Announcement

Collapse
No announcement yet.

Private Practice Interview: First meeting etiquette

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Sid16
    replied
    Very true. That is my concern too...autonomy sounds good but I'm wary of unlimited responsibility. It's Endocrinology, there are a few solo docs and few group practices in the area. Most jobs are hospital employed. I'm planning to interview for both PP and hospital employed positions. Will keep you all posted.

    Thank you for the suggestions.

    Leave a comment:


  • beagler
    replied
    What specialty is this? Are there other solo docs in the area? How high is hospital system based employment? Solo docs are like dinosaurs around here.

    In my area, most specialists and primary care are hospital employed. Most of the new attendings are looking to be simple employees with guaranteed first year salary, vacation and hours.

    My guess is there's not a lot of interest in taking over a solo practice. Gives you leverage.

    There are pros and cons to solo practice - unlimited autonomy and unlimited responsibility. You don't have to put up with administration, but you have little leverage with insurance companies.  For the right person, it's great! For the wrong person, it can be a headache.

    Leave a comment:


  • Hatton
    replied










    In my mind it is most important to discuss the clinical aspects of the job and the practice philosophy first to see if that is a fit.  There is no point in discussing compensation and paid time off if you are not a match in terms of practice style and philosophy.  When we are interviewing candidates for our group, it is a huge turn off when the first question asked is about pay.  It is way more important that the practice style is a good fit.  Who cares if the compensation package is good if you are going to be miserable practicing with someone who has a different practice philosophy.

    A doc in our group recently left for a slightly better pay package elsewhere.  After a few short months, she was right back to us asking for her old job back.  She says she loves the way our group emphasizes patient care as our first priority, and that we focus on our collective success as a group, on working together, on supporting one another, on creating a culture of caring for patients and for colleagues.  The daily satisfaction I get by working with a group that shares my practice philosophy is worth so much more than a couple of extra bucks.  Everyone in our group is very highly compensated anyway.  That is a given.
    Click to expand…


    It shouldnt be, this is business. That idea overall, is pretty dumb. If you’re pay is 10% of standard, I dont care what your practice model or philosophy is, Im not taking your job. Pretending it isnt near the unanimous number one priority for everyone is a huge mistake. There are thresholds where you wont work at the best places if they dont pay enough and where you’d work for the devil if pay was enough.

    Obviously, you’re not talking about such a discrepancy, but you have to realize how important it is and the pressure a recent grad may be feeling (real or imagined). Every position says they have as great environment and its impossible to tell what bs and whats true until you’ve done it a while. Its a great idea but very difficult to know in advance.

    Its just a typical doctor attitude that isnt representative of the rest of the working world, and everyone should be less sensitive about it. Its really a continuation of the taboo to talk about money as a physician mindset that has hampered so many. Playing coy and acting as if anyone is truly hearing, understanding, or caring at all about your practice pitch without a hint of pay/benefits is just kidding themselves.

    Now, you’re practice and philosophy sound great, and was caricaturized for example purposes only.

    If you can suffer through residency you can suffer through a bad culture if the pay is significantly better. Stack it up and move on.
    Click to expand…


    Zaphod, I am talking about small differences in pay.  Our practice likely pays around the 65th to 75th percentile for our area and specialty.  But in my opinion we really do have a better culture than 90% of the practices out there.  Is it worth it to join a toxic practice for 5% more pay?  I don’t think so.  Being happy with your group and your colleagues is way more important than a small difference in pay.
    Click to expand...


    The culture is important.  I left the first practice I joined because of a toxic culture.  Almost a cult.  I took a 50% pay cut to move back to my home town.  I was able to establish myself and then left to start my own practice.  I ended up making twice what I was making in the toxic practice.  If you find yourself dreading Monday starting on Sunday afternoon then your practice is toxic.

