What to do and not do during an interview

[Man o War]

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I asked this in the other thread but didn't see an answer. Do any of you ever have candidates come work as a locums for a week or so?

Downside, credentialing, EMR training, and possibly no license in the state yet.

Upside, what better interview could there be than observing someone work and talking to the surgeons and other staff?

No for all the reasons you listed, but it’s a great idea.

 

[Noyac]

Interesting. One would think those stuff are some stuff you'd get out of the way quickly since they somewhat matter to everyone. Though if the job posts a salary range won't that act as a filter of sorts for applicants? If they know going in the job pays 200k for 60 hrs w q4 calls they may not even apply! Less work for everyone

I find the exact opposite to be true. If yo7 have a very good compensation and vacation package then yo7 will get people applying for the wrong reasons. I would rather someone apply because they are interested in the location first. Location is the number one reasonsomeone leaves a practice in my opinion. I have no data on this. Second would be practice dynamics.
So I want people that want to live here first and foremost. Like I said before, interviewing and hiring is a total pain in the arse. I want to do it as little as possible. I enjoy meeting applicants but it is very costly in both time and money.
So if you want to live in my area then great, let’s talk about the practice. If you are still interested then let’s set up an interview. If yo7 are still interested then we can talk finances and time. Sorry if yo7 wasn’t that up front but that’s not how I roll. I’ve been doing this a long time and this is what I have developed as a system that works for “me”.

 

[Noyac]

As someone who went to a brand new medical school...the devil is in the details...one should attempt to root those out ahead of time. I've read a ****eload of stories on this site from a significant portion of the people who are posting on this thread about **** jobs out there that people got screwed over in because **** was hidden during the interview.

I’d argue that crap wasn’t necessarily hidden but that the applicant didn’t weed it out. Many groups will keep the crap under wraps until you ask. That’s why interviewing is a dynamic process. You learn something every time you do one.

 

[Noyac]

I asked this in the other thread but didn't see an answer. Do any of you ever have candidates come work as a locums for a week or so?

Downside, credentialing, EMR training, and possibly no license in the state yet.

Upside, what better interview could there be than observing someone work and talking to the surgeons and other staff?

Yes this would be ideal but it is extremely difficult. As most candidates have jobs and are either changing or unavailable until they leave their current job. They want some sort of guarantee before quitting their current gig.

 

[anbuitachi]

I asked this in the other thread but didn't see an answer. Do any of you ever have candidates come work as a locums for a week or so?

Downside, credentialing, EMR training, and possibly no license in the state yet.

Upside, what better interview could there be than observing someone work and talking to the surgeons and other staff?

i know residency is different from jobs, but i actually heard one of the program directors say they not uncommonly get med students who does away at their institution and are very impressive and once they take them as residents, they turn to really difficult residents. i guess the idea is when you are there trying to impress you are going to put on your A game but once you got the job that may go down the drain

 

[anbuitachi]

Yes this would be ideal but it is extremely difficult. As most candidates have jobs and are either changing or unavailable until they leave their current job. They want some sort of guarantee before quitting their current gig.

Do you guys fire people when they work too slow? When you look for new candidates for job, is it because the job has a open spot or do you also hire to replace people currently working for you? (hire 1 fire 1). I know people always say pay attention to detail but i've definitely seen anesthesiologists who are VERY into the detail.

 

[Noyac]

i know residency is different from jobs, but i actually heard one of the program directors say they not uncommonly get med students who does away at their institution and are very impressive and once they take them as residents, they turn to really difficult residents. i guess the idea is when you are there trying to impress you are going to put on your A game but once you got the job that may go down the drain

That’s hard to say. I think that if you do this enough you will learn personality traits that can cause issues. That doesn’t mean that you won’t hire bad people once you have learned these traits because there is so much to learn. And then once you are really really good at it, then it’s time to retire because it takes so long to get good at the hiring game. But residencies tend to focus on scores, rightly so because they compete in a different arena.
I could care less about your scores. I couldn’t tell you how well a single partner of mine did on their boards or STEP’s. All I know is that they passed “first time”.

