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An on-site interview is your opportunity to assess how well your values and those of a potential employer align.

Fam Pract Manag. 2001;8(1):38-40

Finding a job that provides long-term satisfaction takes more than the right connections or good luck. For me, it has required a strategy that takes into account my personal and professional needs and values. In a previous article I shared the framework I’ve used to identify my values and determine what I can and can’t live without in a new position (see “How to Find the Job That’s Right for You,” November/December 2000, page 30). Knowing exactly what I want enables me to focus my efforts on only those opportunities that best suit me. Plus, it saves me time and stress. I approach a job interview the same way.

Relax

Most of us treat a job interview as a form of mild interrogation: the employer asks the questions, and we provide the answers. Instead, I would encourage you to consider a job interview another opportunity to see how well the organization fits your needs. The truth is, by the time you and a potential employer actually meet for an interview, your motives are well aligned. You want a position at a place where you fit in and can stay a while and where you can see a lot of satisfied patients. That’s exactly what employers want. They want the best person for the job, and they’re hoping that person is you so they can get back to work. Some will even use the on-site interview to try to “sell” you on their organization. Don’t be led astray. Stay focused and ask questions that will help you determine whether your values and expectations align with theirs.

Key Points:

  • Think of the job interview as an opportunity to determine how well a potential employer can meet your needs.

  • Interviewing support staff can provide you with valuable insight into an organization.

  • Touring the physical space where you might work can tell you a lot about the values and priorities of a practice.

Use lists

It’s likely you won’t be conducting a job search too many times in your career, so don’t invest time and effort memorizing your interview questions. Instead, write them down. This recommendation may go against the grain, particularly for physicians who are trained to memorize questions and take minimal notes during a patient interview, but my personal experience has been that everyone reacts positively to my lists. Most administrators are relieved that I am interested and educated enough to bring a list. Many physicians are unsure about what to ask me and seem quite relieved that I have a list of things to talk about. Nurses and support staff seem ecstatic that I cared enough to prepare questions for them.

I tailor each list of questions to each person who interviews me (see page 39), but as you’ll see, there are some questions I ask everyone. Their responses – particularly the inconsistencies in their responses – speak volumes. And, while it’s likely you’re going to interview with the administration and some potential colleagues, don’t pass up the opportunity to talk to nurses and the front-office staff. They can also provide you with valuable insight about your potential employer. If the opportunity isn’t offered, ask.

I highly recommend asking about the financial health of the organization and the specific clinic with which you may be affiliated. It’s a vital question considering the amount of change that’s occurred in health care in recent years. Also ask about strategic planning: What is in store for the next year, and the next five or 10 years? While an administrator is the logical source for this information, I also like to ask physicians and support staff. If the administration is planning sweeping changes and your future colleagues are unaware, the work environment might become quite uncomfortable.

WHAT QUESTIONS SHOULD YOU ASK?

The following are examples of questions I have asked during job interviews. Consider them a bank to draw from. Your questions may differ depending on your personal and professional needs and values and on the practice setting you’re considering.

Ask a physician

What’s the call schedule?

How many calls and admissions do you handle on a typical call night or weekend?

How is sign-out handled?

Does the practice use a nurse triage system?

Do you have evening or weekend office hours?

What hospital(s) are you affiliated with?

How is the ED covered?

Are FPs welcome in the ICU/CCU at the hospital(s) where you work?

What is the policy regarding prescribing narcotics and antibiotics over the telephone?

Are patient charts well organized? Are they dictated or handwritten? Do they include problem and medication lists, flow sheets or other reminder forms?

What are the weaknesses of your current charting system?

Is the practice computerized? What are the future computerization plans?

How would you describe your level of autonomy?

How many patients do you see per day?

Who decides how much time you spend with each patient?

Do you receive appropriate feedback about performance quality?

Do you receive feedback or education on billing and coding?

How would you describe your relationship with the staff?

What are the staff’s foremost concerns?

Are you satisfied with the current compensation package?

How is productivity measured?

How would you characterize the pressure to produce?

How would you describe the organization’s overall financial health? How is this clinic doing financially?

Is any expansion, integration or corporate rearrangement currently being considered?

Are you aware of any specific plans for capital improvements?

How would you describe the practice's relationship with third-party payers?

Is the administration responsive to your concerns?

Ask an administrator

Does the organization have a mission statement? If so, what is it?

What are its goals?

How would you describe the organization’s overall financial health? How is this clinic doing financially?

What is the business plan for the next five to 10 years?

What is the overhead?

Is any expansion, integration or corporate rearrangement currently being considered?

Are you aware of any specific plans for capital improvements?

How would you describe the practice’s relationship with third-party payers?

Is the practice computerized? What are the future computerization plans?

What’s the payer mix?

How long does it take to get credentialed with the major plans in your area?

How much autonomy do physicians have in this organization?

Do physicians choose their own hours?

Do physicians determine how much time they spend with each patient?

Do physicians work any evening or weekend office hours?

Do physicians receive feedback or education regarding performance quality, billing and coding?

Do physicians receive feedback regarding patient satisfaction?

Do physicians hire and fire their own staff? Do physicians have the authority to hire more staff, if needed?

Do physicians conduct performance reviews for staff?

