The Job Hunt: How to Make a Match That Will Last

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A successful job interview looks beyond the offer letter

There are many ways one might define a successful interview in a typical scenario; usually, job offer = successful interview. But for an EM physician in most markets, the offer is almost a given.

A successful interview can and should be so much more than getting an offer or making a great impression. A truly good interview is rather a step in the process of making the best possible match.


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As you’ve likely heard before, a large percentage of EP’s stay in their first job less than two years. And while a portion of that group can be attributed to situations such as taking a fellowship, the number is too high to eliminate the realization that in many instances a poor match has been made.

So how does one prepare for the interview experience?

When I was in my final months of college, guys bought the 1980’s ubiquitous yellow tie, girls bought “power suits”, and we all practiced our handshakes on one another. Naively, we considered this interview preparation.


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Today after participating in the interview process with hundreds of EM physicians, I’ve formed some strong opinions on the interview process.

For the novice but wise job seeker, the first interview questions should be to yourself:

  • What is truly important to me and to my family?
  • What aspects of my profession are the most and the least fulfilling?
  • What are my strengths and weaknesses?
  • Where do I want to see myself in five years? At the end of my career?

The first question is likely one you’ve long been considering. Issues of location, hours, compensation, and spouse career are typically at the forefront of consideration. And of course the second question is part of the answer to the first: job fulfillment.  Some of the most important aspects of professional fulfillment are the setting – acuity, coverage, schedule, etc. But it is also decisions about the culture and environment, colleagues and support staff, academic involvement, participating in the management or not, and availability of professional development opportunities.

These aspects also reach to considerations of compensation and group models: independent contractor v. employee v. owner. By acquiring a thorough understanding of the advantages and requirements of each of these three primary EM group models, you will weigh the best fit not only for your current work/life balance, but also your retirement plans.


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Looking to where you want to see yourself in a few years and in later years are considerations best addressed now. Do you have leadership aspirations? Student debt? Children to educate? Should you seek a high-living lifestyle now while you are young? Or should you plan now to make provision for the option of a slower-paced position in latter years?

Once you’ve taken a serious look at what really best fits your work/life style, it’s time to get information. Create a list of topics you want to cover; the points offered within this article could be used to craft your list.

The actual interview process often starts with a recruiter. For obvious reasons I may be biased on this point but speaking with a recruiter often presents a great opportunity to glean information in advance as well as confirm whether you genuinely want to move onto a site interview.

A good recruiter will often be able and willing to provide significant insights into analyzing potential matches. One recruiter I work with feels so strongly about residents making good matches; she will spend the better part of an hour providing interview guidelines to a resident even if he or she is going to an area where my group doesn’t do business

Being an “old school” recruiter myself, I have noted a difference in this era of texts and tweets that reminds me of the old adage about practitioners “learning less and less about more and more”. Residents frequently are overloaded with snippets regarding a plethora of opportunities but less often gaining the in-depth perspectives that will help them match to their best fit. Seek depth over quantity in your interview choices.

Although I strongly suggest preparing a list of information you’ll want to obtain, avoid simply making this a Q & A session and strive toward true conversation. Whether you are speaking with a site Medical Director or a recruiter, you’ll glean greater insights, a truer picture, and much more in-depth information by engaging in a genuine exchange.  Just be sure to circle back to cover remaining issues. As you begin preparing your topic list you’ll find excellent guidance on the EMRA website; and may utilize the cheat sheet below.

THE CHEAT SHEET
A few topics you might consider asking about during a job interview:

The Basics

  • ED size & volume
  • Coverage; shift length; hours required
  • Size & stability of local group
  • Total annual package (based on average hours worked)

Compensation

  • Are compensation models Independent Contractor, Employee or Ownership?
  • Is there productivity compensation? If so, how does it work & when do I participate?
  • What is the average compensation for new physicians? Established physicians?
  • What is included in addition to clinical wages in my total compensation?

Malpractice Coverage

  • Who is the carrier, and what are the coverage limits?
  • Is it occurrence or claims made? If claims made who pays the tail?
  • Do I have the right to refuse to settle if I am named?
  • What is the pay-out record of the group?

Staffing

  • How are nights/weekends/holidays shared?
  • How are time-off requests handled?
  • How are shifts covered if understaffed?

Work Environment

  • ED layout and operational policies
  • Documentation system
  • Are there procedures or codes on the floor?
  • Hospitalist support; specialty back-up
  • Are there committee requirements? What about on-call duties?

Benefits

  • Is health insurance offered? If so, when am I eligible? Who is covered?
  • What is the deductible? Monthly cost?
  • Are additional benefits available?

Management Participation

  • What is my level of participation? Who votes? If there is not voting, how are decisions made and who participates?
  • When do I get a vote and how much of a vote do I get?
  • What issues typically are voted upon?

Contracts

  • Any non-compete or restrictive covenants?
  • What is the term/notice clause? Is it the same for both parties?

Ownership

  • Who owns the group? What percentage does each own? How long has the company been in business?
  • Who manages the group? Who does the billing and collecting?
  • What are the company’s five and ten-year plans?
  • Am I eligible for ownership? If so, are the books open? When is ownership offered? What is the value of my share of ownership? Is ownership guaranteed? If not, what are the terms and what percentage of providers are offered ownership?
  • What is the cost of buy-in?
  • What do I get for that buy-in?
  • Is there any cost to me involved in exiting the group?

Retirement Program

  • Is there a retirement program? If so, how much does the group fund and when does the funding start?
  • Is there a vesting period? Who directs the investments?
  • Is the fund portable if I leave?
  • Is there a supplemental program available to individuals?

Education

  • Are there requirements for ongoing education?
  • Is there any CME funding provided?
  • Are any internal educational opportunities provided? If so, what are they?

Career Development

  • Are there opportunities for development?
  • Does the group provide any training for career development?

The Interview Process

  • Who pays for my travel? Is my spouse/S.O. included?
  • Will I meet hospital leadership?
  • Who else will I meet with?
  • Can a realtor/community tour be included?

Additional Considerations

  • Are there PAs, NPs, Scribes?
  • If so, how are they utilized?
  • Will I have an opportunity to speak/follow up with the other ED staff physicians?

ABOUT THE AUTHOR

Rachel Klockow works for EMP. She has been a physician recruiter for 26 years.

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