Questions about Interviewing for a Private Practice Job

[univlad]

I'll finish my fellowship at the end of June and am starting the process of looking for a private practice job. I am curious about what a typical interview is like with a private practice group.

I am assuming that a suit and tie is the expected dress for such an occasion, or since it's a private practice group would I be overdressed?

Also, I've heard that many private groups administer a slide test to their applicants. What types of cases typically show up on these tests?

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[EUA]

+1, but more so would like to hear the kinds of questions you wished you'd asked in the interview, but didn't till it was too late. Also, pitfalls and traps, and red flags beyond the usual like high turnover.

 

[djmd]

I'll finish my fellowship at the end of June and am starting the process of looking for a private practice job. I am curious about what a typical interview is like with a private practice group.

I am assuming that a suit and tie is the expected dress for such an occasion, or since it's a private practice group would I be overdressed?

Also, I've heard that many private groups administer a slide test to their applicants. What types of cases typically show up on these tests?

I would say suit for the most part. You might be overdressed, but it is generally hard to be overdressed for a job interview...

The job sticky has some good info re: questions to ask.

 

[deschutes]

The job sticky has some good info re: questions to ask.

Wow, someone other than the mods invoked the Stickies!

 

[LADoc00]

I'll finish my fellowship at the end of June and am starting the process of looking for a private practice job. I am curious about what a typical interview is like with a private practice group.

I am assuming that a suit and tie is the expected dress for such an occasion, or since it's a private practice group would I be overdressed?

Also, I've heard that many private groups administer a slide test to their applicants. What types of cases typically show up on these tests?

I would go in a suit, only because thats what most old timers expect. You cant really go wrong and you shed your jacket almost immediately anyway.

Slide test sets are rare, when they do occur I consider that a red flag. I would politely take the test, answer any questions asked of me and then leave asap. I wouldnt bother contacting that place again. Personally, Im of the school every interview is a learning experience so I would go even if I knew I wasnt after the job just to gather the info.

I had one place show me a case of an alveolar rhabdomyosarcoma metastatic to skin. The sad thing was I knew for a fact that not a single person in the group knew what the flying fk it was and they had sent it off to an academic center for a massive stain battery and the final dx. But I guess they were showing off they get rare stuff too..idiotic IMO.

Another place showed me a slide of uterine carcinoma with a floater of prostate cancer in it...why? Im not sure, but my reply was that their histology services and grossing protocols stunk of a fresh fudge monkey. They uncomfortably laughed and I left, never returning their calls.

If you act like a ****** as an employer dont expect serious candidates to give you the time of day. I honestly dont give a rat's arse that someone has been in private prac for 30 years...

I have been on exactly 1 ultimate interview, ONE. One interview where the people (pretty much hardcore ex-mil types) actually had a real system that involved an atheletic component (trail run in the rain, 5 miles, was very intense, while being asked questions), lunch, dinner questions and a 2 hour interview session over port, desert wines and cigars that lasted until 1am. I can count on one hand the number of pathologists that could traverse a guantlet like that. Not suprisingly, that was my highest out the door job offer I have ever received.

 

[PathSoccerDude]

LADoc...that interview sounds awesome and I definitely would have been up for the jog/interview and dinner and drinks later...gives me hope that there are some chill path people out there and private practice groups...that definitely sound smore my style...so did you enjoy the cigars lol?

 

[PathSoccerDude]

Oh yeah, and did you take the offer? and if no, why not? This group must of been from the East Coast...

 

[LADoc00]

LADoc...that interview sounds awesome and I definitely would have been up for the jog/interview and dinner and drinks later...gives me hope that there are some chill path people out there and private practice groups...that definitely sound smore my style...so did you enjoy the cigars lol?

The interesting thing was they told me change into jogging gear (they prepared me for this ahead of time of course) but they were still in suits/ties. We get the trail and I thought they were going to run me like a dog and just time me, then these guys whip off their suits and they had these silver and black lycra running suits on underneath like James Bond or some ****. I almost crapped myself, seriously we had Chinese for lunch. I cant fabricate a story that good.

The interview experience was the single best Ive ever had, survived the run, spent a day closely examining their biz model and couldnt find a single major flaw (unprecendented for me) and got the job offer.

No I didnt take it tho, I started my own company, well now I just started another one, so 2. Once companies 1 and 2 are off the ground, company 3 will get flushed out by my legal people (very nontraditional biz model plan for a pathologist, top seeeecret!).

that specific group is actually looking for another person at the moment, but I dont think I know a single guy still in training I would send there.

