What Do You Need to Know About a Job Before You Will Interview?

[AD04]

I have an interview coming up. The only thing I know about the job is:

- pay
- number of patients a day
- setting: inpatient vs outpatient

In my opinion, I think the pay is too low and the number of patients a day is too high. I made a rash decision over the phone to schedule the interview, thinking much of the details can be hashed out face-to-face. Now I'm thinking about it and it seems like a potential waste of my time.

I don't know anything else about the job. I don't know if they will pay for travel. I don't know if they will cover malpractice. I don't know if the rates are negotiable. I've e-mail questions but I didn't get a response yet. I don't want to waste my time going on an interview that leads to nowhere.

I'm thinking of canceling the interview.

There are many job opportunities and if I don't screen well, I can see myself flying all over the place wasting my time.

How do you make sure the interview is worth the effort?

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[WisNeuro]

If it's close, the interview is worth the effort. Almost everything is negotiable, outside of the VA anyway. Although, I wouldn't be scheduling any interviews unless they were paying for travel/lodging for the interview. I didn't mind it as much, gave me a ton of free airline miles last time I interviewed.

 

[dl2dp2]

My experience has been that you can get a lot of info from phone calls and Skype. On site visit is almost unnecessary except as a confirmation of an offer that's already accepted. There's nothing that you can't get from interview over the phone that you all of a sudden can get in person. And generally speaking the answers to the questions won't change no matter where you are.

The job market is good enough that you should not be flying anywhere on your own dime. I would start with eliminating places you can't possibly go to--regardless of the number. Then out of that batch of left over, pick the facility you like, then ignore the numbers they give you upfront. Starting point right now I'd say is a 20-30% above MGMA median at your location. We are in a rising market. Garden variety outpatient jobs are giving out starting offers at 275k, which means you can bring it up easily >300k. From what I've been talking to, facility directors don't care that much about that 20% added cost if they can bring someone on. Ask nice, but do NOT sell yourself short.

 

[WisNeuro]

I can get plenty of information over the phone/Skype, but if it's a place I am unfamiliar with, I definitely want to see it in person. Call me old fashioned, but I want to see where I will be housed and the digs.

 

[FlowRate]

I can get plenty of information over the phone/Skype, but if it's a place I am unfamiliar with, I definitely want to see it in person. Call me old fashioned, but I want to see where I will be housed and the digs.

As an extreme case, no amount of money would be worth working in the tiny interior office with the large AC inlet that I had a few years ago. It was the middle of summer and I'd wear my ski jacket in the office...

 

[dl2dp2]

I can get plenty of information over the phone/Skype, but if it's a place I am unfamiliar with, I definitely want to see it in person. Call me old fashioned, but I want to see where I will be housed and the digs.

As an extreme case, no amount of money would be worth working in the tiny interior office with the large AC inlet that I had a few years ago. It was the middle of summer and I'd wear my ski jacket in the office...

But that's my whole point though. You don't need to visit the facility to know what your expected salary/patient load/benefits package would be and how negotiable it would be. I have a decent amount of experiences where the facility calls me and want me to show up to their place right after an interview, only to tell me that their salary is not negotiable (via the recruiter). No thanks. "After discussing with the family, your position while attractive will not be a good fit for me." Another big thing is profit sharing agreements. For a private facility, if they don't allow this (and often it's not negotiable), 100% that they'll exploit you. At this point in time, MD availability is a MAJOR draw to any mental health facility. So if they are getting patients in, it's often because of you. You should to get a cut.

 

[AD04]

These are all wonderful answers. I felt it was a bit off that the person wanted me to interview without telling me much about the job. I canceled the interview.

Regarding travel / lodging expenses, does the potential employer pay for that up front or do they reimburse you? If the latter, what if the never reimburse you?

 

[WisNeuro]

But that's my whole point though. You don't need to visit the facility to know what your expected salary/patient load/benefits package would be and how negotiable it would be. I have a decent amount of experiences where the facility calls me and want me to show up to their place right after an interview, only to tell me that their salary is not negotiable (via the recruiter). No thanks. "After discussing with the family, your position while attractive will not be a good fit for me." Another big thing is profit sharing agreements. For a private facility, if they don't allow this (and often it's not negotiable), 100% that they'll exploit you. At this point in time, MD availability is a MAJOR draw to any mental health facility. So if they are getting patients in, it's often because of you. You should to get a cut.

Well, sure, if they are standing pat on things being non-negotiable, it's a waste of time. But, at least outside of the VA, I have not found places unwilling to negotiate.

These are all wonderful answers. I felt it was a bit off that the person wanted me to interview without telling me much about the job. I canceled the interview.

Regarding travel / lodging expenses, does the potential employer pay for that up front or do they reimburse you? If the latter, what if the never reimburse you?

The vast majority of the time, they should be scheduling this all for you. I've only had one place do the reimbursement route. And, I already knew someone there, so I knew that they would pony up after the interview most likely.

 

[dl2dp2]

Well, sure, if they are standing pat on things being non-negotiable, it's a waste of time. But, at least outside of the VA, I have not found places unwilling to negotiate..