 

[Noyac]

Do you guys fire people when they work too slow? When you look for new candidates for job, is it because the job has a open spot or do you also hire to replace people currently working for you? (hire 1 fire 1). I know people always say pay attention to detail but i've definitely seen anesthesiologists who are VERY into the detail.

You may be concerned about something that really isn’t a big issue. Once hired then there is investment in the person and it is in the best interest of the group to resolve any issues so that everyone is happy.
But from time to time there are issues that just can’t be resolved for various reasons and before it comes to a point of “firing” the individual, that person realizes that something isn’t jiving and they move on. I have never had to “fire” someone but I have had a few move on.
So no, we don’t hire in order to fire someone. We hire because there is a spot to fill.

 

[pjl]

That is how backup call works, yes. You generally don't get paid unless you get called in for a shift. The benefit to you is that you can call out of work when you/your kid is sick. Actual call ins with a backup call system are pretty rare, so your responsibility is mostly to do sober things within an hour of the hospital on your day off.

There's usually, though not always, some kind of financial incentive to keep people from abusing it. You can make people spend vacation days, make up two shifts for each call out, pay the back 1.5x the cost of the shift. Whatever works


Backup call is, again, another way to get to reliability. You need someone showing up for the shift. That can mean expecting people to take backup call or expecting people to work with gastro. They're different kinds of suck for the same result. I'd personally prefer backup call.

Many reasons this is not a useful approach:

I can make enough more money not having this backup system to hire a year round nanny.
When I have days off, I can go on vacation. A system like this, in my 10 person group would make me lose 5 weeks worth of vacation.
Sitting around town waiting to be called for someone’s sick kid is just dumb and limiting, you never actually get to relax.

 

[dhb]

Well, a good amount of our subsidy is metrics. check the box type stuff. If you aren’t good with details, you will cost us money.

Ok, not here...

 

[Gern Blansten]

Always “Dr X”.

One mistake applicants make all the time at our program (usually in email) is referring to our male PD as “Dr Jones”, and our female APD as “Jane” in the same message. Huge mistake.

 

[zero0]

You can be a cool guy behind a keyboard all you want.

But the fact is SDN selects for those who have been professional test takers or just didn't have anyone to show them the ropes. Reminders like these, while simple or no brainer to some, could be life changing for others.

but if you want to sum up this thread in 1 post, i would say "be the best interviewee", just that simple man.

In all fairness, it's probably not as easy to implement as it sounds. Also, all the stress has a funny way of making some people regress and forget basic people stuff they should have hammered out in grade school... It's a working theory I'm developing, along with how this whole process slowly chips away at our humanity.

 

[Notorious T.E.E.]

I find the exact opposite to be true. If yo7 have a very good compensation and vacation package then yo7 will get people applying for the wrong reasons. I would rather someone apply because they are interested in the location first. Location is the number one reasonsomeone leaves a practice in my opinion. I have no data on this. Second would be practice dynamics.
So I want people that want to live here first and foremost. Like I said before, interviewing and hiring is a total pain in the arse. I want to do it as little as possible. I enjoy meeting applicants but it is very costly in both time and money.
So if you want to live in my area then great, let’s talk about the practice. If you are still interested then let’s set up an interview. If yo7 are still interested then we can talk finances and time. Sorry if yo7 wasn’t that up front but that’s not how I roll. I’ve been doing this a long time and this is what I have developed as a system that works for “me”.

I got burned early on by not asking about salary and vacation up front. I took three days off from fellowship to interview with a group. Loved the location, the practice was great, and the three partners I spent the most time with seemed like great people. The offer came in very low, and there was no budging from it. It was inconsistent with what I would work for, and having that knowledge would have saved me interviewing. Potentially, it would have saved the group some money too since they paid the interview expenses. Now that I am on the other side of the process, I am always clear with candidates how they will be paid and how much they will make during the interview. Usually during the phone conversation we discuss a range, and if someone takes the time to come see us they get the full picture.

 

[Twiggidy]

I asked this in the other thread but didn't see an answer. Do any of you ever have candidates come work as a locums for a week or so?

Downside, credentialing, EMR training, and possibly no license in the state yet.

Upside, what better interview could there be than observing someone work and talking to the surgeons and other staff?