 

[microdot]

I have been on exactly 1 ultimate interview, ONE. One interview where the people (pretty much hardcore ex-mil types) actually had a real system that involved an atheletic component (trail run in the rain, 5 miles, was very intense, while being asked questions), lunch, dinner questions and a 2 hour interview session over port, desert wines and cigars that lasted until 1am. I can count on one hand the number of pathologists that could traverse a guantlet like that. Not suprisingly, that was my highest out the door job offer I have ever received.

Is there ever a time when your gaming fantasies start meshing with reality?

Since when does interviewing for a pathology group become like joining the Special Forces or the Seals..... Have you been watching James Bond and Die Hard movies and fantasizing again?
We are talking about pathologists...."ex military types" sheesh

 

[Neddy]

Is there ever a time when your gaming fantasies start meshing with reality?

Since when does interviewing for a pathology group become like joining the Special Forces or the Seals..... Have you been watching James Bond and Die Hard movies and fantasizing again?
We are talking about pathologists...."ex military types" sheesh

Sounds like someone is going to flunk the digestif section of the AP boards...

 

[docbiohazard]

...then these guys whip off their suits and they had these silver and black lycra running suits on underneath...

"It's a high-efficiency filter and heat exchange system. Perspiration passes through the first layer and is gathered in the second. The salt is separated. Breathing and walking provide the pumping action. The reclaimed water circulates to catchpockets from which you can drink through this tube at your neck. Urine and feces are processed in the thigh pads. Should you be in the open desert, remember to breathe in through your mouth, out through the nose tubes."



BH

 

[djmd]

"It's a high-efficiency filter and heat exchange system. Perspiration passes through the first layer and is gathered in the second. The salt is separated. Breathing and walking provide the pumping action. The reclaimed water circulates to catchpockets from which you can drink through this tube at your neck. Urine and feces are processed in the thigh pads. Should you be in the open desert, remember to breathe in through your mouth, out through the nose tubes."

I had no idea they had pathologists on Dune... cool.

 

[homealone3]

The interesting thing was they told me change into jogging gear (they prepared me for this ahead of time of course) but they were still in suits/ties. We get the trail and I thought they were going to run me like a dog and just time me, then these guys whip off their suits and they had these silver and black lycra running suits on underneath like James Bond or some ****. I almost crapped myself, seriously we had Chinese for lunch. I cant fabricate a story that good.

These guys sound like total tools! I wouldn't have taken the offer either.

 

[docbiohazard]

I had no idea they had pathologists on Dune... cool.

I keep thinking LAdoc sounds more and more like the Pathology equivilent of the Kwisatz Haderach.

Muad'Dib!
BH

 

[GreatPumpkin]

I
Slide test sets are rare, when they do occur I consider that a red flag. I would politely take the test, answer any questions asked of me and then leave asap. I wouldnt bother contacting that place again. Personally, Im of the school every interview is a learning experience so I would go even if I knew I wasnt after the job just to gather the info.

I consider it a red flag as well. But, I took the one job that gave me a slide test and I love it. So go figure.

In their defense they wanted to see how I handled the pressure and how I talked through the slides, not really if I got them all right or not. I don't really like the method myself and if I am ever managing partner it will stop, but I wouldn't totally disregard a group if they want to see you sweat a little.

I knew by the end of the day it was the group I wanted, they were all just real good people and you could tell. The way they talked to others, the questions they asked, history of the group, etc..

 

[univlad]

I consider it a red flag as well. But, I took the one job that gave me a slide test and I love it. So go figure.

In their defense they wanted to see how I handled the pressure and how I talked through the slides, not really if I got them all right or not. I don't really like the method myself and if I am ever managing partner it will stop, but I wouldn't totally disregard a group if they want to see you sweat a little.

I knew by the end of the day it was the group I wanted, they were all just real good people and you could tell. The way they talked to others, the questions they asked, history of the group, etc..

What is your current job like, GP?

 

[b&ierstiefel]

In their defense they wanted to see how I handled the pressure and how I talked through the slides, not really if I got them all right or not. I don't really like the method myself and if I am ever managing partner it will stop, but I wouldn't totally disregard a group if they want to see you sweat a little.

