Recruiting Resources

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@chocomorsel i get it. I understand labels and how they can make or break you, especially in residency. I wish human nature isn’t what it is, but I’m not smart enough to figure that out and fix it. I can tell you though, you seem solid and there’s no reason you should believe otherwise. Have confidence in yourself and your abilities. Best of luck.
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Southpaw said:
I would not hold your residency experience against you if you were forthright and honest. We all know the pluses and minuses of anesthesiology residency and how good, solid people don’t always get looked kindly upon by faculty.

However, if you’ve had a work experience or two since then, or a fellowship, and people talk highly of you (never late, rarely if ever calls out sick last minute, everyone likes you and finds you easy to work with, you provide GREAT CARE to your patients, etc.) then there’s no reason to worry. It’s the people who consistently, everywhere they go, find the ‘rotten egg’ reputation following them, that practices will avoid.
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It's so friggin' easy to be judgmental. You know the saying "you never get a second chance to make a first impression"? That's exactly what happens when one comes with the "rotten egg" reputation.

I know how that works. I was one of the superstars in my high school. As Trump would say, I could have taken a pee in the middle of the classroom and people would have forgiven it. On the other hand, if some poor soul, who had underperformed for a while because his family was going through a tough time, suddenly started to show some promise, it would have been considered an accident for a very long time.

In American medicine, all it takes is to piss off the wrong person. It's a much smaller world than people imagine. In somebody with no/minimal malpractice history, I wouldn't care much what some third-party says about them (except to bring it up with the candidate and see the reaction), unless that third-party is both a great anesthesiologist AND human being. A reference is worth exactly as much as the person it's coming from (especially his/her people knowledge). I constantly work with residents who come with good recommendations from colleagues, just to discover how weak they are professionally (but how great at brown-nosing).
 
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FFP said:
In American medicine, all it takes is to piss off the wrong person. It's a much smaller world than people imagine. In somebody with no/minimal malpractice history, I wouldn't care much what some third-party says about them (except to bring it up with the candidate and see the reaction), unless that third-party is both a great anesthesiologist AND human being. A reference is worth exactly as much as the person it's coming from (especially his/her people knowledge). I constantly work with residents who come with good recommendations from colleagues, just to discover how weak they are professionally (but how great at brown-nosing).
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I haven’t found American medicine to be any different than any other facet of life. I had a different career before medicine. To judge is human nature. It takes an awful swell person to realize the problem isn’t so much with the person they’re looking at as much as the person in the mirror. I don’t meet many people like that.

I agree that it’s harder to overcome a bad start and win over hearts and minds, than it is to have a wonderful start and then later lose the trust of your peers. But both can be accomplished over time.

I also agree, in general, with your assessment on recommendations. But I think l I have a pretty good feel on who’ll give me a solid, honest recommendation (good or bad!) about a candidate and who is just blowing smoke. For some people, that’s tough to differentiate. So, on that note, in general I appreciate the system of word-of-mouth and recommendations. You just have to understand where it’s coming from. I much more prefer a person who is recommended highly by a person that I trust (and there are few..) than a person that may look good on paper but the recommender that I trust doesn’t have the best things to say.
 
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Southpaw said:
Geez. I didn’t notice much arrogance in the OP. I admit to not really understanding a desperate CV. However, the story certainly will unfold over an interview and review of references.

I only took note that perhaps their package isn’t as good as they feel it is. Recruiting isn’t complex. For a given location the money and vacation need to be competitive. If it isn’t you’ll struggle to get good people. If you’re not in a great location, then it may take a while to get someone to be a good fit for your practice. In my opinion, recruiters offer little to nothing that a motivated practice can’t do on its own.
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This. This. This.....and This.

Some people want the open air, not another person for miles, and just the local mom and pop bar and grille for their social nights out. Others need "Hamilton", Michelin 5 star restaurants, and a nearby pro sports team.

Many competitive graduates go on to do fellowships, stay on at their residency, or get a pick of the litter of jobs in places they want to be simply because they're competitive. So I understand how a practice that may be in a not so optimal place may end up with "desperate CVs". I think "non-competitive" would have been a better term to use. As the OP even stated, not all California is the California we think about. Redding is not San Diego but even Monterrey isn't Los Angeles or San Francisco.