I honestly feel this is a good idea and I think a lot of groups should adopt this strategy. It really benefits both sides. Put someone on as a locum for a month of two to see who both sides work out. If it fails then both sides can part ways. If it works, then hire as a permanent. I say it takes a few months because I think it takes a few months for both sides to really get to know each other, the support staff, and the system.

 

[chocomorsel]

In formal correspondence I always use titles, but if you introduce yourself as Joe or Erin during the interview I will usually use that name in person.

What if you introduce yourself as Dr. Jane Doe. Does that give people permission to call you Jane?
It used to happen to me, and now I don’t even tell them my first name. It led to some nurses calling me by first name. But they don’t do it to the males.

 

[Twiggidy]

What if you introduce yourself as Dr. Jane Doe. Does that give people permission to call you Jane?
It used to happen to me, and now I don’t even tell them my first name. It led to some nurses calling me by first name. But they don’t do it to the males.

This one can be difficult to deal with Choco and probably more so as a female. When I first started I was sold on the whole "this hospital is a family" so there are a lot of first names thrown around. The problem for me came with a certain population of nurses who are sort of the step children of the hospital started introducing me to patients by first name. At that point I got uptight with them and wanted them to always refer to me as doctor. It didn't make me the most popular person with them but they obviously didn't know boundaries. So at this point now I'm just that jerk, which I don't care about because in front of patients call me "Doctor". What are they gonna do, tell the admin "Dr. Twiggidy is a jerk because he wants us to call him 'Dr.'"? Okay.

 

[deleted162650]

I honestly feel this is a good idea and I think a lot of groups should adopt this strategy. It really benefits both sides. Put someone on as a locum for a month of two to see who both sides work out. If it fails then both sides can part ways. If it works, then hire as a permanent. I say it takes a few months because I think it takes a few months for both sides to really get to know each other, the support staff, and the system.

But isn't that sort of the point of the "partner track"? Bring someone on as an employee. You get to know them, they get to know you. Everybody's happy. They get a set of keys to the kingdom.

*Note: I'm referring to real/fair/equitable/not excessively long partner tracks. I realize the concept has been bastardized by the greedy in many practices*

 

[chocomorsel]

I get what you’re saying, it sucks to work sick, hurt, or post call. Nobody *wants* to do that. But I also don’t want to be an employee and I don’t want to make $250k. Like you said, different strokes for different folks.

Are those two plans/schools of thought mutually exclusive?
As in can’t you be in a hardworking group and have a backup call person? As in where people are rarely calling in but in case of a pretty bad flu/stomach virus/severely sick kid, there is someone available? Should we be exposing our patients and coworkers to all these viruses/bacteria?

Doctors are humans too. We get sick, have sick kids just like someone else. Why do we feel the need to punish ourselves just because we are doctors? I have attempted to call in sick once in my private practice life and of course there was no one to take my place and make it happen. It sucked going to work feeling like ****, headache, stuffy, can’t breathe, coughing, low energy. Most times it’s not bad to work with a cold. But not all colds are the same. Some are even the flu and people don’t know. Until they end up in the Unit or dead. My friend who’s group was very lean, told me she had vomiting and diarrhea at work all day and was puking in the OR trash cans. How nice is that?

I would think that ideally if you can’t afford to have a doctor free at home on back up, make that person the post call person. That is of course if the post call person was always free post call. And in that regard, on the rare occasion that a the post call person has to work for someone ill, they can then get one less call the next month to make up for it or a day off.

We aren’t invincible. And I don’t think asking about “what happens/what’s the back up plane when a doc has to call in sick” should be a problem. It’s a legit, real world thing that happens in all other fields of life.

 

[dhb]

We aren’t invincible. And I don’t think asking about “what happens/what’s the back up plane when a doc has to call in sick” should be a problem. It’s a legit, real world thing that happens in all other fields of life.

What you are saying is reasonable but it should be a rare occurrence for a normal person.
Bringing it up on the first interview gives the impression it could be something regular with you.

