Physician’s job hunting timeline 

Getting your job application ready 

Writing a good cover letter 

 What do physician employers want?

How to handle the telephone interview

Anatomy of a physician job interview 

In the restaurant with physician employers

Do’s and Don’ts in a doctor job interview 

Interview Dress Code for Doctors

Evaluating a physician job opportunity 

Physician Employment Benefits

Using an attorney to review your physician employment contract 

Understanding physician employment contract 

Physician Contract Negotiations 

How to negotiate physician employment contract 

Getting ready for your first physician job 

1) WHOLE LIFE INSURANCE: When I was a medical resident, one insurance salesman wasted a whole day of mine to convince me to buy a “Whole Life Insurance”. He said it has ‘Cash Value’, and the earlier I buy it my rates will be cheaper. Some of my friends did buy it but they could not maintain the high payments of a ‘Whole Life Insurance’ – which are almost as huge as car payments. The truth is there is not enough residency stipend to maintain these payments. And most likely you will end up dropping it. I prefer a 30 year term life insurance as it is cheaper to maintain and runs out once there is a good likelihood of all debts being paid off.

Here is the link from MSN to learn more about Types of Life Insurances.

2) OPEN RETIREMENT ACCOUNT WITH US: One Insurance salesman wanted me to open a retirement account with his firm. He was well versed with the benefits offered by my residency program, including a matched 401K, which almost nobody saved into. Yet he conveniently forgot to mention it to me.

Ask your Residency Progam Coordinator about the benefis offered by your residency program. And save money in the 401K, especially if it is matched. Even if you want to open IRA then go to low cost funds like www.Vanguard.com .

3) PHYSICIAN RECRUITERS’ SCAM: In the final year of my residency a physician recruiter wanted me to go to an interview in a god forsaken place in he middle of no where. I told him even if I get a job there I will not take it. Yet he persisted. But so did I. I never went there as it would have been a waste of time. Later I find out that the physician recruiters sometimes get paid based on how many candidates they manage to get interviewed for a spot.

4) EARLY PARTNERSHIP: A friend of mine was offered an early partnership in a medical practice within six months of his employment. He was ecstatic. He signed it without realizing that a partnership does not have a base salary guarantee and his income instantly dropped into five digits, as he did not have enough patient base. Read my article on Timing your Partnership in a medical practice.

No doctor has time to read all of these papers. They all rummage through it and sign wherever the signature needs to go. After all there are atleast 100 or more signatures to be done everyday for which there is no compensation.

Among these papers are those sent by some shady vendors and companies. Here are few examples of those:

1) Diabetic Supplies:Diabetic Supply is a big business. That is why you hear those ads about free diabetic supply delivered to your door. Automatically! It is not that automatic. Once the patient requests diabetic supply from the company, they will send a form to the physician to sign. This form has the diagnosis codes and frequency of use, which is usually already filled out by the company salesmen. What they won’t tell you is that they documented the patient needs to check his or her sugar 5 times a day. Even when they are not on insulin. If you sign this form without correcting it, they will send the patient enough supply so they can check their sugars five time a day. This is called Upselling – Selling more than what someone needs. If Medicare comes after them, they have a good defence – “the doctor told us to do that!”

The doctor did not even have the time to read the form thoroughly and gets dinged for overutilization of medicare resources!!

2) Motorized Wheelchair and Scooters: You get these prefilled forms that patient needs a scooter. He may not need it. He probably will do fine with a manual wheel chair. But those sell cheap. So these wheelchair dealers will try to get you to sign a motorized wheel chair for the patient. If Medicare audits, then your neck is on the line.

3) Change Meds to Generic and save $$$: But they won’t tell who saves the dollars. The company or the patient. The patient many a times still pays the same. But if you sign it thinking patient would not mind saving this money, you will be in for a surprise. The Pharmacy will turn around and tell the patient that the doctor asked us to change it. The patients will be angry that they were not consulted before doing so.

4) Refill these prescriptions: Patients who have not followed up with you in a year may go to the pharmacy to see if they can get their meds. The pharmacist will send you a fax. Sign it for refills for next few months will increase your liability as you are now responsible for the side effects of the meds if not monitored. If such a request comes in just give out enough pills to give the patient time to et to your office. Definitely NO REFILLS!

Moral of the story: No one can read everything. But know what to check for each document before you sign it.

