Avoid First-job pitfalls: Eight questions to ask a potential employer

By Lance J. Kugler, MD

When evaluating an employment opportunity after training, one typically focuses on the obvious issues: salary, practice style, call schedule, geography, etc. However the nuances of how a new physician will fit into the dynamic of an existing group practice are often overlooked. If it is not clear why a practice is hiring, or how a new associate will fit into the current practice model, it may lead to misunderstandings after employment begins. Here is a list of questions to ask a potential employer during the evaluation process in an attempt to avoid these problems:

1. Why are you hiring another doctor?
If the employer cannot give a clear, rational reason for hiring another doctor, then it may indicate that they either have not considered the question or they are not being forthcoming.

2. How will you help me build my patient volume?
In residency programs there is no shortage of patients and residents often feel overwhelmed. Once you begin practice, however, the schedule can look barren. If an employer has not considered the source of your patients, then it may mean they are not prepared to take on a new associate. In contrast, an employer that is prepared to hire a new associate may have a marketing strategy to get your practice up and running.

3. Am I expected to generate my own patients and referrals, or are there already patients within the practice that require my skills?
The practice may be hiring someone new as a way to bring in new patient volume. If that is the case, then they likely are expecting you to generate your own patients and referrals. In contrast, a practice that is hiring because they lack sufficient physician coverage to handle the existing patient volume may have adequate patient load to keep a new physician busy from the start.

4. Do the current physicians have the same skills that I have, and if so, will they be upset if their patient volume is diluted in order to fill my schedule?
It may be a source of tension within a practice if a new associate is receiving referrals from outside the group or from within the group that previously went to the other associates. If there are physicians with the same skill set, it is advisable to discuss beforehand precisely how such referrals will be handled.

5. Will I be allowed to attend the business meetings and if so will I have any input into the decisions?
Depending on the structure of the particular employer, the current physicians or partners may be involved in the management. It is wise to know beforehand what role, if any, you will have in that process.

6. Do I have any input into the hiring of new staff, particularly the staff members with whom I will be working directly?
Your job satisfaction is only as good as the quality of the staff with whom you work. If you do not have control over the hiring or firing of the staff with whom you are directly involved then it may lead to problems.

7. Do the current physicians have an amicable relationship and work well together, or are there rifts or factions?
There is no such thing as a practice without any interpersonal relationship issues, however some situations are worse than others. Although you may get along well with all of the current physicians in the potential practice, they may not get along well with each other. If that is the case then you may find yourself trapped between factions or caught in a political game. To the extent possible, find out how well the group works together.

8. Have any physicians left the practice, and if so, why?
Turnover in new associates may indicate a problem with the way they are treated by the physicians in the group. If possible, contact doctors who left the practice and learn more about their experience.