Residents & Fellows – On choosing your first practice – Focus on these 3 areas

For graduating residents and fellows, job opportunities are nearly endless. With that comes some pros and cons, creating the proverbial two-edged sword. The physician turnover rate is doubled in the first 3 to 5 years of graduating, so how do you increase your odds of choosing the right practice? Let’s look at the top reasons physicians leave their practice and develop a plan to overcome these potential landmines.

The top reasons for physician turnover historically include:

  1. Lack of “chemistry” with colleagues or supervising physician
  2. Issues relating to the spouse, partner, or significant other
  3. Burnout, lack of appreciation, and support (on the rise)

Knowing this, how do you approach and evaluate each?

Chemistry or Confidence in Your Colleagues

This is one of those subjective areas that can be difficult to define and/or evaluate. Here are a couple of rules of thumb:

  • If you don’t walk away from your interview clicking your heels at the thought of being part of that practice, keep looking.
  • You should have butterflies in your belly like after the best-ever first date!
  • If you end up using a job as the benchmark you compare all other jobs against, that’s a great sign.
  • Ask questions during your interview about their practice style and philosophy to make sure it’s in line with yours.

Your Spouse or Other Person in Your Life

Over the years, I’ve conducted a whole boatload of exit interviews, and I can’t tell you how many times physicians told me their spouse came with a level of trepidation or uncertainty. Here’s how to make them as much a part of the interview process as you:

  • Start by having a real discussion with your spouse or partner.
  • What is important to them?
  • Don’t assume anything.
  • Listen… really listen. You may be surprised.
  • Make sure potential employers know what your spouse or significant other is interested in seeing and doing while there.
  • Recruiters will often ask to speak to the spouse before the interview to ensure their needs are met. It amazes me how many times the physician candidate turns down this opportunity. Don’t. Make sure they are fully engaged so they don’t walk away from the interview with more questions than answers.
  • Does your partner have a career outside the home?
  • Are there job opportunities for them in the area?
  • Did you know that issues relating to the spouse are the second most stated reason for physicians leaving their current practice? Don’t minimize it. Make sure they are part of the process and their needs are met.

Make Sure You’ll be Appreciated and Supported

The interview process is a two-way street. You are allowed to interview them as well! This is the best way to catch the “vibe” of the practice. Here’s how to approach it:

  • Make a list of questions you want answers to.
  • Write them down and take them with you to the interview.
  • Include questions for interviewers such as:
    • Do you feel supported in your practice?
    • Why do you say that?
    • How do you feel burnout affects physicians and other staff?
    • What has been the physician turnover rate over the last 2 years? Over 6 to 8%? Red Flag.
    • Does the organization have a defined wellness program? If so, what is it comprised of, and how is success measured?
  • Listen, not only to what is said but how it’s said… the tone.

A Word about the Geography Trap

Geography plays such a major role in the decision process; it sometimes overshadows some important aspects of the practice and the people there to the point you may ignore certain red flags.

  • Listen to your “little voice.”
  • If your little voice is saying slow down, you need more information, explore something further or RUN… Run like the wind! Do it.