Job Hunt, Agencies, and headhunters

[DocEspana]

so I'm beginning my job hunt in earnest. And I've realized a few things.

1) headhunters in the type I'd get contacting me from places like practice link all seem to be serving hospitals way out of the way from any civilization and in 'ancillary' sites which seem desperate for a residency trained EM person to replace their FM/IM peeps.
2) I have very specific preferences. In this case its that I want to be within 1 hour of the ocean in a swath of states along the southern atlantic coast or the gulf coast. So basically the band of coastline from Corpus Christi Texas to somewhere in North Carolina. And this means that while I have many many many choices, working with a recruiter for a specific state is a pain in the ass since they represent the state and i want only the eastern edge or southern edge of their state.
3) Groups like Resolve know how to sell themself damn well as the group that will get you the job you want, but they want that $$$ from you. 1K upfront 7.5K after you are working.
4) I could do the work the agencies are doing (calling every hospital under the sun that meets my preferences. Arranging all my interviews. Filtering my responses. negotiating my contract) for free, but there is a pretty significant time cost unless I strike it lucky with one of my first few e-mail requests of "do you have a job opening for july/augst 2017"

Has anyone any thoughts on how to do the job hunt if I do have sort of a strong regional preference that spans so many states - as I do? And any thoughts on physician job agencies for EM in general, and perhaps any particular thoughts on specific companies over others? Resolve seems to be the go-to agency for specialists with unique demands for their job, but maybe I'm only thinking that because their advertisement department (including at conferences I attend) is very good.

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[deleted109597]

You can make a list of cities.
Then, cross reference it with all the major CMGs. They're hiring at almost every single site currently, so you're unlikely to miss, say, an EmCare shop on their want ads.
Then google map to see if there's any hospitals missed that might have unicorns (SDGs that aren't malignant).
I've found using google goggles to search the pictures of the "this charming town 74 hours by space shuttle from a D3 college town" is actually pretty good at finding the cities, ~75% successful.
Post in the "jobs" thread that was created and see if anyone knows something about said towns.
Or, take a job, work for a year, be active in whatever state college of EP exists, and learn about all the shops in your state. I recommend renting if you go this route.

 

[Angry Birds]

I think googling hospitals and cold calling is best route. It cuts out the middleman.

 

[canigetawhatwhat]

I found my job on PracticeLink. Democratic private group.

Every hospital website has a "For physicians..." Section where you can apply for a job or get the email of someone who can help you apply.

Its honestly not hard to find a job as an EM trained doc unless you are going to a saturated market.

 

[emergentmd]

so I'm beginning my job hunt in earnest. And I've realized a few things.

1) headhunters in the type I'd get contacting me from places like practice link all seem to be serving hospitals way out of the way from any civilization and in 'ancillary' sites which seem desperate for a residency trained EM person to replace their FM/IM peeps.
2) I have very specific preferences. In this case its that I want to be within 1 hour of the ocean in a swath of states along the southern atlantic coast or the gulf coast. So basically the band of coastline from Corpus Christi Texas to somewhere in North Carolina. And this means that while I have many many many choices, working with a recruiter for a specific state is a pain in the ass since they represent the state and i want only the eastern edge or southern edge of their state.
3) Groups like Resolve know how to sell themself damn well as the group that will get you the job you want, but they want that $$$ from you. 1K upfront 7.5K after you are working.
4) I could do the work the agencies are doing (calling every hospital under the sun that meets my preferences. Arranging all my interviews. Filtering my responses. negotiating my contract) for free, but there is a pretty significant time cost unless I strike it lucky with one of my first few e-mail requests of "do you have a job opening for july/augst 2017"

Has anyone any thoughts on how to do the job hunt if I do have sort of a strong regional preference that spans so many states - as I do? And any thoughts on physician job agencies for EM in general, and perhaps any particular thoughts on specific companies over others? Resolve seems to be the go-to agency for specialists with unique demands for their job, but maybe I'm only thinking that because their advertisement department (including at conferences I attend) is very good.