Recruiting in California can be tricky because it's easy to say, "Hey it's California", but not all California is the same. Just like Albany may be in New York, but it's not what I picture when someone says "New York".
 
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chocomorsel said:
@Man o War, @nimbus,?
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@chocomorsel I think I'm probably much more forgiving than most when it comes to CVs. I don't necessarily think multiple jobs is bad, unless it's really excessive. Big gaps in employment would give me pause. Spelling errors automatically gets a CV thrown in the trash. If you're not attentive to detail on a CV, you won't be at work either. Metrics are here to stay, so we need people who are really detail oriented as well as good doctors. Me and two other group members do most of the recruitment, and we all like to actually talk to people via phone screens- I think you get a much better sense of what kind of person they are.
Excessive malpractice history is a non starter.
We do consider the program people graduated from, but it isn't necessarily some snobby name requirement.....but if your cardiac fellowship didn't have a robust and challenging variety of cases, you wouldn't succeed here. We aren't trying to set people up for failure. We need people to be functional and fast/efficient from day 1, we just don't have time for hand holding at all....and our surgeons demand that, so it is what it is. It truly isn't snobbery, we just don't want to waste anyone's time, and our goal is to partner everyone who starts with us.
What I see a lot is people looking for easy money. This also gets a CV thrown in the trash. So many lazy people out there. I actually had one guy on a phone screen ask if we would be ok with him having "some last minute call offs for personal issues". Seriously, that happened. Yeah, let me just explain to the surgeon his case is cancelled because you can't manage your personal life. He looked great on paper, but that one went in the trash.
Military service and collegiate/pro athletics also gets people a leg up with us, they tend to be disciplined and work hard in our experience.
We always, always call people a candidate has worked with; with their permission of course. But we talk to many people, and require some surgeons' names we can get in contact with. That way one personality conflict doesn't sink a good candidate. I'm sure we have all come across one or two folks in training or the OR that we didn't click with- that's fine. It just can't be a pervasive problem. This of course varies depending on the level of discretion required for the candidate, but we need to talk to other people who have seen the person in action.
Hope that helps?
 
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Man o War said:
@chocomorsel I think I'm probably much more forgiving than most when it comes to CVs. I don't necessarily think multiple jobs is bad, unless it's really excessive. Big gaps in employment would give me pause. Spelling errors automatically gets a CV thrown in the trash. If you're not attentive to detail on a CV, you won't be at work either. Metrics are here to stay, so we need people who are really detail oriented as well as good doctors. Me and two other group members do most of the recruitment, and we all like to actually talk to people via phone screens- I think you get a much better sense of what kind of person they are.
Excessive malpractice history is a non starter.
We do consider the program people graduated from, but it isn't necessarily some snobby name requirement.....but if your cardiac fellowship didn't have a robust and challenging variety of cases, you wouldn't succeed here. We aren't trying to set people up for failure. We need people to be functional and fast/efficient from day 1, we just don't have time for hand holding at all....and our surgeons demand that, so it is what it is. It truly isn't snobbery, we just don't want to waste anyone's time, and our goal is to partner everyone who starts with us.
What I see a lot is people looking for easy money. This also gets a CV thrown in the trash. So many lazy people out there. I actually had one guy on a phone screen ask if we would be ok with him having "some last minute call offs for personal issues". Seriously, that happened. Yeah, let me just explain to the surgeon his case in cancelled because you can't manage your personal life. He looked great on paper, but that one went in the trash.
Military service and collegiate/pro athletics also gets people a leg up with us, they tend to be disciplined and work hard in our experience.
We always, always call people a candidate has worked with; with their permission of course. But we talk to many people, and require some surgeons' names we can get in contact with. That way one personality conflict doesn't sink a good candidate. I'm sure we have all come across one or two folks in training or the OR that we didn't click with- that's fine. It just can't be a pervasive problem. This of course varies depending on the level of discretion required for the candidate, but we need to talk to other people who have seen the person in action.
Hope that helps?
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It does. Thanks.
If you are looking for a CT doc and don't live in a cold climate, I know someone.
SDN is my "contact" source. Lol
 
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chocomorsel said:
It does. Thanks.
If you are looking for a CT doc and don't live in a cold climate, I know someone.
SDN is my "contact" source. Lol
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choco, I sincerely hope you are not switching from CT anesthesia to CCM.
 