I heard the same regarding these slide tests...that the thought process and what you would do next is as important as "nailing the diagnosis". Plus, if one shoots from the hip too much coming up with wild diagnoses instead of thinking through the differential, wouldn't that be a red flag from the employer's point of view? Anyways, I also remember hearing one story about how one job applicant said, "I think it could be this but I would send it out for consultation" and that the employer said that he did exactly that. The guy got the job...

 

[GreatPumpkin]

What is your current job like, GP?

Busy, but I love it. Busy is good in private practice.

I really like the people I work with and that is of utmost importance.

We have kind of a rotating schedule. Day one gross, next day on signout, next day on CP/Cyto, next day on 2nd signout (help the signout person). 5th person is off all week. It doesn't always work out so nicely, but that is the jist of it.

Every 5th week off. Every 5th weekend on call. 2 people work a half day on Sat. But, usually signout day and 2nd signout day are short days.

Most of our specimens are GI, Breast and Skin. But, get everything. We do bone marrows pretty frequently and usually have one or two to read everyday.

I am lab director of a smaller sister hospital to the main one and blood bank and chemistry director of the main hospital. I have strong CP background so it has been no problem.

Anything else I missed?

 

[LADoc00]

You DO BM procedures? Ouch. Why...

In the hour it takes me to chat up the patient, get consent, coordinate with nursing, buy the kit, chart my notes, do the actual procedure (and that is high efficiency) AND bill/code, I couldve been doing lots of other more productive things like drinking coffee and surfing the web.

BMs are by far the roughest 100 bucks pathologists can earn.

I dont even know what medicare allowable is for the procedure...do you even cover the kit costs??

 

[GreatPumpkin]

Not sure how it started, but the group has been doing them for years and years.

It is no big deal for me, I did tons during residency. VCU pathology (my ex-residency) does all the bone marrows in the hospital. So they do about 100 or more a month. Here where I work now we do about 3 or 4 a week.

We don't buy the kits. Just the bone marrow needles, other than that we use the the bulk supplies in the lab. We have a relatively good system down and I can usually have a BM and aspirate done in about 30-45 mins.

Is it worth the money? No. But, it is one of the many things we do to keep the physicians who send us specimens and the hospital happy. Kind of like autopsies and at least we do get paid something.

I don't know what it all adds up too but we charge 85097, 88305x2, 88311, 88313, 38221 all for doing and reading the BM. And, if we do flow 88189.

 

[LADoc00]

OMG...

Medicare allowables for 85095 and 85102 are $91.90 and $96.66..

IMO, you are chasing the wrong biz. Until you have ALL the derm, GI and GU biopsies and still have excess manpower, I would step away from doing procedures.

Step 1 is to identify your customers, gen. internal med arent your primary customers. Hell, they arent even in your top 5 I bet.

My guess is your gen internists are ordering BMs, which is a slippery slope. That crap needs to go through a heme-onc anyway to understand what the flow and cytogen mean. So essence you are letting gimp QBs run hematologic issues by enabling them with your process.

Patient care issue IMO.

Secondly, heme-oncs are trained to do marrows, period. If they cant or wont, then the hospital needs to get people on staff who can. Someone else's ******ation will not be part of my biz plan.

What percent of your gross is heme? Seriously, you are bending over backwards, washing their car for what? 5% of your total? Come on....

And I would bet you have an exclusive contract with the hospital and they have to send you all in-house marrows anyway..so what if you stopped doing them and they had to do them? How would your business suffer?? They going to do them and sneak them out to Quest?? LMAO.

I showed up at one place and day one sent out a memo staffwide saying I wont be doing ANY procedures. Its not my job, its not covered by my malpractice and I DONT have a relationship with the patient. You know what? Every clinician agreed, they may not have liked it but I made sense.

Is Quest Diagnostics and Ameripath going to show up to do their marrows?? No, no.

Do you do lung biopsies when surgery is overwhelmed? Do you do colpo when GYN is overburdened? Head and neck biopsies? Skin biopsies? No? Then why are you coddling lazy and/or incompetent internists??

I dont even want to touch the issue of what if Medicare/CMS decides since you DO the procedure and read it, you are violating anti-kickback laws. Put another .38cal bullet in the gun of your Russian Roulette game.

Tradition isnt a good enough answer anymore folks.

 

[GreatPumpkin]

I don't really disagree with what you are saying business wise. But, we don't turn away business just because it is not as profitable as sitting and doing skin biopsies all day. Thank goodness actually. I like heme and don't mind seeing patients.

