented a furnished apartment for a year,” she says. That way, there was no need to move furniture twice when she decided to move somewhere else.

Webber, however, says that, depending on the market, it can be much easier and less stressful to find a home ahead of time. “In tight markets, shopping and making offers from your hotel can create a lot of stress. If you can arrange a home shopping tour ahead of time, before the move, then the contract to close can be done during your absence,” she says.

“If you rent first with the intention of buying a home in a year, the home may actually cost you more,” Webber continues. If, for example, you relocate to an area where there is a demand for housing, which is often the case in cities, chances are prices will rise over the year—while your options narrow.

If you’re selling a home before you move, Webber also cautions you not to rely on “off-the-cuff” estimates of your selling price. “Don’t assume you’re going to make a good profit from the sale of your house,” she says. Sellers often underestimate their costs, in addition to any buyer’s expenses they may have to pay. “Get accurate numbers so you know what you will net when you sell,” she says.

While you’re gathering information, it’s also a good idea to sit down and prepare a projection for all the expenses you’ll run into when relocating, says Hinds. In addition to moving costs and buying and selling a home, there will also be costs for trips to the area and for licensure. “Also consider costs of daycare and even the costs of living in the new location,” he says.

6. Make your move

Now that you’ve visited the area, established where you’ll live, seen to your paperwork and any childcare needs, it’s time for the move itself.

Low said the move, for her, was easy. “I didn’t have any furniture or big items to move.” But for many, a move can be stressful.

“Changing location is listed as one of life’s biggest stress factors,” says Webber. “Hiring experts can help.”

She suggests you talk to your employer’s human resources department and ask for referrals. Hinds agrees: “Most hospitals have realtor partners they work with and can recommend,” he says. Phairas adds that office and group practice managers can also refer you to realtors, movers and other experts in the area.

Young, however, took a more self-directed approach: “I Googled realtors in the area,” she says. And Tsai credits his wife for taking on most of the house-hunting chores. For Zaslavsky, “My wife and I were a team. We looked at homes together.”

“Most physicians are experts in their field, but novices when it comes to relocating,” Davis says. “And health care is way behind corporate America in successfully relocating people.” Hospitals can only do so much. “They may refer you to a realtor and tell you where to get three bids for movers, then you’re on your own,” he says. But relocating involves much more. “A consultant or relocating company can bundle services like mortgage contacts, financial advisors and attorneys,” he says.

Will you be reimbursed for your relocation expenses? It depends on the employer and the location. Hertzler says employers generally help relocating physicians by putting together a benefit package that will ease moving costs. Whether that’s a signing bonus or a stipend depends on each situation.

Tsai says his employer did not help him with moving expenses. “But our company does offer a loan to assist with the move or it sometimes offers a signing bonus,” he says. A typical amount of the loan or bonus is $10,000—which seems to be the going rate for relocation expenses when they are offered, adds Hinds.

Says Webber: “You never know whether or not you’ll be reimbursed unless you ask.”

7. Get settled

By now, you’ve found a home, unpacked your boxes, and are starting to know your way around the hospital and maybe around your new community as well. But don’t stop there.

“This is the time to network,” says Phairas. Go to hospital meetings to meet your colleagues, and to medical and specialty society meetings to meet other physicians in the area, she says. These physicians can become friends or referrals, and they can also let you know about restaurants, parks, hiking trails and other things to do in the community in your area of interest, or maybe those of your spouse or children.

“Networking is important, and not just from a business perspective,” she says.

Hertzler says Patient First often arranges a dinner where relocating physicians can meet with other physicians from the local Patient First urgent care centers. “It’s a time to meet colleagues and their families, and to learn more about the workplace and the area,” she says.

It’s also important at this time to keep the happiness of your family in mind. You may be delighted with the new location and job, but if your spouse or children are having a miserable time of it, you may have to re-assess your priorities.

“Relocating can be a real culture shock for children,” says Davis. “It’s why your family’s needs and feelings must be considered before you actually make the move.”

Young says she gave herself a timeline. “I told myself and I told my family that we’ll give the location and the job two years. If after that time we weren’t happy, we’d move back. I think it’s really important to have an exit strategy like that, an escape route,” she says.

Even more essential, however, is taking time to decide if the move is right for you. “Before you move, you have to sit down and ask yourself why you’re making this move,” she says. “If you’re not sure why you’ve put yourself and your family through this, it’s not likely to work.” But you can’t let fear of the unknown and the occasional unpleasantness stop you either. “Don’t be afraid to relocate,” says Young. “There’s no advancement without risk. You’ll become a better person for it.”

 

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The Top 5 Physician Interview Mistakes

By Matt Wiggins | Job Doctor | Summer 2017

 

Physician interview mistakesEmployment interviews are the cause of much angst among the physician community at large. Upon scheduling an interview, you may start envisioning yourself sitting across from much more experienced and potentially jaded physicians, business professionals looking to sniff out a bad investment, or HR assassins trained to pick apart your flaws to ensure they don’t let a weak link through the doors of the hospital.

Though this fear is a bit far-fetched, it’s surprisingly common. The truth is, you can’t control how the interviewers handle the interview, and thus shouldn’t worry about it. You can only control how you handle an interview, and the key to handling it well is to prepare thoroughly and avoid these mistakes that are often a part of the physician interview process.

Mistake #1: One and Done

Many physicians, especially those just finishing training, have in their minds an ideal scenario for practicing medicine. They have preconditions and preconceptions about where and how they want to work. Having such ideas may lead you to interview with only one employer, but this is a huge mistake. Most physicians are not master poker players, and eventually an employer will realize you are only interviewing with them. When this happens, you can forget negotiating for better income, vacation, call schedule, bonuses or really anything else. If they’re your only interview, they hold all the cards: You have nothing to compare them to and lots of motivation to take their offer. At any stage of your career, having multiple interviews ensures you will be able to evaluate factors you may never have thought of. You can use pros from each opportunity to make the others better and negotiate from a position of strength and opportunity rather than weakness and dependence.

Mistake #2: Failure to Prepare

You would never take your boards without preparing. You would never invest your money without researching ahead of time. You would never propose marriage without some sort of knowledge of the person and some plans in place. The same should be said for interviewing. Before sitting across the conference table from a much more experienced interviewer, you should do the following:

  • Research the employer’s location, reputation, background, achievements, size, patient population, recent headlines and any other important information you can get your hands on.
  • Create a list of employment priorities for yourself, and your family if applicable, in order of importance.
  • Develop a list of questions specifically designed to learn about your priorities so that if time runs short or you lose your nerve, you will at least leave the interview with an idea of how your most important concerns would be addressed in that situation.
  • Finally, review what you know about the position they are interviewing for. Prepare a list of the top three to five things that make you a good fit for that job and make sure that the questions they ask are answered in a manner that conveys those main points as much as possible.

