It is important to be sure that you have an understanding of the contract and how they run their business—and that it is a way of doing things that you’re comfortable with.
Explore this issue:September 2014
—Lawrence Simon, MD
Getting the Job
One of the keys to getting a job, in otolaryngology or any other field, is nailing the interview, and one way to do that is to follow the “Four Rs” as previously described to ENTtoday (see “Just the FAQs,” December 2012, p. 24) by Jim Stone, president of The Medicus Firm and immediate past president of the National Association of Physician Recruiters. Stone suggests performing proper research, setting up references in advance, making sure your resume is in shape, and using a roundtable to ask personal stakeholders what their needs might be.
Assuming you pass that threshold, the most difficult decisions often have to do with how to handle a job offer. John Sinacori, MD, director of the otolaryngology residency training program at Eastern Virginia Medical School in Norfolk, said that looking at job offers is not as simple as taking the one that offers the most money. “You compare the details of the practice, the people in the practice,” he said, “and then you look at what the actual practice will look like. Suppose you would like to concentrate your efforts on endocrine surgery but someone is already fulfilling that role; you may want to look somewhere else if they are not willing to share those types of patients.”
Dr. Simon also urged young physicians joining a private practice to be inquisitive about the financial state of the business. It can be intimidating after years of applying for medical school, residency positions, and fellowships, where the onus is always on the candidate. “When you’re looking at jobs, you’re looking at people who have already expressed an interest in hiring someone,” he said. “They have a need, and you can meet their need. This isn’t you trying to earn an educational spot, … so instead of you trying to impress them, now both of you are trying to impress each other.”
The Value of Experts
Both Drs. Simon and Sinacori strongly recommend using lawyers to go over a first contract. “Physicians always think they know everything, and the bottom line is lawyers know more when it comes to contracts,” Dr. Sinacori said.
He added that in academic practices, contracts often have less “wiggle room,” because the size of an organization means the contracts are relatively standard. In private practice, where group sizes can vary widely, the vagaries of contracts can deal with potential paybacks for production quotas, equipment purchase, or the growing role of accountable care organizations. Those details, depending on wording, can have serious long-term impacts.