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chocomorsel said:
It does. Thanks.
If you are looking for a CT doc and don't live in a cold climate, I know someone.
SDN is my "contact" source. Lol
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I will definitely message you next time we hire, thanks for the connection!
 
Man o War said:
..
We do consider the program people graduated from, but it isn't necessarily some snobby name requirement.....but if your cardiac fellowship didn't have a robust and challenging variety of cases, you wouldn't succeed here. We aren't trying to set people up for failure. We need people to be functional and fast/efficient from day 1, we just don't have time for hand holding at all....and our surgeons demand that, so it is what it is. It truly isn't snobbery, we just don't want to waste anyone's time, .
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Nice post M-O-W
I have just two comments and I’m sure I’m taking them the wrong way but it sounds like you guys don’t hire new grads be they are not “fast/efficient from day 1. They need a little hand holding in order to succeed. If you throw them to the wolves they are destined to fail most of the time.
Also, it isn’t honest to say you don’t want to waste anyone’s time. I’m sure I’ve said it in the past as well. What you (and I) really mean is that you don’t want to date your time. It is a huge endeavor to recruit someone. And then to bring them along in the group. If things don’t work out, it’s a tremendous waste of time. None of this should be taken lightly.
 
So I am sitting on a beach bored out of my mind right now. Windy, choppy and no waves. Therefore I have all kinds of time to respond to posts.
Some have said that they wouldn’t hold residency experience against a candidate. But very rarely do we interview just one candidate. And if they both come with equal CV’s but one had a bad residency experience or job experience and the other didn’t then it matters. Everything matters. There are many times in life when past behaviors can come back and bite you in the arse.
 
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Noyac said:
Nice post M-O-W
I have just two comments and I’m sure I’m taking them the wrong way but it sounds like you guys don’t hire new grads be they are not “fast/efficient from day 1. They need a little hand holding in order to succeed. If you throw them to the wolves they are destined to fail most of the time.
Also, it isn’t honest to say you don’t want to waste anyone’s time. I’m sure I’ve said it in the past as well. What you (and I) really mean is that you don’t want to date your time. It is a huge endeavor to recruit someone. And then to bring them along in the group. If things don’t work out, it’s a tremendous waste of time. None of this should be taken lightly.
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@Noyac we have hired some heavily vetted new grads, out of our last 6 hires 2 were new grads. Our call/work schedule is fairly brutal so we can’t really afford to hand hold too much. That being said, they aren’t put on the call schedule for two months to give them some time to get oriented. But after that they go into the call pool and they have to be able to manage well whatever comes in the door. They have to be able to get the patient ready to go quickly, we would never hear the end of it if we hired a new guy/gal who took forever to do lines while the surgeon waited.
We also carefully select the cases for them that first 8 weeks. We ease them into it. So maybe that is considered hand holding?
That being said, we expect they may need to run things by us, ask questions, etc. We just can’t take over management of a case for someone who is floundering; if someone is free we are happy to lend a hand, but that can’t be counted on.
I can honestly tell you most if not all of us would feel bad if a person moved here and it didn’t work out. We all hang out together on weekends, vacation together, our spouses go out to dinner together, so we are all friends too. It’s a group of genuinely nice people. Sure, it’s also a hassle on our parts for a new person to not work out too. Nobody wants to see someone move their wife/husband and kids across the country, get settled in the community, and then get canned. You seem like a good guy, I’m sure you wouldn’t feel good about that either.
 
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Man o War said:
@Noyac we have hired some heavily vetted new grads, out of our last 6 hires 2 were new grads. Our call/work schedule is fairly brutal so we can’t really afford to hand hold too much. That being said, they aren’t put on the call schedule for two months to give them some time to get oriented. But after that they go into the call pool and they have to be able to manage well whatever comes in the door. They have to be able to get the patient ready to go quickly, we would never hear the end of it if we hired a new guy/gal who took forever to do lines while the surgeon waited.
We also carefully select the cases for them that first 8 weeks. We ease them into it. So maybe that is considered hand holding?
That being said, we expect they may need to run things by us, ask questions, etc. We just can’t take over management of a case for someone who is floundering; if someone is free we are happy to lend a hand, but that can’t be counted on.
I can honestly tell you most if not all of us would feel bad if a person moved here and it didn’t work out. We all hang out together on weekends, vacation together, our spouses go out to dinner together, so we are all friends too. It’s a group of genuinely nice people. Sure, it’s also a hassle on our parts for a new person to not work out too. Nobody wants to see someone move their wife/husband and kids across the country, get settled in the community, and then get canned. You seem like a good guy, I’m sure you wouldn’t feel good about that either.
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Sounds like we are in the same group.
 
