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Successful Job Search Approaches for Physicians
Martin H. Osinski and Michael J. Kirschner
(Reprinted from JAMA - The Journal of the American Medical Association)

Seeking a practice position is easy if you are not particular about the location, practice arrangement or financial compensation. However, most physicians are, and that is why your approach needs to be comprehensive, organized and efficient. If your search process is managed in this manner, you stand a better chance of receiving an offer from the best practice that meets your criteria without wasting valuable time. This article explains the eight critical steps needed to identify the most appropriate practice positions in a reasonable time frame. Whether you are a resident, a fellow seeing your first practice position, or a practicing physician wanting a change, this decision is one of the most important you will make in your career.

Step 1: Personal Analysis
Before contacting any outside sources about opportunities, write down and prioritize your desires (and your family's, if appropriate), motivating factors and general criteria. This initial step will save you hours, days, perhaps months of frustration. For example, Dr. Jones has decided she wants to practice family medicine in a larger practice setting that offers at least one-in-five call coverage and is located in a larger community (population exceeding 100,000) in the Southeast region (e.g., Charlotte, NC, Charleston, SC or Tampa, FL, areas) with good schools. She would be available to move within 3 to 4 months. The financial package needs to exceed $125,000 annually. Her motivating factors are to improve her lifestyle, move to a warmer climate, live closer to her family, and provide her children with a good education system. Dr. Jones has now established focus of her practice search and has ensured that her time will not be wasted on practice opportunities that do not fit her criteria. Depending on your specialty, you may have to be more flexible on the criteria, but you can make that decision later in the process. You should also start your career search within a 12-month period of your availability date.

Step 2: Personal Consulting
Contact any of your peers, colleagues, or associates who have performed a job search within the last 2 years. Learn from their experiences, obstacles and problems. Ask them about their specific search process and how they would have done things differently. Your goal in these conversations is to gain as much knowledge as possible. Recognize that their circumstances are different but that you will have the advantage of knowing what to expect.

Step 3: Prepare a Curriculum Vitae
There are numerous formats to select. Whatever format you choose, ensure that your curriculum vitae is a brief, clear outline of your education, training, experience, certifications, and publications (if applicable). Design the vitae to the type of job you are seeking. Remember, any written documents that you send out are an impression of you. Make sure the document is a professional product. At this time, decide on several references that can be used. They should include physicians who can comment on the quality of your clinical skills and on your personality within the last 2 years. It would be appropriate to include administrators, nurses and referring physicians.

Step 4: Job Search Sourcing Methods
Now that you have established and prioritized your practice criteria, prepared a curriculum vitae, and consulted with your colleagues, you are ready to use other available sources to locate potential practice opportunities. We recommend using several methods to increase your options because the best opportunities are often the most difficult to locate. Organization is extremely important. The more sources you use, the more confusing the search could become if you are ot organized. The recommended sourcing methods to perform a comprehensive search are:
* A. Personal Networking - Contact all friends, family members, colleagues, associates, acquaintances, and mentors in yor specialty area for referrals. Briefly explain what you are looking for so that you are looking for so that you are not spending time of inappropriate opportunities.
* B. Specialty Societies/Associations/Conventions - Contact the national, state and local organizations appropriate for your specialty. A majority of these organizations have job opportunity/placement lists. Attend anual specialty conventions and investigate promoted opportunities. If possible, arrange interviews with potential practices.
* C. Advertisements - Review medical journals' classified sections for appropriate positions. Gain as much information on the opportunity as possible prior to forwarding your curriculum vitae.
* D. Physician Search Firm - Contact a limited number of recruitment organizations. In selecting search firms, you can contact various national recruitment associations to receive lists of firms, recommendations, and referrals. It is very important when working with search firms that you require them to discuss all positions with you and receive your permission PRIOR to sending out your curriculum vitae. This is important because you want to keep the process organized and focused and to control who receives your curriculum vitae. If you are performing a confidential search, make sure that you inform the search firms. We would recommend that you interview each firm, discussing their strategies, methods, and suggestions, prior to sending your curriculum vitae. You should be able to narrow your choices down to about five firms that you will work closely with. It is best to work with more than one firm because one firm is not capable of knowing all the available oportunities.