If you have to pay anyone money to find you an EM job today means you either are too lazy to do alittle work or like to waste money.

Seriously, its not that difficult. Hiring a headhunter means that you are wasting money. If you really need a job soon, find a job with a CMG near the ocean which should be quite easy. Sign a 90 day termination contract, and then you can take your time finding your perfect job.

 

[DocEspana]

If you have to pay anyone money to find you an EM job today means you either are too lazy to do alittle work or like to waste money.

Seriously, its not that difficult. Hiring a headhunter means that you are wasting money. If you really need a job soon, find a job with a CMG near the ocean which should be quite easy. Sign a 90 day termination contract, and then you can take your time finding your perfect job.

That may be a good way to do it

 

[Arcan57]

You don't lose anything going through a CMGs recruiter since the cost is already figured into the overhead of the CMG. Depending on the CMG, your area of preference may run through different groups (for TH it would be mid-South, and Southeast I believe) so you may be dealing with 2-3 different recruiters per CMG to cover your entire area. I would suggest that you work on narrowing down your preferences somewhat since you're going to have more options than you have resources to investigate. Western/Northern gulf coast, western Florida below the panhandle, eastern Florida, and SC/NC are all pretty different areas. Why not try for your ideal spot and then broaden out if you're not finding the options you're looking for?

 

[dchristismi]

Or you post here specifically about where you're looking and see what we know. Asking residency buddies from a year or two prior also help if you're in the same geographic area.

EM is a very small world, and networking is the best way to find your ideal gig. And it may not be the first, or second, or third gig.

 

[DocEspana]

Or you post here specifically about where you're looking and see what we know. Asking residency buddies from a year or two prior also help if you're in the same geographic area.

EM is a very small world, and networking is the best way to find your ideal gig. And it may not be the first, or second, or third gig.

Specifically? Looking for places near or in Wilmington NC, Myrtle Beach SC, Charleston SC, Savannah GA, Tampa FL, Pensacola or Destin FL, Mobile AL, Biloxi MS, New Orleans LA, Houston/Beaumont/Galveston TX.

Preference being for mid-size level II type centers. I trained with plenty of Level I trauma but realize that life is slightly better when the trauma is filtered off by the nearby level I centers rather than when you're in the level I yourself (but I could totally keep doing level I). And might be bored in a total low acuity "hypochondria center of excellence"

Ive tried working with the CMGs a bit and they literally give me multiple recruiters per state since I want water and some proxmity to a city and that means im looking at places hours apart from each other.

 

[TeamZissou]

so I'm beginning my job hunt in earnest. And I've realized a few things.

Wow time flies

 

[deleted109597]

Specifically? Looking at every possible city on the coast

I'll bite.
Wilmington-Small group. They farm you out to Goldsboro and you work in purgatory for 5+ years before you can move to New Hanover. Oh, and there's a VA there if you want to work there. Southport has a "hospital". You can work in Jacksonville NC if you want to see Marines.
Myrtle Beach-lots on the Grand strand, last I checked they're all CMGs
Charleston-If you find a job there, I'm cutting your Achilles and taking it. No, there's not much turnover at the medical school, or at the private shops. Sometimes they hire you on, like Wilmington, and farm you out into rural Dorchester County (I've seen it in the want ads, "work 60 minutes from Charleston!")
You didn't ask, but Hilton Head is hiring (or was), as was Beaufort SC.
Florida and Savannah-not a clue
Mobile-They were trying to start a residency at USA, not sure where they are on that now
Biloxi-If it's anything like the rest of MS, there's plenty of jobs, for good pay
NOLA-no clue
Houston-There's a million jobs. The freestandings have wiped out the supply. Mostly CMGs. Galveston is an EmCare shop, but they're hiring moonlighters right now. I have no earthly idea why you would want to go to Beaumont.

