Transition from residency to practice Michael Griffin Mayo Health System Administration 10/25/2001

RECRUITERS Inhouse Recruiter ASPR - Association of Staff Physician Recruiters Employed by Healthcare Entity Concerned about retention Agency Recruiter NAPR - National Association of Physician Recruiters Commission-based sales agents Fee of $15- 20,000 cost to the entity

PRACTICE SEARCH WEBSITES MedScape (MedBulletin.com) Physicians on Line (MDDirect.com) ASPR (aspr.org) PracticeLink (practicelink.com) Physician Employment (physemp.com) Specialty:(ACP - acponline.org, AIM - annals.org, AAFP - aafp.org) General (JAMA - jama.-assn.org, NEJM - nejm.org)

Practice Search Timeline ACP 25-30% of residents commit one year ahead of graduation Indicates that 50-60% of new grads will change practices within the first five years

Practice Search Timeline Months Prior to Graduation Decide on the type of practice options (academic, clinical, locums, solo) that fits your needs List the quality of life attributes required and desired Ask others (prior graduates & current) what they are doing and why Collect information on practice search techniques Determine income and benefit requirements Prepare your CV and cover letter

Practice Search Timeline Months Prior to Graduation Choose practice locations based on criteria Select practice rotations at these sites if possible Send out your CV Use contacts to investigate opportunities Talk with references---prepare them for calls or letters Collect Chamber of Commerce and community information

Practice Search Timeline 10-6 Months Prior to Graduation Narrow interview choices to 5 or less Talk with the Administration & Physician Leader you will work with at each location prior to the interview Continue to scan ads and internet sites Clear your schedule for interview time and prepare to switch call with others if needed Identify a lawyer and financial advisor Consult your advisor & Program Chair regarding locations Do additional Research on the practice opportunity with drug reps, nurses or other third party contacts

Practice Search Timeline 6-3 Months Prior to Graduation Final negotiations Prepare for relocation needs House hunting Licensure, Credentials and Hospital Privilege preparation Prepare for office set up

Practice Search Timeline 3 Months to Arrival - Personal Relocation Banking, insurance, schools, churches, mail, phone, utilities start up preparation Practice Start-Up - office, equipment, appointments, medical society Paperwork, details Move in, meet people Practice marketing Orientation

The Site Visit Dress professionally - you never get a second chance to make a first impression Call ahead and clarify what you would like to see, who you would like to meet Bring extra copies of your CV Come prepared with a list of questions Bring your spouse, send them off on their own itinerary Bring children older than 12 years (they have an opinion) Ask for time to explore on your own Clarify which visit expenses will be covered Do not order large lavish meals on the employer’s account

The Site Visit (Cont’d) Ask questions and investigate the competition. It is not ethical to interview with the competition unless they split the bill Coordinate visits when possible: lower cost, convenience. Visit your two top choices a second time, if possible Ask to meet with a banker and a mover on the second visit

Post Interview Process Make a Pro & Con list, for each practice opportunity Interview at least 2 places, try to limit to 5 Review contract with an attorney, expect to pay $ Review benefit package with a financial planner Could save you thousands of dollars & help compare offers, $

Post Interview Process (Cont’d) Compensation & methodology - ask for it in writing Contract: termination, amendments, assignability, bankruptcy, arbitration, benefits, non- compete clause, malpractice insurance Clarify the next step and decision date required

Job Search Tips DO NOT- EXPRESS- CLARIFY- Discuss salary until it is clear you are wanted. Enthusiasm and interest, but do not accept immediately. Expectations, specifics of responsibilities, compensation, benefits.

Job Search Tips INFORM- FOLLOWUP - COUNTER- OFFER- DO NOT- Other employers when you are about to accept the other position. Be prepared for enriched offers. Know your options before you decide. With all other employers as soon as you make your final decision. If you know the offer is low by informing the employer. Be confident of your facts and ask for understanding. Continue to interview after you have accepted an offer. This is unethical.

COMPENSATION MGMA(Medical Group Management) Modern Healthcare Medical Economics Ask Colleagues, Faculty, Recruiters Academy, Specialty Associations

PHYSICIAN COMPENSATION: *2001 MGMA REPORT BASED ON 2000 DATA

Median Income by Geographic Region

BENEFITS Vary widely: Financial Advisor helpful Get it in writing: addendum to the contract Disability: portability, taxable, own occupation, cancelable, renewable Pension: defined benefit, defined contribution Matching for 401K,403B know the other risks, responsibilities

The Essential “Web” Study How Physicians Look for a Job Independent survey Commissioned by: New England Journal of Medicine

Demographics of Respondents -- Specialty

Methodology Surveyed 1000 physicians Used AMA list on an n th name basis Received 287 responses (28% response)

Demographics -- Continued 85% of respondents were ages % have been in their position for 4 years or less 28% said that they were looking for a job now

What Sources for Job Leads Did You Use When You Last Looked for a Job?

Which One Source Did You Find Most Useful?

Transition from residency to practice Michael Griffin Mayo Health System Administration