Post-Training Job Search: Everything You Need To Know, and Should Not Be Afraid to Ask

SAN DIEGO-How much will I make? That question is, understandably, front and center for many otolaryngology residents and fellows weighing their first career opportunity. According to Karen A. Zupko, President of Karen Zupko and Associates of Chicago, young physicians would also be wise to size up other important factors about their prospective employers-factors that can affect their incomes, working conditions, and even quality of life.

As CEO of ENT and Allergy Associates, LLP, a large specialty practice with 30 locations in the New York-New Jersey area, Robert A. Glazer, MPA, has noticed that candidates often do not ask the right questions of him during the job interview. He believes that young physicians should more carefully evaluate the practices they are hoping to join.

Ms. Zupko and Mr. Glazer spoke during two related miniseminars designed to provide young physicians with vital education about the business of medicine. Both sessions were sponsored by the Academy’s Section for Residents and Fellows, and were moderated by Michelle M. Roeser, MD, Chief Resident Associate in Otorhinolaryngology at the Mayo Clinic in Rochester, MN.

In the first session, Financial Tips for a Successful First Year of Practice, Ms. Zupko and her colleague, Mary LeGrand, RN, MA, a coding and reimbursement specialist, summarized types of practice opportunities and compensation packages. They also urged attendees to educate themselves about the complexities of coding and billing. In Practice Considerations and Contracts for New Employment, Mr. Glazer and copresenter Michael R. Moore, JD, LLM, a partner with Sheppard, Mullin, Richter and Hampton, LLC, in San Diego, got specific about contract negotiations.

More than the Money

The annual survey of physician compensation and productivity published each fall by the Medical Group Management Association (MGMA) gives you a frame of reference for the real world of compensation and productivity, said Mr. Moore. The most recent report showed that physicians with one to two years of practice in otorhinolaryngology had a median income of $307,792.

The range of practice opportunities is also important to consider, said Ms. Zupko. Should you start a solo practice? At this point in time, the headwinds against you are considerable, she cautioned.

Direct employment with a hospital is a growing trend, but job seekers should be careful to validate that the initial pay package that is offered will be sustainable. (They can ask to see the same reports and documents described below for group practices.) An academic practice may be attractive for others. The downsides of an academic career, according to Ms. Zupko, include lower compensation, departmental politics, and limited ancillary opportunities. Nor will an academic job insulate the physician, in this regulatory and reimbursement climate, from wrestling with productivity and business issues.

Focus on Your Values

Most of the subsequent commentary in both sessions focused on group practices. Even small group practices have a culture-and you will be expected to fit in with that culture, noted Ms. Zupko. If you join a group practice with a lukewarm feeling, it’s a little bit like marching down the aisle on your wedding day and thinking, ‘Oh, I don’t know if I should be here,’ she quipped. Just as with marriages, the consequences of a bad match can be expensive if you decide to exit the relationship before your contract is up.