Sorry maybe I wasn't being clear. I *personally* think that the negotiation of the big picture items should occur PRIOR to on-site interview. Yes if you are talking about <30k a year of salary that's one thing, but if you are not willing to specify out exactly the nature of the job very clearly, there's no point in in person, because likely when you go in in person you'll also get a vague answer, which doesn't help your decision making process at all.

Salary is meaningless IMHO in private practice medicine in general. What really matters is what proportion of your billing in the end goes to you. That number can be easily estimated without having firm salary quote.

 

[AD04]

I have a decent amount of experiences where the facility calls me and want me to show up to their place right after an interview...

How do you steer the conversation towards the numbers before the site visits?

I had so many places inviting me to do a site visit without first doing the negotiating. When I suggest before doing site visits, let's talking about numbers and get something approximate that is acceptable for the both of us, the mood of the conversation changes. I'm still new to this song and dance of job hunting. So did I commit a faux pas?

Why do people want to spend their resources of fly me over and to spend both of our time without making sure it is a good for the both of us?

I've reached out to physician job search agencies (ones that physicians can hire to help with job search) and they mentioned that not many employers are willing to disclose the compensation prior to interview. How true is that?

One of the hospitals I spoke to is owned by a corporation that owns multiple hospitals in many states. The executive I spoke to said numbers are somewhat negotiable, but I shouldn't see something like $50,000 more than what they're offering. (And the numbers they offered are quite low, especially for the number of patients they want me to see.) Are there employers I should not waste my time with? If so, do they typically fall into a specific type?

 

[FlowRate]

How do you steer the conversation towards the numbers before the site visits?

I had so many places inviting me to do a site visit without first doing the negotiating. When I suggest before doing site visits, let's talking about numbers and get something approximate that is acceptable for the both of us, the mood of the conversation changes. I'm still new to his song and dance of job hunting. So did I commit a faux pas?

Why do people want to spend their resources of fly me over and to spend both of our time without making sure it is a good for the both of us?

I've reached out to physician job search agencies (ones that physicians can hire to help with job search) and they mentioned that not many employers are willing to disclose the compensation prior to interview. How true is that?

One of the hospitals I spoke to is owned by a corporation that owns multiple hospitals in many states. The executive I spoke to said numbers are somewhat negotiable, but I shouldn't see something like $50,000 more than what they're offering. (And the numbers they offered are quite low, especially for the number of patients they want me to see.) Are there employers I should not waste my time with? If so, do they typically fall into a specific type?

I have no experience in these matters but it sounds just like old school car sales tactics. Get the other party to invest their time so that they want to get something out of the deal (a car, a job) before they've actually had a chance to address price.

I'll need to talk to my sales manager. (get a coffee for a half an hour while you stew in this chair.)

 

[dl2dp2]

How do you steer the conversation towards the numbers before the site visits?

I had so many places inviting me to do a site visit without first doing the negotiating. When I suggest before doing site visits, let's talking about numbers and get something approximate that is acceptable for the both of us, the mood of the conversation changes. I'm still new to this song and dance of job hunting. So did I commit a faux pas?

Why do people want to spend their resources of fly me over and to spend both of our time without making sure it is a good for the both of us?

One of the hospitals I spoke to is owned by a corporation that owns multiple hospitals in many states. The executive I spoke to said numbers are somewhat negotiable, but I shouldn't see something like $50,000 more than what they're offering. (And the numbers they offered are quite low, especially for the number of patients they want me to see.) Are there employers I should not waste my time with? If so, do they typically fall into a specific type?

You did not do anything wrong. Furthermore, what you do on interview matters very little for a typical facility based job. These jobs are "average" jobs that care little about individual doctor's credential. You will be treated like a cog in the machine just like you are. This can be good and bad: everyone is the same and will be paid approximately the same (i.e. "not 50k more than 1st offer"). Sometimes people at facilities like to play games (i.e. make you jump through random hoops just to show that "you care"). However, you should not be going to interviews randomly. If this is the type of job you are settling down with you should pick things other than salary (i.e. location, practice group environment, % overhead charged, etc), since salary has little variability and is dictated by things like Medicare reimbursement schedule, etc. Employers of this type (i.e. large corporate owned hospital) in general will act in this way, because they often don't really want to fill the job and psychiatry service often (if not well managed) loses money for the facility. Salary numbers are often driven by HR/bureaucratic processes not market, and many jobs are unfilled for years without the management team responding by increasing salary offers. Patients very obviously die because of lack of access, but this is not something hospital management cares about.

Also realize that if you work at a large facility and they quote a number of patients you see that sounds high and if your salary is fixed, it's very possible that you won't see that many patients. Management often has no clue how many people are actually seen. You can always just refuse and empty your schedule randomly, and nobody cares. Cancel appointments randomly, show up late. Also you can max out your vacation days and sick days and no one will care. In fact, most people who stay in these places tend to like doing things of this type, so this becomes a default work ethic. These are the "perks" of working for such facility, not salary. It's really good for people who like a very clear segregation of work and life. If you are paid a fixed salary and say you are full, who's gonna know? Also, refer out difficult patients and fill yours schedule with easy short f/us that take the scheduled blocks.