Noyac said:
Sounds like we are in the same group.
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I know from your previous posts you live in a way better part of the country than I do!
Nice to know there are similar good groups out there though.
 
pgg said:
This is a great thread. I'm a few years away from looking for a new job. Good to see how people who recruit for their groups think.
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The follow up thread should be, “What to do and not do during and interview”. We have had theads like this but it’s been a long time.
 
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chocomorsel said:
Thanks.
But he/she didn't say the unit value yet. Keeping us in suspense I guess.
I know docs out West making 600 to 700k on $ 30 to 40 a unit. They work like dogs. Not worth it to me.
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Yep, that is a red flag to me. The San Antonio Groups I think you are familiar with all bank minimum $50/unit. Deep Appalachia where the payment is majority medicaid was $45/unit at one place I interviewed at. Rural Alabama was above $40/unit. I am curious since his benchmark was $25/unit. No way am I even going to call back for less than $40/unit----ESPECIALLY if it is a place like California where the COL is so high.
 
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Do any of you have potential new hires come out and work locums with you for a week or two? Or is that something nobody is really willing to do? Seems like it'd be a good way to check out serious candidates, and just as importantly let the candidate evaluate the group for fit.

I have, over the years, done quite a bit of moonlighting away from my day job. Some have extended deferred job offers for when I'm done with the Navy. Some places I thought I'd enjoy working have turned out to be kind of unpleasant but worth the paycheck, and there was one that I thought was unsafe so I didn't go back. All of these places looked nice from a distance. Few are places I'd want to work permanently though.

I'm thinking that around the last year of my Navy time, when I'm seriously looking, it would be worth my while to schedule some actual work at places I'm considering, which are also considering me. But I've never heard of anyone actually doing this. Are the logistics just too inconvenient, or are people not willing?
 
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Another red flag for my group is someone that has only supervised and rarely ever doing their own cases. They will struggle in my group.
 
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FFP, perhaps I should have clarified a bit more...someone who has been out 10 plus years and had a new job every few years is less desirable. I hate recruiting and turnover.

Choco, I understand your concerns regarding the networking, but those contacts who know a resident or experienced guy well and are discerning are a better predictor of success than any other method I have found. It is just hard to find the ones that are good at assessing and being honest. To speak about the elephant in those networking statements, we have been referred males, females, and most protected classes of people. But it does take finding the right network.
 
pjl said:
FFP, perhaps I should have clarified a bit more...someone who has been out 10 plus years and had a new job every few years is less desirable. I hate recruiting and turnover.

Choco, I understand your concerns regarding the networking, but those contacts who know a resident or experienced guy well and are discerning are a better predictor of success than any other method I have found. It is just hard to find the ones that are good at assessing and being honest. To speak about the elephant in those networking statements, we have been referred males, females, and most protected classes of people. But it does take finding the right network.
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What is a “most protected class”? That’s a new one to me.
 
pjl said:
FFP, perhaps I should have clarified a bit more...someone who has been out 10 plus years and had a new job every few years is less desirable. I hate recruiting and turnover.
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I am afraid you don't get it: people usually don't just walk away from a job. The interview process, paperwork and stress involved are much-much higher than on the employer side. Plus we all know how it looks on our resumes. So we walk away from a job only if we are fed up.

I will give you a personal example: one academic employer slashed my entire division's already undermarket salaries two months before contract renewal, while adding the requirement to cover remote sites and 10 hour-long regular workdays. You probably wouldn't have even gotten out of bed for that salary. This is the reality of bad markets.

In the East, I would almost never fault the person for leaving a non-partner position, unless I hear the same serious complaints from the employers. The main reason people leave is because they get screwed, not because they are incompetent. I would almost argue that these people are actually more experienced than those who do the same things in the same place for years, due to cross-polination (I know I am).
 
