Site visits: Are you asking the right questions?

Site visits: Are you asking the right questions?

And are you giving the right answers?

February 2019
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YOU’VE BEEN LOOKING for a new job (or your first out of training), and you’ve done everything by the book, from creating a well-organized CV to talking with potential employers during screening interviews on the phone. But now you’re arranging in-person interviews with prospective employers, and you’re not exactly sure what to expect.

The good news is that if a practice is willing to bring you onsite, you’ve made it more than halfway through the process. But before you pat yourself on the back for a job well-done, you need to prepare.

During a site visit, you’ll meet a lot of people, be asked a ton of questions and be expected to be “on” the entire time. You want to ask good questions yourself, and you don’t want to say the wrong thing or appear to be too pushy. In other words, you want to present your best self.

“The interview day is more like a social litmus test.”

Parti~ Naveen Parti, MD

Here’s an overview of how your onsite interview will likely play out, along with advice to not only impress your future colleagues, but get the information you need to make sure the job is right for you.

A two-day affair
How does the site visit work? While there are many variations, most groups will bring you in for a two- or three-day visit. Practices generally keep visits short for residents and fellows because they know that training programs give them relatively few days off for job interviews.

Naveen Parti, MD, a neuroradiologist in Greenville, S.C., leads the efforts to hire neuroradiologists in his 40-member group. He explains how the recruiting process works in his practice.

When he and his colleagues are recruiting, says Dr. Parti, they receive about 40 CVs. About 10 meet the group’s internal criteria, and Dr. Parti conducts a phone interview with each candidate. He then brings in three or four of the most qualified for a site visit.

“We fly the physician in the day before the interview,” he points out. “We put him or her up at a nice hotel and have dinner the evening before with five or six of the radiologists. The next day, we begin the site visit at about 8 a.m.”

“The size of the practice and its turnover rate are important indicators of how comfortable and happy people are working there.”

Burke~ Matthew T. Burke, MD
MedStar Health

The visit starts with coffee and a chance to “sit down for a half hour or so,” Dr. Parti says. “Candidates will meet every neuroradiologist who’s here that day.” Lunch runs from noon until 1 in the doctors’ dining room, so “candidates have a chance to meet physicians from other specialties besides radiology in a casual setting.”

The afternoon usually includes a meeting with the president of the group, who goes over the nuts and bolts of the practice, including details about the employment track. The day is usually done by 3 p.m. or so, giving the physician time to travel home.

Other groups have a three-day plan instead. Another common model is to bring physicians in late Thursday, have a site visit and dinner on Friday, then breakfast with physicians on Saturday and a community tour. Physicians leave Saturday afternoon.

Are you a good fit?
During phone interviews, you’ll probably be asked a lot of questions about your education and training. Once onsite, however, expect the conversation to focus more on you as a person.

“If you make the cut for the interview, we know you can do the job,” says Dr. Parti. “The interview day is more like a social litmus test: Would you fit in with our group culture? Are you someone we want to work with and sit next to for the next 20 years?”

That sentiment is echoed by other physicians and recruiters, who say that the purpose of the site visit is to give the group and physicians a chance to get to know one another—and size each other up.

Rick Novak, regional vice president of recruiting for the physician staffing firm Merritt Hawkins, says that because the social components of the site visit are so important, he doesn’t even think of it as an interview. “It’s personal time to sit down with these people and see if you can spend the next phase of your life and career with them.”

Dr. Parti echoes that sentiment; for him, the people aspect of the visit is critical. “I’m in a radiology practice of 40 people, and we have five neuroradiologists,” Dr. Parti says. “Those five physicians are going to have the most input when we hire a neuro person. The decision really is based more on the small group that you’re looking to join, so those interactions are important.”

Get specifics
During a site visit, remember that you’re not the only one being judged. Use your visit as an opportunity to gather the information you need about the practice.

“The interview allows you to see potential colleagues in their natural environment,” Mr. Novak explains. “I always remind physicians that they are interviewing the practice as much as the practice is interviewing them.”

That includes arriving armed with questions. “Too often,” Mr. Novak says, “doctors clam up during the interview. I see physicians come in asking, ‘Where do you want me to sign?’ When you’re sitting across the table from your future boss, your future employer, be prepared to ask questions.”

It helps to have questions you really want answered. One good strategy is to ask very specific questions about the group or practice you’re interviewing with. Matthew T. Burke, MD, a family physician who works as an urgent care physician with MedStar Health in Washington, gives some examples of the specifics he asks when talking to urgent care centers.

“In urgent care, you want to be especially attentive to onsite capabilities, whether it’s labs or medications,” say Dr. Burke, who recently served on the board of the American Academy of Family Physicians. “You also want to pay close attention to referral services and networks. You need to know that your handoff to dermatology or orthopedics or the ER by ambulance is going to go smoothly and that you’ll be connected to these people.”

Dr. Burke worked at one urgent care clinic that was part of a huge hospital system, which made finding follow-up care for patients relatively easy.

“We had a massive internal network of providers we could refer to,” he notes. “But if you work for a standalone private urgent care clinic, referral patterns might be a little more challenging.”

