The Practice of Accepting a Physician Job Offer

Obtaining a physician job offer is a great step when it comes to your long-term medical career path, but really, it’s only part of a much more in-depth process. Due to the stress of finding the ideal opportunity, some doctors tend to jump a the chance to take any offer, but that may not always be the best decision. Here are some of the things recruiters should consider before offering a position and some of the items physicians should consider before signing on the dotted line.

1. Before offering a job to a physician

Before you offer a medical job to someone with the right credentials and proper pedigree, make sure the physician fits the job requirements as a person. As Buckingham and Harter wrote in First, Break All the Rules, “people don’t change that much.” Choosing an extrovert as a pathologist may not be the wisest selection.

If you hire a doctor who is temperamentally ill suited to the position you are filling, the result will be either a disgruntled employee or a turnover. Doctors and nurses are not fungible commodities. Each one is unique so make sure the person inside the white coat fits the specific job requirements.

2. Before accepting a physician job offer

• Have written, detailed quantifiable expectations of both the work process and the outcomes expected using acronym SMART (Specific, Measurable, Attainable, Relevant, and Time limited)
• Be quite sure you understand the corporate culture and that you fit in, or that you want to fit in. The elements of corporate culture include: business environment; values; heroes; rites and rituals; and contact network. Do you feel comfortable with these elements? You are going to have to live with them if you accept the job.
• You spend more time with your coworkers than with any patient. Find out if you want to work with these people before you have to.
• Be clear and precise about support factors: salary, benefits, pension including vesting schedule, insurances especially liability (do not assume that hospital legal counsel will “have your back”), etc. Make a list and check on it before you sign on.
• If the position carries a level of authority such as Chief or Chair, you must also consider the following before accepting a physician leader job: personnel, lab space, clinical facilities, how much budget control, and do you have authority commensurate with your responsibility? Do not let them judge you for outcomes over which you have no control.
• What recourse do you have if you are dissatisfied or if they fail to honor the employment contract? It is not lack of good intent, but rather wise and prudent behavior to plan for the end at the beginning.

Useful reading

The readings below contain helpful management information for both the hiring facility and a physician-employee thinking about accepting a job.

1. Buckingham M, Coffman C, 1999. First, Break All the Rules: What the World’s Greatest Managers Do Differently, Simon & Schuster: New York, NY.
2. Deal TE, Kennedy AA, 2000. Corporate Cultures—The Rites and Rituals of Corporate Life, Perseus: Cambridge, MA.
3. Collins JC, Porras JI, 1997. Built To Last, HarperBusiness: New York, NY.
4. Waldman JD, 2010. Uproot U.S. Healthcare, Second Edition. ADM Books: Albuquerque, NM.
5. Waldman JD, et al. 2004. Changing the approach to workforce movements: Application of net retention rate in healthcare. Journal of Applied Business and Economics. 24(2): 38-60.

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