Deborah A. Levine, M.D.

Job Requirements

1. Salary Requirements
• Consider monthly loan payments
• Create a budget
  
2. Type of position
• Hospitalist (good for transition)
• Private practice (serious investment, more control): solo or group practice
• HMO (regular hours, less control)
• Government employment (regular hours, less control, good for transition)
• Urgent care center
• Academic medicine
• Non-patient care (quality assurance reviewer, medical consultant)
  
3. Place of Residence
• Explore job market
• Explore cost of living/housing market
• Explore job market for significant other
  
4. Others (J1 waiver)
   
5. Consider needs and wants

Job Hunting

1. Sources
• Medical journals: NEJM, Annals of Internal Medicine, JAMA
• County and state medical societies
• Chairmen and program directors (The Green Book)
• Websites
  • http://www.acponline.org
  • http://myh.monster.com
  • http://www.aafp.org
• Hospital practice development offices
• Physician placement agencies
• Personal contacts
• Others (National Health Service, Locum Tenens)
  
2. CV
• Obtain letters of recommendation/references
• Draft CV
• Draft cover letter
• Obtain review of CV/cover letter
• Mail CVs/cover letters
• Call if no reply
• Schedule interview
  
3. Licenses
• State Medical, DEA, State Controlled Substance

Interviewing

1. First Interview
• Look good-professional, eager, rested, relaxed
• State what you will bring to the practice
• Prepare answer as to why you wish to join the particular practice
• Do not ask tough or inappropriate questions (vacation, your salary, part-time options, partner salaries, etc.) until second interview unless they address first
• Do ask where doctors live, benefits, practice arrangement and management, why position is open, hospital affiliations, teaching options, research options
• Ask open-ended questions (e.g. how does the practice…, can you tell me about…)
• Consider discussing non-medical topics (sports, hobbies, interests, region)
• Ask as many questions as needed to know if this job warrants further look
• Let the interviewers talk and inform you; be a careful listener
• Observe the practice (staff, providers, office setting, equipment)
• End warmly and assuredly
• Send thank you letters
  
2. Second Interview
• Ask as many questions as needed to determine whether your needs and wants will be met
• Try to speak with all providers
• Ask the following:
  • actual hours of each doctor
  • salary of each provider
  • level of autonomy with your schedule/practice
  • partner requirements and rewards
  • financial arrangement of practice, ownership of practice
  • organizational structure of practice, management of practice
  • your role in practice management
  • collection rate (time to payment receipt from payor, percentage collected)
  • number of patients in full practice, productivity requirements
  • call, vacation, part-time possibilities, maternity and sick leave
  • overhead cost per month
  • practice consultants
  • negotiation of managed care contracts for the practice
  • staff to provider ratio (3:1)
  • practice plan for next five years, next ten years
  • Amount and method of your initial salary and payment of overhead
  • Insurance or payor mix of patients
  • Determine time for your immediate predecessors to be self-sufficient, full
  • Inpatient coverage, nursing home coverage
  • Prior physician departures from practice

Choosing a Practice

1. Do your homework
• Determine the financial status of the practice
• Determine the financial status of the hospital
• Explore the real estate market for your price range
• Contact others who know the practice
• Explore your doubts
• Consider return visit during office hours
  
2. Take the time that you need
• What practice is best for you and your family
  
3. Contract Negotiations
• Hire a contract attorney
• Termination (20-30% doctors change positions during first few years after residency)
• Malpractice coverage
• Restrictive covenants, no-compete clauses
• Partnership
• Compensation (include CME, moving expenses, professional fees)
• Job Responsibilities
• Balance responsibilities and risk with compensation

References:

• Kronhaus, Alan K., Choosing Your Practice, Springer-Verlag, 1990.
• American Medical Association, Starting a Medical Practice, Coker Publishing, 1996.
• Solomon, Gregory, Preparing for Practice (pamphlet), 1997.