Any time that you have to buy an equipment or service, you will have to do your homework. Just because one salesman gives you a price for a product, does not mean that is the market value of that product. People in the business community are well aware that physicians lack of training in the business aspect of anything. They use that to their full advantage by inflating the prices, selling unnecessary services, and even to the extent nickling and diming the doctors.

Always be paranoid and when dealing with business people. Even if it saves man appears to be your friend, he may not be so. Salesmen and are trained to develop a relationship with their customers on a friendly basis. And that is how they get their stuff sold.

Be aware of common sales techniques. It is important. For it will give you better handle on negotiations. Here are some of the commonly used sales techniques:

Upselling: It is a technique by which a salesman will sell you something more than what you initially asked for. For example when you go to buy food at a fast food restaurant, they ask you if you need French fries and Coke with it. Even though you did not initially plan to, there is a good chance you will say yes to the offer. This is Upselling.

Management fees: Somehow seems like all the doctors get charged management fees. Whenever we tried to buy a product or service, the salesman would tag on a management fee to the whole deal. If you look closely they charge anywhere between $100 to $200 management fee per hour. That is ridiculous. Even Physicians do not make that much for an hour anymore.

Inflating price then giving discount: Many times salesman will give you a very high price. Then he or she will deeply discount it for you for a limited period of time. It will make you feel you are getting a deal. You will be surprised, if you did some research, that even the deeply discounted price is much more than that product or service is available for elsewhere.

Deadlines: One of the favorite ways for the salesman to close a deal is by telling you that the offer is good until end of the week. In my opinion, if they can give you a product for X price this week, they should be able to give you the same product for X price next week.

Charging extra for various modules: Companies love to nickel and dime Physicians. This is especially true in the case of Electronic Medical records. The Electronic Medical records software is sold in various modules. Many of these modules are mandatory. This way they can bulk up on the total price without making the Physician realize it.

Appearing desperate: salesman may try to invoke your sympathy to be able to make a sale.

So once you know the common tactics the sales personnel uses, it will become easier for you to read in between the lines and continue to negotiate better through these gimmicks.
How do you make sure you’re getting a good price? Here are some pointers. Keep one practicing with every purchase you make and every time you will get better at it.

Get offers from three or four companies for a medical product or services. Never rely on bid from a single company or salesman only.

Go online, Google it, search and see how much the product or service is available online for.

Let the companies bidding for the purchase know that you have researched the price. Then ask them to beat the price.

Go for the lowest offer with the most reliable post sales service.

5) If two companies offer you the same price, go with the one which has been honest with the dealing during the process.

You can find medical vendors at directories such as VendorMD.com

It is almost July and most of the residents should have landed a physician job. If not, but you are mulling over several physician job offers — then you are still good to go. But if you have not done a single interview yet or worse if you have not started applying yet, then you are really getting late. But do not despair, as there are plenty of physician jobs available.  Those who have visa issues need to be extra careful about the deadlines for applying for one.

There are several strategies to catch up for your Doctor job search. These techniques can be used by the early birds too as they are very effective in getting the contract in hand.

1) Networking: Talk to your attending physicians in the hospital and program. Many if them will be looking for a partner in the near future. May be you can fit into that role. Even if they are not looking, they may know someone , who is looking for physician employees.

2) Medical Staff Office: Talk to the Medical Staff Office in your training hospital. They are usually aware of MDs looking for potential partners/ employees. 

3) Pick up the phone!: Yes! pick up the phone and call up all the places you have put your resume to. Ask them for the physician responsible for making hiring decision. Talk to the hiring MD and ask him if you can set up an  interview to discuss the opportunity further. Many a times, a reverse interview offer like this does work.

4) Physician recruiters: Call the physician recruiters in your specialty and they will be do glad to have you signed up somewhere. Why? Because that’s how they make the big bucks.

5) Friends and Seniors: Do not forget friends and seniors who are already employed or own their own medical practice. They can also hook you up with a physician job.

What if the worst fear comes true. What if you graduate and there is no physician job in sight for you. Well that is a rare thing and should not happen if you have read the ‘Secrets of physician job hunt’.  But even if it does, then you still have option of locum tenens and moonlighting. This option is not for you if you need a visa for employment. The biggest drawback of having a  gap between residency and employment — you will have  to explain it on all  your applications  in the future. I hope this sets you on fire to get started!!!

Website names (also called domain names) are running out! More than 80 million websites have been registered so far per ICANN. Do you realize that there are no single word website names left in most languages including English. People who invest in website names (also called Domain Name Investors) have taken them all. In fact to get a two word website name is also very hard.