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@CCCMDMBA , I'm in SoCal - if you want to PM me any more info about your location then maybe I can lend some insight. Your numbers seem a little outta touch though. No group in SD (except for maybe one little S-hole employed gig) pays at $25/unit. There's not that many groups down there, but they're pretty much all in the 32-38$ range. Nor-Cal/Bay Area typically pays a little better, though I'm not sure what the salary is for MAC these days s/p buyout.
 
chocomorsel said:
Minorities I gather. Except I don't know how it is we are "protected"?
Or maybe you mean people with disabilities?
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Protected, as is, cannot legally discriminate against. Turns out, there are a lot of protected classes. I became one when I got out of the military (recently separated veteran). Employers can feel free to discriminate against me, though, in another couple of years when I'm just like every other civilian.

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psychbender said:
Protected, as is, cannot legally discriminate against. Turns out, there are a lot of protected classes. I became one when I got out of the military (recently separated veteran). Employers can feel free to discriminate against me, though, in another couple of years when I'm just like every other civilian.

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Oh. Didn't know this. Don't we all qualify to be "protected" then from each other? Lol
That just sounds funny to me. Protected. I am protected.
And White people aren't included?
It's kinda funny but in a sad way.
 
SaltyDog said:
@CCCMDMBA , I'm in SoCal - if you want to PM me any more info about your location then maybe I can lend some insight. Your numbers seem a little outta touch though. No group in SD (except for maybe one little S-hole employed gig) pays at $25/unit. There's not that many groups down there, but they're pretty much all in the 32-38$ range. Nor-Cal/Bay Area typically pays a little better, though I'm not sure what the salary is for MAC these days s/p buyout.
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Some PP people just can't understand that one gets what one pays for. I know a PP group who has been struggling to get a cardiac anesthesiologist for years, due to location, yet they are too cheap to offer an above-market salary.
 
chocomorsel said:
And White people aren't included?
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They can be protected, too, but not because they are white (at least not as long as whites are the majority), mostly by the Civil Rights Act of 1964.

Protected group - Wikipedia

Most Americans belong to some protected group(s), except most of the white Christian males. Hence frustrations, hence Trump, hence the alt-right.

You belong to at least 3 protected groups, AFAIK.
 
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FFP said:
They can be protected, too, but not because they are white (at least not as long as whites are the majority), mostly by the Civil Rights Act of 1964.

Protected group - Wikipedia

Most Americans belong to some protected group(s), except most of the white Christian males. Hence frustrations, hence Trump, hence the alt-right.

You belong to at least 3 protected groups, AFAIK.
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Damn! I am special. I belong to 4 "protected" classes!
 
SaltyDog said:
32-38$
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Gross. Unless you’re doing cardiac and/or lots of thoracic, or working long days every day, or taking very little vacation, I have to think you’re working way too hard for what I consider a ‘market’ salary. Everyone is different though. Just curious, why is the unit value so poor there? Is it like that in all of Cali (<$40/unit) or just in the more popular areas (LA, SD, SF)?
 
chocomorsel said:
Thanks.
But he/she didn't say the unit value yet. Keeping us in suspense I guess.
I know docs out West making 600 to 700k on $ 30 to 40 a unit. They work like dogs. Not worth it to me.
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Where about? Need to pay off some loans and be on the Best Coast


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chocomorsel said:
In the desert. Vegas.
You can find better bang for your buck though is what I am saying.
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Ah damn. I would totally do the Vegas but I’m my fiancé’s fellowship took us to Cali. Locked up a gig in the Bay Area - seems like a good deal. I haven’t heard of anyone in the Immediate Bay/East Bay Area making 500k for a new grad? Unless I’ve been looking in the wrong places.


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turnupthegas said:
Ah damn. I would totally do the Vegas but I’m my fiancé’s fellowship took us to Cali. Locked up a gig in the Bay Area - seems like a good deal. I haven’t heard of anyone in the Immediate Bay/East Bay Area making 500k for a new grad? Unless I’ve been looking in the wrong places.


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You may have been looking in the right place, but unfortunately some may have not been looking back. The reason why those types of jobs don't always show up on a radar is because people in the Bay Area rarely leave their jobs unless they're retiring. Plus the area is completely saturated with physicians, and most will work insane hours to increase their salary versus hire more people and decrease their salary.
 
