Interviewing for your first post-residency job is a delicate process. You should begin by assessing a practice’s general characteristics. Don’t worry about the details until an offer is made. Save contract negotiation for later interviews, closer to when an offer might be made. The following questions may be helpful as you assess a practice’s health and viability to determine if you want to join the team.
Interviewing is a two-way street. Just as employers are trying to determine if you are a good match for the practice, you must determine whether the practice is a good fit for you. The potential partner(s)/employer will be trying to assess your clinical skills and whether or not your personality and work style meet their expectations of the ideal candidate. In turn, you should be assessing their personalities, work style, and expectations to determine if they will work well for your lifestyle.
One physician manager recently discussed the hiring process with CAFP. He asks himself three questions about the physicians he interviews:
· Do they know their stuff?
· Can they get along with staff and physicians?
· Will patients like them?
This is your opportunity to “sell” yourself. Be yourself; be confident, but not cocky; and, remember to breathe!
Before the First Interview
Decide where you want to practice, the type of practice you are looking for, and key features (sort of like house-hunting!). Identify the ideal practice characteristics before you send out your résumé so you don’t waste anyone’s time.
Your cover letter should be concise, engaging, and persuasive. Communicate why your background and interests have led you to apply for the position and why you would be a good fit. Limit the cover letter to one page and have at least two people you trust proofread it for spelling and grammatical errors.
Your resume or CV should highlight your accomplishments and skills. Consult online sources, such as CAFP’s Guide To Writing a CV.
At the Interview
Schedule the interview on a day you will be rested; never interview post-call. Always be prompt for a job interview. Leave plenty of time for transportation and plan for the unexpected: getting lost, having trouble finding parking, etc. If you are unfamiliar with the area, it may be worthwhile to do a practice run. Dress professionally; it is always better to be overdressed than underdressed.
Try to relax and enjoy yourself as much as possible. Be natural, but professional, and try to establish rapport with your interviewers. A quality family physician has good people skills, so show your friendly side. Make eye contact and smile as much as possible. The person interviewing you is likely thinking, “What are our patients going to think of this person? Will they like him/her?” Try to demonstrate attention to detail, inquisitiveness and follow-through—all essential attributes for physicians.
Listen carefully to the questions you are asked and always assess what the interviewer is trying to discover about you through his or her questions. Take a moment to gather your thoughts before answering. Be as responsive as possible in your answers. Give concise examples from your work or life to back up what you say.
Questions you might be asked:
· Why do you think you are a good fit for this practice?
· What are your strengths?
· What are your weaknesses? What steps have you taken to improve?
· Describe a few difficult patient interactions and how you dealt with those situations.
· Describe how you respond to work pressures.
· Tell us about your experiences working with non-physician personnel; how do you see their roles in providing care to patients?
· Pretend you joined our group, and it is a year from now. You are happy. Why is that?
· Where do you see yourself in five years? In 10 years? How does working in our practice fit with your professional goals?
· What do you like most about your specialty?
· If you could turn back the clock, what would you do differently?
· What are your interests outside of practicing medicine?
· Tell me something about yourself that is not on your résumé /CV.
Demonstrating stability, maturity and commitment is critical, and this involves looking beyond the day-to-day elements of practice. You will be joining not only a practice, but a community, as well. What can you contribute to the community? Your “fit” with other personnel can be crucial, so be friendly, open and establish eye contact. Smile!
Additional Factors to Consider
Many other factors should be considered when you make your decision about which practice to join:
· Does the location meet your family’s needs/desires?
· What are the community's demographics? Are there other singles, young couples or families with young children you can relate to?
· Is it a growing or underserved community?
· What is the cost of living? How will this affect your ability to meet your financial obligations (e.g., loan repayment)?
· What is the working relationship between doctors? Is there collegiality among physician peers? Do interactions between personnel seem friendly?
· What is the scope of practice? Do you want to do OB? Gastro? Are there local obstacles to expanded scope, such as restrictive hospital medical staff rules?
· Do physicians in the practice have the option to care for their hospitalized patients?
· Have there been barriers to privileging at the local hospital?
· Is there support and cooperation between medical specialties in the area?
Quality of Care
· How is quality measured by the practice, and is the culture conducive to improvement efforts?
· How does the practice encourage improved patient outcomes?