You sound like someone who might not be a good fit for a facility based job... I would plan strategically---pick a job on location you like and find an acceptable job, then ramp up private practice as quickly as possible. PP billing is extremely local market driven. You are exactly what the market thinks you are worth. There is no game to be played.

 

[AD04]

You did not do anything wrong. Furthermore, what you do on interview matters very little for a typical facility based job. These jobs are "average" jobs that care little about individual doctor's credential. You will be treated like a cog in the machine just like you are. This can be good and bad: everyone is the same and will be paid approximately the same (i.e. "not 50k more than 1st offer"). Sometimes people at facilities like to play games (i.e. make you jump through random hoops just to show that "you care"). However, you should not be going to interviews randomly. If this is the type of job you are settling down with you should pick things other than salary (i.e. location, practice group environment, % overhead charged, etc), since salary has little variability and is dictated by things like Medicare reimbursement schedule, etc. Employers of this type (i.e. large corporate owned hospital) in general will act in this way, because they often don't really want to fill the job and psychiatry service often (if not well managed) loses money for the facility. Salary numbers are often driven by HR/bureaucratic processes not market, and many jobs are unfilled for years without the management team responding by increasing salary offers. Patients very obviously die because of lack of access, but this is not something hospital management cares about.

Also realize that if you work at a large facility and they quote a number of patients you see that sounds high and if your salary is fixed, it's very possible that you won't see that many patients. Management often has no clue how many people are actually seen. You can always just refuse and empty your schedule randomly, and nobody cares. Cancel appointments randomly, show up late. Also you can max out your vacation days and sick days and no one will care. In fact, most people who stay in these places tend to like doing things of this type, so this becomes a default work ethic. These are the "perks" of working for such facility, not salary. It's really good for people who like a very clear segregation of work and life. If you are paid a fixed salary and say you are full, who's gonna know? Also, refer out difficult patients and fill yours schedule with easy short f/us that take the scheduled blocks.

You sound like someone who might not be a good fit for a facility based job... I would plan strategically---pick a job on location you like and find an acceptable job, then ramp up private practice as quickly as possible. PP billing is extremely local market driven. You are exactly what the market thinks you are worth. There is no game to be played.

Thanks for the confirmation and for the very helpful reply.

I'm definitely not flying out to interviews randomly. My vacation days are too precious to spend in airplane and in hotels without a good payoff.

A filter / screening system is definitely needed when getting jobs / gigs. There are just too many options. Getting numbers upfront is good. And also the way they treat potential employees / contractors is a good way to gauge how they will be later on after the contract is signed. Someone who is evasive now won't be transparent later.

If I'm going to place myself under administration and seek security, I might as well just work for the government instead of a for-profit entity. In the former, you're only under the burdens that administration sets on your plate. And government employees are allergic to work. In the latter, you're under the burdens from administration and you'll have productivity standards.

I think you're right that I'm not a good fit for facility-based jobs. I don't like being told what to do by people who do less and know less than me. I have enough of that in residency. My long-term goal is to get into the business side of medicine -- likely with private practice.

Anyways, for other psychiatrists out there who are looking for jobs and encounter corporate medicine, this is what I found:

Thoughts on Working for a Private, For-Profit Hospital Chain?
Thoughts on Working for a Private, For-Profit Hospital Chain?

How Much Are YOU Actually Worth? (very good -- EM's perspective on how corporate medicine works)
How Much Are YOU Actually Worth?

 

[Psychotic]

I guess this a timely response, but I recently went to a job interview in another city where I was not told any details about pay, etc., prior to the interview, and that interview effort - even though they paid for the flight, hotel, etc. - was 2 days out of my life I wish I had back.

The "pay" discussion came up in the first interview of the day, and the pay was really, really low for the job and the city. If I could have done it without raising eyebrows, I would have excused myself right then and left the building because I had another 4 hours of interviews that day I had to sit through knowing that there was no way in hell I was taking that ridiculously low paying job.

Bottom line: don't do any interviews where this information hasn't been divulged in advance. I had read that advice here, ignored it at my own peril, and I learned the hard way. Never again...

 

[ziggyhope]

I guess this a timely response, but I recently went to a job interview in another city where I was not told any details about pay, etc., prior to the interview, and that interview effort - even though they paid for the flight, hotel, etc. - was 2 days out of my life I wish I had back.

The "pay" discussion came up in the first interview of the day, and the pay was really, really low for the job and the city. If I could have done it without raising eyebrows, I would have excused myself right then and left the building because I had another 4 hours of interviews that day I had to sit through knowing that there was no way in hell I was taking that ridiculously low paying job.

Bottom line: don't do any interviews where this information hasn't been divulged in advance. I had read that advice here, ignored it at my own peril, and I learned the hard way. Never again...

I am learning it the hard way as well, went on an interview without knowing specifics, and the only interview during the day that was not positive was the one person I started discussing compensation with. I just started being extremely blunt with what I want in a job up front, if they don't want to discuss, oh well. It def. feels strange though, since no one taught us how to negotiate at all, and I find that people want to pay me a lot less and work me a lot harder than what I should be worth.