Your best resource when looking for employment in this high-tech age? It's that old standby--other people.
Your best resource when looking for employment in this high-tech age? It's that old standbyother people.
By Kent Bottles, MD
Cleveland Clinic neurologist Richard M. Ransohoff remembers when a colleague passed along a letter from a senior medical student in Denmark who was looking for a job in the US. Ransohoff wasn't interested in someone so junior, but since he happened to be going to a meeting in Norway, he agreed to meet the young doctor. Ransohoff was so impressed with the man that he hired him.
Welcome to the world of networking.
For physicians, job hunting conjures up thoughts of newspaper and journal ads, executive search firms, and, more recently, Internet job sites and bulletin boards. These methods of looking for a clinical position can work and should be part of any job seeker's arsenal, but the most powerful way to locate and secure challenging and rewarding jobs is through direct contact with other people. Ransohoff summarizes the process of recruiting as "a guy knows a guy who knows a guy who needs a guy."
William S. Beckett, an internist at Finger Lakes Occupational Health Services in Rochester, NY, believes that searching for a job in medicine is a lot like looking for an apartment in New York City. "Everyone knows that the really cool apartments are found by word of mouth, not by looking at newspaper ads," he says. "The same is true for clinical positions in medicine."
Molly D. Shepard, president of Shepard Executive Resources in Philadelphia, concurs: "In counseling high-level executives and physicians, I have found that at least 85 percent of the really good, exciting jobs are found through personal contacts. There is no doubt that networking is the one key skill for any job hunter."
Networking serves many functions: It can lead to discovery of available jobs, introductions to influential people in your field, and priceless feedback on how well you're presenting yourself, how effective your resume is, and how realistic your goals are.
For networking to be most effective, you need to begin well before you're ready to change jobs. You also need to balance the give-and-take in these relationships. As psychiatrist Gigi Hirsch observes in Strategic Career Management for the 21st Century Physician, "If you develop a reputation as a 'taker' rather than a 'sharer,' your ability to network will be drastically diminished." Realize that you are a potentially valuable resource for those you meet, and do what you can to reciprocate, she says.
Who's good to network with? Everyone. People you meet in the course of your day, or identify by doing Internet research, or talk to on the phone, or know as an opinion leader in your field can all help. You can never tell who will lead you to your next job, as ob/gyn Janice B. Asher learned when she moved from Chicago to Philadelphia with her attorney husband. "Three teenage girls welcomed us to the neighborhood with home-baked brownies," she recalls. "We became friendly and had a nice talk. After I revealed my occupation, they returned to their house to tell their father, who immediately rushed over and started recruiting me for his hospital. He was an internist who knew that the ob/gyn department desperately needed doctors."
Asher's second job in Philadelphia also came through networking, this time with an internist she saw as a patient. "After listening to me talk about my challenges in balancing work and family, she said I should work at student health, and she told me who to call at the University of Pennsylvania," explains Asher, who is now director of women's health at the school's student health service.
But networking is seldom that passive. "You really have to work at not becoming insulated in your daily cocoon," says Hirsch, founder of MD IntelliNet, a Brookline, MA, firm that helps physicians diversify their careers. "Join clubs and associations that introduce you to people other than your colleagues in a particular specialty. Periodically take CME courses that don't relate to your specialty. Keep your feelers out."
Hirsch recalls one physician with expertise in alternative medicine who made a deliberate effort to become known to the key players of the health care system he worked for. As a result of his efforts, he was named director of all alternative medicine initiatives across the entire system.
Of course, your peers can be helpful, too. The colleague you schmooze with at those annual meetings may provide you with just the right information at just the right moment. That's what happened to pathologist John D. Olson, when he and his family decided to leave Iowa in search of a warmer climate. "I started my search on the Internet by looking at the job bulletin board on the Web site for the American Society for Investigative Pathology," says Olson. "One listing was for director of clinical laboratories at the University Health System in San Antonio, and I sent in an application."