 

[Arcan57]

Specifically? Looking for places near or in Wilmington NC, Myrtle Beach SC, Charleston SC, Savannah GA, Tampa FL, Pensacola or Destin FL, Mobile AL, Biloxi MS, New Orleans LA, Houston/Beaumont/Galveston TX.

Preference being for mid-size level II type centers. I trained with plenty of Level I trauma but realize that life is slightly better when the trauma is filtered off by the nearby level I centers rather than when you're in the level I yourself (but I could totally keep doing level I). And might be bored in a total low acuity "hypochondria center of excellence"

Ive tried working with the CMGs a bit and they literally give me multiple recruiters per state since I want water and some proxmity to a city and that means im looking at places hours apart from each other.

Not sure it's helpful but you're picking some of the most popular cities in those particular states. I think having to deal with multiple recruiters isn't too much to ask given the specificity of your requests.

 

[Hercules]

Specifically? Looking for places near or in Wilmington NC, Myrtle Beach SC, Charleston SC, Savannah GA, Tampa FL, Pensacola or Destin FL, Mobile AL, Biloxi MS, New Orleans LA, Houston/Beaumont/Galveston TX.

Preference being for mid-size level II type centers. I trained with plenty of Level I trauma but realize that life is slightly better when the trauma is filtered off by the nearby level I centers rather than when you're in the level I yourself (but I could totally keep doing level I). And might be bored in a total low acuity "hypochondria center of excellence"

Ive tried working with the CMGs a bit and they literally give me multiple recruiters per state since I want water and some proxmity to a city and that means im looking at places hours apart from each other.

Living in Mobile, I can give you info on this town:
USA- level 1 trauma center in town but volume only ~30k/yr. Academic but no EM residency and not many EM boarded guys. They recently hired a new chairman and he has the goal of starting an EM residency, so I assume they will be aggressively pursuing EM boarded docs.
Providence: 55-60k volume community ED staffed by a CMG. Contract held by ApolloMD without many boarded EM docs currently.
Mobile Infirmary: 50k volume community ED staffed by a CMG. Contract held by TeamHealth without many boarded EM docs currently. Director is EM boarded and looking to add more EM boarded docs. Only hospital with inpatient psych in town, so decent chunk of ED volume is psych (that can be a positive or negative depending on your preference).
Springhill: 55k volume community ED staffed by a SDG that has had the contract for >30yrs. This is my group and we are the unicorn with a leprechaun jockey that isn't supposed to exist. We are a true SDG (everyone has an equal vote and there are no senior partners or double secret bonus pools) with true open books from day one, all EM boarded docs, supportive administration, and top 5% pay. We have a partnership track that lasts two years but even while on the partnership track you are making significantly more than any of the other ED positions in town.

I'm happy to answer any questions either on here or via PM.

 

[RustedFox]

I can give you some Tampa data. PM me. But, it's CMG city.

 

[GeneralVeers]

I had one respond to me via e-mail with "Jackass" when I told him my rate was $400/hr. Some of these people are complete *****s when they don't know how much ED docs are making in some areas.

 

[Old_Mil]

I think you are making a mistake in letting geography play such a large role in your job search.

I did coming out of residency and it was a disaster.

Pick the right job in the state with the right malpractice/reimbursement climate and you can buy a vacation home wherever you want.

 

[Pons Asinorum]

Wow time flies

That was my thought as well. Fun seeing old premed/med posters (just like me) starting to look for jobs as attendings. The world turns.

 

[Cinclus]

I think you are making a mistake in letting geography play such a large role in your job search.

I did coming out of residency and it was a disaster.

Pick the right job in the state with the right malpractice/reimbursement climate and you can buy a vacation home wherever you want.

Sooooo, Texas then? Texas is my plan.

 

[bravotwozero]

Sooooo, Texas then? Texas is my plan.

That's exactly right. You come to Texas, and stay the hell away from Cali.