 

[Noyac]

I got burned early on by not asking about salary and vacation up front. I took three days off from fellowship to interview with a group. Loved the location, the practice was great, and the three partners I spent the most time with seemed like great people. The offer came in very low, and there was no budging from it. It was inconsistent with what I would work for, and having that knowledge would have saved me interviewing. Potentially, it would have saved the group some money too since they paid the interview expenses. Now that I am on the other side of the process, I am always clear with candidates how they will be paid and how much they will make during the interview. Usually during the phone conversation we discuss a range, and if someone takes the time to come see us they get the full picture.

If I told you over the phone that the compensation package and the vacation package are more than fair and that nobody has left our group due to either one of these, ever. Would you still need to hear the details before yo7 would interview?

 

[pgg]

If I told you over the phone that the compensation package and the vacation package are more than fair and that nobody has left our group due to either one of these, ever. Would you still need to hear the details before yo7 would interview?

I'd need a ballpark.

 

[Arch Guillotti]

If I told you over the phone that the compensation package and the vacation package are more than fair and that nobody has left our group due to either one of these, ever. Would you still need to hear the details before yo7 would interview?

Ballpark, not details.

 

[deleted171991]

I got burned early on by not asking about salary and vacation up front. I took three days off from fellowship to interview with a group. Loved the location, the practice was great, and the three partners I spent the most time with seemed like great people. The offer came in very low, and there was no budging from it. It was inconsistent with what I would work for, and having that knowledge would have saved me interviewing. Potentially, it would have saved the group some money too since they paid the interview expenses.

+1. I do the same before I invest significant money or time in the process. If it's a local interview, I usually don't.

I consider the employer not bringing up the subject, during the phone interview, a red flag (usually it means that the pay is below market). As pgg and Arch said, I want to hear a ballpark number.

 

[dhb]

I'd need a ballpark.

Tropicana field or Dodger stadium? 😉

 

[B-Bone]

I honestly feel this is a good idea and I think a lot of groups should adopt this strategy. It really benefits both sides. Put someone on as a locum for a month of two to see who both sides work out. If it fails then both sides can part ways. If it works, then hire as a permanent. I say it takes a few months because I think it takes a few months for both sides to really get to know each other, the support staff, and the system.

I agree in theory, but how would this ever work in real life? Who quits their job in order to move somewhere, jump through all the credentialing/licensing hoops, and "hope" that everything works out after a few months? And if it doesn't? You'd have to do the whole thing over (and potentially over and over) until you find a situation that works for you. I think the only people who would take that kind of risk are people with no other options (fired, crazy, substance abuse issues, etc), so probably not great for employers either.

We generally have candidates we're serious about hiring come back at least a second time. Our interview process usually involves a phone call or series of phone calls. This is followed by "extreme vetting", when possible (firsthand feedback from trusted individuals, generally from our preferred residency program). Then, a first interview (day at the hospital meeting everyone, looking at workflow, plus/minus nice dinner to see them in more of a social context), a second interview if they're a good fit (similar to the first, meeting people they missed the first time, dinner with spouses if applicable), and an offer. This system seems to work well for us. I think recruiting primarily from a single program where we have numerous reliable contacts for frank feedback is the most essential factor in not hiring duds.

Regarding "don'ts", here are few things that led to a hard pass from our group:
-wearing a wife-beater and dress pants while sitting in a backwards-turned chair to "rap" with group-members in the office
-finding out you failed oral boards the night before you interview
-when asked about hobbies, staring transfixedly at your hands and talking earnestly at length about how you used to have many hobbies but now your hands are far too important to risk with any leisure activities
-getting "the wrong kind of hammered" at dinner
-being boring
- asking numerous questions about money, vacation, and "what time we get outta here" with no inquiries into clinical/administrative/social/interpersonal issues

 

[deleted171991]

If I told you over the phone that the compensation package and the vacation package are more than fair and that nobody has left our group due to either one of these, ever. Would you still need to hear the details before yo7 would interview?

Partners are usually not even close to "fair" when it's about parting with money.

 

[pgg]

Tropicana field or Dodger stadium? 😉

Not the same ballpark.

 

[deleted171991]

Not the same ballpark.

I didn't mean partner-level income. I meant even just paying market/above-market salaries. I know a case where it took weeks to offer a future employee extra $20K (it wasn't me).

