What are the different kinds of recruiters?

By PracticeLink Staff | Web Exclusive

 

There are two main types of physician recruiters that you may encounter when engaging in your job search: in-house recruiters and search firm or agency recruiters. On PracticeLink.com’s job search results, you may notice three separate tabs: “In-house jobs,” “Agency jobs” and “Both.”

What is an in-house recruiter?

An in-house recruiter is employed by the hiring party, whether that is a hospital, health system, private practice, physician group, etc. This person will also often work in the town where the job is located and could be classified as a recruiter, office manager, hospital CEO or a number of other titles.

What is a search firm or agency recruiter?

A recruiter for a search firm is a third party that has been “hired” by the employer to help them locate good physician candidates. Some search firms are labeled “contingency,” meaning the hospital/practice only pays them a fee if their candidate is hired. Others are “retained,” meaning the hospital/practice retains them for a fee to assist in the physician search. In either case, the search firm is paid by the employer and not by you.

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How can you calculate your worth as a physician?

Wondering if your compensation offers are in line? So did I.

By Steven R. Bruhl M.D. and David A. Bruhl | Remarks

 

Finding a job right out of residency is a complicated and daunting task. Although many young physicians might think they have some idea about their expected income, they often have difficulty correctly assessing the effects of different practice settings and geographic regions on their relative worth.

Once a salary and sign-on bonus has been agreed on, many new physicians fail to ask exactly what measuring stick their employer will use to evaluate their productivity and corresponding future income.

My experience with finding the perfect job was no different, and as practices started sending me contracts and benefit packages the size of small phone books, the same questions kept running through my mind: How do I know what I’m worth? How do I know which contract offers are fair, and which are attempts to take advantage of my financial inexperience?

After several hours of sifting through the various contracts, I knew I was in over my head, so I met with the business manager in charge of the cardiology practice where I was completing my fellowship.

Almost immediately, she recommended I consult the same resource their practice and hundreds of other practices use for answering these questions: the Medical Group Management Association (MGMA) manual.

Every year, the MGMA sends out the Physician Compensation and Production Survey to medical practices in order to obtain current information about the compensation and productivity of physicians around the country.

These surveys are provided to all specialty types, practice structures and regions of the country. The results of these surveys are then organized and compiled into charts to help medical practices gauge their own productivity and compensation.

Medical groups often use this information to set their own internal benchmarks for establishing future compensation and productivity standards for current and new physicians.

What I learned from the MGMA manual was that, although there are a myriad of potential variables that go into what determines a physician’s salary, there are six major practice variables that are tracked and that appear to consistently affect a physician’s compensation. They are: practice ownership, group type, geographic section, demographics, partners in practice and call responsibilities.

I found that by using the information in the MGMA manual, I was further able to estimate the average salary of a specific job offer based on the characteristics of each practice.

For example, let’s assume you are an invasive cardiologist and receive three identical compensation packages from three different practices. Practice 1 is a non-hospital owned, single-specialty group type located in a large metropolitan city in the Eastern region, such as New York City.

Practice 2 is a non-hospital owned, single-specialty practice located in a smaller metropolitan city in the Midwest, such as Cincinnati.

Practice 3 is a hospital-owned, multispecialty practice group, located in a non-metropolitan city also in the Midwest, such as Dearborn, Mich.

The first step in determining the average salary of Practice 1 is to look up the average salary for an invasive cardiologist working in a city over 1 million people and record the value. Next, look up the average compensation for an invasive cardiologist working within that region of the country.

Do the same thing for an invasive cardiologist working in a non-hospital-owned practice setting as well as an invasive cardiologist working in a single-specialty practice.

If you add up the average salaries from all four variables and divide by four, you will get what is likely an even closer estimate of the average annual salary for an invasive cardiologist working in Practice 1.

If you then repeat this process for your other job offers, you can now compare the average expected salaries of all job opportunities side by side.

Although there is no doubt that this method is a relatively crude attempt to estimate the salary of a specific practice setting—and no doubt lacks dozens of variables important to the equation—the composite estimates are at their core based on actual reported salaries of physicians working in your specialty within each specific practice setting.

Although the process of averaging four different compensation values based on four different variables is imperfect, these values can help shed light on the current trends in compensation as well as your relative worth in a given practice setting.

In about an hour, I was able to construct a chart comparing the average expected compensation from my top three job offers. Although all of the initial salaries were within 10 percent of each other, I found that the proposed salary for my favorite was 25 percent lower than my estimate from the MGMA manual.

With this knowledge and the counsel of other advisors, I counter-offered for 25 percent more than my initial offer, plus a bonus salary based on my productivity.