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[VA Hopeful Dr]

Specifically? Looking for places near or in Wilmington NC, Myrtle Beach SC, Charleston SC, Savannah GA, Tampa FL, Pensacola or Destin FL, Mobile AL, Biloxi MS, New Orleans LA, Houston/Beaumont/Galveston TX.

Preference being for mid-size level II type centers. I trained with plenty of Level I trauma but realize that life is slightly better when the trauma is filtered off by the nearby level I centers rather than when you're in the level I yourself (but I could totally keep doing level I). And might be bored in a total low acuity "hypochondria center of excellence"

Ive tried working with the CMGs a bit and they literally give me multiple recruiters per state since I want water and some proxmity to a city and that means im looking at places hours apart from each other.

McLeod health in Florence, SC. About 1 hour inland from Myrtle Beach area. Good sized hospital, FM residency program but nothing else, level 2 trauma. Florence itself is pretty meh but awful close to lots of beaches. SC is a good malpractice state, still pretty physician friendly overall. Very low cost of living.

 

[GeneralVeers]

That's exactly right. You come to Texas, and stay the hell away from Cali.


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I would add New York, New Jersey, Oregon and Illinois to that list. A combination of taxes and/or malpractice make them bad.

 

[RustedFox]

I would add New York, New Jersey, Oregon and Illinois to that list. A combination of taxes and/or malpractice make them bad.

Add Pennsylvania.

 

[link2swim06]

I had one respond to me via e-mail with "Jackass" when I told him my rate was $400/hr. Some of these people are complete *****s when they don't know how much ED docs are making in some areas.

Are these just locums jobs you are filling temporarily? For a new upcoming grad who can live anywhere in Texas....where do you learn about these jobs. I don't really see any of these on Practice Link or any other job site, but most don't show salary either...

 

[emergentmd]

I had one respond to me via e-mail with "Jackass" when I told him my rate was $400/hr. Some of these people are complete *****s when they don't know how much ED docs are making in some areas.

Ha.... I get the same crap from cold call recruiters. I start with 350/hr if I don't have to drive outside my home city. If I have to drive 1-2 hrs, its 450/hr. If my wife didn't hate me going 3-4 hr drives away, I would be picking up some 5-600/hr gigs. Happy wife is a happy life.

I don't even know why recruiters call offering me 225/hr. The conversation ends quickly after I give them my rate.

 

[GeneralVeers]

Ha.... I get the same crap from cold call recruiters. I start with 350/hr if I don't have to drive outside my home city. If I have to drive 1-2 hrs, its 450/hr. If my wife didn't hate me going 3-4 hr drives away, I would be picking up some 5-600/hr gigs. Happy wife is a happy life.

I don't even know why recruiters call offering me 225/hr. The conversation ends quickly after I give them my rate.

I'm mystified as to what doctors they can find to staff these crappy jobs at low rates. Are there really enough suckers out there to keep them employed?

 

[Psai]

I had one respond to me via e-mail with "Jackass" when I told him my rate was $400/hr. Some of these people are complete *****s when they don't know how much ED docs are making in some areas.

Great way to recruit docs to work

 

[bravotwozero]

Add Pennsylvania.

Yeah Pennsylvania really takes the cake there. The worst malpractice laws in country hands down, and terrible weather to boot!


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[deleted547339]

I'm mystified as to what doctors they can find to staff these crappy jobs at low rates. Are there really enough suckers out there to keep them employed?

Residents. And people who are desperate because they either 1) owe a ton on student loans or 2) spend more than they make.

 

[deleted547339]

I asked for a number (significantly lower than some of the numbers above). The business guy acted all offended and said I had no idea what I was talking about and no ED in the state can support that....except I know how many RVUs an hour I bill. Yes, I know there's a difference between billed and collected and I understand there's overhead, but come on.

 

[Hercules]

I'm mystified as to what doctors they can find to staff these crappy jobs at low rates. Are there really enough suckers out there to keep them employed?