How much input do physicians have regarding staff salaries?

Is there an office manager for the clinic or is the office manager in a centralized location?

What is the compensation plan (i.e., salary, benefits, vacation, time off for CME, maternity leave)?

Is compensation tied to productivity?

Is there any money allotted for continuing medical education?

Are bonuses given?

Who pays for beepers, cell phones, professional dues and licenses?

Are moving expenses covered?

Ask a nurse

Are patient charts well organized? Are they dictated or hand-written? Do they include problem and medication lists, flow sheets or other reminder forms?

What are the weaknesses of your current charting system?

How would you describe your organization's relationship with third-party payers?

Is the practice computerized?

Is the computer system easy to learn? To use? How often does it have problems?

Is it difficult to get equipment replaced or to get new equipment when needed?

How manageable is the volume of telephone calls that the practice receives?

What is the practice’s policy for prescribing narcotics and antibiotics over the telephone? How closely do providers adhere to this policy?

How would you describe the nurses' level of autonomy?

How much responsibility do nurses have for telephone triage and patient education?

Do you feel that physicians can effectively address your concerns?

Is the office manager responsive when you have concerns?

How satisfied are you with the organization's compensation package?

Are bonuses given?

Do you have any issues or concerns regarding compensation?

How does the overall organization seem to be doing financially? What about this clinic?

Are you aware of the organization’s future plans?

Ask support staff

How manageable is the volume of telephone calls the practice receives?

What are the weaknesses of your current charting system?

How would you describe your organization’s relationship with third-party payers?

Is the practice computerized?

Is the computer system easy to learn and to use? How often does it have problems?

Is it difficult to get equipment replaced or to get new equipment when needed?

How would you describe your level of autonomy?

Do you feel the physicians can effectively address your concerns?

Is the office manager responsive when you have concerns?

How satisfied are you with the organization's compensation package?

Are bonuses given?

Do you have any issues or concerns regarding compensation?

How does the overall organization seem to be doing financially? What about this clinic?

Ask everyone

How long have you worked here?

What do you like best about the organization?

What would you change if you could?

How much turnover has occurred during the past 12 months?

Why have people left?

Have you ever considered leaving?

Evaluate the facility

The interview process should also include visually inspecting the practice. Again, if no one offers to show you around, ask. What you see will shed light on how the organization views its doctors, staff and patients and is another indicator of whether your values align with theirs. For example, are exam rooms a comfortable temperature? Are they well lit and private? If so, it’s likely that patient well-being is a high priority. What about the waiting room? Is it clean, comfortable and stocked with up-to-date reading material? Are check-in and check-out areas well marked and easily accessible? Using the same mind-set, walk by the nurses’ stations and peek into physicians’ personal offices. I also recommend reviewing a few patient charts. Charts that are disorganized and illegible may be a sign of unhappy times to come.

Interview follow-up

After each interview allow yourself some time to review and reflect. You may want to type up your notes and summarize the information you’ve received. Review your list of questions to make sure you’ve filled in all the blanks, and call back for more information or clarification if needed. Then write down pros and cons of the position and talk them over with someone who knows you well to help stratify what’s most important you.

Job offers

There are plenty of job opportunities for family physicians, so don’t feel pressured to accept the first job you’re offered. And don’t accept a job without a second interview. You’ll be cheating yourself out of another chance to evaluate the organization. Why take chances, especially if it means uprooting your family?

Even when you’re really sure this is the right job opportunity for you, don’t accept an offer immediately. Give yourself and your prospective employers and co-workers some time for “courtship.” You’ll learn a lot about them by the way they treat you and, to get you on board, they may grant you a few favors not offered to established employees. Perhaps you’ve identified a few key issues that would make your workday more productive and enjoyable. For example, the office may need another part-time receptionist or medical records clerk, or a better transcription service. Be selective and polite. If you ask for the right things, even the administrators will be glad you asked.

Whatever you do, don’t accept a job if you’re hesitant or have any questions. The rationalization that “maybe this one issue won’t be problem” will inevitably backfire. Instead, ask the employer to address it. If they know an issue is really important to you, they may be willing to make some accommodations.

Get any verbal clarifications or commitments in writing. Perhaps you’ve been told that you can select your own nurse or that the organization offers six months of maternity leave. Make sure there are no qualifiers attached. The six months of maternity leave may only apply to people who’ve been employed for three years. Or you may get one opportunity to choose a nurse. What happens if he or she isn’t working out? Ask for details, and you may also want to have a lawyer review the contract.

Assuming the job market is a place you’d rather not be, I’d advise you to do everything you can to get exactly what you want. Be choosy and ask questions that will help you determine which job opportunity is the right one for you.

Editor’s note: In an upcoming issue, James Giovino, MD, will explore alternative practice styles available to family physicians looking for a change of pace, whether it’s working in the emergency department, in a resort community or on Capitol Hill.

  • To prepare for the interview, write down questions, tailoring them to each person you interview with.

  • Ask about the financial health of the organization and the clinic with which you may be affiliated. Also ask about strategic planning.

  • Allow yourself time to reflect following an interview and don’t hesitate to call a potential employer for more information or clarification.

  • Never accept the first job you’re offered and don’t accept a job if you’re hesitant or still have questions.

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