FINDING and ACQUIRING the “RIGHT” PRACTICE

1. FINDING and ACQUIRING the “RIGHT” PRACTICE • Tips on writing cover letters and your C.V. • Interviewing Techniques • Things You Should Want To Know About The Practice • Making Your Decision • Negotiating • Buyer’s Remorse • Using a Recruiting Firm (“Out-house” Vs “In-House Recruiters”)

2. C.V. Do’s and Don’ts • Do include a cover letter • Do personalize the letter • Do use a high quality paper • Include your specialty in the cover letter as well as the C.V.

3. C.V. Do’s and Don’ts • Don’t hand write anything on your C.V. • Don’t cram too much into a small area • No general cover letters (Dear Sir or To whom it may concern) • Don’t FAX unless requested • Don’t include references letters and other credentialing documents

4. With All The Choices Out There, How do I decide Where to Interview? • Decide up front, based on your personality and practice interests: • What type group or practice fits you best? • Small intimate single-specialty group with close relationships • Large group with lots of colleagues to consult with • Multi-specialty group with sub-specialists • Hospital based with lots of “action” • Solo • Academic

5. Consider The Area Before Accepting An Interview • Size of the Community • Amenities • The arts and cultural activities • Recreational possibilities • Professional sports • Quality of the schools • Cost of living

6. Consider The Area Before Accepting An Interview cont'd • Use the internet for your research • Chamber of Commerce • Department of Parks and Recreation • Colleges and Universities • Places Rated Almanac • PracticeLink.com

7. If You are on a Visa… • Do you need an area with HPSA designation? • Call that state’s Department of Health to find out if the site and area qualify • H1B Visa holders, you will probably need to go with a “Reduction in Recruitment” approach • A recent case set precedent, “A physician working in a local area does not qualify for a National Interest Waiver.”

8. If You are on a Visa… Resources • Department of Health for the state you are considering • Immigration Attorneys • Goldblum and Hess, Philadelphia, PA • (215) 885-3600 • Leibl & Kirkwood, Del Mar, CA • (619) 481-5211

9. Up-Front Planning Will Keep You From Spinning Your Wheels

10. Interviewing Techniques • Do your homework about the practice • Ask for a recruitment brochure/video • Check out their web site • Prepare a list of questions prior to the interview • Put them in a nice notebook and take it with you

11. Interviewing Techniques cont’d • The Phone Interview • Will make or break an invitation for an on-site interview • Remember, they can’t see your face. • Be enthusiastic • Be sincere • Use different intonations in your voice

12. Interviewing Techniques cont'd • Dress appropriately and conservatively • Firm handshake • Maintain eye contact • Don’t leave the interview with questions unanswered

13. Your Goal? • Make them want to present you with the offer!

14. Things You Should Want To Know OR “Establishing Mutual Expectations” • Their productivity expectations • Will I have a chance to “ramp up?” • What are the threshold numbers? • Are there incentives for exceeding expectations? • What are the ramifications if I don’t meet expectations

15. Things You Should Want To Know cont'd • Hours expected • Evening hours? • Weekend hours? • Call = ? • Are there any plans for the call to change one way or another? • Mandatory CME requirements? • What is the paid time off for CME? • What is the CME $ allowance?

16. Things You Should Want To Know cont'd • What is included in the benefit package? • Days of vacation time • Number of paid holidays and which ones are they? • Health and Dental ? Cost? • Retirement contribution and vendor(s) used • Is it a matching plan? • Can you contribute additional $ ?

17. Things You Should Want To Know cont'd • Number of sick days? • Long and short term disability? • Is there an option to tax the premium? • Is the coverage “same occupation?” • What type of medical malpractice insurance? • Is tail coverage provided if you leave? • Who pays the premium?

18. Things You Should Want To Know cont'd • Are there any management responsibilities • Who does the hiring /firing • Are there any opportunities for further study? (mini sabbatical) • Tuition assistance? • Research opportunities? • Are there any plans to merge?

19. Things You Should Want To Know cont'd • Does the practice AND area qualify for any state or federal loan forgiveness programs? • If so, do they have a procedure for helping you apply?

20. Ownership, Employment or Association? • If there is ownership...How much is the buy-in? • How long before offered? • Is the amount financed? Over what period of time? • What are the benefits of partnership? • What are yourliabilities as a partner? • Talk to new partners for the straight “scoop”

21. Ownership? cont'd • What has their turnover rate been for the last couple of years? • Any physicians separate right before partnership was offered?

22. What Are Their Philosophies On: • The future of Healthcare • Managed Care • Expansion • Support Services • Information Systems • Mid-Level Providers

23. How Do You Decide? • Keep these fundamentals in mind

24. 5 Key Items To Think About • Make the practice itself the priority decision • 72% of the providers that put geography first (instead of the practice), start looking again within two years • Beware of the “glamour factor”

25. Key Items cont'd • Put chemistry high on your list • The number one reason physicians leave their practice? • Personality conflicts with colleagues. • Is the area able to provide you (and your family) with the things you like to do for fun? • Are you going to be compensated appropriately? • Don’t be pressured into making a decision before you are ready.

26. Negotiating It’s not as bad as it sounds!

27. Please always remember and never forget... don’t start negotiating until you are prepared to accept an offer.

28. To Negotiate Successfully: • Give them your wish list in its entirety • Don’t keep coming back with additional demands • Make sure your wants are reasonable and doable • You don’t want to come off as a shyster • In order to get something, you have to give something • In other words, you say to them, ”If you do this, I’ll accept your offer”

29. Contracts… “Oh Noooo!” • Is it a contract or a letter of offer? • Is there a specified period of time or term of agreement?

30. Contracts… cont'd • First… Look over the contract yourself, BUT... • Don’t pretend to be a contract attorney • You’ll know if you need a contract attorney • Remember though… • They don’t make much money unless they find things to change!

31. Contracts… cont'd • Termination clause? • Under what circumstances • With or without cause? • Do they define cause?

32. Contracts… cont'd • Is there a restrictive covenant? • If so, for what length of time and what is the geographic distance • Are there provisions for buying out the restrictive covenant? • Is your state a “right to work state?”

33. Contracts… cont'd • Is there an expiration date on the contract or offer letter? • If so, and you are using an attorney, MAKE SURE YOUR LAWYER KNOWS THE TIME FRAME !

34. After you accept an offer, expect some buyer’s remorse It’s natural, but... Don’t fall into the trap of continuing to look at practices.

35. Recruitment Firms... Pro’s and Con’s • Pro - They can do a lot of legwork for you • Pro - They can be effective negotiators on your behalf • Con - The fee attached to you makes you less attractive to potential employers • Con - They will relentlessly pressure you for a decision • Con - Their main focus is the money and do not really have your best interests at heart

36. Out-House Vs In-House Recruiters Out-House recruiters work for search firms In-House Recruiters are employed by the health system doing the recruiting

37. ASPR Association of staff physician recruiters 500 professionals dedicated to recruiting physicians for their health systems Hospitals Group practices IDS’s Private practices HMO’s Academic health centers State programs

38. ASPR Members Are Employed by the Health Care Facility Recruiting the Physician! • Their number one priority is to fill their vacancies with the very best match possible • Physician retention is in their job description • Members in nearly every state • Check out their web-site at www.aspr.org