Mistake #3: Interviewing Dory

You can tell I have three kids 10 and under when I reference a Pixar movie. If you haven’t seen it, “Finding Dory” is a cute animated movie that is sort of a sequel to “Finding Nemo” and follows the character of Dory, an adorable blue fish that suffers from extreme short-term memory loss. This obviously leads to a lot of bad decisions, mistaken identities, frustration and comedy. It’s not so comedic, however, when physicians display the same thing while interviewing for employment opportunities.

I’ve heard it said that we forget 50 percent of what we hear within one hour of hearing it and close to 70 percent within 24 hours. This means that just one day after an interview, you may only retain 30 percent of what was said. No one should make a major life decision based on 30 percent of the information. The solution is to take notes during the interview and to use the same prepared questions for each interview. This will both help you retain what has been said and give you a way to compare different opportunities (specifically, how they measure up with regard to your top priorities) in an apples-to-apples manner.

Mistake #4: Failure to Follow Up

Take some advice from an earlier generation and send a thank-you note, card, letter or email after your interview. Simply showing appreciation for the interviewers’ time speaks volumes about your communication and relational skills. It can also improve the prospective employer’s perception of both your bedside manner and your potential as a colleague. I’ve seen physicians get offered positions in highly competitive situations as a result of their interview follow-up—don’t forget to do this!

Mistake #5: Not Taking this Advice

The physicians who will do well are those who will listen to the advice of people who have worked with thousands of doctors before them. It’s tempting to believe that interviews are either easy—just an opportunity to answer questions about yourself—or impossibly hard. In actuality, interviews should not be taken lightly, but they also shouldn’t be cause for nightmares. By preparing thoroughly for your interview, you can interview the prospective employer simultaneously. Based on their answers to your questions, you can decide whether you want to work for them. Their answers will also help you compare multiple offers and ultimately negotiate the best employment opportunity possible.

Matthew J. Wiggins is partner and senior consultant for Pattern.

 

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Picking Your Position

Feature Articles | Summer 2017

 

You’re nearing the end of your medical training, and suddenly your email inbox is flooded with messages from physician recruiters alerting you to jobs that may interest you. Then the phone calls start, inquiring about your potential willingness to move from north to south, from east to west —and everywhere in between.

Though at first it can be exciting to feel so popular, that euphoria can turn to anxiety as you anticipate making long-term decisions about your career and lifestyle. But being in demand is a plus, as long as you can convert a practice’s initial interest into a job offer you’d like.

Your goal should be to express interest in certain opportunities without eliminating the possibility of others that may also turn out to be a good fit—while turning down those you’re not seriously considering.

Fortunately, there are strategies you can use to zero in on the opportunities you’d most like while not damaging the possibility of future work. That’s the trick to handling multiple expressions of interest in a professional manner.

Determine Your Career Priorities

Chandler Park, M.D.

“Perfect” may be attractive, but finding your “best fit” is a better goal in your job search. “The key is to remember that there is no perfect job and to keep in mind the factors that are most important to you and your family,” advises Chandler Park, M.D.

“It’s kind of a dance,” explains Chandler Park, M.D., board-certified hematologist and oncologist and clinical assistant professor at the University of Louisville School of Medicine. “The key is to remember that there is no perfect job and to keep in mind the factors that are most important to you and your family.”

Some of the major factors many doctors weigh—about both the job and the city—include:

  • Salary
  • Geographic location
  • Climate
  • Outdoor activities
  • Lifestyle fit
  • Public school quality
  • Proximity to an airport or train line
  • Call schedule
  • Academic practice, hospital employment, or private practice
  • Research opportunities
  • Opportunities for mentoring

Park says he has heard it said that, of the three overarching things doctors can choose from—money, lifestyle and location—only two are possible. That is, you can’t get your desired location and an exceptional salary and lots of free time for hobbies; you must pick your top two. For this reason, he put location—specifically, being closer to his hometown in Kentucky—at the top of his requirements, followed by the lifestyle choice to work in a hospital setting. Money was not a determining factor for him, though it was for several of his classmates. In fact, one colleague moved several states away in order to maximize his starting salary.

Regina Bailey, M.D., J.D., facility medical director at First Choice Emergency Room in Humble, Texas, says compensation was her primary concern when she took her first job. But she also knew it wasn’t a position she would have to keep long-term. “There is a huge shortage of emergency room doctors in Texas, so there are always options being thrown at you,” explains Bailey, who is also a clinical assistant professor at the University of Texas Medical Branch (UTMB) in Galveston. “So there is less pressure to choose something that’s perfect for the long term.”

Still, Bailey advises physicians to pursue positions that are good fits for their goals and lifestyles. For her, that meant good backup and flexible hours. With her full-time position squared away, she began looking for part-time work to fill in around her primary job. She found it two hours away at UTMB. Because Bailey had been upfront with the facilities where she interviewed for full-time work, she knew there would be no non-compete issues or scheduling problems if she decided later to take on additional part-time work. By being completely honest about her goals from the start, Bailey found the best fit for her.

Be Open to the Possibilities

Abhishiek Sharma, M.D., an attending neurosurgeon at Honor Health System in Scottsdale, Arizona, advises figuring out what you want in a position while keeping an open mind about other types of opportunities that may also be a good match.

The number of neurosurgeons, he explains, has not changed in the past few years despite increasing demand. The American Association of Neurological Surgeons confirms this trend, reporting in 2008 that, though the U.S. population had increased by 20 percent in the previous 15 years, the number of practicing neurosurgeons had remained static over the same period. The result of such a shortage, says Sharma, is that neurosurgery residents receive about three offers each.

Some of those interviews and resulting offers may be in locations you hadn’t initially considered—and that’s OK. The differences you encounter among areas and organizations can enrich your options or confirm your initial vision.

Learn How to Juggle

Regina Bailey, M.D., J.D.

Regina Bailey, M.D., J.D., found a good work/life balance by being open about her desire for a role with good backup and flexible hours.

There’s no question that physicians are in high demand. As a result, you may find yourself fielding inquiries from recruiters and hospital systems before you’ve done much evaluation of your career priorities and goals. Sharma reports having received an average of one or two emails per day listing positions available in neurosurgery. Bailey, too, received plenty of information on available jobs.

The information you’re sent will vary from personalized, detailed inquiries to brochure-like information. Much of the initial contact depends on the recruiter’s style, the organization’s approach, the confidentiality of the search, the urgency of the need, and other factors. After you’ve responded with interest, you may be invited to submit your CV if you haven’t already. A screening call is generally next, during which the recruiter continues to assess your fit and qualifications. If all goes well, more phone discussions or an invitation for a site visit may follow.