    Leave a comment:


  • Zaphod
    replied










    In my mind it is most important to discuss the clinical aspects of the job and the practice philosophy first to see if that is a fit.  There is no point in discussing compensation and paid time off if you are not a match in terms of practice style and philosophy.  When we are interviewing candidates for our group, it is a huge turn off when the first question asked is about pay.  It is way more important that the practice style is a good fit.  Who cares if the compensation package is good if you are going to be miserable practicing with someone who has a different practice philosophy.

    A doc in our group recently left for a slightly better pay package elsewhere.  After a few short months, she was right back to us asking for her old job back.  She says she loves the way our group emphasizes patient care as our first priority, and that we focus on our collective success as a group, on working together, on supporting one another, on creating a culture of caring for patients and for colleagues.  The daily satisfaction I get by working with a group that shares my practice philosophy is worth so much more than a couple of extra bucks.  Everyone in our group is very highly compensated anyway.  That is a given.
    Click to expand…


    It shouldnt be, this is business. That idea overall, is pretty dumb. If you’re pay is 10% of standard, I dont care what your practice model or philosophy is, Im not taking your job. Pretending it isnt near the unanimous number one priority for everyone is a huge mistake. There are thresholds where you wont work at the best places if they dont pay enough and where you’d work for the devil if pay was enough.

    Obviously, you’re not talking about such a discrepancy, but you have to realize how important it is and the pressure a recent grad may be feeling (real or imagined). Every position says they have as great environment and its impossible to tell what bs and whats true until you’ve done it a while. Its a great idea but very difficult to know in advance.

    Its just a typical doctor attitude that isnt representative of the rest of the working world, and everyone should be less sensitive about it. Its really a continuation of the taboo to talk about money as a physician mindset that has hampered so many. Playing coy and acting as if anyone is truly hearing, understanding, or caring at all about your practice pitch without a hint of pay/benefits is just kidding themselves.

    Now, you’re practice and philosophy sound great, and was caricaturized for example purposes only.

    If you can suffer through residency you can suffer through a bad culture if the pay is significantly better. Stack it up and move on.
    Click to expand…


    Zaphod, I am talking about small differences in pay.  Our practice likely pays around the 65th to 75th percentile for our area and specialty.  But in my opinion we really do have a better culture than 90% of the practices out there.  Is it worth it to join a toxic practice for 5% more pay?  I don’t think so.  Being happy with your group and your colleagues is way more important than a small difference in pay.
    Click to expand...


    Yes, I know, and your practice does sound nice. However, many are not that open, and all of them, all of them are convinced they are the best and some frankly lie. In some specialties with single docs you may not have the luxury of interviewing with other docs. Also, new grads are pretty naive, I know I was.

    Leave a comment:


  • White.Beard.Doc
    replied
    When we interview new docs, we have them meet separately with leadership, with mid-career physicians, with young physicians and with administrative staff.  They get to hear the perspective of many different members of the group in office interviews, walking around to see the facilities, and then over lunch.  By meeting with lots of different folks at different stages of their careers, the applicants get to hear varied opinions and perspectives.  We also invite them to come spend some time working with another physician for an extended visit.

    These types of experiences allow for a deeper perspective of the practice environment.  It is one thing for the boss to say there is a great practice environment, but when you get to discuss the practice with a whole range of docs in private, plus you get to spend time with docs doing their work before joining the group, you can get a better sense of what the practice is really like.

    Every practice has struggles.  How open, direct, and honest are they when you ask about the challenges and struggles faced by the practice?

    Leave a comment:


  • White.Beard.Doc
    replied







    In my mind it is most important to discuss the clinical aspects of the job and the practice philosophy first to see if that is a fit.  There is no point in discussing compensation and paid time off if you are not a match in terms of practice style and philosophy.  When we are interviewing candidates for our group, it is a huge turn off when the first question asked is about pay.  It is way more important that the practice style is a good fit.  Who cares if the compensation package is good if you are going to be miserable practicing with someone who has a different practice philosophy.

