Doctors

Job Search Checklist – Besides my CV, what should I have prepared for my interview? What types of references might potential employers ask to see?

1. Cover letter. A cover letter should share details about your professional interests and goals as well as who you are outside of work. A well thought out cover letter can help you stand out in the crowd, especially if you are a resident.
2. Depending on your specialty and the position you are interviewing for, you may want to include case logs, descriptions of expertise in various procedural areas, experience with specific surgical or diagnostic equipment, description of leadership experience, etc. Make sure these items match the position you are interviewing for. If you are applying for a leadership role, tailor this information to showcase your experience as a leader.
3. Professional references. References should be recent and pertinent to the position you are interviewing for. Depending on the confidentiality of your search, this can sometimes be difficult, but try to avoid providing references that you haven’t worked with for an extended period. Also, if you are applying for a clinical role, provide references who can speak to your ability as a clinician.
4. Make sure you have an itinerary and know where you are going and who you are meeting. Showing up late and unprepared never makes a good first impression.
5. Prepare questions. Part of the interview process is to gather information so you can make an informed decision. That said, don’t fly by the seat of your pants, prepare professional questions so you can get the most out of your interview. Never leave an interview without all your questions answered.
6. Research the practice and area where you are interviewing. Many employers like to see that you have done your homework on their hospital/practice. They might ask questions to see how serious you are about their position.
7. Get contact information of those you meet with during your interview. A personal letter or email to express your appreciation post interview has become a lost art. A quick follow up will help you stick out in the minds of those you met.

1. They fail to identify what is truly important to them in their first position. It will save a lot of time and headache to sit down and decide what your priorities are before starting your search. Sometimes an enumerated list can be a helpful way of identifying what is truly important to you.
2. They fail to ask others for guidance. Insight is gained by speaking to experts in licensing, credentialing, physicians’ contracts, etc. It can also be helpful to speak to those with knowledge of the market to gain perspective of what is available.
3. They rely too heavily on the opinions of others. While insight from others is great and can provide additional viewpoints, at the end of the day, everyone needs to make their own decision. Sometimes relying on your feelings and experiences are best, after all, you will be the one living and working in this position day in and day out.
4. They have unrealistic expectations. Don’t expect to find the ‘perfect’ position. Odds are it simply doesn’t exist. Try to find a position that is aligned with the priorities you have established and if you find something that matches 7 or 8 out of your top 10, be happy.
5. They go on too many interviews. There will be many chances to interview, but the more you interview, the more difficult it can become to separate one position from another. It also takes time to interview, which can be stressful and costly. Additionally, attending too many interviews can create a long decision process which can be perceived negatively by potential employers.

When evaluating practice opportunities, it is essential to understand your compensation model for the long hours and specialized care you will provide. Below is a brief break down of several of the most common physician compensation models to help you know what will, or won’t, be a good fit for you.

1. Straight Salary – As the name implies this type of compensation model offers a guaranteed annual salary. Typically, the salary is guaranteed for the life of the contract and is up for negotiation when the employment agreement comes up for renewal.
Pros – Your compensation is guaranteed up front and not impacted by patient volumes, collections, etc.
Cons – There is no incentive for seeing higher volumes of patients and the salary can sometimes be lower to off-set the annual guarantee.

2. Salary Plus Productivity – This model offers base compensation along with a productivity incentive that can be measured in several ways (see a few examples below). When evaluating a position that provides salary plus productivity make sure you clearly understand if the salary remains intact, will reduce or go away completely over time. Most salary plus productivity models set a threshold and then pay you a portion of what is produced over that threshold. For example, your compensation could be a salary of $200,000 annually along with 50% of collections exceeding $500,000 annually.

1. RVU based production – Relative Value Units (RVUs) are a measure of value used in the United States Medicare reimbursement formula for physician services. The math to come up with the RVU is quite complicated so we won’t dive into that here, but at the end of the day, RVUs have been used since the 1990s as a straightforward way to evaluate patient complexity, geographic factors, payor mix, and physician efficiency.
2. Collections based – Collections speak directly to the amount of billed revenue collected by a practice. When considering this type of production model, it is essential to determine the efficiency of the billing and collections department of a prospective employer.
3. Encounter-based – This production model is based solely on the number of patients that a provider treats over a given period.
   Pros – You have guaranteed compensation, with the ability to increase your take-home pay by treating more patients, more complex patients, or picking up extra work (depending on the productivity model).
   Cons – Your income could be impacted by factors outside of your control. For instance, the efficiency of office or clinic staff, no-show rate of scheduled patients, how reliant the clinic is on walk-in patients. Typically, the collections rate of the clinic, the socio-economic status of patients, etc. impact the amount paid per encounter.

3. Straight Productivity – As the name implies this employment model bases your compensation strictly on your productivity. There are a variety of productivity models, several listed above, in which your income could be based upon. Many employers will offer one or two-year salary guarantees but eventually, the guaranteed salary will go away, and you will be compensated strictly on a production-based formula.
Pros – You have complete control over your level of income. Typically, this type of compensation model offers the most autonomy for an employed setting when it comes to scheduling, work volume or time off. This model can be the most lucrative for that reason.
Cons – There is no guaranteed compensation to fall back on. If you take time off or are forced to miss work due to illness, this can impact your income.

4. Net Income Guarantee – This model is rare but worth mentioning. Generally, a hospital or health system would offer an income guarantee, essentially a loan, for one to two years for a physician to open a private practice in a given location. Typically, at the end of the guarantee period, the guaranteed money would be forgiven in two to three years. You would be accepting a loan from a hospital or health system to set up your private practice.
Pros – You will have complete autonomy. You will decide where and how big your clinic is, how you will staff your practice, how many patients you see, etc. You will be entirely in charge and in most case eventually own your practice.
Cons – In addition to practicing clinical medicine, you will be responsible for running a practice. Running a practice can entail staffing, billing, collections, and much more.

5. Partnership – Partnerships can take on many forms depending on specialty, size of the group, ownership of ancillary services, etc. Partnership offers the opportunity to be an equal ‘partner’ in a practice. Generally, this entitles you to ownership over physical assets and gives you a voice in how the practice operates.
Pros – Depending on the practice, this can be a very lucrative model, especially if the practice owns physical assets (surgical center, etc.). It also provides you with input into how the practice operates on a daily basis.
Cons – Most partnerships require a cash buy-in, although some will offer a full or limited partnership after a period of ‘sweat equity.’