If sitting back and waiting for news of an opening in the city you want seems too reactive, be direct and go on the offensive—it can work.

One of Sharma’s friends decided to be proactive about his job search to increase the odds of landing a position in his hometown. Instead of sifting through incoming emails and taking phone calls as they came, the physician called the town’s main hospital and spoke with the in-house recruiter.

He said, essentially, “I know you’re not advertising an open position at the moment, but would you be interested in discussing future openings?” Given the low supply of available candidates in the specialty, the hospital was only too happy to begin a conversation. That call resulted in subsequent phone calls and, later, an invitation for a site visit, followed by negotiations for a new role created just for him.

Sharma looked at almost 10 places over the course of two years, narrowing that list to three based on geography: one in Wisconsin, where he was in residency; one in Chicago; and one in Arizona, which he ultimately took. All three jobs were appealing, so to break the tie, Sharma ranked each position based on three main factors: geography, the job itself, and intangibles about the opportunity. Then he weighted each factor, with geography counting for 30 percent of the decision, the job, 50 percent, and the intangibles, 20 percent.

With that formula, it became clear that Arizona was going to be the best fit for him.

Park interviewed at 12 places during the first round, focusing most on where he could become part of the community and be closer to family. He then whittled the list to three practices where he was confident he could be happy. After the interviews, he sent thank you notes to all the programs for taking the time to meet him; he was completely honest about whether he wanted to consider pursuing employment there.

“Some recruiters were surprised by my forthrightness,” he says, but he didn’t feel comfortable keeping hospitals hanging after he had determined they were not the right choice.

He advises physicians to be completely honest about where they are in their decision-making processes. Doing so enables you to uphold your professional reputation and avoid burning bridges you may need later in your career, especially since most physicians eventually move on from their first jobs.

That said, it’s also important to let a potential employer know when you just need more time. It’s OK to tell a recruiter you want time to check out more options. “No one goes on one interview and decides that’s it,” says Park. He says the typical number of subsequent interviews is two or three.

“Telling other practices that you’re considering other options doesn’t make you less appealing,” he says. “It actually makes you more appealing.” It means you’re a desirable candidate.

Simon Gordon, director of search operations and physician recruitment at Healthsearch Group, based in Westchester, New York, advises physicians to explore their options—but not to go overboard. “You can have too many [options],” he says.

If you want to have initial discussions with several organizations, that’s fine, but once you have enough information to determine you’re not seriously interested in a position, don’t string that organization along. “Don’t pursue a role you know won’t ever be your final choice,” says Gordon. That only leads to wasted time (yours and theirs) and potential irritation. For this reason, limit your site visits to only those facilities that are serious contenders.

Sending Signals

Investigating job opportunities is not an all-or-nothing decision, says Park—it’s a process. After an initial on-site interview, you may be invited back for a second interview. This lets you know that the hospital or practice liked you. If you also liked what you heard and saw on the first visit, you can accept the second.

“This allows you time to learn more about the program and tells the hospital that you’re interested. It lets them know how serious you are,” says Park. Similarly, declining a second interview conveys that you didn’t feel there was a fit and aren’t interested in continued conversations about the job. Don’t pretend to be interested once you’ve decided that you aren’t.

After an on-site interview, a recruiter may ask for feedback about the job opportunity. They may ask, “Is there anything you don’t like about our program?” Park strongly advises against getting specific about disadvantages you perceive early on, but instead wait for a second visit to bring up your concerns with their current physicians. If the negatives are significant enough to cause you to lose interest right away, however, consider reaching out to a physician to ask for their honest input about your concern.

Gordon recommends being transparent and honest throughout the process. If you saw something on your visit that concerned you, bring it up. Ask questions to better understand the internal operations; strive to learn more about the day-to-day activities you’d be part of. And when asked for feedback, it’s important to express enthusiasm and to explain why it’s appealing and what value you can bring (if you think you’d like to work there). You can let the recruiter know that you’re considering other opportunities as well, but conveying enthusiasm about the job is essential if you want it, he says.

Fielding Offers

Once you have an offer from a facility, it’s time to get serious about making a decision. Sharma took the opportunity to provide feedback as a step toward negotiating a more advantageous offer. To each of the three hospitals he was considering, he pointed out what he really liked and what, in particular, was holding him back from accepting their offer. He also asked if they could do any better. His script went something like this:

“I have an offer from another hospital, but I really like the opportunity at [your hospital]. One thing that concerns me is the amount of call you require. Would you consider giving me a physician assistant to reduce the amount of call I have to do?”

Or:

“I have an offer from another hospital, but I really like the opportunity you’ve presented. One thing that concerns me is that the salary you’ve offered is substantially lower. Can you do any better, or can you offer a signing bonus or cover my moving expenses?”

Gordon recommends letting a practice know if you have reservations about any aspect of working for them before you make your final decision. “They’ll be frustrated” if you tell them after you’ve accepted another offer and your complaint was something they could have addressed, he says. Long-term, that reaction could limit future opportunities at the practice, should you ever change your mind.

“Relationships are of utmost importance during schooling and the hiring process,” says Gordon. Developing and nurturing relationships with decision-makers, even if you don’t ultimately choose to work at their facility, can be beneficial for your career, especially if you determine you’d like to make a move a few years down the road. For that reason, it’s important to be considerate during your job search. “Don’t burn any bridges,” he underscores.

After the second visit, many physicians are offered a contract. Park recommends responding right away if you receive a preliminary term sheet. After several months of conversations, on-site visits and discussions, both parties should have a good sense of whether there is a match, and making a decision should not take several more months, says Gordon.

Timing is Everything

Although it can take weeks or months to get an offer, once you receive a contract, the hospital or practice will expect a decision within about a week. “They want an answer quickly,” says Gordon. As they’ve been carefully vetting you, you’ve been vetting them and must be interested in being employed there. Once you receive an offer, the decision to accept should be fairly easy—at least that’s the hospital’s assumption. Some physicians think that they can take their time deciding because the practice took so long to make their decision, but that’s not the case. “You have to be ready to move quickly at the end,” Gordon says. By the time they’ve extended an offer, they assume you’re as excited about working there as they are about hiring you.

When you’ve narrowed your choices to the top two or three, it’s important to let the other practices know when you’ve received an offer. That gives them the opportunity to expedite their decision-making and potentially make an offer as well. Some hospitals, however, can’t move as quickly, Gordon points out, and you may have to decide between accepting an offer in-hand and waiting for an offer that may never come. “You need to understand that, until you get a contract or a signed offer letter, it’s still just an opportunity, which could get derailed,” he warns. It’s not concrete until you get that offer. Given the amount of time required to secure a medical license and credentialing in other states, Park recommends that physicians start their searches early—like the middle of their second-to-last year of residency.