Let's not forget one thing: AMCs were founded by the same kind of people as those who run PP groups. Most of the latter are not anything remotely close to "fair". As long as you are not a partner, you are just a body.

 

[AdmiralChz]

I asked this in the other thread but didn't see an answer. Do any of you ever have candidates come work as a locums for a week or so?

Downside, credentialing, EMR training, and possibly no license in the state yet.

Upside, what better interview could there be than observing someone work and talking to the surgeons and other staff?

While this is a good theoretical idea, the practice I’m joining has never had locums. They haven’t had any staffing shortages and have relied on the traditional recruitment model, which has worked well.

Going through full credentialling now, which is a bear at 4 hospitals and 3 ASCs, I cant see how this would be possible for most true PP gigs.

 

[deleted162650]

Let's not forget one thing: AMCs were founded by the same kind of people as those who run PP groups. Most of the latter are not anything remotely close to "fair". As long as you are not a partner, you are just a body.

Damn dude, I feel sorry for you. Suffice to say, this does not hold true for all groups.

 

[deleted171991]

Damn dude, I feel sorry for you. Suffice to say, this does not hold true for all groups.

Of course not. There are always exceptions. Heck, I can even believe that, in certain parts of the country, most groups are decent.

 

[Twiggidy]

But isn't that sort of the point of the "partner track"? Bring someone on as an employee. You get to know them, they get to know you. Everybody's happy. They get a set of keys to the kingdom.

*Note: I'm referring to real/fair/equitable/not excessively long partner tracks. I realize the concept has been bastardized by the greedy in many practices*

Yeah. That's true.

 

[Twiggidy]

Are those two plans/schools of thought mutually exclusive?
As in can’t you be in a hardworking group and have a backup call person? As in where people are rarely calling in but in case of a pretty bad flu/stomach virus/severely sick kid, there is someone available? Should we be exposing our patients and coworkers to all these viruses/bacteria?

Doctors are humans too. We get sick, have sick kids just like someone else. Why do we feel the need to punish ourselves just because we are doctors? I have attempted to call in sick once in my private practice life and of course there was no one to take my place and make it happen. It sucked going to work feeling like ****, headache, stuffy, can’t breathe, coughing, low energy. Most times it’s not bad to work with a cold. But not all colds are the same. Some are even the flu and people don’t know. Until they end up in the Unit or dead. My friend who’s group was very lean, told me she had vomiting and diarrhea at work all day and was puking in the OR trash cans. How nice is that?

I would think that ideally if you can’t afford to have a doctor free at home on back up, make that person the post call person. That is of course if the post call person was always free post call. And in that regard, on the rare occasion that a the post call person has to work for someone ill, they can then get one less call the next month to make up for it or a day off.

We aren’t invincible. And I don’t think asking about “what happens/what’s the back up plane when a doc has to call in sick” should be a problem. It’s a legit, real world thing that happens in all other fields of life.

I do understand where you're coming from but there is a financial aspect to this, which may sound like greed but it is part of a larger truth. When you have a group that covers a certain amount of services there is only so much food at the buffet. If you start adding people just to have "back up" the you have less food to go around. Just like I said above, no one wants to be on-call for free even if it is home on back up. There is a bit of "suck it up" aspect to this field. That's why some at the beginning of this thread (or in another) said they like college athletes and former military types. They tend to be highly reliable because you "always have to show up to help the team". It's just like when you see a surgeon scrubbed in "coughing up a lung" but they're still operating. The expect the same out of us and in a field that is saturated (and definitely popular areas of the country that are saturated) with anesthesiologist, groups will find someone who will "always be there". I've definitely had awful flu doing cases and covering OB while damn near OD's on DayQuil but in my head if I tried to call out I'd be inconveniencing some surgeons and my colleagues and I'd rather not have those negative check boxes on my profile.

It kind of sucks to put it that way, but that's kind of how it is at many places and I wouldn't even categorize these places as "malignant'.

 

[Noyac]

I'd need a ballpark.

That’s fair.

 

[Noyac]

Partners are usually not even close to "fair" when it's about parting with money.