After hearing nothing for months, Olson assumed the position had been filled. But when talking with a fellow pathologist in Arizona he had known for years, he learned the position was still available. So Olson called the chair of pathology in San Antonio to express his continued interest, and eventually landed the job.
The value of networking isn't limited to finding full-time employment. Tucson FP Evan W. Kligman used networking to help round out a three-part career. He splits his time equally among his private practice, a job doctoring at Canyon Ranch Health Resort, and a position as co-director of the Center for Aging at the University of Arizona. The Canyon Ranch opportunity resulted from a casual "how ya doin'?" call to his former boss, who had retired from academic medicine to become a senior vice president at Canyon Ranch.
Keith Pryor, a Philadelphia-based consultant and career counselor, encourages job seekers to keep in touch with a network of contacts by e-mail, and not to hesitate to cold-call influential leaders in a particular field. "Most people are willing to talk with a fellow professional who calls up for 15 minutes of mentoring," says Pryor. "Who can resist giving advice and being regarded as an expert?"
Networking isn't the only job-hunting strategy, of course. In addition to scanning advertising in newspapers and professional journals, doctors are increasingly turning to the Internet to ferret out job openings. However, plum opportunities are rarely advertised on the Web, and even if they are, you'll face stiffer competition than if you learn about the job from a contact before it's advertised.
Still, using the Web may give you a slight edge in getting your CV in front of employers who advertise in medical journals if the journal routinely runs online classifieds before putting them in print. The New England Journal of Medicine (www.nejm.org/careerlinks), for instance, gives its registered members the option of receiving e-mail job alerts of new openings before they're listed in print or online.
If you're just beginning your search, browse the Web sites for your specialty society and the larger recruiters such as Cejka & Company (www.cejka.com ), CompHealth (www.comphealth.com ), Merritt, Hawkins & Associates (www.merritthawkins.com), and Weatherby Health Care (www.whcfirst.com). Also consult the Medical Economics Career Center site at www.memag.com or www.hospitalhub.com/medec. In addition to job listings, you may find current physician compensation surveys, CV writing tips, and other career information.
Physician-related job search engines available at some specialty sites or physician recruiting sites can give you a quick feel for what's available in your specialty in a specific area. The Web site of the American Academy of Family Physicians (www.aafp.org/careers), for example, allows very targeted searches. Family doctors can narrow the search by state, type of practice, community size, salary range, and services offered by the practice.
The Web can also help job seekers research specific employers, jobs, or geographic locations, or obtain information on potential networking contacts. An important tip: Confine your job-hunting Web forays to your home computer. Otherwise you risk having a nosy co-worker tip off your boss or colleagues.
Recruiters are another way to supplement job-hunting efforts. Just remember that recruiters make their money from employers, so that's where their loyalty liesno matter what they tell you. And don't look to them for long-term career counseling, or to answer questions such as, "How do I leave practice and get a job in administration?" Those questions are better addressed to a career coach or counselor.
Recruiters may have leads that you couldn't easily get elsewhere. Or they may not. "When I've engaged recruiters to find someone for my practice, they've tended to present the same candidates who contacted me after reading my classified ad in The New England Journal of Medicine," complains pulmonologist Ira P. Krefting from Silver Spring, MD. Most recruiters work on either contingency or retainer. The contingent firms typically recruit for lower-paying positions, and they don't have an exclusive contract for the jobs they seek to fill. "Rarely, if ever, do they have an opening in a prestigious practice in a metropolitan or suburban area," says Krefting, who has used a number of recruiters during his career.
Retained search firms usually have an exclusive arrangement with the employer. Since they're expensivethey typically charge one-third of the new employee's annual salaryemployers use them to fill only higher-paying positions. These recruiters are more apt to help candidates understand the prospective employer's stated (and hidden) agenda, and will often help applicants polish their presentation skills.
On the plus side, recruiters are good at providing valuable information and setting up interviews, Krefting says. They should be able to provide the information you and your spouse need, for instance, to determine whether the community in question is right for you. On the downside, using a recruiter will make you more expensive to the employersomething to consider in this era of cost constraints.