If you don’t start your search until the beginning or middle of your fourth year, you may not be able to start working until months after you finish residency. “The whole process is slow,” Park says, though some states are slower than others.

In neurosurgery, whose residency lasts seven years, physicians start receiving information about jobs in their fifth year. Since it takes 12 to 18 months to recruit a neurosurgeon, says Sharma, it’s rarely too early to start reviewing and evaluating opportunities.

Although much of the job hunt seems reactive—receiving emails and phone calls and following up with those that are of interest—physicians have a lot of control in the process.

Rising demand for health care services means physicians are often in the driver’s seat when it comes to considering job opportunities. This is especially true in locations such as Mississippi, Idaho and Alaska, which have the fewest physicians per capita according to a recent report from financial advising website WalletHub.

“Doctors have a fair amount of bargaining power,” confirms Sharma. As long as you stay in touch with the practices you’re interested in, communicate about where you are in your job hunt, and are honest about which positions may be a good fit, you’ll quickly become adept at juggling multiple job opportunities successfully.

 

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What’s Your Interview Style?

Physicians who know their natural conversation style are better able to tailor their interview skills.

By Debbie Swanson | Feature Articles | Summer 2017

 

Were you the one who always took charge of group projects in school—or the quiet confidant whom people drew aside for advice? Do you deliberately limit your social interactions, or do you become more energized when you spend time around others? Whatever your preferences, recognizing your natural tendencies and personality traits—and knowing how to make them work for you—can go a long way toward job interview success.

Start with a self-assessment

You’re probably already aware of your strengths and weaknesses, but when you’re facing a round of interviews, it never hurts to do a little introspection. A simple, informal method is to reflect upon what you already know about yourself. What have teachers always said about you? Friends and family? Which situations make you feel confident and comfortable, and which throw you out of your element? Reflect on your behavior patterns with a constructive, yet critical, eye.

If you need more direction or are interested in a more formal assessment, there are many personality assessment tools available. One is the Myers-Briggs Type Indicator, based on the work of psychiatrist Carl Jung and co-creators Katharine Briggs, and Isabel Briggs Myers. This popular tool evaluates personality based on the following four areas:

  • Extraversion or introversion: whether you prefer to spend time in the outer world or your inner world
  • Sensing or intuition: whether you like to focus on information gathered through your senses or apply your own interpretation and meaning to the information you receive
  • Thinking or feeling: whether you prefer to deal with principles and facts or people and circumstances when coming to a decision
  • Judging or perceiving: whether your goal is to reach a decision or explore information and options

Another popular assessment is the Big Five personality traits, developed by several different researchers over many years, starting with D. W. Fiske in 1949 and continuing through Robert McCrae and Paul Costa as recently as 1987. This theory focuses on five general areas, sometimes referred to with the acronym OCEAN:

  • Openness: characteristics such as imagination, insight, and abstract thinking
  • Conscientiousness: your propensity for organization, attention to detail, impulse control and goal-directed behaviors
  • Extraversion: whether you gain or expend energy in social situations
  • Agreeableness: your levels of cooperation and competitiveness among others
  • Neuroticism: your emotional resiliency and stability

Once you’ve assessed your personal style—whether formally or informally—consider how to make the most of your strengths and adjust for your weaknesses.

Are you all ears?

William Silber, M.D.

Active listening is a helpful interview skill. “People are willing to tell you what you need to know, if you give them the opportunity,” says William Silber, M.D.

Perhaps you’re known for being a good listener among your friends, and your patients seem to relax and readily share with you. Even so, being a good listener in an interview can be difficult. In addition to having nerves working against you, your mind may be distracted—anticipating the next question or meeting or mulling over the last topic discussed.

William Silber, M.D., a gastroenterologist from Dallas, makes a dedicated effort to focus on his listening skills at an interview, and he takes it a step further by asking targeted questions to draw out the information he needs.

“People won’t hear you until they’ve been heard,” Silber explains. “I want [interviewers] to tell me their situation, what they’re looking for from me, so I know if I can fulfill that. People are willing to tell you what you need to know, if you give them the opportunity.”

To fine-tune your listening skills, brush up in everyday life; listen more attentively to co-workers, your partner, even the radio. Another useful strategy is to practice mindfulness, which teaches you to remain focused in the moment.

Even with the best intentions, don’t panic if your listening efforts are derailed, either due to a wandering mind or an unexpected tangent. Refocus on the speaker, perhaps paraphrasing or asking a question to zero in on the topic again. “So you’re saying that… ” is a good phrase to use to steer the conversation back to the original topic.

Do you go after what you need?

Malika Fair, M.D., M.P.H.

Malika Fair, M.D., M.P.H., identified a key question she wanted answered during the interview process. Prioritize your questions so those most important to you are answered first.

Some people find it easy to ask questions; others proceed with caution, concerned they’re being a bother or coming across as too assertive. But asking questions—even the hard ones—is an expected part of any interview.

Malika Fair, M.D., assistant clinical professor and emergency medicine physician at George Washington University and senior director of health equity partnerships and programs at the Association of American Medical Colleges, recalls that when she was interviewing, she raised a question that provided valuable insight into an area important to her.

“I asked them to describe their commitment to diversity,” she said. “Not only did it get them to explain their commitment, but it enabled me to evaluate how comfortable the person was in answering the question. If a place looked great on paper, but the person was uncomfortable with that answer, that gave me valuable information.”

Fair says this input provided her with additional helpful criteria for ranking her options and determining where she’d feel most comfortable.

Experts agree that you should always arrive armed with a solid bank of questions. In addition to showing that you’re well prepared, having questions on hand ensures you’re ready for whatever is thrown your way.

Do you tend to ramble?

Being easy to talk to can be an asset in many walks of life, but in an interview, tread carefully—verbose responses can hinder success.

“If you provide too many details [or] your stories are too involved, you can’t tell if they’re interested or if they’re bored. Don’t overload them,” suggests Silber.

Whether you have the gift of gab or tend to ramble under pressure, practice providing short, direct answers to some common interview questions. Key in on your point early on. Studies show that the average listener remains focused for about 90 seconds.

Being observant can also help you gauge if you’re talking too much. Watch for clues that someone isn’t really listening: robotic nodding, detached responses such as “hmm” or “uh huh,” or stolen glances at the clock. Have some strategies in mind to pull yourself back if you digress—like smiling, pausing and revisiting the question asked. “So in summary, my favorite rotation turned out to be….” Or simply wrap up your answer, leaving the ball in their court to request more details.