Lifestyle concerns
Dr. Burke also has a list of basic questions he asks at every practice he interviews with. “The size of the practice and its turnover rate are important indicators of how comfortable and happy people are working there,” he says. “It’s also important to ask for a call schedule and frequency of calls, and what is expected of you after hours.”

As for electronic health records, he adds, “ask how the practice’s systems are integrated with those of local hospitals, and how easy it is to get admitting information from those hospitals. Is everyone on the same EHR so you can follow your patients and provide good continuity of care?”

Be aware, however, that not all questions are created equal. Dr. Parti recalls one physician who asked the president of his group if everyone was finished work by 5 o’clock. That candidate didn’t receive a job offer.

“You can shoot yourself in the foot if you ask the wrong questions,” he says, “so be careful what you do and don’t say. You don’t want to say anything that implies you don’t have a good work ethic or that you’re more interested in vacation and money than doing quality work and being a team player.”

While younger physicians are known for being focused on lifestyle, remember that older generations don’t necessarily see the world that way.

“Millennials need to be a little careful because they’re so lifestyle-oriented,” says Dr. Parti. “But the people doing the interviewing usually are not millennials, so they have different expectations.”

One way to bridge that generation gap, he adds, is to find a younger physician in the practice you’re visiting. “They’re closer to your age,” he explains, “so can relate to being in your shoes. They’re also more likely to shoot straight with you.”

Tough questions
If you think that asking a specific question might make you look rude or pushy, consider other options. Instead of bluntly asking about a group’s quitting time, for instance, ask how physicians enter patient information into the group’s electronic medical record. That advice comes from Jamie Thomas, executive vice president of recruiting for The Medicus Firm, a physician staffing company.

“Everyone has an EHR,” Mr. Thomas says, “and some are more challenging than others. It’s not realistic for residents to know whether that EHR is going to be easy or difficult to work with unless they’ve worked with that system before, so asking about the EHR is reasonable.”

He suggests something like, ” ‘At the end of your day seeing patients, how long does it take you to complete your charts?’ You don’t directly say, ‘I don’t want to be here until 7:00.’ But you still are getting information about when peoples’ days typically end.

Dr. Burke offers similar advice. “There is always an opportunity to ask challenging questions,” he says, “but if stated respectfully and professionally, you can get at things. I think wordsmithing can be important, so if you’re having lunch or interviewing with someone who is a peer-level colleague, personal questions are often a good place to start.”

Ask those physicians, for instance, what drew them to that specific practice, and what has their experience with the practice been, Dr. Burke says. “Asking about an individual’s attraction to a practice and what keeps them working there is a great ice-breaker.”

Once the conversation is going and everyone is relaxed, he adds, ask for more specifics. “A great way to get at a challenging question,” he explains, “is to ask what challenges they see for the practice in the next several years. That will sometimes reveal interesting information about finances, infrastructure, outreach or clinical quality improvement programs. All practices have things they’re proud of and things they’re working on.”

Once you’ve developed some rapport, “ask about what group members would like to see the practice tackle,” Dr. Burke says. “That’s a great way to get information—and if you can ask multiple people, you’ll get a clear sense of the strengths and weaknesses of a particular practice.”

Edward Doyle is Editor of Today’s Physician.

 

Look for these red flags during your site visit
WHAT KINDS of red flags should you look for during an onsite interview?

“Some practices operate like a turnstyle where they hire associates and don’t offer them partnerships,” says Naveen Parti, MD, a neuroradiologist in Greenville, S.C. “It’s lucrative for the physicians at the top, but they’re paying their colleagues less, so they don’t want them to become partners. You see that more in big cities where residencies are churning out labor and there’s a large pool of physicians.”

According to Dr. Parti, these groups usually keep nonpartner physicians in the dark. “There are a lot of groups where associates don’t get to go to partner meetings,” he says, “so they don’t really know what’s happening. They don’t see the numbers or what people are making. That would be a red flag if I were looking for a job.”

Jamie Thomas, executive vice president of recruiting for The Medicus Firm, a physician staffing company, urges physicians to keep an eye out for “anything that is not consistent with the message that you’ve heard throughout the process, from patient volume to physicians’ interaction with the administration. Physicians and administrators may seem unified during phone interviews, but once you arrive onsite, that can change.”

Mr. Thomas gives the following example: “You’re told, ‘We are going to pay you $250,000 plus during your first year as you grow this practice, and here’s how you can grow this practice.’ But during the site visit, you start talking to physicians, and they tell you, ‘I’m not making that much money myself and I’ve been here three years.’ That’s an inconsistency that needs to be addressed.”

Some questions you need to ask

• What are rounding schedules, if appropriate?
• What’s the call schedule, and what has the call schedule been for the past year?
• What are your types of patients and procedures, if appropriate?
• What is per-day volume?
• What’s the employer’s background and practice style?
• What’s the turnover rate, and why?
• What are practice and community issues and/or controversies?
• What new services is the practice thinking of adding?
• How is access to specialists?
• How often are practice or group meetings held?What are advancement opportunities?
• Are there opportunities for part-time work as, say, a moonlighter in local hospitals?

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