Navigating the Job Search Superhighway. (Career Management).

Cyberforums are structured opportunities provided by the American College of Physician Executives to use your computer and the Internet to talk to other physician executives about a topic that interests those who sign up. They are not live chat sessions. You receive emails during a three- to four-week period, read them when you have time, and post your responses.

The Cyberforum on Navigating the Job Search Superhighway," which ran from November 15 to December 17, 1999, had 131 participants. It generated hundreds of pages of responses. I have listed below comments that convey the essence of the discussion. In most cases, a new paragraph indicates a different speaker, so you will see opposing viewpoints from one paragraph to the next.

The words are not mine, although I have edited many of them, but my influence is in the article because I chose which comments to show you. The words are from physician executives who have gone or are going through the job search process and from some who have hired physician executives. The final section on contract negotiation is a composite of comments on the subject during the Gyberforum.

Value of experience

"I had lots of medical staff experience, but that didn't mean much until I had a part-time medical director position under my belt., something I was paid for...a position where deliverables were actually important. Once I had a 'real' job, interviews came fast and furious."

"My advice is to look for a managed care position or a UM position at a health plan, hospital, clinic, etc. These jobs are plentiful and can be done part-time while maintaining a clinical practice. From there you can begin to build credibility with clinicians and non-clinicians alike. Then you can demonstrate your business acumen, as well as your medical management knowledge. This experience could lead to a broader job description, managing health care professionals, handling conflict, developing strategy, etc. These experiences will establish a foundation for a physician executive position, such as a VPMA or CMO ."

Importance of a management degree

* "The advanced degree requirement is used to influence the final cut. Otherwise, experience and demonstrated job performance are the main criteria."

* "My MMM degree helped in being hired and may well have assisted in getting the interview, but I also had my own history of leadership experience, medical staff positions, a part-time medical director position, and health care consulting for mergers and acquisitions for a for profit."

* "MMM, MPH, and the like are fine as long as you are interested in hospital system VPMA, UM fobs, and CMO positions in physician groups. But insurance, pharmaceutical, and other business-based industries are only impressed by the MBA."

Value of becoming a CPE (Certified Physician Executive)

* "Some people rated the CPE highly and others hadn't heard of it. There are situations where it may give you the edge if your resume is otherwise equal to the competition. Its usefulness is growing as an indicator of accomplishments and of personal ability and commitment to acquiring and maintaining management skills."

Tips on networking

* "First, develop a two-minute spiel about yourself, starting with what you are doing now--describing your interests, competencies, and experiences--and ending with where you want to go. You can either write out a script or do it from memory, but make sure you can explain what you do and where you're going so that even your grandmother could understand it. Also, you want to convey excitement and enthusiasm about exploring new opportunities.

* Once you have your introduction down pat, have a list of questions in mind that you could ask. 'Do you know anyone who may be interested in what I have to offer?' 'Do you know of companies that would have an interest in my skill set?' 'Do you know any recruiters I can speak with?' 'Do you know anyone who knows lots of people?' (The latter question is a last resort, but can be useful because it helps you identify extraverts who may know just the people you would like to meet.) Notice that these questions avoid asking for jobs, because most people may not necessarily know of open positions.

* When someone asks you what you do, you can present your spiel and weave in the questions and see what happens. Clearly, you want to learn about the other person and establish rapport. Try this on people that you know, but do not be so selective that you confine your networking to physician friends and acquaintances. You never know who the hairdresser, barber, postman, priest, rabbi, etc. may know."

Dealing with recruiters

* "There are two types of executive search firms--retained and contingency. Retained search firms are paid for their efforts, usually whether one of their candidates is offered the position or not. Some retained firms spend a great deal of time getting to know their clients' needs before beginning to seek candidates, spend more time getting to know their candidates and their families, and play a major role in candidate visits, making an offer, and subsequent activities. Contingency firms are paid only when the person is placed in the job and may be more apt to present less ideal candidates."

* "Retained search firms, which usually do searches for individuals with salaries over $90K, tend to be very selective and deliberate about their candidates, because they are paid some percentage up front to do the search."