But what can a website do for a doctor? Ever heard of HillaryClinton.com or BarrackObama.com? A website in your name can make it easy for your patients to follow you on the web. Many a times they will enter your name in the browser and see if they could get some information about you. Now if your competitor registers a website in your name before you could, he can lead your potential patients to his website. And worst of all, you won’t even know.

It is vitally important for you to at least register your name as a website name or domain name. e.g. RobertSmith.com or RobertSmithMD.com. If you know what you will name your medical practice in the future, then you should register that website name too.

Here are some FAQs for registering  a website. 

But I am in the medical school why should I register now? Can I do that later? Registering website names or domain names is very cheap to do. If you wait too long, someone else may register your name as a domain name. Then you will have to buy it from those domain investors or you will have to settle for something different.

But isn’t registering Domain names a highly technical stuff?

No. In fact it is as simple as typing the name and click submit. Follow the instructions to a credit card payment and you can get your own website name (domain name) at www.HelloDello.com where CareerMedicine.com is registered.

But how do I make a website on my domain name?

The easiest way to make a website is to use a website template. It is a readymade website design. All you have to do is type in the content just like you do in Microsoft word. I register website or domain names at www.HelloDello.com because they give access to a website builder for free. Some of the registrars charge for that kind of stuff. That way I do not have to spend more cash to design the website or keep it running.

What can I do on my website?

You can write a blog on your website, share pictures, and advertise your services etc on your website. The possibilities are endless.

How do I register domain names?

You can go to easy to use website such as www.HelloDello.com. Then type in the desired website name. Press search button. It will tell you if it is available or not. If it is then you may want to register it right then and there, to prevent any other person from registering it.

Summary:

Advantages of Domain name registration (or registering website names)

Creates your identity on the web.

Easy for patients to find you.

Easy for you to find patients.

Once registered by you, no one can snatch your website name from you.

In the future, you may be able to sell your website name just like real estate. But not all website names sell for millions, most of them sell for few hundreds to thousands dollars only.

It is cheap to do so. HelloDello.com charges only $9.99/ year to register most website name.

Disadvantages of not registering a name as soon as possible:

Someone else may register it and you will never get a chance at it.

You will miss out on a lot of business because of not having a web presence.

To register a website:

Go to www.HelloDello.com

Type in your desired website name in the search bar.

If the domain name is available to register, grab the domain name right away.

If not available, try a different variation to see if that is available – such as RobertJones.com, RobertJonesMD.com, RJones.com and so on.

Also consider registering different extensions of the website name such as .com .net .org etc.

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]]> http://www.careermedicine.com/2008/06/why-should-physicians-have-a-website-and-how-to-get-one/feed/ 1 http://www.careermedicine.com/2008/04/buying-medical-equipment-for-your-practice-caution-advised/ http://www.careermedicine.com/2008/04/buying-medical-equipment-for-your-practice-caution-advised/#comments Mon, 28 Apr 2008 04:26:26 +0000 admin http://www.careermedicine.com/2008/04/buying-medical-equipment-for-your-practice-caution-advised/ If you own or run a medical practice, or plan to do so, one of the most frequent decision you will have to make is whether or not to buy or lease a medical equipment. As the cost of technology is going down, more and more medical equipment is becoming affordable for medical practices to acquire. As technology advances, older models are becoming available in the used medical equipment market for fraction of the price.

Why should a medical practice acquire medical equipment: Reasons can be:

1) Out of necessity: If you are an ophthalmologist, you need some of the equipment to practice your trade.

2) Service to patients: Patients prefer to go to their Doctors office for procedures rather than to a hospital.

3) Tax Breaks: Your accountant can tell you how to depreciate the price of the medical equipment to get some relief from Uncle Sam.

5) Survival: In the era of reducing insurance reimbursement rates, an additional income from the procedure may become an important source of revenue.

But beware of the medical  equipment salesmen. Many of them are good but many of them are not. Their job is to sell the equipment. They may promise to stick by you after the sale but admit it, how many times have you seen a any sales guy checking on you after a sale. Also the only way they can convince a physician to buy  a medical equipment is  to talk about the profitability of the tests. So ultimately it is the duty of the physician purchasing the medical equipment to decide whether or not it is a good buy.

How do you determine if an equipment is a good buy or not ? How do you know if the medical equipment salesman is telling you the truth about the reimbursement rates. The answer is you cannot guarantee the reimbursement rate by insurance companies for a particular test. The only way to do it will be to submit a claim to the insurance company. You can submit a claim only after you buy the equipment and do the procedure. Even if you submit the claim, whether it gets paid or not will take atleast one to three months. Thanks to the processing times of various insurance companies.