What if I told you that everyone is paid the same from day one and nobody has left the group because of income?

 

[Twiggidy]

If I told you over the phone that the compensation package and the vacation package are more than fair and that nobody has left our group due to either one of these, ever. Would you still need to hear the details before yo7 would interview?

I mean you should be able to toss out a mean number or something close because if we don't have similar numbers in our head then all of this would be a waste for both parties.

 

[Noyac]

- asking numerous questions about money, vacation, and "what time we get outta here" with no inquiries into clinical/administrative/social/interpersonal issues

Yep, exactly. If you do this in an interview with my group, don’t count on an offer.

 

[deleted162650]

I mean you should be able to toss out a mean number or something close because if we don't have similar numbers in our head then all of this would be a waste for both parties.

 

[Noyac]

Partners are usually not even close to "fair" when it's about parting with money.

Not in my group a new grad is paid the same as an old fart like myself. But I bring a tremendous amount more to the table. 😉
So I guess I’m the one getting screwed.

 

[Noyac]

I mean you should be able to toss out a mean number or something close because if we don't have similar numbers in our head then all of this would be a waste for both parties.

Then I may just pass on that candidate.

 

[deleted162650]

-wearing a wife-beater and dress pants while sitting in a backwards-turned chair to "rap" with group-members in the office

Is that why I never heard from you guys???

 

[Twiggidy]

Then I may just pass on that candidate.

I get where you're coming from. It's "the offer is so good you don't need to open the envelope" type thing but to get all "medicine-y" on the topic if someone wants to make an informed decision they may ....

H/T: @SaltyDog

 

[Twiggidy]

Walking out of THAT interview like......

 

[Noyac]

Is that why I never heard from you guys???

No!

 

[Noyac]

I get where you're coming from. It's "the offer is so good you don't need to open the envelope" type thing but to get all "medicine-y" on the topic if someone wants to make an informed decision they may ....

View attachment 233734

H/T: @SaltyDog

And I understand your point but I will take my chances on someone that isn’t fixated on income any day over someone that won’t interview without hard numbers.

 

[Psai]

And I understand your point but I will take my chances on someone that isn’t fixated on income any day over someone that won’t interview without hard numbers.

 

[Noyac]

Go somewhere else!

 

[Noyac]

Walking out of THAT interview like......
View attachment 233736

And where is McGregor now?

 

[deleted162650]

I think part of the reason @Noyac ’s approach works for him is his location. He’s in a somewhat less “conventional” area. Those that are interested in working there likely have other priorities ahead of $$. Thus, if someone was overly focused on income, that practice is probably not a good fit for them. Now if Noy was in a major metropolitan area, he might find he needs to be more forthcoming with #’s.

 

[Noyac]

I think part of the reason @Noyac ’s approach works for him is his location. He’s in a somewhat less “conventional” area. Those that are interested in working there likely have other priorities ahead of $$. This, if someone was overly focused on income, that practice is probably not a good fit for them. Now if Noy was on a major metropolitan area, he might find he needs to be more forthcoming with #’s.

That is mostly true. The issues we have in my group is not income or time off. It’s location. I live in what I consider the absolute best place in this country. But I understand that the majority of anesthesiologists would disagree with me. If you are not active in an outdoor manner then you would struggle here. Work is usually only half of my day. After work is when the fun starts. Tomorrow I leave work for a weekend of flyfishing on world class waters on a private ranch among massive mountain peaks onLy a few hours from my hospital. Every weekend is a cacophony what do I do now. If I wasn’t going fishing then I’d be in a 12 hr mountain bike race On a team with my partners. This is why I don’t go into details of money and vacation. I want to know, can you ride a bike? Can you skin up a mountain in a blizzard and say” that was awesome,let’s do it again”. If this isn’t your shtick then you won’t be happy here. My newest partner came from Connecticut. He bought a bicycle a couple weeks ago and some touring gear then took off solo on a biking camping trip unsupported for days. Just getting out there. We never talked about money during the interview. If you are lucky enough to get an interview with us (😉) then you spent a good bit of time with our new members. If they can’t convince you it isn’t about money then you are not for us.