Are you hard to get to know?

Some people have no trouble opening up and sharing personal details, while others are naturally tight-lipped, especially in a professional setting. But if you keep your conversation only on academic and professional topics, you’re missing the chance to make yourself stand out as a unique candidate.

“We need to understand what makes you tick,” says Laura Screeney, director of physician recruitment at New York-Presbyterian Hospital in New York City. “There are good jobs from coast to coast, so we want to know why us, why you’re here. The CV doesn’t tell us your whole story.”

If it’s hard for you to open up, plan ahead. Identify a few topics you’re comfortable bringing up that lend insight into you as a person. For example, location can be a starting point for conversation, says Screeney. Share what attracts you to the area at hand (or why you want to stay there)—whether you’re drawn by your passion for the ocean, making a move nearer to family or relocating to accommodate a loved one’s job.

“Showing your ties to the area is always helpful,” agrees Screeney.

Another talking point can be a pertinent fact or two about your family or significant others: children’s extracurricular interests, loved one’s jobs or educational pursuits, or special child or senior care arrangements. This information not only gives a glimpse into your world, but often prompts others to share details that could aid in your decision-making process.

“I once met with a candidate who mentioned his daughter was a talented dancer,” recalls Screeney. “My niece was heavily involved in this area, and I was able get information from her about teachers in the area and pass this along to him and his wife.”

Even if you’re much more comfortable sticking with your credentials, you can still do your best to bring your personality to life in these conversations.

“Use real-life examples or a personal story in your responses,” suggests Fair. “For example, if you’re asked [how] you deal with a difficult patient, you could give a canned answer—‘I keep my voice low, stay at eye level,’ etc.—or you could share an example: ‘Well, a couple weeks ago, I did this….’”

Though you shouldn’t go overboard about your personal life, do offer a glimpse into your non-work personality.

Do you always do your homework?

Research and preparation are second nature to some people, while others proudly tout their proven ability to wing it. Whichever has been your standard method of operation, experts agree that prep time is essential prior to an interview.

Christopher Ewing, M.D., emergency medicine physician at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, always goes into an interview armed with knowledge.

“I learned in residency that you really have to understand the people, environment and culture of a place,” he says. “Ahead of time, get the interview agenda to find out who you’ll meet and look up the names of people on LinkedIn and staff bios. This helps you anticipate the needs of the people you’ll be meeting.”

In addition to learning the who’s who of people you’re meeting, delve into the company—read about their strategic partners, special interests, planned growth or future direction and values. Look for both things that attract you and things you question.

Ewing recalls one interview where he used a potential concern to raise questions and generate a useful conversation.

“I used this as an opportunity to ask questions to learn about their process and think of ways to improve it,” he recalls.

Your research can also provide you with topics for side conversations. Make note of similar backgrounds, shared alma maters or mutual acquaintances, and pull these out when there’s a lag in conversation.

Are you a perpetual pleaser?

Do you often agree to things you don’t really want to do? Are you more likely to smile and nod politely than stir up controversy? Focusing too hard on trying to please can thwart progress in an interview. It doesn’t support a meaningful exchange of information and risks leaving your interviewers with a vague or false impression of you.

“Don’t put on a front and tell us what you think we want to hear. Answer honestly, even in situations where you think it’s not what we want to hear,” says Justin Sharpe, in-house physician recruiter at Tallahassee Memorial HealthCare in Florida. “For example, don’t be afraid to say, ‘This isn’t my first choice, but…,’ and then go on to tell us why you’re here, what ended up bringing you out.”

Experts suggest initiating further conversation, rather than quickly accepting, when something doesn’t quite mesh with your goals. Ask the speaker to elaborate, suggest a compromise or present an alternative. Your probing could result in a scenario that works better for both of you.

Do you avoid social interactions or seek them?

Do you thrive in group settings, drawing energy from people? Or do you crave time alone to recharge and prefer to work independently? Whatever your style, your comfort in social interactions can be a factor in an interview.

If you’re an introvert—with a preference for independent tasks and “me time”—your quiet, composed nature can be an asset in a professional setting. But at an interview, that same nature may be misinterpreted as stand-offish or detached. If you’re an introvert, try these tips:

  • Watch your body language. “Sit straight up, lean forward toward your speaker, and appear engaged and interested. Keep eye contact,” suggests Fair.
  • Schedule wisely. Book events at the time of day that works best for you and try to build in a window for down time to collect your thoughts and refresh prior to the meeting.
  • Show that you’re not all about isolation. Bring up examples of past successful team activities.

If you’re an extrovert—comfortable in groups and happier with exposure to people—an interview may seem like your ideal setting. But your social confidence may make you seem domineering or self-important. If you’re an extrovert, consider these factors:

  • Don’t go overboard. Keep your answers focused. Don’t ramble, go on tangents or hijack the topic.
  • Show stability. Discuss situations that depict your dedication and long-term commitments.
  • Be humble. Touting your strong points may come easily and can be a positive trait. Just don’t take it too far—express gratitude for past opportunities and give credit to people who have helped you.

Whatever your personality, most people find interviews stressful. Get an edge on your nerves through preparation. Understanding and working with your true nature can help you put your best foot forward.

 

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How Tight is the Job Market in Your Specialty? Summer 2017 issue

Summer 2017 | 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?

Indexes

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 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 your experience of searching for a job in your specialty? Do you need to widen or narrow your job-search parameters as a result?

This PracticeLink Physician Recruitment Index was pulled April 1. Candidate ratios include physicians who have registered with PracticeLink.com within the past 24 months.

 

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The Great Outdoors

Live & Practice | Summer 2017

 

Working in medicine can be taxing, no doubt about it. So it’s no surprise that when many physicians plan their next career moves, they look for locations with easy access to the great outdoors. Whether they opt for active hobbies like biking and skiing or meditative activities like hiking and fishing, the fresh air helps them find peace in nature.

If you want to be close to nature while accelerating your health care career, read on to learn more about Glens Falls, New York; Columbus, Mississippi; Bangor, Maine; and Anchorage, Alaska.

Glens Falls, New York

Glens Falls is located north of New York’s capital but south of the Adirondack Mountains. It offers the outdoor activities that come with living near a park, as well as excellent outdoor arts and culture. Nearby Saratoga Springs is bustling with outdoor concerts, performances and a world-class horse racing facility during the summers. In the winter, ski slopes, tubing tracks and snowmobiling paths distract residents from the cold.

Chris Mason, D.O.

Chris Mason, D.O., found his job in an area where he had previously vacationed—Glens Falls, New York.

