Blogging with The Doctor Job

A physician’s job search is only successful if the physician finds the best job available to him or her. In any other situation, whether the physician finds a less-than-ideal job, no job, or decides to remain with the old job, that job search is a failure.

The only way to make sure that the search is a successful one is to (a) be aware of every job available, and (b) take the one that matches your criteria on as many levels as possible.

With physician recruiters telling you that a market is saturated, and only having one or two jobs in a metropolitan area, this might seem impossible. Savvy physicians know that the best jobs are unadvertised. They’re not available through recruiters and rarely posted on any type of forum. The only way to find them is by applying basic marketing principles to your job search.

1. You are a commodity. Your skills and experience make you into a product. Employers who want this product have to negotiate and offer money and benefits in order to enjoy what you have to offer. Many employers will not be aware that you are even available, even if they have a need for your product.

2. Identify your audience. Your audience is very limited. You’re not going to be a product that a grocery store or a hardware store wants. The only audience for you is comprised of single-specialty groups, multi-specialty groups, solo practitioners, hospitals, labs, researchers, and health care organizations.

3. Reach your audience. Imagine a five-person group that has a healthy patient base and is overworked trying to keep up with it. They are not going to run out and place an ad. They are not going to waste $25,000 on a recruiter. They’re just going to continue working, and working hard. This is an audience that does not know that you exist. They don’t know that you’re looking, and they don’t know that they need you. You have to reach them. You can do this with direct mailing, making phone calls, aggressive networking - anything you can. In the end, by using The Doctor Job, you can make sure that your search reaches your entire audience at once.

4. Assess your interest. Marketing is all about numbers. If you are selling a product, you might send out 100,000 flyers and hope for 2,000 orders. Likewise, your job search should be the same. Send out 1500 resumes. If you get a 3% response, that’s 45 possible opportunities in your area. This can be a big city like Chicago or New York, or an area like the DC Metro Area or South Florida. As long as it matches your geographic parameters, this is viable “lead”. Identify which, out of the 45 leads, are the best to you. You should be able to come up with 15-20 that are perfect.

5. Negotiate your success. When you have employers who have only recently been made aware of who you are and what you offer, and they have a need for you and are highly interested in you, use that to your advantage! Do not accept any job until you have tried to negotiate every term of the contract at least once. Only by making sure that you pick the ideal positions and negotiate the best for you can you make sure that your job search is an actual success, and not a failure that leaves you desiring a new job within a year.

It’s time for another story of a client of The Doctor Job who had great success after having no luck with physician recruiters.

Dr. A is a male Ob/Gyn in North Carolina

Dr. A graduated from medical school 36 years ago. He practiced in several different areas of the country before spending the last few years in Wisconsin. He did not enjoy it. The weather and the small-town environment was driving him crazy. He yearned to practice in a larger town in a warmer area. Since his grandchildren lived in North Carolina, he decided to try to move there.

Two years go by. He’s called every recruiter in the book. They don’t return his calls. When he manages to actually get one on the phone, they give him excuses about there being no positions for a physician his age. They tell him to consider locum tenens. Dr. A doesn’t want any more transitions. He wants one job that he can work at until he retires, and he wants to be near his grandchildren.

One day, he finds The Doctor Job. He calls, not quite understanding how our services work and expecting that we’ll treat him shabbily like every recruiter out there. To his surprise, we don’t. We explain that there are plenty of jobs in North Carolina - they’re just with groups who refuse to work with the same useless recruiters who wouldn’t help him! He discovers that most employers will not work with recruiters at all, so he’s been wasting his time by even trying to talk to them!

With our help, he sends out 1200 resumes to Raleigh-Durham, Charlotte, and other metropolitan areas of North Carolina. Within five days, he has received 10 phone calls from interested employers. Within ten days, he received 23 phone calls. By the end of two weeks, he’s gotten over 30 phone calls or emails from employers who are interested in him. After going on several interviews, he finds a job that is less than 15 miles from his son’s house with a small private group. This group never advertised anything and were surprised to get his resume, but after some consideration, they decided they could use his help.

Without us, Dr. A would still be pining away in Wisconsin thinking that his prospects were non-existent. Luckily, he found us, and we were able to help him find a fulfilling job very easily. Good luck, Dr. A! Enjoy your grandchildren and your new job.

Physicians, there’s a simple mantra to keep in mind when you get an offer: You can always ask for more.

