Abstract:
For the most part, retained firms might be more of the norm for a health system or hospital, as they might have many open searches throughout the year and need a company, or multiple companies, searching on their behalf full-time to fill their open physician slots. Private practices, however, might have a finite need, one or two slots to fill that are very specific and don’t require an ongoing retained relationship with a recruiter. In these instances, the practice might choose to use a contingency fee–based recruiter. Contingency agreements are usually for the duration of a search, but can be for an ongoing relationship where the agreement is signed and in effect every time a practice has a physician need to fill.
Reprinted from Jeffrey T. Gorke, The Employed Physician: Your Essential Guide to the Business of Medicine, American Association for Physician Leadership®, 2018.
Recruitment Firms
The two forms of agreement are what they seem: a retained search is where a firm is paid to find a candidate. A contingency agreement is where the recruiter is not paid until after the candidate is delivered, meaning payment is contingent upon the deal coming to fruition. It’s not unheard of in a contingency agreement for a recruiter to place a candidate and receive a majority, if not all, of their fee after the placement. Some caveats built into the contingency agreement may allow for the practice to recoup some of its money if a candidate does not last on the job for six months or a year.
If a recruiter asks for a fee from you, run, don’t walk, to the nearest door or away from the nearest Internet connection.
Recruiters are a good way to go in your search. Since it’s their business, many recruiters have their ears to the ground and a feel for what jobs are out there. They’ll do a great deal of the legwork for you. There also are recruiters who work in subspecialties. They have their business ears to the ground hunting out certain jobs for certain specialties. So, if you are in a specialty with limited spots available, these recruiters might offer an even more acute awareness of certain opportunities throughout the country. A recruiter can help cut down on the paperwork and reduce the length of the search process. And it’s a good business for them when they make a hit. In some specialties, a recruiter will garner $18,000 to $30,000 to land one physician for a practice. Not bad. But on the recruiter side of the business, that endeavor is dog-eat-dog and fairly arduous.
Lastly, most recruiters work for the searching physician group, which means the hiring practice will pay the finder’s fee. If a recruiter asks for a fee from you, run, don’t walk, to the nearest door or away from the nearest Internet connection. Though I’ve never seen this scenario, you can rest assured that folks like these are not looking out for you. It’s the same theory in writing: if an agent wants up-front money from you, they’re in it for themselves, not you.
You may want to contact your associates to determine what recruiting firms they’ve used in the past.
The “Friends Network”
At some point in your job search, you may very well have a recruiter working for you in addition to getting information from an associate or friend via word of mouth. This arrangement can be effective and costs neither party anything in terms of placement. Job searches via word of mouth can be productive. You may also try looking through your specialty society, as most have active placement pages on their Web sites and brochures. These serve as fertile locations to chase down available positions within your specialty. Another source of job leads in your specialty may be the medical society in a state you’ve pondered, or your specialty society state chapter, if they have one. For example, the American College of Cardiology has several state chapters.
Now, Land Your Ideal Group
So, you’ve determined where you want to be geographically and what type of group you’re looking for, you’ve reviewed the payer mix, and you’ve figured out how many specialists there are; or, you’ve done none of these things and tossed caution to the wind. Your next job, even given these attributes of your search, might not be the be-all, end-all for you. It might not be the last stop on your career continuum, but hopefully you’ve performed your due diligence and think you’ve selected an area and practice site that suit the needs of you and your significant other.
The CV should serve as an entree to getting your foot in the door.
Now it’s time to begin flipping over the rocks. Make sure you have your curriculum vitae (CV) in order. Ensure that it lists your education and recent experience leading the way, along with where you attended school, publications, studies, research, etc. Never put your social security number on your CV and, really, there’s no need to list personal interests or family information. No one cares that your wife was born in Palo Alto or that you have three kids: Maggie, Chris, and Fred. The group is not hiring your family, and though your familial situation is interesting, it’s not of concern to the group you’re courting save for the fact that your family will need to like the area of choice. The CV should serve as an entree to getting your foot in the door. If you take a step toward the altar of contractual matrimony, you can then cover your interests over a nice, refined recruiting dinner. Remember, there is no need for the hiring practice to know about your family, and technically, they have no legal right to inquire.