· How are consultations and referrals handled? Any restrictions?
· Are complete and accurate medical records kept in the practice, and are they available for review?
· What preventive tools are used in the practice?
· To what extent are evidence-based, peer-reviewed guidelines used?
· Will you have a voice in determining clinical policies?
· What are the current and future goals for the adoption of technology tools?
· Is there senior leader support for participation on quality improvement projects?
· How efficient is patient scheduling?
· How far in advance are physicians in the practice booked?
· How long, on average, does a patient sit in the waiting room?
· How frequently does the office measure patient cycle time and flow?
· How is patient satisfaction and/or patient experience measured?
· How is provider satisfaction measured?
· What is the billing/collection ratio? Days in accounts receivable?
· Does the office staff like working there?
· How often are staff meetings held? Do all staff participate or just clinical and practice leaders?
· Is the staff committed to patient care?
· How is staff commitment encouraged and reinforced?
· Is there space for all-staff meetings?
· What is the staff turnover rate?
· Is the equipment adequate for the scope of medicine you wish to practice? If not, would the practice buy or lease needed equipment?
· Is the facility comfortable? Could you work there efficiently?
· What type of information and technology systems are in place and are they suitable to meet the practice’s long-term needs? What are the short- and long-term costs of the practice's information systems?
· Will you have a voice in office policies? Who has ultimate responsibility for office management?
· When was strategic planning last conducted and what type of plan is in effect?
· What kind of reserves or financial backing does the practice have?
· What is the ownership agreement?
· What is the turnover rate of physicians? Who has left within the past five years and why? Can you talk with former employees/physicians?
· Will there be opportunities for "buy in"? At what price? Is there a non-compete clause if you leave the practice and wish to stay in the community?
· How many patients will you see each day?
· How large would your patient panel be?
· Are productivity requirements flexible enough to ensure that patients needing extra care and attention receive it?
· How are work-ins and emergency visits handled? Is there open-access scheduling?
· Is the call schedule fair? Is it weighed according to seniority?
· Does the practice know the patient population's language access needs? Do they use or access professional interpretation services? If you speak another language, would you be expected to provide services using another language?
· How many days per week do you work?
· Do you receive paid vacations? CME time and/or financial support for professional education?
· How are practice finances monitored and by whom?
· Is the practice busy enough? Too busy?
· How many patients leave the practice each month? Why do they leave?
· What is the percentage of capitated patients?
· How many HMO contracts are there? What would be, or has been, the effect of losing one?
· Are health plans/IPAs/medical groups in the area accepting new physicians?
· What type of billing system is used? Have there been billing issues, such as a recent switch to move billing in or out of house?
· Is the practice participating in Pay for Performance (P4P)? If so, how many different programs? How are performance bonuses calculated and which staff receives them? Who is responsible for submitting and reviewing data submitted for P4P?
· What is the total overhead and how is it divided among the physicians?
· How does the practice fund capital expenditures?
· What is the ratio of full-time employed support staff per full-time employed provider?
· Will current revenues be used for retirement of any partners? If yes, when?
Access to Risk Pools
· Are you at risk for using outpatient services?
· Is efficient management of care rewarded? If so, how?
· Does the medical group accept pharmacy risk?
· What is the salary guarantee and how long does it last?
· What are your anticipated earnings in the first, third and fifth years of practice?
· How are bonuses administered? Are there internal quality incentives?
· How are administrative, vacation, CME, and holidays calculated?
· What is the retirement plan?
· What are the health, dental, and disability benefits?
Signing the Contract and Other Legal Matters
This may seem obvious: read the contract and make sure you understand everything contained within.
It is always smart, and strongly recommended, that you have it reviewed by an attorney or practice management consultant. We suggest you take advantage of CAFP’s Employment Contract Review Service. An attorney who specializes in physician matters will review your contract for a small fee. It’s always best to ensure you fully understand your contract before signing so there are no surprises down the road.
A written employment agreement should cover:
· The work expected of you
· Exclusivity requirements (i.e., can you moonlight?)
· Compensation (i.e., amount and when paid)
· Malpractice insurance including tail coverage (i.e., coverage required if/when you leave a professional liability company or leave practice)
· Employment termination clause (i.e., does the clause have “for cause” and “without cause” termination policies?)
· Non-compete clause: if there is one, how restrictive is it?