Pathologists in many places do bone marrow biopsies. I am covered for it under my malpractice insurance and am quite proficient at it. We do FNAs too for that matter and read the slides. And, our derm path guy does on rare occasion do an in house skin biopsy.

We don't have to worry about doing the biopsy and reading the slides because we do not order it. If we also ordered it, then it would be touchy. Though quite a few derm/dermpath folks do just that.

 

[yaah]

Some people like doing procedures though, it is a nice break in the normal routine. And the "building a relationship" part of it is important, although it's hard to know HOW important.

Personally I agree, I don't like doing procedures and don't ever really want to do them, especially marrows. I figure there are enough people in the world who love procedures that I should be ok. That worked in med school. If I have to, I have to.

 

[LADoc00]

I don't really disagree with what you are saying business wise. But, we don't turn away business just because it is not as profitable as sitting and doing skin biopsies all day. Thank goodness actually. I like heme and don't mind seeing patients.

Pathologists in many places do bone marrow biopsies. I am covered for it under my malpractice insurance and am quite proficient at it. We do FNAs too for that matter and read the slides. And, our derm path guy does on rare occasion do an in house skin biopsy.

We don't have to worry about doing the biopsy and reading the slides because we do not order it. If we also ordered it, then it would be touchy. Though quite a few derm/dermpath folks do just that.

Im not saying I tally the bottom line and if there isnt a big $$$, I refuse to do it. Hell, I even do gratis postmortems on occasion!

What I resent is feeling like people can dump on Pathology because somehow we need their business. I dont. I dont NEED any single speciality's business aside maybe from GI. I want business but Im not willing to ***** myself by doing biopsies on morbidly obese patients while big corp's like Quest simply send a 10dollar/hour courier to pick specimens up.

In terms of "building relationships"(an excuse I often hear from pathology groups that do the BMs)...Lehman Bros doesnt build relationships with Alcoa Steel by sending their newly minted MBAs from Harvard to work in Alcoa's Penn. steel mill do they? No, you take said clinicians out to a fine steak dinner, buy em some drinks and get to know them. Maybe play golf with them, get a cabin in the woods and invite em fly fishing...you dont do their dirty work. That engenders a degradation of their respect for you.

 

[Anna Plastic]

Don't know if anyone else has encountered this: in doing an initial telephone interview with a private practice, the interviewer said that they *don't* pay for travel and expenses for the first interview, but they will for the second. Anyone else heard of this approach before? Sure was new/shocking to me.

 

[LADoc00]

Don't know if anyone else has encountered this: in doing an initial telephone interview with a private practice, the interviewer said that they *don't* pay for travel and expenses for the first interview, but they will for the second. Anyone else heard of this approach before? Sure was new/shocking to me.

I have never heard of a private practice group that does multiple rounds of interviews.. NEVER...they are waving more red flags than a Communist parade in Bejing.

Phone interview and 2 in person interviews?? What dipshiatz LMAO. Let me guess, they are paying you a tidy of sum of 150K/year too, probably will make 200+K off you for starters.

Obviously, they are fishing for the biggest tool they can land.

Run, do not walk. Unless they are flashing serious $, and Im talking 700+.

I had less interview hoops when I was diving into the whole consultant thing with McKinsey, Bain etc.

Reminds of a phone interview I had with a group somewhere in San Diego, I started off by saying what type of business model I consider the worst for Southern California and sure enough they hit every red flag. Clueless as can be. The lady could tell I was scoffing at the whole thing but still asked what I thought about the group at the end of the conversation....I just chuckled. The number of tools running around in private prac is truly shocking, esp. the old timers. Its no wonder insurance companies have suceeded in the last 20 years.

 

[Anna Plastic]

The interviewer didn't even mention what the compensation was for the gig. Wonder when they were planning on clueing me in with that--after I paid for going out to interview?

 

[LADoc00]

The interviewer didn't even mention what the compensation was for the gig. Wonder when they were planning on clueing me in with that--after I paid for going out to interview?

next. I wouldnt walk across the street to interview with that group. If someone was coming from out of town to interview for a pos. in my corps, the LEAST I would do is put em up at the Embassy Suites and take em to dinner. That is beyond question IMO.

If they are so broke as to not be able to afford expenses, WHY THE HELL WOULD YOU WANT TO WORK FOR THEM?

 

[GreatPumpkin]

That does sound a little odd. They sound like cheapskates. Red flag.

My group paid all my expenses to come out for my interview and then paid for both me and my wife to return and look around for a house.

I guess if this group is in your dream place then maybe consider it.