First Rheumatology Job

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vivella

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Hey guys! I am a current rheum fellow and is actively looking for my first job after training. I have been offered a position at a large multi-specialty group in town but I would be the only rheumatologist there. Ideally, I would like to work with other rheumatologist starting out but given this is the first offer I have at a location I want to be in I am seriously considering it. Have any of you guys have experienced working as the only rheumatologist in a group? Any advice for things I should look out there when talking to them? Thanks so much for your help.

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I am very interested to know the measures you need to go by for the first job out of training?
 
Being a solo rheumatologist as your first job would be tough, but obviously you wouldn't be the first to do it. Rheumatology in particular is a specialty where it is as much "art" as science... there are many different ways to approach a particular complaint or problem and you can't always rely on guidelines to tell you what to do. In that sense I do think having more experienced colleagues who are approachable and interested in your professional development is a major plus. However, if you have a good relationship with fellowship attendings or other rheumatologists elsewhere, they can be your "virtual" colleagues to bounce things off periodically. I still text my co-fellows and fellowship attendings pretty regularly to discuss crazy cases, weird drug reactions, etc.

Beyond that, regardless of the specialty mix I think the most important thing in a new job is whether you feel like your colleagues will treat you fairly and as a fellow professional, or whether to them you are just an RVU generator that they can get rid of and replace if you don't behave. Obviously to some extent you can't know this ahead of time, but if you get weird feelings before you join the group I would pay attention to that. It's easier to back out in the first place than it is to get in a bad situation where you are being treated poorly and are unhappy. Partnership opportunities are important to know about.

In my opinion
if there is no chance of partnership at all, I would be very reluctant to take such a job because you will never have any say in your practice or your future. You will always be subject to the whims and desires of either the established partners who extract revenue from your work to pay themselves a profit share, or the administrators of the group/practice who may not even be physicians and just look at numbers in a spreadsheet and tell you what to do without any knowledge of what it takes to be a good rheumatologist or deliver appropriate care to our patients.
 
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I am starting an early search for jobs and I am mostly using practicelink and doc cafe but I wonder if there are other resources to utilize in my search and so far what I am looking for is:
A single specialty practice
A friendly work environment hopefully
A 4 days schedule preferably

But I have no idea about how to interpret RVU/what I should look for regarding pharmacy and preauthorization process/ I am also training and we do have MSK radiologists who are very easy to get hold of but not sure how this works in the private world/what I should negotiate in terms of vacation and pay?

Please throw any ideas that helped you choose the best fit for your first job?
 
I am starting an early search for jobs and I am mostly using practicelink and doc cafe but I wonder if there are other resources to utilize in my search and so far what I am looking for is:
A single specialty practice
A friendly work environment hopefully
A 4 days schedule preferably

But I have no idea about how to interpret RVU/what I should look for regarding pharmacy and preauthorization process/ I am also training and we do have MSK radiologists who are very easy to get hold of but not sure how this works in the private world/what I should negotiate in terms of vacation and pay?

Please throw any ideas that helped you choose the best fit for your first job?
In terms of finding job offers....you should "cold call" (call offices in the area you would like to live) and ask if they may be interested in hiring a new associate when you're done with your training. In the allergy/immunology world...."cold calling" is standard protocol for job searches. You'll find the number of practices interested in hiring a new associate quite surprising (at least I did).
 
In terms of finding job offers....you should "cold call" (call offices in the area you would like to live) and ask if they may be interested in hiring a new associate when you're done with your training. In the allergy/immunology world...."cold calling" is standard protocol for job searches. You'll find the number of practices interested in hiring a new associate quite surprising (at least I did).


When you cold call, do you talk to the receptionist or ask to talk to one of the doctors? Who do you ask for the job? And do you tell them your qualifications and selling points over the phone?
 
When you cold call, do you talk to the receptionist or ask to talk to one of the doctors? Who do you ask for the job? And do you tell them your qualifications and selling points over the phone?
the physician recruiter...if you get the receptionist, then ask for the physician recruiter or practice manager.
 
When you call a practice ask for the office manager (if there is none, then try to speak to physician or even receptionist). Introduce yourself to them (2 sentences) and that you’re contacting practices in the area for positions. Often the practice manager will know if they are like looking or not. Then I always ask for an email (office manager, physicians, or even secretary) to send my CV so the physician(s) can look it over. Even if physicians are not looking they will often call you back and share advice, know of practices looking etc.
 
I would avoid talking to physician recruiters. The exception being a physician recruiter employed by a medical center (ie Dartmouth Medical Center in NH). Physician recruiters looking to fill positions at multiple locations serve a different purpose. During my hospitalist search I found using a physician recruiter delayed my start date significantly (8 months vs 1 month), often had significantly lower pay (close to half the pay) and one recruiter claimed I used him to find a job, when in actuality I called the hospital directly to get the position, for a position I had taken in the past. Maybe I had a bad experience.
 
I would avoid talking to physician recruiters. The exception being a physician recruiter employed by a medical center (ie Dartmouth Medical Center in NH). Physician recruiters looking to fill positions at multiple locations serve a different purpose. During my hospitalist search I found using a physician recruiter delayed my start date significantly (8 months vs 1 month), often had significantly lower pay (close to half the pay) and one recruiter claimed I used him to find a job, when in actuality I called the hospital directly to get the position, for a position I had taken in the past. Maybe I had a bad experience.
i wasn't talking about employees of a company trying to find a position (don't talk to them at ALL)...i was talking about the in-house recruiter for hospitals or large group practices...sorry thought that was implied in the fact that the OP is cold calling practices not placement companies...otherwise its usually the practice manager that handles physician recruitment.

I really don't see what a receptionist is going to do with your CV.
 
i wasn't talking about employees of a company trying to find a position (don't talk to them at ALL)...i was talking about the in-house recruiter for hospitals or large group practices...sorry thought that was implied in the fact that the OP is cold calling practices not placement companies...otherwise its usually the practice manager that handles physician recruitment.

I really don't see what a receptionist is going to do with your CV.

No worries. I wanted to drive the point home, because a lot of residents/fellows do not know there is a difference between a physician recruiter affiliated with a medical center versus one that is not.

In regards to allergy/immunology, private practices receptionist often have a good pulse on the practice, especially if there is no office manager (ie are married to the owning physician, etc.). Secretaries/receptionist may be helpful and they forward your CV to the owner (if you’re nice to them).

I hope this makes sense in my sleep deprived stare. I only have one more hospitalist shift tonight to complete my 36 hour weekend at the Cleveland Clinic.
 
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