How to become site visit savvy

Job seeking can be a lot like dating.

There’s the talking and emailing to get a feel for personalities. There’s the ubiquitous Google search to dig around a little more. There’s the goal of learning if you’re going to work well together, help each other, and be in each other’s lives.

There’s even the wining and dining. In the physician job search, that part happens during a site visit.

The physician site visit gives both you and your potential employer the boots-on-the-ground information that will help you both decide if you want each other. It’s when you’ll delve into the community and see firsthand what it has to offer.

By the time you go on a site visit, you’ve already spoken with a recruiter or a physician at the facility. You’ve tagged it as an opportunity of interest. You’ve done the soul-searching about your and your family’s needs, and you’re ready to find out if you’re right. After all, you can work just about anywhere— you’re trying to decide if you can live there, too.

“In all of the studies we’ve seen within the first three years out of training, residency and fellowship, physicians are three times more likely to change jobs than they are beyond that period,” says Angela Abraham, executive director of physician recruitment at Mercy Clinic in Springfield, Mo. “It’s because they’ve figured out what they like and don’t like and what they want. The first job, a lot of times, that’s not it.”

“A lot of times, people leave after their second year because they didn’t ask the right questions and listen to the answers,” says Kay Wysong, an in-house physician recruiter with Methodist Health System in Dallas. “They just heard what they wanted to hear.”

Yes, job searching—like dating—can become a daunting, time-consuming and at times overwhelming ordeal. But with these tips on making a site visit great, it can also be productive and enjoyable.

Before your physician site visit

Derrick Mena, M.D., a hospitalist, was a resident at Woodhull Medical Center in Brooklyn, N.Y., when he went on a site visit with Southern Hospitalists to Florida Hospital- Heartland Medical Center in Sebring, Fla., where he now works.

“Do as much research as possible before you go on an actual site visit,” he says. “Don’t go to every site and every interview. Find out your priorities first and just focus on that. Just go on the interviews that have your priorities.”

As with most things in life, preparation prior to a site visit is key.

Abraham says it’s not uncommon for physician candidates to show up unprepared and uncertain about what they’re really looking for. “Sometimes they simply show up and begin the interview and then realize what they need to be asking,” she says. “They may not know what they want yet because they haven’t thought about it until they’re forced for six to eight hours to think about it because we are with them nonstop. If they can give it some thought ahead of time, it would behoove them.”

Questions to ask yourself before your interview

• Where do you want to live?
• What type of lifestyle suits you best?
• What cost of living level are you willing to accept?
• What is your significant other’s career needs?
• What type of practice setting do you like best?
• How many patients would you like to see in a day?
• What are your career goals?
• What are your family’s goals?

What is the purpose of a site visit?

“Everybody brings the physicians in and shows them the community, the practice, the hospital, and they interact with them to see if it’s a fit,” says Wysong.

Ask the recruiter what expenses are covered (airfare, rental car, hotel?) and who will make the reservations. Is your significant other invited, and are those travel expenses also covered? Who will take you on a tour of the community?

Remember, the goal of a site visit includes discovering if you can live in the community and fit in at the facility.

Most likely, a physician recruiter will put together the details and plan the site visit for you. That doesn’t mean, however, that you’re without anything to prepare.

“One thing I always suggest for residents is that they go to the website of the hospital or Facebook and get familiar with the hospital and their services,” Wysong says. “For instance, on our website…you can go directly to the clinic, see pictures of the clinic, pictures of the other physicians and prepare for it that way.” You may also want to request brochures of the medical facility or look at the Chamber of Commerce site to learn about the area’s demographics.

Jamie Marquart, M.D., a primary care physician, is a third-year resident at Brown University, Rhode Island Hospital in Providence. She recently went on a site visit to Saint Luke’s Health System in Kansas City.

She not only looked up the hospital website, but also talked to one of the physicians before going there so she knew what to expect when she arrived.

“I also spoke with the recruiter a couple of times on the phone and via email before going there so I had an idea of what I was getting myself into,” she says.

Who should you bring to the site visit?

Ask your recruiter if your spouse  or significant other is welcome to join you—and for which aspects of the visit.

“Every place is different,” says Abraham. “I invite them to bring their spouse. Their children are more than welcome to come, and we want them to come. I will never prohibit them from bringing their children. What I will do is to ask them if they will bring someone to watch their kids, or we can find childcare so they can perform the interview and not worry about what the kids are doing and where they are.”

Abraham suggests that the physician attend the actual interview alone. “When you  bring them to an interview, the group tends to wonder if you can make a decision without your spouse,” she says.

She plans for spouses to go out with a realtor to see,the community, schools, and any other areas of interest.

“We invite the spouse to dinner that evening so they,can meet the partners and their spouses,” Abraham says. Lunch with another physician spouse is also an option.
“Some of them don’t want anything,to do with that. They just want to come and relax, take in the tour and go to dinner—and that’s fine,” Abraham says.