    A doc in our group recently left for a slightly better pay package elsewhere.  After a few short months, she was right back to us asking for her old job back.  She says she loves the way our group emphasizes patient care as our first priority, and that we focus on our collective success as a group, on working together, on supporting one another, on creating a culture of caring for patients and for colleagues.  The daily satisfaction I get by working with a group that shares my practice philosophy is worth so much more than a couple of extra bucks.  Everyone in our group is very highly compensated anyway.  That is a given.
    Click to expand…


    It shouldnt be, this is business. That idea overall, is pretty dumb. If you’re pay is 10% of standard, I dont care what your practice model or philosophy is, Im not taking your job. Pretending it isnt near the unanimous number one priority for everyone is a huge mistake. There are thresholds where you wont work at the best places if they dont pay enough and where you’d work for the devil if pay was enough.

    Obviously, you’re not talking about such a discrepancy, but you have to realize how important it is and the pressure a recent grad may be feeling (real or imagined). Every position says they have as great environment and its impossible to tell what bs and whats true until you’ve done it a while. Its a great idea but very difficult to know in advance.

    Its just a typical doctor attitude that isnt representative of the rest of the working world, and everyone should be less sensitive about it. Its really a continuation of the taboo to talk about money as a physician mindset that has hampered so many. Playing coy and acting as if anyone is truly hearing, understanding, or caring at all about your practice pitch without a hint of pay/benefits is just kidding themselves.

    Now, you’re practice and philosophy sound great, and was caricaturized for example purposes only.

    If you can suffer through residency you can suffer through a bad culture if the pay is significantly better. Stack it up and move on.
    Click to expand...


    Zaphod, I am talking about small differences in pay.  Our practice likely pays around the 65th to 75th percentile for our area and specialty.  But in my opinion we really do have a better culture than 90% of the practices out there.  Is it worth it to join a toxic practice for 5% more pay?  I don't think so.  Being happy with your group and your colleagues is way more important than a small difference in pay.

    Leave a comment:


  • VagabondMD
    replied




    Thank you Vagabond. That is a very good question. He has been trying to recruit for quite some time. I know one other person who did not take up the offer and chose a hospital employed position. There was another physician who almost signed the contract but instead chose a part time job in an academic setting. He is quite desperate as he wants someone to join him ASAP so he could devote 50% of his time to another profitable venture. At the same time, I feel this may be a good fit for me. I don’t have the motivation to start solo practice, am tired of hospital employed positions( have previous work experience as a hospital employee prior to fellowship) and find the idea of building a practice, becoming a partner exciting.

     
    Click to expand...


    In that case, break out the Trivial Pursuit board.

    He needs you more than you need this job. You can ask what you want and demand what you need. It sounds like his offer is too low if you need to take a pay cut AND leave an academic job (!!!).

    Leave a comment:


  • Hatton
    replied
    I think you just need to check it out. You don’t mention what type of practice we are talking about but I am thinking internist or fp.  You need to see if you like him and the PA.  Do you like the facility. What about the call schedule.  If all these are positive then you ask about money and benefits.  Then you look at the books.  Those are my thoughts.

    Leave a comment:


  • Zaphod
    replied




    In my mind it is most important to discuss the clinical aspects of the job and the practice philosophy first to see if that is a fit.  There is no point in discussing compensation and paid time off if you are not a match in terms of practice style and philosophy.  When we are interviewing candidates for our group, it is a huge turn off when the first question asked is about pay.  It is way more important that the practice style is a good fit.  Who cares if the compensation package is good if you are going to be miserable practicing with someone who has a different practice philosophy.

    A doc in our group recently left for a slightly better pay package elsewhere.  After a few short months, she was right back to us asking for her old job back.  She says she loves the way our group emphasizes patient care as our first priority, and that we focus on our collective success as a group, on working together, on supporting one another, on creating a culture of caring for patients and for colleagues.  The daily satisfaction I get by working with a group that shares my practice philosophy is worth so much more than a couple of extra bucks.  Everyone in our group is very highly compensated anyway.  That is a given.
    Click to expand...