Realize, too, that the quality of recruiting firm varies greatly, says Krefting. To size up the firm, he adds, "always ask: 'How many physicians do you place? How long do the doctors stay in those positions? Do you visit the practice before advertising it?'"
Don't be shy. People enjoy helping enthusiastic, optimistic job seekers who are determined to help themselves.
Start networking before you need a job. Keep in contact with your professional network by regular e-mails, telephone calls, visits, and letters. Send (via e-mail if possible) newspaper clippings of stories that might interest them.
Don't brush off anyone. Every new acquaintance is a possible connection, even if he isn't in a medical field.
Always have a business card handy, and remember to get a new contact's address, phone number, and e-mail address.
Write a thank-you note to those who go out of their way to help you.
Make appointments for mentoring with opinion leaders and experts in the field you want to work in.
When you're a foreign medical school graduate, staying here to practice is not easy. Only the most persistent survive.
In 1993, I entered an internal medicine residency program at what was then known as the Westchester County (NY) Medical Center, the teaching hospital of New York Medical College. I decided to pursue general internal medicine. Since generalists aren't in much demand back home in Manila, I knew I'd have a difficult time supporting my wife and child if we returned.
To stay here, however, I'd have to find an employer willing to participate in the J-1 waiver program, which is open to foreign graduates who agree to practice for at least three years in medically underserved areas. If I couldn't find an employer to participate, the immigration laws would have required me to remain away from the US for at least two years before I could come back to live. Unfortunately, very few practices are willing to complete the paperwork the J-1 waiver program requires. I sent out 200 letters and didn't get a single answer.
Then a fellow resident passed on the name of a family physician in an underserved area in southern New Jersey who was looking for an associate. A mutual friend who practiced in the area agreed to serve as our liaison. I was excited.
The first meeting with Dr. Conda, as I'll call him, went well, and we had several more. Eventually, I met with a representative from the local hospital, which planned to buy Conda's practice. That meeting went well, too, and the hospitalwhich had almost consummated the deal with Condaoffered me a contract.
I felt lucky, and started the waiver process. The paperwork went relatively smoothly. But then I learned that the deal between the hospital and Conda had fallen through.
Conda assured me I still had the job; he'd simply draw up a new contract. But he slashed the agreed-upon salary by 20 percent. I protested meekly. I was in no position to argue, and he knew it. I tried to convince myself that this wasn't about money, it was about getting the waiver, but deep down, I knew I had been taken.
That episode pretty much summed up Conda's attitude toward his associates. I soon learned that dozens of doctors had worked for him over the years. None of them left on good terms. I did my required time and moved on. I eventually joined a large group practice in Delaware, where I still work.
In retrospect, I'm happy I persevered, as painful as it was at times. I consider it a privilege to practice the kind of medicine I enjoy in a country that my family and I have learned to call home.
1: If you're married to another physician and your spouse is in a specialty where there are very few jobs, help your spouse find a job first. Then look for something within comfortable commuting distance.
Connie Henderson-Damon, practice management/career development consultant
2: Young physicians who are seriously entertaining the notion of solo practice should work for a group first. This will not only provide a steady paycheckwhich can speed repayment of debtbut invaluable experience. You can learn a lot about the workings of an officeand decide what you want to emulate and what you want to do differentlyby working for another practice first
Jeffrey J. Denning, practice management consultant
3: If you're leaving because of a problem related to faulty interpersonal dynamics, resolve it before you move on. Otherwise, it's likely to surface again in your next job.
Peter Farmer, MD, physician coach
4: If you decide to leave one group for another, be sure to carefully resolve any legal issues around the following: payment still due you at the time of departure, continuity of patient care, access to patient medical records, restrictive covenants, and professional liability coverage.
Steven Harris, attorney
Kent Bottles. Job search strategies that really work. Medical Economics 2001;1:62.