Let’s take a scenario. Dr. Keith Dudemeister, an Internist, is about to graduate from his residency program in New York City. He’s a normal resident, with no problems, but nothing amazing to brag about, either. Just your normal, average physician.

He gets an offer for a job in Chicago, where his family is, for an outpatient job with privileges at a local hospital. (He found this job through The Doctor Job, but that’s not important). The offer is for $140,000 for the first year, plus 1 week paid vacation, comprehensive health and dental benefits, reimbursement for his CMEs, and full medical malpractice coverage. Call is 1:4, and they pay up to $5,000 in moving expenses. After two years, he can become partner track, and the partners typically make about $300,000 a year or more. Sounds like a pretty good job, right? Why should Dr. Dudemeister even think twice?

Because you can always ask for more. It is an absolute certainty that this group is not offering you the extent of what they’re willing to offer. No employer would. They’ll offer a little bit less, but they’ll be willing to negotiate.

So what should Dr. Dudemeister do?

Even if he knows there are three other candidates who interviewed for the job, he should remember that he is the one who got the offer. Which means that they like him the best. Don’t feel that by negotiating, you will revoke your offer. You’re not. You’re just seeing what else they’re willing to do.

He should meet with them in person, if at all possible.

Sit down, with a smile.

Say, “Thank you for the offer. I love your practice, and I can see myself at home here. I am very interested, but I have a couple of questions.”

“First of all, is there any flexibility on the starting salary? After looking at my expenses and the cost of living here, I was looking for something closer to $160,000 if at all possible. I know it’s not that much more, but it would make a huge difference on being to live in this great area.” In this sentence, he’s explained a rational reason, given an amount he wants (looking for about $155,000), and made them feel like it’s not a huge difference in salary, which it’s not.

“Second, my wife and I had already planned a trip this year that will likely conflict with the vacation policy. Would there be a way to get that changed to two weeks?”

“And, finally, I was looking at moving expenses from NYC to Chicago, and it looks like it will be about $8,000. I’d be happy to pay for it and be reimbursed, but I’d like to get the whole cost covered.”

What is the worst that can happen? They can say “No, No, and No”.
What is the best that can happen? They can say “Yes, Yes, and Yes”.

In the best case scenario, you get more money (maybe about $15,000 more), another week of vacation (that’s worth about $3,000) and more money for moving expenses (another $3,000), for a total of $21,000 more. Just by asking.

This seems simple and obvious, but physicians are notorious about not negotiating. They find an offer, it seems good, and they take it! Even if you’re only asking for about 10% more, you should try. The worst they can do is say no. They will not rescind the offer - no reasonable employer would. And, honestly, if they ever did rescind your offer based on a mere request for flexibility, it’s not a group that you would want to work for, because it would be a horrible environment.

Always remember: You can always ask for more!

There are two types of program directors.

First, the bad ones. They just don’t care anymore. They’ve lost the desire to help their residents or fellows and just see them as cheap labor to be exploited and used until they graduate and leave. They barely remember the names of their residents and fellows. They don’t care if the residents find jobs after graduation, and they don’t care about anything other than their little world. If you find yourself with this type of program director, prepare yourself for a miserable experience.

Then, there are the good ones. They care. They take the time to educate residents and fellows on business (starting up your own practice), careers (how to find a job and write a resume) and other elements that might never come up in training. They know the name of every resident and fellow in the program, and they want to make sure that their physicians are rewarded for their hard work. This doesn’t mean that the program is easy, though. Residents work long, hard hours and are still tired and stressed, but the environment is friendlier, which makes a big difference. If you are in one of these programs, you are very lucky.

What are some of your program director stories? Good? Bad? Neutral?

This is just a brief article discussing Family medicine for those medical students and FMGs who are still considering which medical specialty to enter. We’ll have these articles occasionally to act as a resource for anyone trying to make the most informed decision.

What to expect from Family Practice

Family practice is a broad ranging specialty that focuses on the idea of treating a patient through all facets of his or her life. Sometimes referred to as a general practitioner or primary care physician, this doctor will attend to conditions both acute and chronic as well as providing a wide array of medical advice, from preventive issues to opinions on major procedures. Some family practitioners will even perform minor surgical procedures and handle obstetric matters up to and sometimes including childbirth.

While this choice of specialty has seen a decline in selection in the last decade, many physicians find it to be one of the most rewarding specialties, both professionally and personally.