When Chris Mason, D.O., started looking for his next position, he signed up for a physician account with PracticeLink.com. He still remembers the subject line of the message he received from Antoinetta Backus, manager of physician recruitment and retention for Glens Falls Hospital in Glens Falls, New York: “Live like you’re on vacation.”

Mason was living in Long Island at the time, and for several years, he had taken annual vacations to nearby Saratoga Springs with friends. He was very familiar with the area, so it wasn’t too hard of a sell. Backus invited Mason for an interview, and she showed his wife around the town. Today, Mason is a hematologist at Glens Falls Hospital. He enjoys living with his wife and infant son in New York’s Adirondack Region.

“I love that there are things to do in all four seasons,” he raves. “We love to be outdoors. We love to ski. In fall and spring, the leaves change, which is beautiful. There is hiking and mountain biking. There are a lot of great restaurants, and there is a lot of culture.” Mason also enjoys seeing the New York Philharmonic during the orchestra’s annual residency at the Saratoga Performing Arts Center, an outdoor amphitheater in Saratoga Springs.

Outsiders don’t always realize the area has so many offerings. Backus says, “When folks ask me about the size of Glens Falls—depending on where they are coming from—they may think it’s rural. But everything is here that you need. You can be as busy as you want or as quiet as you want.”

The same could be said for Glens Falls Hospital. Physicians can find work-life balance while accelerating their careers. “It’s a 410-bed hospital,” says Backus. “We have 570 physicians and advanced providers on staff. Every specialty is represented: orthopedics, surgical and labor and delivery, to name a few. We have a busy ER. Our staff is stable. People have been here many, many years. Our staff is so stable. There is very little turnover.”

The hospital’s work-life balance and the area’s high quality of life were what attracted Mason to Glens Falls Hospital.

Mason chose hematology and medical oncology because of the deep doctor-patient relationships he saw in the specialty. “I’ve been inspired by the patients,” he says. “Patients with cancer develop a close personal relationship with their doctor. My interest in my subspecialty was always inspired by oncology patients.”

But although Mason enjoyed his work with his previous employer, life in a New York City suburb wasn’t a match for his love of the outdoors. “Our quality of life had eroded on Long Island,” he says. “The amount of people, the amount of traffic, noise had started to really get to us.”

When Mason and his wife visited to meet Backus and interview at Glens Falls Hospital, they felt an instant connection to the area. “We found what we were looking for in the sense of having a house with a nice yard and less congestion and traffic on the roads,” he says. “There are a lot of opportunities and activities to spend time with kids. Now we have a 6-month-old son, Christopher Jr., and that was another reason we looked to come up here. We wanted to have a family, and this job provided an opportunity to focus on work-life balance and have a higher quality of life.”

Speaking of which, Mason just got a new pair of skis. “It’s great being so close to Vermont and Lake Placid. In a couple years, we will start Christopher Jr. in a ski program. For now, we all go on hikes.”

Columbus, Mississippi

Combine Southern hospitality with a thriving economy, and you get Columbus, Mississippi. The area offers the best of both worlds in more ways than one. Newcomers can settle into historic homes or modern neighborhoods. Outdoor enthusiasts can enjoy boating and fishing or venture into the nearby woods to hunt. Physicians can relax in Mississippi nature one day and spend the next working at a 315-bed hospital that has been growing at a dizzying pace.

John Reed, M.D.

Life in Columbus, Mississippi, allows for both a cutting-edge work life and weekends spent in the woods for John Reed, M.D

John Reed, M.D., had almost retired. He was ready to pass his nephrology practice on to his partners and turn his focus to running a small farm, hunting and volunteering by tagging deer for a state wildlife study. But an opportunity arose at Baptist Memorial Hospital-Golden Triangle, a 315-bed hospital in Columbus, Mississippi, that was too interesting to pass up.

A born-and-raised Mississippian, Reed settled in Jackson, Mississippi, where he completed a nephrology fellowship and opened a dialysis and nephrology practice.

He ran this practice for 30 years—opening four sites and recruiting several partners along the way. “We had clinical trials and published a good bit,” remembers Reed. After three decades, he wanted to spend more time at his cabin in the woods. But just as he was getting ready to hand over his practice to his partners and spend more time outside, he learned Baptist Memorial was looking for a quality director who could start a hospitalist program.

The position was right up Reed’s alley, and he could still enjoy the great outdoors during his off-time in Columbus. So Reed continued to work.

“I did both the hospitalist program and quality for a few years,” Reed says. “I started that hospitalist program, and then other opportunities started to pop up. There were a number of medical directorships within the hospital that I was considering. I was named the first chief medical officer.”

Reed enjoyed his work as chief medical officer, and that showed in his outcomes. Reed says, “The hospital grew. It had great, great outcomes. In 2013, we were named one of top 10 hospitals in America for VHA. We’ve grown exponentially. I initially agreed to work a couple years. I’ve worked 10. It’s been so exciting.”

Christina Dickey, who works in physician development for Baptist Memorial Hospital, says that Baptist Medical Group operates seven clinics in the Columbus area in addition to the Baptist Memorial Hospital flagship site. These include family medicine, internal medicine and pediatrics, cardiology, cardiovascular surgery, general surgery and pulmonary disease.

Reed says, “Baptist Memorial Hospital is based out of Memphis. They have been in the hospital business over 100 years. Baptist Memorial Hospital-Golden Triangle is a standalone entity, and yet we’re also a part of this system, and we’ve got some really great leaders there. When we talk about the growth of Baptist Memorial Hospital, I give almost all the credit to having been able to be on a great team with great physicians and above-site administrators. I happened to be a part of a number of great teams. I’ve recruited 30 to 40 doctors in the past few years. I’ve found myself to be surrounded by great people, and we’ve had some great outcomes for our patients and for our system of hospitals.”

Dickey is currently recruiting for psychiatry, pulmonary medicine, general surgery, internal medicine and cardiology. She says that the area is attractive to physicians because it’s a “great place to live and raise a family, with close proximity to larger metro cities, an excellent airport for travel connecting to Atlanta and low cost of living.”

“I feel like people think of Columbus as a hidden gem,” says Nancy Carpenter, executive director and CEO of Visit Columbus. “People frequently say to me, ‘I had no idea that Columbus was this pretty.’”

Carpenter explains, “We’re a town of 25,000, and the county has 50,000 people. We have 135 restaurants and 1,600 hotel rooms. We have a brand-new Fairfield Inn, a Courtyard and a Marriott, and we’re getting a new Holiday Inn Express in January.” Carpenter notes that Columbus is one of the largest industrial markets in Mississippi, adding, “We got a great burst of economic development.”

She continues, “We’re fortunate for our location. We’re in the middle of a lot of communities that are thriving, not just surviving. If people like old-world charm and Southern hospitality, they’re certainly in the right place. But they can also have great recreation and modern culinary choices and housing options. People can certainly enjoy being in Columbus in a quaint historic area or a thriving neighborhood that is child-friendly.”