To my somewhat surprise, the hospital agreed to my three-year salary proposal, but suggested that my bonus salary be based on a specific work revenue value unit standard, also known as wRVUs.

Their initial productivity goals seemed somewhat high and unrealistic to my lawyer and me. So by referring to the standards published in the MGMA manual for my specific practice structure, we were able to work out a wRVU standard that was more appropriate for my specific practice setting.

From my experience, I found the MGMA manual to be a powerful tool in sorting out my financial value across very different practice settings. However, I would advise anyone consulting the MGMA manual to remember that the data should be use as a general guide rather than as a weapon.

Furthermore, if your potential employer intentionally or unintentionally tries to suggest that your proposed compensation is out of proportion to the average for your area, you may be able to use information in the MGMA manual to show otherwise.

Don’t overlook call responsibilities when discussing your relative productivity. Because call responsibilities often generate little to no direct revenue, make sure this variable is not overlooked when discussing your relative productivity.

Each practice is unique, and it is impossible to tease out the exact value of any particular variable, much less the exact value of a physician in that practice setting. However, using the variables that are known and understanding how they tend to affect compensation will help you better approximate your worth in a given practice setting and take some of the guesswork out of the negotiation process.

Although the process of estimating your worth is somewhat tedious, time-consuming and expensive, I would urge every physician to take the time and spend the money necessary to consult with physicians, practice managers and a lawyer experienced in physician contract law.

In the end, every hour and every dollar spent will likely pay dividends that go far beyond your starting salary.

Steven Bruhl, M.D., is a third-year cardiology fellow at the University of Toledo Medical Center and will be taking a position as a cardiologist at Mercy Tiffin Hospital in Tiffin, Ohio. David Bruhl is a lawyer with Rohrbachers Cron Manahan Trimble & Zimmerman Co.

The views expressed in Remarks are solely those of the author and may or may not be shared by PracticeLink or its advertisers.

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When should I start my job search?

Start your search for a practice 12 months before you'll become available

By David Townsend, PracticeLink Director of Physician Relations | Web Exclusive

 

“When should I start my job search?” is by far is the most common question physicians ask PracticeLink.

The answer is that there is no set day on the calendar; it is up to you.

We generally recommend that you begin your search for the right practice as soon as you are ready to investigate the possibilities and make decisions about where and with whom you would like to work.

You should start interviewing when you feel you are ready to make a decision. If you want to talk to potential employers in the information-gathering stage, then be upfront with the employer and let them know your situation.

Hospitals and practices normally determine their physician needs a year in advance, and they are actively recruiting for those positions a year in advance as well.

With that said, given the steps involved in possible relocation and start up of a new practice, it is ideal if you have landed a job at least six months before you plan to begin your practice. For many residents and fellows, this means beginning the interview process in August and finding a job and agreeing to terms no later than January.

We recommend that you start looking for a practice 12 months or more in advance and begin speaking with potential employers to gather information. Many employers are willing to help you through this early stage and inform you upon contact if they are capable of waiting an extended period of time before making an offer.

One advantage to using PracticeLink in your job search is that you do not have to register to view the job postings. This is a great help because it allows you to start looking at jobs before you are ready to actually be contacted by recruiters. This way you are able to view jobs and get an idea of the types of practices in your area of interest, learn about what the average practice offers in your area and just get an overall feel for how many jobs are available. When you are ready to be recruited, then create a free physician profile to easily save and respond to jobs and find your next practice.


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What physicians need to do when starting a new job

What do you have to do before you start?

By Christine Hinz | Feature Articles | Winter 2012

 

When Nicole Ottens, D.O., joined Mattoon, Ill.’s Sarah Bush Lincoln Health Center in July 2010, setting up her practice was “incredibly easy,” she recalls. As an emergency room physician employed by the 128-bed rural hospital, she didn’t have to make many decisions.

Setting up your practice

The hospital’s recruiter and human resources department processed the paperwork for securing her credentials. She didn’t have to market her services, because sooner or later people use the ER. And because she joined a department already staffed with nurses, she just became one of the team.

Ottens, who will soon be dual boarded in emergency and family medicine, was delighted with the process and even happier with her choice of employers. “All I want to do is to provide quality care to my patients,” she says. “This is the perfect job and the perfect way to do that.”

Perhaps you’re looking for the same streamlined experience. You want to sail through the formalities of launching a practice so you can just take care of patients. But establishing your practice is as important as anything you’ll do in medicine. It usually takes time, patience and attention to detail to make the smooth transition from training to your first job or from your first job to the next. To launch yourself as a skilled practitioner open for business, you’ll have to focus like a laser on key tasks: putting your credentials in order, marketing your name, staffing your office and equipping it too.