Though your CV does not need to be pristine (as many physicians read for content vs. style), it should be presentable. After all, you’re getting ready for the big dance and your first impression should be a good one. Make it count and stand out. As an aside, as a business person, I’m still interested in spelling, grammar, punctuation, so I’m looking to see that you have some sort of a mastery of the English language. But that’s me. I think everyone I hire should have some proficiency in English.
Now, as an aside to that aside, if you’re dealing with a large group, whether single-specialty or multi-specialty, chances are that the head of that ship (from a business perspective) is a PhD, an MBA, an MHA, a JD, or some other combination. In more advanced practices (advanced is defined as groups with a prototypical business structure), the folks running the ship most likely will see and pass your resume on to a reviewing committee or some other body assigned with reviewing CVs. That means that a layman like me will look at what you submit and may be in a position to give you the thumbs down from the get-go. Is that fair? No, as we’re not clinicians. Does that matter? No, it does not.
Once you have your CV in hand, you need to begin contacting groups, whether they’re looking for you or not, to let them know that you’re out there and you have an interest.
There’s plenty of demand for good physicians and, as I’ve said, you should not need to pay for the privilege of using a recruiter; they should be paid by a group for what you bring to the table. Demand for healthcare is on the rise as the population ages, and the supply of physicians is not expected to meet that demand.
When you identify a practice to go after, make some cold calls to determine if there’s a standing search committee within the practice or, if the group is small, a lead doctor to whom you could send your CV. In larger groups, copy the administrator if you can determine his or her name. Some administrators are more in touch with the clinical recruiting needs of the practice than are their physician-bosses. So, an astute administrator might just see a good CV for a very defined business need within the group. (Think a cardiology group looking for an EP guy or gal to round out their cardiology continuum of care.)
Another source, of course, is your friends, as discussed previously. You probably have some friends who finished a year or two ahead of you and are now out in the real world. They might know of positions that are available, have a keen understanding of what compensation might look like, and can be instrumental in getting you in the door.
You should aggressively go after the groups that interest you. As I’ve said, even if they are not advertising for a position, it is worth submitting your CV to them. It shows interest, motivation, and initiative. And you never know when they might pull out your CV and give you a call.
Keep your expenses to those associated with the recruiting trip.
And remember this: if a group is interested in interviewing you, the cost of the process is borne by them, not you. They should pay for your expenses, including, but not limited to, reasonable air travel, a rental car, a hotel, and minor miscellaneous items like tolls, etc. Typically, you will make your flight reservations and other travel arrangements, pay for those services, then keep your receipts and turn them in after your recruiting trip. I have also seen some groups make the arrangements for the interviewee. This is fine, as you don’t need to charge your trip, but I like to let the visiting candidates arrange the trip based on their needs and time constraints.
Don’t tuck in a bunch of miscellaneous garbage on the receipts you submit for reimbursement; keep your expenses to those associated with the recruiting trip. Exaggerated or overinflated expenses are a pretty darned good red flag for the recruiter. If you’re willing to cheat on your expenses during a recruitment trip, what the heck else might you cheat on?
Compensation
We’ll now take a leap. You’re employable (good for you), and someone actually has an interest in you (even better!). The stars are aligned, and you feel like you’ve waltzed gingerly into a perfect job fit.
Now that you’ve decided to dance with this group and take steps toward your second marriage, it’s time to figure out what you’re worth. How do you know what you’re worth to the group? Well, you’ve done your research on the area in terms of the specialty demand, you know how many docs there are out there, and you have an idea of the possible patient demographics. You know that you are worth a good bit to the group (or not). But first, you need a baseline—a jumping-off point, if you will, to know how much above or beyond a reasonable salary you should go.