There’s plenty to do in Columbus, thanks in part to Mississippi’s warm climate. Carpenter says, “We have a terrific waterway—it’s the largest manmade waterway after the Panama Canal. There’s boating and fishing on the waterway, and every summer, we have Fireworks on the Water where 10,000 people come out to see an elaborate fireworks display. People also enjoy the riverwalk. There is a 45-mile path that people like to walk and run.”

As for Reed, he is able to work at a cutting-edge medical center and spend his weekends at his cabin in the woods. During the past hunting season, he provided deer meat to four needy families in the Columbus area. Reed’s commitment to caring for others extends to his life outside the hospital. He says that this sense of community is simply part of life in Columbus.

Bangor, Maine

Bangor, Maine, offers the visual beauty of New England, including the picturesque summers and the winters that look borrowed from a holiday card. Part of Bangor’s allure is its beautiful landscapes, as well as the many outdoor activities provided by nearby Hermon Mountain, skiing areas and the Penobscot River. Top talent is attracted to the area in part for the rural beauty and in part for the interesting challenges that come with a large service area.

When Jonathan Wood, M.D., was looking for a new position, he had a choice between pursuing a job at a freestanding children’s hospital or looking for one at a smaller hospital with no intensivist program.

He found a happy medium in Eastern Maine Medical Center, a 411-bed hospital with a tertiary pediatric center, where he is the senior lead physician for pediatrics. “We are the only tertiary pediatric offering in the northern two thirds of the state,” says Wood. “I’ve been supported in trying to grow the inpatient services and some of the outpatient services so that we can genuinely say we’re a full-service institution with few pointed exceptions”

Wood attended Yale for his undergraduate degree in history. He taught high school for three years before attending Dartmouth for medical school. He completed his pediatric residency at the University of Rochester in Rochester, New York, then worked at the University of Massachusetts Medical School.

“When I was at University of Massachusetts Medical School in Worcester, we were looking to change our location, so I was looking at a bunch of different jobs,” Wood says. He didn’t have specific criteria in mind. Rather, he wanted to see what was available somewhat locally.

Eastern Maine Medical Center appealed to him for its pediatric offerings, and Bangor appealed to him as a place for him and his wife to raise their four children. “It was a very welcoming place. When we moved here, I had a fifth grader, two eighth graders and a sophomore in high school. It was striking how welcomed they felt. It’s really been great. In my 15th year, my kids are all out and about, but some of them talk about coming back to Maine to live.”

Kerrie Tripp, executive director of the Greater Bangor Convention and Visitors Bureau, says, “There’s a lot of great things about life in Bangor regarding physicians with families or physicians planning to start a family, the entertainment we have and the school districts. They’re pretty spectacular. We also have great outdoor activities. We’re a four-season area.”

She continues, “We have a phenomenal municipal golf course. It’s Audubon-rated and played for three seasons. Then during the winter, they groom parts of the course for snowshoeing areas and cross-country skiing areas. They’ve turned it into this wonderful outdoor space for all ages.”

This vibrant local culture attracts top-notch medical talent to Bangor. Wood says, “We have a group of really young, energetic, driven, mission-based people. They are all incredibly well-trained.”

A program called Maine Career Connect focuses on those who moved for their spouses’ jobs, since they may not have the same opportunities as their spouses to meet people and get acclimated through work. Tripp explains, “This is a program that helps them make connections, make friends, learn about industry in the area and help them to feel at home here.”

Another large employer in Bangor is St. Joseph Hospital, a 112-bed hospital. David Koffman, M.D., one of the site’s medical directors, says, “One of the things I stress about St. Joe’s is that it is a place that really has a patient-first approach. That’s something people like about this place. It’s not about the bottom line. Our priority is to take care of our patients. For a small hospital, we feel we offer a pretty wide range of services, and it’s a place people like to come to work. Everyone knows each other. You don’t feel like you’re working in a nondescript environment. You’re working with people you know and like, who know you by name. The patients are incredibly appreciative to receive care.”

Lisa Cramm is a physician recruitment and retention specialist for Covenant Health, of which St. Joseph Hospital is a member.

Cramm says, “We have a pretty big primary care base. We have five local family practices with a total of 17 primary care physicians. We have an internal medicine group with 18 providers. We have rheumatology, as well as endocrine-diabetic. We have general surgery. We partner with an excellent orthopedic group. We have gastroenterology, cardio, pulmonary and critical care. We have a good wound service. We’ve got a great occupational health group, and we have a full-service emergency room.”

St. Joseph Hospital also operates two family practices in Bangor, one family practice in Brewer and one in Hampden, a suburb of Bangor. Koffman says, “We are truly a community hospital for this community. And then there are a bunch of communities where patients come from some distances to see us. St. Joe’s is the place they depend on.”

“We are a fairly rural community, but we are lucky enough to provide good health care and have top-notch equipment. We are four hours north of Boston. Most patients don’t want to get their health care outside of the local area. If possible, they want us to manage it and not send it out to referral centers. Hospitals our size don’t often have the opportunity to do this, but we do. We can see and manage pretty complex cases,” says Koffman.

Eastern Maine Medical Center also channels a community-oriented mission.

Wood believes this contributes to the organization’s culture. “I think the physicians who come here are here for good reasons,” says Wood. “They don’t come here for the reasons that a lot of tertiary centers attract talent. There’s no climb the ladder feel. You come here to practice. It’s hands-on, and there are not a ton of trainees between you and the patient. We have a taste of an academic medical center, but that’s not what people come here for. They come here to practice … and then they come here for the geography, for the outdoors. They come here for the mountains and the lake. They come here for the hiking and the outdoor activities. They want a city that is kind of a small city but also has excellent outdoor offerings.”

Anchorage, Alaska

If you picture coats, hats, boots and scarves when you picture Alaska, you’re only half right. Alaska winters offer lots of reasons to get bundled up and enjoy the great outdoors, but Alaska also has picturesque summers. Many residents enjoy hiking, biking and camping—no parkas necessary.

To say that Daniel Hartman, M.D., is outdoorsy would be an understatement. He is a family practice physician with Southcentral Foundation, an Alaska Native-owned health care organization in and beyond Anchorage. And long before he became a physician, Hartman spent his time outside, learning about the many inhabitants of the great outdoors.

As an undergraduate at the University of New Hampshire, he majored in biology and concentrated on marine invertebrate zoology. His early career foreshadowed his move; he spent some time as a marine mammal biologist, a career that brought him to Alaska frequently.