Yes there are. I tell them not to call unless it's at least $500/hr.


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[emergentmd]

Residents. And people who are desperate because they either 1) owe a ton on student loans or 2) spend more than they make.

 

[DokterMom]

When the mechanic at the Mercedes dealership is billed out at $195/hour and many lawyers bill at $300-700/hour, I can't see how headhunters can complain about $350-400 for an EM doc.

 

[DocEspana]

I think you are making a mistake in letting geography play such a large role in your job search.

I did coming out of residency and it was a disaster.

Pick the right job in the state with the right malpractice/reimbursement climate and you can buy a vacation home wherever you want.

the caveat as to why Im letting geography play such a large role is that I have a source of income allowing me to live pretty much anywhere I want in that dream house already. So I'd rather work someplace where every day is a vacation, take 9 months to get that dream house built, move in and then work on building vacation house 2/3/4 in other states while working someplace great to begin with. I dont like the idea of being paid significantly less than what I could be earning (otherwise I'd stay in NY with its crappy incomes), but I dont need to chase the crazy salaries either. I just think a solid >250 per hour is a reasonable amount and then wouldnt mind working.

lesson here: marry filthy stinking rich.

 

[RustedFox]

the caveat as to why Im letting geography play such a large role is that I have a source of income allowing me to live pretty much anywhere I want in that dream house already. So I'd rather work someplace where every day is a vacation, take 9 months to get that dream house built, move in and then work on building vacation house 2/3/4 in other states while working someplace great to begin with. I dont like the idea of being paid significantly less than what I could be earning (otherwise I'd stay in NY with its crappy incomes), but I dont need to chase the crazy salaries either. I just think a solid >250 per hour is a reasonable amount and then wouldnt mind working.

That last sentence, tho.

Lol.

 

[DocEspana]

That last sentence, tho.

Lol.

I couldnt even get that in NYC (or long island, or the hudson valley. and just barely if im lucky in north jersey). I just dont want to feel underpaid. I dont need to be doing above the median.

 

[Old_Mil]

the caveat as to why Im letting geography play such a large role is that I have a source of income allowing me to live pretty much anywhere I want in that dream house already. So I'd rather work someplace where every day is a vacation, take 9 months to get that dream house built, move in and then work on building vacation house 2/3/4

That is great - but I would then add that if you are in such a fortunate place financially a state's malpractice laws will matter much more to you than your average physician just starting out.

Go to Texas.

 

[DocEspana]

That is great - but I would then add that if you are in such a fortunate place financially a state's malpractice laws will matter much more to you than your average physician just starting out.

Go to Texas.

Partner was just in houston and Galveston scouting hospitals along the coast for me. So could happen.

 

[RustedFox]

I couldnt even get that in NYC (or long island, or the hudson valley. and just barely if im lucky in north jersey). I just dont want to feel underpaid. I dont need to be doing above the median.

Enjoy not working, then. Even in the high -paid south... jobs at 250+ are slim to nil. Otherwise, we'd all have two. 200 is more like it.

 

[deleted109597]

Enjoy not working, then. Even in the high -paid south... jobs at 250+ are slim to nil. Otherwise, we'd all have two. 200 is more like it.

I haven't seen a job advertised for less than that in a year. They're offering 300+ in places now. You people need to vote with your feet already.

 

[RustedFox]

I haven't seen a job advertised for less than that in a year. They're offering 300+ in places now. You people need to vote with your feet already.

Nowhere between Tampa and ft.myers will pay you that much.

You, me, and Texas again.

 

[Vandalia]

When the mechanic at the Mercedes dealership is billed out at $195/hour and many lawyers bill at $300-700/hour, I can't see how headhunters can complain about $350-400 for an EM doc.

Disconnect. There is a huge difference between what someone bills and what someone has as take-home pay.