* "Unless you are a superstar, it is important to understand the fee structure of the recruiters you are working with. One was going to get 30 percent of my base salary for two years, and there was no way that any start-up physician executive could get a chance of making his short list! Also, you need to work with many recruiters simultaneously, because you can be considered for only one position at a time by any one firm--it would make them look bad if you were chosen for two."

* "Two questions recruiters will ask are: "Will you relocate" and, if so, "What geographic limits do you have?" It is important to have a 'heart to heart' conversation with your significant other before you answer this. It will help you avoid looking at jobs that you ultimately won't accept. On the other hand, if you have little experience, getting the first job may require a move to a less than perfect setting. In management, multiple job changes are the norm. So, in considering geography, it is also important to consider what other jobs will be available at a later date, when you have more experience, that won't require moving. Also, is the first job at the corporate or field office? If it's the latter, moving up may mean packing up."

* "When considering a position, you have to do research to answer the following four questions:

1. Do you know what the job is? (Obtain job descriptions, talk with human resources if possible or with people who have been in similar positions.)

2. Can you do the job? (You can answer this only after you know the answer to # 1.)

3. Can you do the job the way the employer wants it done? (This addresses questions of personality/communication style and organizational culture. If you are a big picture strategist being hired by a detail-oriented tactician, you need to assess that either in the interview or through your network.)

4. Can you do the job profitably for the employer? (This relates to questions of productivity, and the ability to generate revenue or manage budgets.)"

* "During my job searches, I found that my most useful 'resources' were the relationships I have formed with physician recruiters. They are often tremendously knowledgeable and should be part of everyone's professional network. I refer contacts to them, update them on my status when I have found a position, send them Christmas cards, etc., and they 'take care of me' when I need them."

* "It isn't fruitful to mail out resumes to recruiting firms unsolicited. Having a contact name is the best way to get a response."

* "There is an excellent book on how to work with headhunters entitled Rites of Passage at $100,000+ by John Lucht, a headhunter. Anyone who is thinking about using an executive search firm must read this book first.

Phone interview

* "Every time you pick up the phone, you must be mentally prepared to find someone on the other end of the line who has just started an interview. I have been extended the courtesy of having someone call to schedule a telephone interview on a specific date and time, but I have also picked up the phone with the TV in the background and lunch in my mouth to find that the interview had already started. It will be difficult for you to get your foot in the door if you don't perform well."

* "My ACPE courses have served me well when they advised to stand up and be animated during a phone interview in an effort to make up for the lack of body language."

* "You should script these calls. Anticipate the questions and write out your responses. Then read them out loud to be sure they come across as intended on the phone."

Prepare for the interview

* "Questions you should be prepared to answer during the interview: What value do you bring to the organization?

What is your vision of the future? How do you build consensus? Lead change? What do you see as the needs of the organizations and how can you best meet those needs?"

* "Before my interviews, I scoured the organization's website for information about the organization, its history, site locations, etc. I examined the profiles on the physicians and administrators interviewing me. I jotted down notes on their educational backgrounds, sites of training, special interests, hobbies, etc. This site had their current pictures, so I had a good idea of who they were and what they looked like before I met them. It's amazing how often these little bits of information received positive recognition from the interviewers. It was particularly helpful to break the ice and make the interview more relaxed."

Face-to-face interview--how many, how long?

* "You might want to ask what the interview format will be before you arrive for it. I have been interviewed by one to 12 people at a time. A large group is difficult. Usually they want to be sure that you can lead a team. You want to be sure that you include everyone, but it can be difficult with limited time."

* "Be careful about giving an air that you have implicit knowledge of any and all disciplines just because you have a medical degree when interviewing before executive directors, CEOs, CFOs, and other business types, even recruiters. You won't even get to the others if the recruiter gets a bad impression--thinks you are arrogant."

* "How we look will determine the first impression of ourselves, so neat, clean, business-like, punctual, and comfortable count."

