Questions, questions: What you should ask a prospective employer

The interview process should be reciprocal and allow a candidate to learn more about the practice.

Issue: March 10, 2016

ByJohn B. Pinto

“The wise man doesn’t give the right answers, he poses the right questions.”
– Claude Levi-Strauss

“Ask the right questions if you’re to find the right answers.”
– Vanessa Redgrave

Few things rattle even the most confident surgeons more than a high-stakes, on-site job interview. Such interviews take place only a few times in your career. They are meant to determine if you are clinically competent, play well with others and can remember which fork to use with the salad course.

Because of all this stress, it is easy to forget that every job interview should be reciprocal. You are being interviewed, to be sure, but even more — with more jobs now than available doctors — you are in the driver’s seat and should be doing at least half of the interviewing and vetting.

Imagine it is showtime. Here is the setup:

You are an ophthalmologist looking for a new job. You may still be in training, or you may be in the middle of your career.
Like most job-hunting ophthalmologists today, you want to become an owner — you do not want just a paycheck — so you are interviewing for a partner-track position.
You are — like most ophthalmologists — adverse to difficult conversations. You would just as soon not ask questions that could make people uncomfortable, much less be uncomfortable yourself.

For partner-track associate positions, you should have two question sets, one for each of the two opportunities you are assessing:

The associate-period employment opportunity, typically 2 or 3 years.
The business ownership opportunity you hope you will eventually be offered.

Realize, that with a relative abundance of jobs for every available doctor today, you have more power than ever to examine all of the details of the target practice.

Of course, you have to be civil to your prospective employer and stage your questions appropriately. This is a little bit like dating etiquette. It is not polite to ask your prospective boyfriend or girlfriend on your first date about his or her STD status; you save this for the fourth or fifth date when things are heating up.

In the same manner, it is not polite to ask the managing partner who is interviewing you during a first dinner about everyone’s malpractice history or adverse Medicare audits.

So here are two question sets: one for the early stages of your discussion with a practice you are considering joining and a second for the later stages in which candor is essential to your professional success.

Stage one: Getting to know you

During this initial period, which may comprise all or most of the initial on-site interviewing visit, you are naturally in “sales mode.” You want to be liked and accepted as a good fit with the employing practice. All the same, there are numerous gentle questions you can ask to determine if this is the practice of your dreams:

Tell me a little bit about the culture of this practice. Are doctor-to-doctor relationships all business, or do you socialize outside of the practice?
What is the leadership structure? Are there opportunities for me to make a contribution to the practice beyond just seeing patients, such as assisting with business projects or lecturing in the community?
Will I be coming in to a ready-made practice, or will I need to work hard to develop referral sources? What statistics support your impression that there will eventually be enough patients for me to be busy in this practice? Is there a need for another subspecialist like me in this community?
What would be my compensation model as an associate? How flexible are you with terms on this? Can we trade off a higher bonus potential for a lower base pay? (Or vice versa?)
Are the other terms as an associate in line with contemporary norms?

Family health coverage

A moving allowance of up to $10,000

Four to five weeks of paid time off for vacation/CE and sick leave

An annual CE stipend (typically $2,000 to $4,000 per year)

Adequate termination notice, should things not work out

Reasonable, mutually fair non-compete terms

Is the work ethic of this group in line with my own perspectives about work-life balance?
Is call shared equally? If not, are doctors who take extra call compensated separately?
What would be my typical weekly schedule? Which offices would I cover? How many patients would I be expected to see? How many exam rooms and techs would be supporting my pod?
I consult (or write or invent) with industry. What accommodations can be made in my schedule to work around this, and how will my outside income be treated?

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Stage two: Getting more serious

At this stage, you pivot from mostly selling your talents to mostly assessing the talents of the subject practice. This may happen toward the end of your first interview or subsequently over the phone. At this point, many job hunters get shy, thinking they do not have a right to ask the tough questions:

Are there any doctors here who you intended to “make” partner, but who, years on, are still associates? Why are they still associates? May I speak with them?
What portion of partner-track associates achieve partner status in this practice? In the last 10 years, how many partner-track associates have you hired, and subsequently dismissed, without making partner? May I speak with them?
What, if any, objective performance standards are required to become a partner? (For example, annual collections or visits per month.)
May I see and have my advisers review the following documents and records before I make a decision?

The last 2 years’ financial statements

The most recent balance sheet

The current shareholders’ agreements

A typical owner-MD employment agreement

A recap of the current owner-MD compensation plan

A description of the portion of the practice available for me to purchase, the valuation method and the slated payment terms

Will I have the ability to own ancillaries such as ASCs and opticals and to participate with any building ownership?
Is the practice facing any exceptional risks? (For example, loss of a key producer or contract, or the encroachment of managed care changes.)
How tightly are patient accounts tracked, and will I receive statistics on my own practice showing utilization rates and the status of open accounts receivable?
Does the practice engage outside expertise to assure we are compliant with coding and charting?
Are doctors invited to board meetings during the associate period? Are associates allowed to see practice financial statistics in the years leading up to partnership?
Is there a written long-term strategic plan? Is the board aligned behind this plan? May I read a copy?
How strong or weak (empowered or not) is the practice administrator? The middle managers? Are their strengths aligned with the needs of the practice? How well do they collaborate with the managing partner and board?

Very few practices you interview with will volunteer answers to these kinds of sensitive, “scary” questions unless you ask.

Choosing one professional opportunity over another will have a profound impact on you and your family. It will determine how much you earn, how satisfying your career is — even the education of your children and the happiness of your family life. So take a chance. Ask the scary, even impolite questions. Just make sure you use the correct fork at dinner.

For more information:
John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams and a new book, Simple: The Inner Game of Ophthalmic Practice Success. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.