Training in Family Medicine

A family physician will undertake a three-year residency after completing their doctoral studies. During these three years, the candidate will complete training in diverse fields of care. Intensive in-hospital training will cover the care of infants, the elderly and everything in-between and in all potential situations, from acute care to emergency services. The family practice resident will also receive extensive training in outpatient situations. Through this manner of training, a resident can find themselves treating a large percentage of a single family, or seeing a number of families on a recurring basis, and learn to develop the talents needed in providing continuous care.

Another side to this all-embracing form of study is learning the ability to manage a patient’s or a family’s medical issues in a comprehensive manner. The ability to handle these multiple problems, not only technically but also in terms of developing and maintaining a relationship with the patient, is one of the most important aspects of this specialty’s training.

Many family practice programs will provide residents opportunities in research and in teaching medical students or junior residents. There is also some variance in the level of technical training across the array of areas required.

This leads to a common perception that influences the choice of this specialty by medical students. A study by the American Association of Family Practitioners revealed the opinion among some medical school faculty, residents and students that the “content of family practice is too broad and cannot be mastered.” In some cases, medical students are actively discouraged from selecting the specialty, taking the view that FP programs are insufficient training for a doctor who will be forced to face such a broad scope of medical problems.

The specialty continues to grow in terms of training. Newer programs have taken to including training in rural areas to address specific issues that arise in such settings, as well as addressing ethnic and racial training issues. Continuing education will also be a big part of the family physician’s career.

Additionally, fellowships are available in such diverse areas as faculty development, sports medicine, preventive medicine and rural medicine.

The life of the Family Practitioner

The lifestyle of a family physician is dependent on many factors, not the least of which is the setting on one’s practice. There are numerous options, from setting out to build one’s own practice to joining with an established medical group.

Joining a medical group will allow for more regular hours and the ability to fix those hours to a desirable schedule. The average family physician will work a little over 50 hours a week, with about 80% of that time spent in direct patient interaction.

Solo practice can be much more demanding, beyond the financial risk from setting out one’s own shingle. Such practitioners often find themselves on call for their patents after normal office hours, a disruption that is minimize in group practice.

There is also a need for specialists from this category in the fields of academia and primary care research. While this may provide a stable schedule and regulated income, it may come at the cost of the satisfaction of seeing immediate results in treating patients.

One consideration is selecting the family care specialty is the need for continuing medical education (CME). Family practice was the first specialty to require periodic certification. While originally set in periods of six to ten years, dependent on the type of CME chosen (as credits can be obtained by more than just coursework), the process is being converted to annual competency tests in different areas. This process is expected to be fully in place by the end of the decade. Additionally, The American Board of Family Medicine, though a program called the Maintenance of Certification Program for Family Physicians, is requiring continuous demonstration of proficiency in areas such as cognitive experience, practice performance and self-assessment.

With additional training, Certificates of Added Qualifications are available in such fields as geriatric and sports medicine.

CME is vital to this specialty, given its broad nature, as each family practitioner must keep abreast on a wide variety of procedures in many areas of medicine.

The average compensation in family practice is over $140,000 annually after the first three years of practice. The high end of the scale comes in just under $200,000 while the lower end settles in at just over $110,000. These figures have gradually risen as the specialty is less often selected and an increasing number of match slots go unfilled translating to fewer new family care practitioners entering the field. Many new family physicians find the compensation sufficient to pay off student loans early.

Time off in this field averages at about four weeks per year, this time can be allocated toward vacations or toward efforts in continuing education.

With many suburban areas experiencing rapid growth from the effect of urban sprawl, a qualified family practitioner can establish himself or herself in any area of the country they choose. Underserved communities that offer loan repayment or loan forgiveness programs in exchange for serving that community for a predetermined minimum time period.

Is Family Medicine for You?

Family care is the only specialty that finds itself geographically distributed as the population is distributed. It is the most visible specialty to the public eye and the first line of medical defense for the majority of the population. These doctors routinely see to the care of the nation on a daily basis and are very much the physicians of the people.

Just had a Surgeon client who was looking for a job on the West Coast. He felt very strongly that his skills were better than almost 100% of the other surgeons in the United States, and wanted his cover letter to reflect the totality of his awesome nature. While we counseled against this, suggesting that some of the recipients of his resume might not appreciate the tone if they consider themselves to be the top in their field, he insisted. So here is the cover letter that we ended up with (names and facts have been tweaked from the actual letter, of course):

Dear Dr. RECIPIENT,

If your practice could benefit from the skills and experience of a surgeon with over twelve years of exceptional training, including four years of fellowship training in Ophthalmic Plastic Surgery and Cosmetic Surgery (with the world-renowned Dr. Christopher Turk), who has been published over 34 times in peer-reviewed journals, and appeared on 13 different television programs as a consultant in cosmetic surgery, please contact me at your convenience. I would be interested in explaining how my presence could be an immediate invaluable asset to your group.