* "When speaking, less is more in these instances, except that recruiting agencies and outplacement firms generally recommend that you support your answers to questions with examples from your experience whenever possible. I have commonly been asked about examples of when I facilitated internal or external change; how I conveyed disagreeable decisions by senior leadership; how I instituted programs that saved money or resources; and how I dealt with problem physicians."

* "You will have a chance to ask questions about the current philosophy, finances, directions, operations, etc. of the organization. You should be able to ask, "How does this organization currently handle ______ and how would you like it to be different?" Also, make sure you understand the organizational hierarchy. I took a job with an organization that indicated it was an independent entity for operational purposes, only to discover that there was a whole hierarchy of medical directors and administrators on the other side of the state who were just as important as my boss!"

* "I found it fascinating to ask my interviewers to describe the "culture" of their organization."

* "Social time is really a continuation of the interview process. I have sat through many candidate interviews where they forgot to smile once in awhile. So many judgments are made about a person by evaluating body language."

* "A candidate who makes a scene during a social event, fails to show his or her human side, or demonstrates negativity, whining, or excessive nerdiness will be the loser. Candidates can also get too loose, Be careful about the alcohol consumption. I've seen good candidates really blow it."

* "Important do's are to look and act interested, display having thought about the position by asking relevant questions that show you have read whatever advance material has been sent to you, and be willing to talk about yourself when asked but do not be boastful or self-centered."

Be respectful to everyone

* "I regularly get feedback from my administrative assistant. She lets me know how the candidates treat the staff, how prompt they are in replying, how difficult they are. Candidates who notice that she provides them with great service and bring it to my attention get extra points."

Negotiating your contract

* "You will not get everything you want when negotiating a contract, so decide the items that are most important to you. Put all the items in a prioritized list and be willing to give up some things at the bottom of the list. Decide which items you have to have or you will not take the job. The organization should bring up the issue of money or the recruiting firm may already have told you the salary range.

Some points to consider when negotiating a contract:

Performance evaluation:

How will your performance be evaluated?

Money:

* What is the market value for the position you are applying for? Learn by reading compensation surveys and talking to others.

* If compensation equals salary plus bonus, what are the criteria for awarding bonuses?

Benefits offered by most organizations:

* Insurance: family health and dental, accident, life, short- and long-term disability

* Retirement plans--details of how long until 100 percent vested, portability

* Continuing education or tuition reimbursement allowance

Paid time off usually includes the following (ask about the numbers):

* Vacation days

* Holidays

* Sick days

* Personal days

* CME days

Relocation package:

* Are moving (van) expenses and house hunting trips included?

Professional stature issues:

* Is malpractice insurance going to be necessary and are you paying for it? If not, will you be covered by directors and officers (D&O) insurance, and will the organization compensate you for any additional legal expenses?

* Are you expected to maintain specialty certification? What happens if you lose it? Who pays the associated expenses of maintaining it?

* Is it important to the organization that you maintain your medical license(s) and membership in medical societies and specialty organizations? If so what expenses is it willing to cover?

Written agreement:

* Will there be a letter of agreement or a more formal contract?

* Are there restrictive covenants?

* Do you need a lawyer to review the contract? (If you decide you do, it is best not to announce it to the organization.)

Termination issues:

* Is there a severance package? (In these days of mergers and acquisitions, this should be negotiated when you take the job, not when you are about to leave it.)

Conclusion

The Cyberforum was a lively discussion that hit all the important issues of career development. In an exchange with their peers, the participants could ask questions, as well as get and give answers. Many of the emails were anonymous, so there seemed to be little fear about discussing career concerns online. I recommend this process to you as a way to gain valuable information, find others are experiencing problems similar to yours, and learn what they are doing to solve them.

Acknowledgement

This information was edited .greatly by Wes Curry, book editor for ACPE, who cut it from 700 to 50 pages and then did a last edit after I had worked with the information.

Barbara J. Linney, MA, is the Director of Professional Development at the American College of Physician Ex-ecutives in Tampa, Florida and a member of its faculty. She can be reached by calling 800/562-8088 or via email at [e-mail].