    It shouldnt be, this is business. That idea overall, is pretty dumb. If you're pay is 10% of standard, I dont care what your practice model or philosophy is, Im not taking your job. Pretending it isnt near the unanimous number one priority for everyone is a huge mistake. There are thresholds where you wont work at the best places if they dont pay enough and where you'd work for the devil if pay was enough.

    Obviously, you're not talking about such a discrepancy, but you have to realize how important it is and the pressure a recent grad may be feeling (real or imagined). Every position says they have as great environment and its impossible to tell what bs and whats true until you've done it a while. Its a great idea but very difficult to know in advance.

    Its just a typical doctor attitude that isnt representative of the rest of the working world, and everyone should be less sensitive about it. Its really a continuation of the taboo to talk about money as a physician mindset that has hampered so many. Playing coy and acting as if anyone is truly hearing, understanding, or caring at all about your practice pitch without a hint of pay/benefits is just kidding themselves.

    Now, you're practice and philosophy sound great, and was caricaturized for example purposes only.

    If you can suffer through residency you can suffer through a bad culture if the pay is significantly better. Stack it up and move on.

    Leave a comment:


  • White.Beard.Doc
    replied
    In my mind it is most important to discuss the clinical aspects of the job and the practice philosophy first to see if that is a fit.  There is no point in discussing compensation and paid time off if you are not a match in terms of practice style and philosophy.  When we are interviewing candidates for our group, it is a huge turn off when the first question asked is about pay.  It is way more important that the practice style is a good fit.  Who cares if the compensation package is good if you are going to be miserable practicing with someone who has a different practice philosophy.

    A doc in our group recently left for a slightly better pay package elsewhere.  After a few short months, she was right back to us asking for her old job back.  She says she loves the way our group emphasizes patient care as our first priority, and that we focus on our collective success as a group, on working together, on supporting one another, on creating a culture of caring for patients and for colleagues.  The daily satisfaction I get by working with a group that shares my practice philosophy is worth so much more than a couple of extra bucks.  Everyone in our group is very highly compensated anyway.  That is a given.

    Leave a comment:


  • Zaphod
    replied
    Why did these others not take the position is my first through ninety nine questions? If hes as desperate as you say nothing is necessarily off the table. In re: to benefits, just realize you can have whatever benefits you want, its all salary in the end. If he agrees to give you cme, that will come off the salary all things considered.

    Leave a comment:


  • q-school
    replied
    Re-tain-er.

    Do you want to be an owner? Does he want to relinquish control? In a two person partnership, especially with a founder who has been sole owner for decades?, it will take some doing to create a balanced relationship.
    Are you ready to do all the work he doesn’t want to do? He wants 50% out but he wants you to do the bad 50%?

    Or he could be the fairest guy in the world.
    Hard to know. What’s his exit plan? Does the pa expect ownership?


    Good luck.

    Leave a comment:


  • Dreamgiver
    replied
    I would also ask him to see the books and, if you do not know what you are looking at, pay someone to examine them.

    Also, I would not mention what you are getting right now. Why put your cards on the table like that?! Salary, vacation, CME, come later.

    Leave a comment:


  • Sid16
    replied
    Thank you Vagabond. That is a very good question. He has been trying to recruit for quite some time. I know one other person who did not take up the offer and chose a hospital employed position. There was another physician who almost signed the contract but instead chose a part time job in an academic setting. He is quite desperate as he wants someone to join him ASAP so he could devote 50% of his time to another profitable venture. At the same time, I feel this may be a good fit for me. I don't have the motivation to start solo practice, am tired of hospital employed positions( have previous work experience as a hospital employee prior to fellowship) and find the idea of building a practice, becoming a partner exciting.

     

    Leave a comment:


  • Sid16
    replied
    Thank you for the advice. My 401 K is vested and I have to give 3 months notice. I can probably negotiate a better pay where I am but we are eager to move to our previous location. It is 3 hours away, a metro with better schools and more job options for my spouse who is not a physician.

    Leave a comment:

Working...
X