Are you in this alone? If you’re flying solo, you’ll have to take care of every aspect—unless, of course, you’ve already tapped a business manager. It’s the nature of being a lone wolf. But if you’re destined to join a group or hospital staff, you’ll likely have lots of guidelines, to-do lists and helping hands.

Organizations are usually quick to help physicians navigate a practice setup. Depending on the size, you’ll have plenty of assistance for mastering the terrain.

As Dorrie LeForce, director of operations for the Dallas-based HealthTexas Provider Network (HTPN), the 500-physician Baylor Health Care System-affiliated group, notes of their extensive soup-to-nuts assistance they give new hires: “We’re the legs and arms to support them in everything they need to open their doors.”

Credentials first on to-do list
You can’t treat patients unless you have proper credentials. It’s that simple. The first order of business in setting up your practice will be to get licensed by the state, affiliated with area hospitals and approved by Medicare, Medicaid and the major payers your employer wants to bill for your services.

Some fundamental items—such as NPI (National Provider Identifier) and DEA (Drug Enforcement Administration) numbers—you’ve likely already presented as part of your application. If not, you’ll need to apply for them before you can bill and prescribe drugs. Likewise if you’re staying in the same state in which you trained, you already have your medical license. But if you’re moving to a new area, getting it will be a priority.

Once you have those basics, you can complete the paperwork for your group’s major payers and professional liability insurance. In terms of malpractice, you’ll likely have the same carrier and coverage as your colleagues in your specialty, but you’ll still have to apply separately. Educate yourself about the coverage limits, how any suit might be settled, and what happens with the tail.

Chances are very good that the group or hospital you’re joining will help you navigate the paper chase. Start dates are usually contractually contingent on having your ducks in a row so you can see and bill patients on day one. Most organizations have an office or function to handle the details and keep the process moving forward.

So what’s your responsibility?

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How to avoid a relocation nightmare

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

By Therese Karsten, MBA, CMSR | Job Doctor

 

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

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

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

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

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CV essentials

Tips for physicians from career coaches

By Jon VanZile | Feature Articles | Winter 2012

 

Designing a CV or résumé is a deceptively difficult task. In theory, it seems easy to give a straightforward chronicle of your career so far. In reality, it’s very difficult to design a piece of paper that, in about 30 seconds, accurately depicts what you’ve done so far, who you are, and what benefit you might offer an organization.

HOW TO FORMAT

While you’re agonizing over word choices and the order of your headings, here are a few pointers from professional career coaches.

1. Keep your formatting clean and open, with lots of white space. Resist the temptation to cram your CV with lots of tiny type. In this case, less can be more.

2. Push your dates to the right side, not the left. You don’t want your CV to look like a list of dates. Make sure your title and/or organization is the first thing the reader sees.

3. Under your headings, list your most recent activities first.

4. Go easy on the creative fonts. Stick with a simple, professional font like Times New Roman.

5. Have it proofread—several times. There should be absolutely no grammar or spelling mistakes.

6. Save the document as a PDF and a Word file. Almost everybody can read a Word file or PDF, and both are easy to email, should the need arise.

 

WHAT TO INCLUDE

A CV is a long-format document that contains a full history of your credentials and achievements, including your education, professional background, and even personal and cultural activities that help define you. Once your CV is finished, most physicians update their CVs every few years, and of course, any time they are job hunting.

As you’re confronting your CV, it’s helpful to know what “typical” headings look like. It’s not essential to include all of these—only include headings in which you have something substantive to add.
Outside of a few broadly accepted rules—your contact information goes at the top, for example—there are few hard and fast rules for the order of your information.

Some experts recommend putting your education before your clinical experience, while others recommend listing your clinical experience first. As always, it comes down to your level of experience and your target audience.

SAMPLE HEADINGS TO INCLUDE

• Contact and personal information: This should be the first thing on the page. Include your name, address and contact information. If you have a LinkedIn profile or personal web page, you can include the URL here.

• Objective: This line is somewhat controversial among career coaches. Some love it, some hate it. If you include an objective section, keep it limited to one or two sentences and make sure it’s tailored to your prospective organization. Consider putting the objective part in your cover letter—especially if it’s not entirely obvious how you fit with the facility. (For example, an internal medicine physician applying for a hospitalist job.)

• Education: Include the name of your school, graduation date, and area of study. It’s not necessary to include individual coursework.

• Academic honors: Many CVs include a line for academic honors just under the education section. This would include honors such as magna cum laude or positions of student leadership.

• Board certification, specialty and licenses: List the specialty in which you’re board certified (and when), and the states in which you’re licensed.

• Internships/residencies/ fellowships: Keep this section relatively basic, listing the institution, location and your specialty. Do include positions of leadership, if possible.