After earning a public health master’s degree at Boston University, Hartman decided to pursue medical school in Philadelphia, then traded coasts for his residency at San Francisco General Hospital. After residency, Alaska called his name. “In 2002, my wife and I moved to Bethel,” Hartman says. “Bethel is in western Alaska near the Bering Sea. It’s a 400-mile flight from Anchorage.”

In 2013, the family settled in Anchorage, where they live today. Hartman says quality of life factored into their decision. “Our kids are 11 and 13,” he explains. “We chose Anchorage and Southcentral because of its work-life balance. …We looked at the whole world for options, and we chose Anchorage for its excellent schools, very short commutes and access to trails and outdoor life.”

Southcentral Foundation provides a full scope of health care services to those living in Anchorage and the 55 rural villages in the Anchorage Service Unit, a service area in southcentral Alaska that spans 107,400 square miles. Southcentral Foundation offers a wide spectrum of care, including audiology, pediatrics, optometry, OB/GYN and Native men’s health services. The foundation also jointly operates an emergency room at the Alaska Native Medical Center with the operators of the medical center, the Alaska Native Tribal Health Consortium.

Another Anchorage employer is Alaska Regional Hospital, a 250-bed hospital which is part of HCA Healthcare. The hospital’s offerings include an orthopedic and spine center, a wound care center, a cancer care center and a NICU.

Ralph Costanzo, M.D., the chief medical officer of Alaska Regional Hospital, speaks highly of the hospital and its community. “The folks are incredibly friendly,” he says. “The medical staff is very gifted. The team comes from all over the world. They’re here mainly because they love the area.”

Costanzo believes Alaska’s outdoor offerings are a big part of the draw. “Anchorage is a wonderful, large-small town. It’s a cliché, but if you do really enjoy four-season recreation, you’ll love it here,” says Costanzo.

Outdoors enthusiasts will never be bored in Anchorage. Hartman says, “Anchorage is an extraordinary place if you like the outdoors and trails. It’s an incredible trail city. It has everything people would want for urban amenities like good coffee, music, restaurants and brewpubs.”

But while there’s plenty to do in Anchorage, it’s not always go, go, go. Julie Saupe, president and CEO of Visit Anchorage, says, “We are the city for Alaska, but still we are not fast-paced at all. People get things done, but we’re relaxed as a community. We are a community of relaxed doers. I think that’s the main thing to know beforehand, before coming to Anchorage.”

She adds that the weather shouldn’t deter prospective residents. “In southcentral Alaska, we are surrounded by water, so we don’t get the extreme temperatures on the warm side and the cold side,” she explains. “Winter shouldn’t be intimidating.”

The advantage of Anchorage, according to Saupe, is “a combination of the scenic beauty and the outdoor opportunities.” She explains, “They go hand-in-hand. We have amazing hiking in the summertime and amazing skiing in the winter. It’s an outdoorsman’s paradise.”

Hartman falls into that category. “I am a climber—winter and summer,” he says. “My family and I go skiing quite a bit. We do trail running, and we are big on mountain biking. This is an incredible city for single-track mountain biking. There are a lot of boating opportunities—limitless boating opportunities.”

When the snow melts, Alaskans leave the extra layers of clothing at home and enjoy other warm weather activities. “In the summer, my family and I do a lot of camping in the national parks,” says Hartman.

Saupe agrees that there are plenty of outdoor activities.

She says, “You can hike on a glacier. You can go whale-watching. If you want to go fishing, we have world-class fishing within an hour of Anchorage. I have lived here since 1990. Every day, I drive home and look at the mountains and think, Wow, this is a beautiful place. It’s in your face every day. You can’t forget that you live in a place of vast wilderness.”

 

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Fractures, Fevers, and Helping Patients Understand Your Choices

Summer 2017 | Tech Notes

 

In this edition of Tech Notes, we’ll cover three useful medical apps for daily practice: two for physicians, and one to share with your patients.

OrthoFlow: Fracture management

Orthoflow

Price: $4.99 Apple; $5.99 Android. Apple: ow.ly/SqM630aLkmv Android: ow.ly/C3K330aLkyK

OrthoFlow is almost like having an orthopedic surgeon in your pocket. It’s especially helpful in primary care, urgent care and emergency room settings, where a lot of basic fracture management occurs.

OrthoFlow’s introductory screen shows a full human skeleton. Simply tap until you localize the affected bone. Once you’re done with this quick process, the app asks questions about displacement, neurovascular function and more. Then it provides specific recommendations, such as which type of splint to use and what key details to discuss with your orthopedic surgeon.

Key ways to use this app. If you are a primary care, urgent care or emergency medicine provider and your patient’s X-rays show a fracture, this app will help you determine fracture management. If you are an orthopedic surgeon, the app’s appendix will provide you with detailed information on necessary surgeries and items to discuss in morning fracture rounds.

Step-by-Step Febrile Infant: Validated Step-by-Step Approach

Febrile Infant

Free. Apple: ow.ly/1NcV30aLkJE

Step-by-Step Febrile Infant is yet another helpful app from Dr. Joshua Steinberg. Steinberg has created more than 15 medical apps, and this one is a great example of turning validated research into an easy-to-use app.

The app is based on the Step-by-Step Approach, a clinical evaluation protocol that helps physicians decide on care for febrile infants.

A validation of the Step-by-Step Approach was published in Pediatrics in July 2016. The app not only recreates the study’s findings and suggestions but also offers several sections that explain the study further.

A word of caution: Since the Step-by-Step Approach is a deviation from traditional practice and management of a febrile infant, make sure you understand your local practice and standard of care before using the app.

Key ways to use this app. If you are an emergency physician or pediatrician who cares for febrile infants, this app can help you understand the validated Step-by-Step Approach. If the Step-by-Step Approach has become the standard of care in your area, this app can help suggest management of care.

Making Healthy Choices: Explaining treatment decisions

Health Choices

Price: Free. Apple: ow.ly/xTYy30aLkZr

When patients come in with very specific expectations for care, it can be difficult to convince them that a particular test or a round of antibiotics is unnecessary. That’s where the Making Healthy Choices app comes in.

In the app, patients can drill down to specific procedures, tests and medicines to learn more about the indications for each of these. This helps them understand why you are—or are not—recommending a certain course of action.

One of my favorite features is the “Questions to Ask” section, which gives patients important questions to ask when a physician recommends a procedure.

Key ways to use this app. If a patient or a family member doesn’t understand your recommendations, encourage him or her to download the app and read about a particular procedure, test or medicine.

Iltifat Husain, M.D., is the editor in chief and founder of iMedicalApps.com, the leading physician publication on digital medicine. He is also an assistant professor of emergency medicine at Wake Forest University School of Medicine.

 

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