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.

1) Healthcare is needed no matter what the economy is. (A very common argument!)

2) The government is a major customer of Healthcare and always retains a spending ability. The government purchases healthcare services through their Medicare and Medicaid Programs

3) The business of healthcare is not as leveraged like finance or construction or manufacturing. That means that we docs do not take too much loans, way beyond our capacity.

4) Banks continue to finance the medical practices due to the stable nature of the business.

Therefore the health care jobs did not go down with the economy. They actually went up by 3%. Yes! The Healthcare jobs were added in this economy.

Now lets talk about Physician Jobs. I do know of some of my friends having trouble finding physician jobs. I do know of hospitals putting hiring freeze on physicians. MGMA does not seem to have commented specifically on physician job data.

I believe that since the physicians are the most expensive piece of personnel in a medical practice or hospital there is some reluctance in hiring them, not knowing what the future holds.

As people lose jobs and their medical insurances, the commercial payers for a medical practice will decrease and cause a dent in the revenue. The workload of indigent care clinic is already increasing. If the recession last too long, then the medical community will definitely be affected.

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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

Since Childhood, everybody has chased the dream of having the workload lighten up once the education part of life is over. Same goes with medicine. Once into Medical School, we realize the amount of work we have to put in it. Every day Medical Students slog through various rotations, schedules, USMLE, reports etc. This list goes on. 

Once the medical school is over, getting into internship is a shocker. If you thought medical school was tough, then you have no idea what an internship would be like. Once the internship is over, the pressure does ease off in the later years of residency but not significantly. There is always more to do and learn.

So for those who wonder if being an attending physician is easier than residency or not, then the answer is NOT. The workload of an attending physician is similar to or worse than that of medical interns. But there are some good differences:

1) The scutwork and running around is reduced.

2) Number of patients the attending physicians take care of  are higher, but then their schedule is not interrupted by conferences and classrooms.

3) With experience, the medical decision making becomes easier and attending physicians do not have to refer to clinical data and research too often.

4) Compensation improves and takes the brunt away from hard work. 

So there is more mental work than physical work after becoming an attending physician, which is a blessing. But it is still hard work and for most of us. There is more responsibility, more rewards. How hard did you expect to work after medical residency?

LAW OF PAGING ORDERS

The more orders you write, more pages you will get. Vice versa is also true: The more pages you get, more orders you will give.

LAW OF SOCIAL PAGING 

Number of pages you get are inversely proportional to your social skills.  

LAW OF UNEXPECTED PAGING

The less you expect a pager to beep, more are the chances it will actually do so.

LAW OF DEMOLITION PAGING

No matter how hard you throw the pager on the ground, how many times you dip it in water, or put in fire, it will not stop serving pages.

LAW OF STATUS PAGING

The number of pagers on your belt are directly proportional to the confidence of patients in your treatment.

LAW OF GARBLED PAGE

More important the page is, more are the chances that it may show up garbled on your pager.

LAW OF FORGOTTEN PAGER

Your pager will get the most pages on the day you forget it at home.

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!!!

Let us talk about taking a break after a medical residency program. Once we are through with the hard labor of medical residency program, the long hours, and the stress, which has haunted as for at least last three years, there is a natural tendency to take a break, To rest, to rejuvenate.

Lets consider the question of financial implications of taking a break after residency. Since you have not the started a Physician job, it is quiet clear that you will not be paid for this vacation time. Other thing to note is that your salary would almost quadruple after graduation. And so taking a break will cost you more than $10K for each month you do not work assuming your starting salary is $120K. This does not includes the money you will spend to enjoy that vacation. That makes it a very very expensive break!

You should rather start working at the physician job and then take a vacation maybe three to four months later which would be paid vacation at that time. So by delaying gratification by four months, you actually earned more than 15K. If you have a higher starting salary then 150K, then the stakes are even high.

The other issue to be discussed is the timing of your board examinations. Should you give board examination right after residency, or may be two or three years down the road?

The likely reason medical residents try to take a break is because of all the stress of examinations. But remember this stress is something that you have been used to already. So why not go through the stressful medical board exams, while you’re used to taking huge amounts of stress. Almost all hospitals require board certification for approving your privileges to the hospital. If you do not have privileges to the hospital, you cannot enter the hospital to work there.

The problem with delaying the boards is that the longer you are away from the residency graduation, the harder preparation you will need for the boards. It is the easiest to pass the medical board’s or specialty medical boards right after residency. Why? Right after residency the knowledge is fresh in your mind. That reduces the amount of readings you may have to do. Also it is the latest knowledge, which is most relevant for the medical board exams. Not to mention your recent practice in preparing for multiple in-house examinations does keep your efficiency at the highest.

So make sure you avoid these two big mistakes often graduating from the residency program. Number one, do not take a break right after residency whether to relax or to prepare for the board exams. It is not worth it. Number two, take your board exams right away.