Step Five: Decide On An Approach
Once you have narrowed down the practice opportunities from your sources, you are ready to interview. Two interviews should take place: a telephone interview and an on-site interview.
* A. Telephone Interview. The telephone interview should consist of speaking with the administrator, recruiter, and/or physician(s) of the organization you are considering. During this interview, you should gain a better understanding of the clinical and administrative aspects of the opportunity. Ask as many questions as appropriate in order for you to decide if this opportunity is worthwhile to pursue. Let them know about your desires, motivational factors, criteria and priorities, clinical style, and philosophy. It is possible through this interview to discover that the original opportunity is not appropriate; however, there may be another practice situation that would be. Prior to the telephone interview, be prepared to provide potential site visit dates.
* B. On-Site Interview. After the telephone interview, if the opportunity remains viable, an on-site interview should be arranged by the organization. This visit should provide you with a comprehensive view of the opportunity and, if you are married should include your spouse. This is your chance to learn as much as possible about the opportunity and the people you will be working with. Make sure you are dressed in business attire each day of the visit, unless otherwise instructed. Inappropriate dress, makeup, and hairstyles can eliminate you from contention even if your credentials are superb. The visit should include a tour of the practice, hospital, and community. Adequate time is needed to meet with the administrator(s), physicians that you will be practicing with, and referring physicians. Depending on the specialty or opportunity, it may be appropriate to meet with the operating room staff, board members, and/or chief of services. Social functions may be planned throughout the visit, as well as meeting with spouses. If desired, the educational systems and religious facilities may also be investigated. The visit may take 2 to 3 days. Before you leave, you should have all your questions answered. A sample contract may be provided to you or be reviewed with you before you depart.

Step Six: Post Interview
After the interview, if you still have further questions, call the contact person at the organization or include the questions in your thank-you note to the organization, which should be sent within a week of your visit. It would not be unusual to visit again if additional questions or concerns need to be addressed. Do not hesitate to investigate the organization thoroughly: they are going to investigate you! Keep the communication lines open. Get back in touch with the contact person at the organization as quickly as possible when they follow up with you. If you decide against the opportunity, inform him or her promptly. Remember not to burn any bridges. You never know what the future holds. However, if you and the organization have decided to pursue things further, the next step will be to negotiate the contract.

Step Seven: Negotiating Contract Terms
Not all organizations will negotiate. Larger corporations may negotiate only slightly and some not at all. For example, if the contract has been approved by the board of directors and 60 physician in the multi-specialty group have the same contract, there may be little room for negotiation. In this case, you may have to decide if your changes to the contract are significant enough to pass on the opportunity. In most instances, there is flexibility on both sides. Timing is very important in negotiations. If negotiations go on too long, the organization may start to question its decision and the offer may be withdrawn. Have a comprehensive list of important questions to ask early in the negotiation process. This will ensure that you are not perceived as nitpicking or vacillating. Investigate insurance and relocation expense coverage. Evaluate vacation time, CME time and allowance and memberships allowance. Understand all incentive compensation, bonuses, performance share programs, and stock options and explore profit sharing, pension plans, and or course, your income salary and guarantee. Also investigate partnership options. Regardless of the "policy" it is tough to go backward. If an organization want you badly enough, it often will compromise "policies" in order to accommodate your needs.

If is very important that you use your attorney as an advisor, not as a spokesperson. Too many times, attorneys do all the talking with the organization and the negotiations fall apart. Remember that you need to be able to demonstrate your effective communication abilities to the organization. Clear and timely communication between you and the organization is essential for a successfully negotiated contract. You have to decide on your most important issues, using your attorney's guidance.

Step Eight: Decision
Listen to your instincts; they are crucial. Consider your family's input. Their feelings are very important. They know you best and will help identify issues you may not realize. Make sure the housing conditions, education system, and social/cultural activities are adequate. The search process is easier if you manage it in a comprehensive, organized and efficient manner. Enjoy the rewards of your new position and what comes from the challenge of change.