I look forward to receiving your phone call.

Regards,

Dr. Periwinkle Cox

I hope he gets groups calling him left and right, but I’m afraid that this ego might not let his head fit in the door.

This is just a quick essay after a depressing conversation with a Pediatrician (Dr. E) who settled for a job in Wisconsin that she absolutely hates, and is slowly feeling defeated and soul-crushingly depressed as a result:

You are a physician. You have years of education and training. You make decisions on a daily basis that affect the health and well-being of hundreds of people. Lives literally depend on you.

So why did you listen to that recruiter? Why didn’t it raise any flags when he wouldn’t help you find a job in the city that you want? Why did you think he was right when he told to look out of state, because your market is “too saturated”? You’re a doctor - you should be able to walk into any city in the country and find a job. You are in demand, and you should never settle for a job that’s anything less than 100% of what you’re looking for.

We have spent time and effort making sure that our company is always on YOUR side. We help every single one of our clients find jobs WHERE they want to live. Not where we want you to live, but where you want to be. We respect the contribution you make to society and the sacrifices you’ve made - we know how to treat a physician. Physicians deserve more than what a recruiter gives them, and that’s why The Doctor Job helps you get the job that you want in the location that you want. Don’t ever settle for a job - you don’t need to.

Dr. E, you do not have to be depressed anymore. We are on your side, and we will help you. You will find a job that will make you happy, and you will find a job that you deserve!

This blog is designed as a free resource for residents, fellows, and physicians looking for jobs, and for medical students and FMGs applying to residency programs. When it comes to physician jobs, you can have the best resume in the world and a cover letter that would knock the socks off of any employer, but if you don’t have anyone to look at it, it’s essentially useless.

So, let’s take a step away from looking for a job and look at the principle of successful marketing. If a business has created the best product in the world, if nobody knows it exists, it won’t get purchased. So, of course, businesses rely heavily on tried and true marketing techniques to build buzz, create a customer base, and ultimately to sell as many of their type of product as they can. They do this through advertising on TV, the radio, the Internet and through aggressive direct mail campaigns that still have strong effectiveness even after all of the advances in technology.

Any first-year MBA student will tell you that it’s all about the numbers. Send out 100 flyers, get 1-2 customers. Send out 10,000, get 10-20 customers. Send out 100,000 flyers, get 500-2000 customers. Send out a million, get 5000-20000 customers. It’s that simple. If you can’t understand this basic principle, then all may be lost for you.

So let’s apply that to a physician looking for a job.

Dr. Perry Cox has decided that he wants to move to Orlando and practice Internal Medicine. He’s an intelligent doctor, so rather than having some inflexible idea of what he wants, he’s more interested in seeing what the market has to offer him. By examining all of his options, he’ll be able to make the best choice for his career.

So Dr. Cox compiles a list of every single Primary Care Physician in the Orlando Metro Area. Every single one. Why? Because when a physician is looking for a job, missing even one opportunity can mean less than perfect success. Half of a job search is networking - you want to make sure that every person who might (a) Have a position, (b) Know of a position, or (c) Refer you to someone who has a position or knows of a position, will receive your resume.

Let’s assume there are 1500 Primary Care Physicians in the Orlando Metro Area (nothing farther than 15 miles away from Orlando). Dr. Cox, being savvy in the way of looking for a job, sends his perfectly-written resume and cover letter (since he reads our blog regularly) to all 1500 physicians.

Is the effort going to be worth it? Absolutely, without a doubt, yes. And this isn’t guesswork or conjecture or empty promises or theory. This is statistical fact.

Out of the 1500 resumes he sends out, Dr. Cox gets 25 phone calls and 15 emails. Some of the calls and emails are from physicians who refer him to someone else. Some are physicians who want to sell their practice and move somewhere else. Some of them are calls for hospitalist positions, and some of them are calls for outpatient positions. In the end, by speaking with all 40 interested parties, Dr. Cox narrows it down to 10 positions that sound perfect.

The chances are that none of these 40 positions were advertised in any real venue, which means that each of these employers is personally vested in hiring Dr. Cox because they have an immediate need that has not been filled, and there aren’t any other people competing for the position.