A lawyer billing $300/hr is probably making about $200K/year at most, probably a lot less. There is thing called "overhead", which for a business is generally 100%, which means half your "income" is automatically gone. Then there is the specialized overhead, the LEXIS/NEXIS databases cost a lawyer doing motions practice - the one's billing at the level - about $100,000-$150,000 a year per lawyers.

Plus, there is a glut of lawyers and tremendous competition. I know that we as a hospital simply refuse to accept about 1/2 the hours lawyers try to bill and then demand a 50% cut off whatever is left. Plus, they can't bill for the hours waiting for a client or trying to drum-up business.

PS: Let me make the example the other way around. About a decade ago there was a "letter to the editor" by a crotchety-old retired guy complaining that his physician in the ED billed $500 but only spent 10 minutes talking to him. His comment was "No wonder this country is going broke. Those Docs in the Emergency Room (sic) are making $5,000 an hour and that works out to $10M a year !!!!" The fallacy works the other way around too.

 

[future_dr_house]

I haven't seen a job advertised for less than that in a year. They're offering 300+ in places now. You people need to vote with your feet already.

Yep, my job is RVU based and avg 325/hr. I can't even imagine doing the same job in a worse legal climate for half to two thirds the pay.


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[Janders]

$Bill > $ Collected > $ Taken home

The amount billed versus collected is a magical reduction, based on payor mix, billing skill, and the ridiculous differences in the numbers we ask for and what insurance, uninsured patient, and the feds give us. Amount billed means very little to me.

The difference between $Collected and $Taken home is much more linear, and deals simply with your overhead. Which better not be 50%.

 

[deleted109597]

Nowhere between Tampa and ft.myers will pay you that much.

You, me, and Texas again.

Hence the last 7 words in my statement. You don't have to move to Texas. Mississippi has now outpaced us for salary (PLEASE, EVERYONE MOVE THERE AND DON'T **** UP THE SUPPLY/DEMAND CURVE IN TEXAS)

 

[DocEspana]

Hence the last 7 words in my statement. You don't have to move to Texas. Mississippi has now outpaced us for salary (PLEASE, EVERYONE MOVE THERE AND DON'T **** UP THE SUPPLY/DEMAND CURVE IN TEXAS)

sooo..... biloxi?

 

[Brahnold Bloodaxe]

Guys, you should all bow your heads, close your eyes and take a moment of silence to appreciate the wondrous good fortune you have to be able to work in a time when $200-300/hr is the norm. My friends and I who are in the beginning stages of our medical training are crossing our fingers and praying to almighty Ben Franklin to be able to make even $100-150/hr by the time we finish training. Taking out 250k in debt, today, then having to wait 7 years to see if the money to repay the debt will still be there is like the nuclear fuel of neuroticism.

 

[deleted547339]

Guys, you should all bow your heads, close your eyes and take a moment of silence to appreciate the wondrous good fortune you have to be able to work in a time when $200-300/hr is the norm. My friends and I who are in the beginning stages of our medical training are crossing our fingers and praying to almighty Ben Franklin to be able to make even $100-150/hr by the time we finish training. Taking out 250k in debt, today, then having to wait 7 years to see if the money to repay the debt will still be there is like the nuclear fuel of neuroticism.

Don't take out $250k in debt...that's your first mistake.

 

[Bojack Horseman]

Don't take out $250k in debt...that's your first mistake.

How else are you supposed to pay for medical school? Not everyone has rich parents.


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[Vandalia]

How else are you supposed to pay for medical school? Not everyone has rich parents.


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Uncle Sam will do it and pay you while in medical school at the same time. Contact your military medical recruiter.

 

[old_boy]

Uncle Sam will do it and pay you while in medical school at the same time. Contact your military medical recruiter.

Uncle sam will also ask for year-for-year payback in sweat and if necessary blood. I'm not knocking the military option, and have great respect for those that serve or have served. But you will still owe a debt, just not in dollars.