Twiggidy said:
You may have been looking in the right place, but unfortunately some may have not been looking back. The reason why those types of jobs don't always show up on a radar is because people in the Bay Area rarely leave their jobs unless they're retiring. Plus the area is completely saturated with physicians, and most will work insane hours to increase their salary versus hire more people and decrease their salary.
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Gotcha. Any idea what the guys at UCSF are making?


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Noyac said:
What is a “most protected class”? That’s a new one to me.
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Most of the protected classes, race/gender/sexual orientation etc.

Like I said, a few job changes are ok, especially with any explainable circumstances, like those you mention. When it is every 2-3 years for over a decade, with nothing over 3 years, that is a red flag to me. Sorry, but it is. Not that a person sucks, but that they won’t be happy and will move on and we will have to hire again.
 
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FFP said:
Some PP people just can't understand that one gets what one pays for. I know a PP group who has been struggling to get a cardiac anesthesiologist for years, due to location, yet they are too cheap to offer an above-market salary.
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Out of curiosity, what do you define as an above market salary for a Cardiac Anesthesiologist either doing their own cases vs ACT model and in high cost vs low cost of living areas? What about fresh out of fellowship vs prior experience?
 
pjl said:
Most protected classes, race/gender/sexual orientation
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Just FYI, national origin/ethnicity and religion can land you in as much legal hot water as those.
 
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sethco said:
Out of curiosity, what do you define as an above market salary for a Cardiac Anesthesiologist either doing their own cases vs ACT model and in high cost vs low cost of living areas?
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One that is above the market (at least above gaswork, which is usually below average).

Regardless, my point was that there are some PP groups that are so "frugal" that they just cannot find "good" people, and they just can't figure out why. It's just common sense. With humans, it's all about having the right incentives. One shouldn't need a consultant or recruiter to figure out that.

If one cannot find good candidates, one should sweeten the deal and keep trying. Instead, many groups hire a warm body (aka a "desperate" doc), then they complain that they got what they paid for. It's probably easier to get water out of a rock than money out of some partners.
 
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turnupthegas said:
Ah damn. I would totally do the Vegas but I’m my fiancé’s fellowship took us to Cali. Locked up a gig in the Bay Area - seems like a good deal. I haven’t heard of anyone in the Immediate Bay/East Bay Area making 500k for a new grad? Unless I’ve been looking in the wrong places.


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The Berkeley group is where it's at, but it's a tough nut to crack.
 
Southpaw said:
Gross. Unless you’re doing cardiac and/or lots of thoracic, or working long days every day, or taking very little vacation, I have to think you’re working way too hard for what I consider a ‘market’ salary. Everyone is different though. Just curious, why is the unit value so poor there? Is it like that in all of Cali (<$40/unit) or just in the more popular areas (LA, SD, SF)?
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CA is bad for a few reasons. #1 is because Medi-Cal (our MediCaid) rates are abysmal. We're talking $12 for OR cases and $16 for OB. If you're lucky, you can negotiate decent rates with some of the Medi-Cal HMO's. MediCare is also a touch lower than average in many areas because they got stuck with a "rural" designation by MediCare in the early days 30+ years ago and never changed even though they are now very suburban. Commercial rates are still much better, but not as crazy good as what I hear about in the South. Crappy locales offer subsidies to attract docs - just like anywhere. The problem with CA BFE gigs though, is that you still get to pay CA taxes but don't get to enjoy the good things that CA has to offer. Worst of both worlds. No point to working in Fresno when you can go work in AZ or NV and take home significantly more of your paycheck.
 
It’s funny to see all this talk of units, etc, when in the AMC/Midwest region it’s literally not discussed at all in hiring/interview process.

I mean I **know** I’m making well below market but I’m in a desirable city.

So I supervise 99% of the time, but I’m only a year out of residency. For you folks who do your own cases, how long out of residency/doing my own cases would make you iffy on hiring me?
 
Shimmy8 said:
It’s funny to see all this talk of units, etc, when in the AMC/Midwest region it’s literally not discussed at all in hiring/interview process.

I mean I **know** I’m making well below market but I’m in a desirable city.

So I supervise 99% of the time, but I’m only a year out of residency. For you folks who do your own cases, how long out of residency/doing my own cases would make you iffy on hiring me?
Click to expand...
Gosh, that sounds all around terrible. Cold climate, work for an AMC, make crap money, and supervise nurses all the time.
You are a true winner. You must really love the Windy City.
 
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