Damien M. Rispoli, M.D., an orthopedic surgeon at Brooke Army Medical Center at Fort Sam Houston in San Antonio, Texas, recently went on a site visit to Western Maryland Health System in Cumberland, Md.

“My family came on some of the site visits,” he says. “Some organizations offered, others did not. We have a big family—four kids at home. Some organizations were in fact reluctant to have the family come not only for the initial but also for subsequent interviews/visits. I think it makes a huge difference if the whole family comes on the visit so they can experience the new area.”

Who pays for your trip?

If you go on a site visit in another part of the country, should you expect to pay out of pocket?

“Normally, it’s the people who invite you to the site visit who pay,” Wysong says. “I will contact them and say, ‘So-and-so would like you to come for an interview on this date.’ Methodist Health System will pay for the airfare, baggage fees, hotel room, tax, valet parking, meals (excluding alcohol), mileage to and from (if you’re driving), and airport parking.”

Wysong requests that candidates make their own air and car reservations. She books a room at a hotel that bills her directly.

After the visit, the candidates fax her receipts and she arranges reimbursement.

What happens during your site visit?

“A recruiter should give them a list of who they are going to go see so they have an idea of who they are going to be talking to,” says Jenny Abbott, an in-house recruiter for Advocate Medical Group in Olympia Fields, Ill. “We generally do that for them.”

“We bring them in, for example, on a Thursday night and get started at 6 a.m. Friday morning,” Abraham says. “The recruiter picks them up from the hotel and is with them the entire day to make sure things run smoothly. The recruiter takes them back to the hotel early to late in the afternoon. Then one of our group members (a physician) will pick them up and take them to a physician/staff dinner and then back to the hotel. So they should prepare for a social event. We learn half of what we need to know about the candidate during the social event because they can be pretty much whatever they want to be during the interview setting. You really start to see their true  personality in that social function afterwards.”

Wysong says that physician candidates meet with her first, depending on the schedule.

They then might spend some time with the group, go to lunch, tour the facility and meet with the vice president of physician services, chief medical officer and the CEO of the hospital. “Some places have dinner with the spouse and the physician and some of the group will arrange for dinner at a country club or a nice restaurant,” Wysong says.

“I went on a Sunday,” Marquart says. “On Sunday evening, we had dinner, and my boyfriend came with me as well as a couple of the physicians and the recruiter—just an informal, get-to-know-you kind of thing. Then on Monday, it started at 8 a.m. and I had a full day with my flight leaving at 4 p.m.”

Things to look for

“I like to say you need to pay attention to your gut reaction,” says Wysong. “Does it feel comfortable? Does it feel like a fit with the group? Did you get all your questions answered? Does the community meet your needs? Location is always the first on the list of things people look for, so does the community fit you and your family? I’ve known situations where the physician has accepted the position, they arranged for the sale of their home, put everything on the moving van and they’re heading for the place and the spouse gets cold feet and decides they are not going and they turn around and go back.”

Pay attention to your and your spouse’s red flags. Do spend some time touring the community to see all kinds of neighborhoods and get a feel for what the area offers.

“When you go there, evaluate and see if that place has what matters to you,” Marquart says. “For me, it’s a good working environment, and are the people happy there and that sort of thing. I was looking for that specifically when I went on the site visit. They are trying to show you what they have to offer, and you are trying to show them who you are and seeing if it’s a good fit. I thought it was a very pleasant day.”

Prepare for these interview questions

In addition to those already mentioned, you can expect to be interviewed by various physician leaders—anyone from a chief operating officer to a vice president of medical management or vice president of operations, depending on the facility and group.

“I interviewed with many individuals,” says Rispoli. “Leaders, clinicians,  mid-levels—each place was different.”

• What you are looking for in a practice?
• Why are you interested in our practice?
• How do you see yourself practicing if you were to join our practice?
• What do you feel you need in order to be supported in your practice?
• What kind of characteristics do you seek in a mentoring physician?
• What do you want to know about us and our practice?

“What I’m seeing that’s new is that a lot of our physician groups are asking behavioral-based questions such as: Tell me about a time when you made a mistake and how did you handle that. Tell me about a time when you were at odds with a colleague and what happened,” Wysong says. Be prepared with some experiences you can relay in the event you are asked behavioral type questions.

After the site visit

It’s important to let the key personnel know that you’re interested in the position. If you want the job, say so. Likewise, if you’re not interested, let them know that as well.

A thank you letter is appropriate.

“A personal note from the physician is always appreciated, especially if more than one qualified candidate is vying for the position,” says Tammie Zwick, director of program outreach for Cogent HMG in Ohio. “Numerous times, I have heard from our directors that a thank you note has also added that ‘I want the job’ statement that is not always conveyed in the interview. Nowadays, email is an appropriate correspondence tool. The physician should be mindful of using a more formal format in the email, but it is not a strike against them if they do not.”

One final tip from Rispoli: “Just bring some enthusiasm and remember to listen twice as much as you talk!”