40 responses out of 1500 letters. That’s a 2.7% response. 10 interviews out of 1500 letters. That’s a .7% response. But those 10 interviews are going to be the best possible positions in this area. Dr. Cox is going to have his choice of the best salary, the best environment, the best benefits, and the best job. Why? Because he was smart, savvy about marketing, and flexible about his options.

So, as a resident, fellow, or practicing physician looking for a new job, be aware and be informed that your perfect job is out there. You’re unlikely to find it with a recruiter, unless you like to live hours and hours away from a major city. You’re less likely to find it on a job board, since they tend to be dominated by the same recruiters. The only intelligent, logical way to find a job that will be a career (and not a 2-year position that you hate from the moment you start) is to use the simplest of marketing and networking techniques to give yourself the best possible option.

Among those of you who surf the Internet, know what a blog is, and check your email more than once a month, it seems logical that mass e-mailing your resume to as many people as possible would be an appropriate way to find a job.

It’s not. Why?

1. Because when it comes to physicians, you are still in the minority. Among professionally educated adults, more physicians are computer illiterate than almost any other profession. That means that, especially over the age of 40, the percentage of physicians who check email regularly and use the Internet is very low. Usually, the physicians who do check their email are fairly proficient with it, but by limiting yourself to email, you will risk missing out on the majority of physicians, which means the majority of opportunities.

2. Because SPAM filters make mistakes. If the physician recipient uses a subscription email program like Earthlink or Comcast or Roadrunner, that provider may have built in protection against Unsolicited Commercial Email (UCE) without his or her knowledge. This might mean that your non-commercial email might get caught and filtered before the recipient ever gets to know it existed! Additionally, if the physician uses a local SPAM filter through Outlook or Thunderbird, or a free e-mail account like Hotmail, Yahoo! or Gmail, e-mail will get filtered directly into a junk e-mail folder. Rather than being diligent and checking this folder for mistakenly filtered email, many recipients (not just physicians) clear this out or ignore it indefinitely. This means that if your email had a keyword the filter didn’t like (job, opportunity, career, and employment being keywords notoriously used in SPAM), your resume might never get seen by a human.

3. Attachments are bad, but text is worse. If your recipient is part of a large group, school, university or organization, be aware that many overzealous IT departments set up email so that attachments are not downloaded or are stripped before being received. This means that your resume will disappear into the ether. The alternative is to paste your resume into the actual email as text. As you can imagine, the problem with this is the formatting. Not only does it look horribly unprofessional but it is also likely that the screwed up formatting will make it confusing to read.

These three reasons should help you realize that phone calls, faxes, and letters in the regular mail are the most efficient way of finding a job the intelligent way. You could just send your resume to recruiters and let them worry about it, but then you’d be missing out on the unadvertised positions that make up 90% of the jobs out there, and that would mean your job search would fail before it even started.

Today, we’ll take the time to answer another question from a frustrated physician. If you too have questions related in any way to finding a job, getting into a program, or specializing in an specific field, please email them to blog AT thedoctorjob DOT com!

Q: I am a recently divorced mother of two and physician who finished residency last year. Now that I’m on my own, I want to work, but I only want a part-time job. Is it possible for me to find a good part-time Internist job in Chicago?

A: Absolutely! Did you know that it’s even easier to find a part-time job as a physician than a full-time job? In every city, there are going to be at least 50-60 practices or more that would love to have you working for them!

Here’s the reason:

Smaller and mid-size private medical practices make up 75% of the private practices in the country. The ones that are successful tend to have overworked physicians who can’t afford or consider hiring another full-time physician, especially one who wanted to be partner-track. They might have enough work for a physician to see 20-40 patients a week. This level of need isn’t enough to interest a recruiter, and it’s not worth putting out the effort.

So this means that the hidden part-time jobs are all over the place! All you have to do is find them! Whether you use a service like The Doctor Job or not, the only intelligent and logical way to find these hidden positions is to get your name out the people who want to hire you. Any first-year marketing student understands that it’s all about saturation. If you can reach 1500 people with your message, you should be happy to get 15 that are interested. But when you’re looking for a job, getting 15-40 responses is tremendous! It gives you a choice that you’d never have in any situation.

My advice is to write a letter to every primary care clinic in Chicago. Enclose your resume. In the letter, explain that you are looking for a part-time job. In a matter of weeks, you’ll have so many phone calls you’ll be amazed, and you’ll be able to pick and choose until you get the best part-time job out there. Good luck!