• Volunteer experience: This can be especially valuable for residents just starting out who don’t have much clinical experience. If you have extensive volunteer experience, consider breaking this into one section for medical volunteering and one for nonmedical volunteering.

• Clinical experience: In chronological order from most to least recent, include the practices and/or hospitals where you’ve worked, including a brief description of the facility, your responsibilities, and the dates you worked there.

• Publications and presentations: Include any publications you’ve written or co-authored. This includes articles in peer-reviewed journals, chapters in textbooks and even consumer-related media. Presentations at conferences should also be mentioned.

• Professional memberships: Include relevant societies and organizations.

• Awards and honors: This list should include any professional recognition you have received outside of school.

• Cultural activities and personal interests. If you’re very involved in a charity or cultural institution, include this.

 

SAMPLE CVS

 

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How to Negotiate like a 5 Year Old

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

By Anne Fowler | Fall 2011 | Job Doctor

 

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

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

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

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

Come prepared for the discussion.

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


• Enlist an attorney to review the agreement.

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

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

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

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

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

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

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

 

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Your Ultimate Job Search Guide

Gold Award winner for Best How-To Article from the American Society of Healthcare Publication Editors!

By Karen Childress | Feature Articles | Summer 2011

 

Elly Laroque, M.D., Orthopaedic surgeon

Elly LaRoque, M.D., suggests starting your job search at least a year in advance—earlier if you’re considering academics. She chose a medium-sized private practice after completing a sports medicine fellowship.

Click to download this article as a PDF

Orthopaedic surgeon Elly LaRoque, M.D., has given lectures to residents and fellows from Stanford, UCSF, and at American Academy of Orthopaedic Surgeons annual meetings on how to choose and start a practice. The content of her presentations is based on her own experience, research, and from talking to her colleagues who share accounts of their job searches. Her most valuable piece of advice? “Start looking early, at least a year in advance, unless you’re going into academics, in which case start even sooner,” says LaRoque.

But how early is early? And how do you know what to do, and when? These are the questions that this article seeks to address in a way that will make your job search relatively smooth and painless.

The process can seem daunting and drawn out, but if you take it one step at a time, the end result will be—if all goes according to plan—your ideal job. more »

 

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How your spouse can help with your job search

By Therese Karsten, MBA, CMSR | Feature Articles | Summer 2011

 

One of the fundamental rules of successful recruiting is that practices recruit the spouse as well as the physician.

James Lopez, M.D.

James Lopez, M.D., and his wife, Melissa, a critical care RN, ranked each of their top 10 needs in a post-residency opportunity. Criteria included proximity to family, cost of living and nights on call. The exercise helped them determine if a job would meet their family’s priorities.

Hospitals and practices expect to interact at some point with the spouse or significant other who will be making the relocation decision with the physician. That interaction can shape the hiring authority’s perception of the candidate’s fit with the practice and community. The spouse has an opportunity to help or hinder the chances of landing the right job offer.

These tips will help your spouse help you.

 

Edit the CV and cover letter

The majority of physicians interviewing today have been immersed in a heavily science-oriented curriculum since 5 minutes after birth.

Spelling, grammar and graphic layout are not usually on the same gene map that leads to highly competitive MCAT scores. Luckily, physicians often marry people whose natural gifts complement their own skills.

If that describes your spouse, give your spouse sample CVs and cover letters to work with so that the final product has the right structure and components. Take the resulting draft to physician mentors or peers known for good written communication.

 

Get the word out that you’re looking

Your spouse can help you set up your online search. Create a job-search email account and keep a master list of sites where your CV is posted so that you can remove or edit as needed.

Your spouse can copy, paste and adapt your cover letter and CV to use on major job-search sites—like PracticeLink.com.

After registering on a physician job bank, you may get a call to gather more information about what you’re looking for in a practice. It’s fine to have your spouse respond, as long as you have agreed on the key messaging points. more »

 

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DeVry Anderson, M.D.

By PracticeLink Staff | Snapshot | Summer 2011

 

DeVry Anderson, M.D., Chief medical officer, CEO, owner: Quick Care Walk In Clinic; brigade surgeon, Warrior Transition Brigade, Fort Hood, TX

 

Work

Chief medical officer, CEO, owner: Quick Care Walk In Clinic; brigade surgeon, Warrior Transition Brigade, Fort Hood, Texas

Education

MEDICAL SCHOOL: Thomas Jefferson Medical College, 2000

INTERNSHIP: Completed an orthopaedic internship in 2000.

RESIDENCY: Carl R. Darnall Army Medical Center, Fort Hood, Texas

IN PRACTICE SINCE: Practiced as a military surgeon until returning to family medicine residency in 2006. more »

 

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