So here is a list of questions you should ask before purchasing any medical equipment:

1) Do I trust this medical equipment salesperson? The answer should be No most of the time. The mistrust will motivate  you to do more research on  your own.

2) Do my patients need this medical equipment? If yes, then how often ?

3) Do medical insurance companies traditionally reimburse for the procedure or will my patients end up footing the bill ?

4) Does the amount reimbursed by the insurance companies will recover my investment in a reasonable period of time ?

5) What is the future outlook of reimbursement on these procedure by third party payors. Are they planning to decrease it or increase it (LOL).

6) Is Medicare or Medicaid planning to add certification requirement for that medical equipment. If so then you need to factor in the added cost of training and paying someone to be a medical director.

7) What is the difference in  pricing between a new and the used medical equipment ?

What are other companies selling the same or similar model for ?

9) Do I have a place in the medical practice to use it ?

10) Will my patients benefit from having the test here ?

11) Will the quality of reports generated by the medical equipment be sufficient enough that I can give a good service to my patients ?

You can find a list of Medical Vendors from the Medical Vendors Directory VendorMD.com for your research. Answer the above questions you do not get stuck with a medical equipment sitting in your office and laughing at you !

 

]]> http://www.careermedicine.com/2008/04/buying-medical-equipment-for-your-practice-caution-advised/feed/ 0 http://www.careermedicine.com/2008/04/inter-physician-marketing-tips-and-techniques/ http://www.careermedicine.com/2008/04/inter-physician-marketing-tips-and-techniques/#comments Mon, 14 Apr 2008 00:30:20 +0000 admin http://www.careermedicine.com/2008/04/inter-physician-marketing-tips-and-techniques/ If you are a Primary Care physician, then  Inter-Physician Marketing can boost the growth of your medical practice. If you are a specialist, inter-physician marketing is a must for you. Whether you are employed physician or you own your medical practice, inter-physician marketing is something you will always need to do.

As discussed before in the last article, inter-physician marketing is the subtle marketing that goes on between physicians to promote themselves and get more referrals. You can be the best doctor in the world, but if no one knows you, no one sends any patients to you, then what good it is to be the best.

Here at CareerMedicine.com,  I will list everything that I have observed and learnt over the years about inter-physician marketing. You can use the following tips and techniques, in any order or sequence and see it work wonders.

BASIC INTER-PHYSICIAN  MARKETING TECHNIQUES:

These are something you should always remember to do. Its simple, its subtle and it works !

1) SMILE and say Hello to each other: All physicians are very busy. They are overworked and under pressure. What a refreshment it is to see a smiling physician colleague once in a while. Life is short, it will end soon, whether you run down the hallway looking at the floor or you run down the hallway smiling. There is nothing wrong in saying hello to your competition either. After all they are colleagues too. If they discontinue an insurance plan, they will be more than happy to send those patients your way.

2) Hang out in the Doctor’s Lounge: At least once or twice a week go to the lunch at the doctors lounge. OR breakfast, if you prefer. You will meet a lot of colleagues and everyone is informal while eating.

3) Keep your business cards handy: Pass your business card whenever you meet someone new. Especially if you have complicated name Keep some always in the pocket.

4) Be courteous to the staff: You have no idea how many patients ask the hospital or clinic staff for recommendations regarding a doctor. If the staff likes you, they will recommend you.

5) Be available: Whenever you get consulted, give prompt service. It may mean you have to get up in the night and see a patient. But that is something you should be doing anyways.

6) Communicate: Call the referring physician or send a letter once you have seen his or her patient.  Always sound cheerful to see the patient.

ADVANCED INTER-PHYSICIAN MARKETING TECHNIQUES

These tips include the ones in which the physicians have to put themselves out in the field. If you are shy in nature then start with those strategies which you feel more comfortable with. Then once you are in it – take it to the next level

1) SEND OUT A LETTER OF INTRODUCTION: Whenever you arrive in a new town, as an employed physician or starting your own medical practice, send a letter of introduction out. DO NOT make it long. No one reads a long letter. (There is a reason all posts in CareerMedicine are short.) Short and sweet introduction will suffice. Send it to every physician in the town.

