By Peter P. Cebulka III, Director of Recruiting Development and Training, Merritt Hawkins
As professionals working in the physician staffing industry know, the first two questions doctors generally ask about a practice opportunity are:
1) Where is it located?
And:
2) “What is the financial offer?”
These are obviously important questions, but physicians interested in determining if a practice opportunity is right for them and for their family should go much deeper. Following are some issues physicians seeking a practice should consider, and questions they should ask, as they work through the intensive (though often quite interesting and rewarding) process of evaluating a practice.
These issues and questions are not just relevant to physicians evaluating the job market, however. They are important to hospitals and medical groups that are recruiting physicians and who will be asked to respond to a variety of candidate inquiries and concerns. Hospitals and groups should be prepared on the front end with a detailed physician recruiting position statement and plan that anticipates what candidates are likely to ask.
First, accept the process for what it is
Physicians considering a career change are taking a step that will have profound consequences for themselves and their families.
- Accept that the process will be rigorous and time consuming.
- Be prepared to spend hours on the phone with recruiters or other representatives of the practice before an on-site interview is scheduled.
- Include your spouse or significant other in these telephone discussions
- Fact-find on the front end. Learn all you can about the parameters of the practice, including financials and contracts, before the on-site interview is set. Keep in mind the interview is for confirmation not for exploration. By the time you meet your potential colleagues or employer, you should know what the practice and the community are all about.
Know the vision of the group, hospital or health system
In an era of health reform, physicians need to understand the vision of the group, hospital and/or health system they will be joining.
- Do they intend to designate as an ACO or medical home?
- Are there key physician leaders within the hospital or health system advocating the physicians’ point of view? If so, who are they and what are their priorities?
- What are the plans for integrated EHR?
- Are there ongoing negotiations with major payers within the state?
- Are there plans for practice mergers or integration with larger entities?
- Where does the practice stand in the shifting continuum between traditional, fee-for-service practice and the integrated model with its associated quality and cost effectiveness metrics?
The leadership, direction and stability of the leading local health systems have become part of the evolving conversation in physician recruitment, whether or not the doctor is considering joining a private affiliated group in the community, or employment by the system.
Determine if there is a defined need for your medical specialty in the service area.
It is important to know whether your services are really needed in the community, and the basis for that need. If part or all of your compensation will at some point be tied to your production, you should be satisfied that an adequate patient base will be available.
- If the opportunity is in a designated Medically Underserved Area (MUA), or Health Professional Shortage Area (HPSA) per the U.S. Department of Health & Human Services, there is probably a need for primary care and there is likely a need for certain specialists as well. The recruiting group or hospital should know if they are in a designated MUA or HPSA. You may research this independently, however, by accessing the web site of prominent immigration attorney Carl Shusterman here: http://shusterman.com/medicallyunderservedareas.html.
- Determine the physician-to-population ratio in the area for your specialty, and compare this ratio to various studies indicating the required number of physicians by specialty per 100,000 population. The recruiting medical group or hospitals should have these ratios. You may also obtain physician-to-population ratios by contacting Merritt Hawkins at 800-876-0500.
- Ask for information about local patient outmigration patterns.
- Determine if the local physicians have full practices, and whether they support recruitment.
- If you are joining a group in a competitive market, will there be patient overflow from colleagues with currently long patient wait times, or is the intent for you to build a practice and capture market share?
- Ask about the group or hospital’s medical staff plan. Many hospitals today, and some large medical groups, prepare staffing plans that analyze patient demographic trends, acuity levels, and other data required to determine community need for physicians.
Ensure that there are adequate resources available for you to establish a practice.
If the groundwork for your recruitment has been laid properly, resources should be in place or pending that will allow you to establish your practice.
- Ask where your office will be located, whether it clean and attractive, and if it has ample space, competent staff, and the necessary equipment.
- If there is limited access to required technology, ask if funds are allocated or available in the budget for purchasing what is needed.
- When the position is not with a major teaching program or tertiary center, it may not be crucial to have all state-of-the-art equipment, but it is important to know how your patients can be referred to subspecialists and the most contemporary diagnostics when necessary.
As I mentioned, assessing a practice opportunity is an in-depth process. These are only some of the questions to ask. I will address others in Part II of this blog which will post Wednesday, August 3.
Contact Peter directly at: peter.cebulka@merritthawkins.com