2) GO OUT and MEET OTHER PHYSICIANS: Have your staff make appointments and then you can go and personally introduce yourself to other physicians. A face to a name solidifies branding. Suddenly you are not a figment of imagination, you are a person. When you meet them, explain to them that you are new in town, to start practicing medicine. And tell them your strengths. Most physicians will be happy to see you.

3) GET ON THE ER UNASSIGNED LIST: Always make sure you are on the ER unassigned list. That is a sure way of generating patients.

4) MEET THE ER DOCTORS: Do introduce yourself to ER physicians and let them know you are interested in providing prompt care to the patients. ER Physicians like prompt medical care for their patients. It helps them clear the ER faster.

So try these tips and see what happens.  

 

 

]]> http://www.careermedicine.com/2008/04/inter-physician-marketing-tips-and-techniques/feed/ 0 http://www.careermedicine.com/2008/04/inter-physician-marketing-what-is-it/ http://www.careermedicine.com/2008/04/inter-physician-marketing-what-is-it/#comments Fri, 04 Apr 2008 06:11:15 +0000 admin http://www.careermedicine.com/2008/04/inter-physician-marketing-what-is-it/  

 

 

One of the goals of CareerMedicine (www.CareerMedicine.com) is to talk about topics which even we physicians hesitate to talk about. Physicians not only market their medical practice to patients, but also to other physicians, who can refer patients to them. It is a legit topic to discuss. For this purpose, lets coin it a term: Inter-Physician Marketing.

We define Inter-Physician Marketing  as the subtle (but legal !) art with which physicians try to encourage their other colleagues to refer patients to them.

There is a difference though in medicine. In Medicine, kick backs or commissions are not allowed in return for referrals. Any attempt to do so will trigger Stark Laws and can wreck havoc on the medical practice. Having said that, Inter-Physician Marketing  when done ethically without any commissions or kickbacks, is a perfect way of developing a medical practice. For specialist  there is no other way to survive a medical practice start up. They have to do Inter Physician Marketing, as referrals is the primary source of patients for specialists. For doctors in primary care, Inter-Physician Marketing is not the first thing they think of, but they can take advantage of this tool to accelerate the growth of their medical practice.

When a new physician arrives to this town, where the referral patterns are already set, how does he break into the circle ?

1) The new physician in town will send a letter out to all other physicians letting them know he has opened a new medical practice.

2) The new physician will go around to other medical offices and introduce himself or herself. 

3) The new physician will enroll on the unassigned call list for his specialty in the Emergency Room.

4) The new physician will be quick to respond to consult request, give a good service to the patient and update the referring physician on the treatment plan.

5) The new physician will try his best to accomodate same day appointments for emergency referrals, thus relieving the referring physician.

6) The new physician will try to go to as many professional meetings as he could to get a chance to introduce himself. AKA Self marketing. 

All these actions are to break down the barrier other physicians may have to refer patients to a new physician in the town. In our next post we will discuss the details and what are some good ways for inter-physician marketing. Till then think about it…..it is not eew, its just business !

 

]]> http://www.careermedicine.com/2008/04/inter-physician-marketing-what-is-it/feed/ 0 http://www.careermedicine.com/2008/03/medical-office-building-stand-alone-or-medical-complex/ http://www.careermedicine.com/2008/03/medical-office-building-stand-alone-or-medical-complex/#comments Thu, 27 Mar 2008 03:51:55 +0000 admin http://www.careermedicine.com/2008/03/medical-office-building-stand-alone-or-medical-complex/

If you are planning to be in a private practice of your own, you need to choose an office space. Medical Office space can be leased or bought. I prefer to lease for first few years until things settle down, cash flow becomes stable, and I find out what kind of office and medical office layout is suitable for my purpose.

The question we are considering is, if a stand alone building is better or not? It sure does look great to be in a stand alone building. It is a complete building of your own, no neighbors and no mess.

But if you are planning to start a new medical practice, it is important not to isolate the medical practice. I have given this a lot of thought before opening my medical practice. And looking back, it surely is good to be in a condominium complex, surrounded by other medical offices. Why?

Because no matter how much marketing your medical practice may do, more than 90% of the patients will choose you because of referrals. This is true for both specialists as well as primary care practice. If you are surrounded by medical offices (as in a medical office condominium complex) they all will be more likely to refer patients to you.

My hunch in the beginning of opening a practice has now proven its ground. The medical complex has a very high traffic of cross referrals. The patients like it because they don’t have to go too far from the place they are familiar with. The Medical Practices thrive in a symbiotic relationship. Everybody wins !

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