One of the fundamental rules of successful recruiting is that practices recruit the spouse as well as the physician.
Hospitals and practices expect to interact at some point with the spouse or significant other who will be making the relocation decision with the physician. That interaction can shape the hiring authority’s perception of the candidate’s fit with the practice and community. The spouse has an opportunity to help or hinder the chances of landing the right job offer.
These tips will help your spouse help you.
The majority of physicians interviewing today have been immersed in a heavily science-oriented curriculum since 5 minutes after birth.
Spelling, grammar and graphic layout are not usually on the same gene map that leads to highly competitive MCAT scores. Luckily, physicians often marry people whose natural gifts complement their own skills.
If that describes your spouse, give your spouse sample CVs and cover letters to work with so that the final product has the right structure and components. Take the resulting draft to physician mentors or peers known for good written communication.
Your spouse can help you set up your online search. Create a job-search email account and keep a master list of sites where your CV is posted so that you can remove or edit as needed.
Your spouse can copy, paste and adapt your cover letter and CV to use on major job-search sites - like PracticeLink.
After registering on a physician job bank, you may get a call to gather more information about what you’re looking for in a practice. It’s fine to have your spouse respond, as long as you have agreed on the key messaging points.
One physician laughs about it now, but her fiancé’s conversation with an interviewer kept her off the radar for several months. The fiancé was tired of calls from recruiters and database interviewers. One day, he answered the phone just to avoid another voicemail. Her desired location? His family hometown. Locations she will not consider? Any other areas. Her hobbies? Shopping.
When the fiancé revisited the profile, he had totally forgotten about the interview.
The online footprint your spouse or significant other creates is important because thousands of hospital and search firm recruiters use online job banks and databases as their primary candidate sourcing tool.
The profile is especially important when you want to work in a state far from where you are training. Recruiters always mail to physicians in the state where the new job is located, but often pass over training programs on the other side of the country. A query might include criteria like "M.D. or D.O., Pulmonary/Critical Care, available 2012, current location or desired location: Midwest or Kansas." Being as honest and complete as possible in your online profile increases the chance that recruiters will approach you with the most applicable opportunities.
Your spouse can simplify your search by taking over as the first filter for opportunities. "Point" the job-search email address to your spouse’s computer so that you both can see incoming email. Set up a system for recording and following up on jobs that meet your criteria, and differentiate between active potential jobs for which you hope to interview and things that might be of interest. An Excel spreadsheet with a sheet for each city, a row for each job, and a column for each key attribute works well. Some spouses use tiers of folders in Outlook or Apple’s Mail application to organize conversation trails.
What went wrong? The highly successful sales executive was just trying to help his physician wife land a job. He explained to recruiters that his wife was "too busy" to talk to recruiters, so he would be handling her search. When the first call was made to interview the candidate, the husband took the call and interviewed the prospective employer. The husband insisted on accompanying his wife on the trip, even after being told the first visit was for the physician only - to assess the practice fit. He asked the hospitals to pay for his trip, though he had just flown in the previous month for his wife’s interviews with other practices in the area. The recruiters initiated interview travel planning. The husband insisted on dates less than 14 days out, during spring break, when airfares soared to $800 per ticket - double what they would be on other dates. One practice backed out, believing these demands were the calling card of a high-maintenance physician. Two hospitals were still willing to subsidize travel but capped reimbursement at the usual airfare level. The husband called the remaining practices and complained about their hospitals’ "unreasonable" stance on expense reimbursement, suggesting the practices make up the difference.
The physician who did the interview recalls: "It was the strangest experience. I called to speak to the candidate, but the husband answered," he says. "He grilled me about details of the structure of my group. . . . I didn’t even have a relationship with the candidate yet." The interviewer did speak later with the physician, but could not shake the concerns raised by the interaction with the spouse. He moved ahead with another candidate.
A practice at a third facility, and then a fourth, followed suit, ignoring phone calls and emails from the husband and the candidate.
One managing partner said the physician might be excellent, but contract negotiations and shareholder buy-in were guaranteed to be a nightmare with the husband in the picture.
The recruiters and facility executives debriefed on the experience the following week.
The conclusion was that the sales professional might well be conducting business according to norms for his industry.
Still, nobody wanted to re-engage the physician. The candidate was eliminated from consideration.
Robert Marshall* Ph.D., MBA, has a few tips for spouses wanting to help. He’s the spouse of a gastroenterologist currently engaged in a job search. He reviews all of the incoming email about job opportunities for his wife.
He speaks with recruiters first to pre-screen and set telephone interview appointments for her. "I work through a list of questions with the recruiter or administrator," says Marshall. "It’s a waste of her time for my wife to talk about the clinical aspects of a job if there is a supporting structural element that will ultimately make the job unacceptable for us," he explains.
Aggressive pre-screening saves time, but with one unseen cost. Some employers simply elect not to engage due to prior bad experiences with spouses running the job search. The candidate will never know they weren’t invited to interview because of something the spouse said or wrote. HR protocol dictates that recruiters simply advise the applicant that the practice has elected to move forward with another candidate, without providing any specifics about why the physician was not the right fit.
Now that most large employers have databases, recruiters can see what their colleagues in other states recorded about their experience and review exchanged correspondence.
It works both ways, though - if a recruiter is unusually warm and nice to you, it may because there are notes in the database saying you are delightful to work with.
If you and your spouse would be an asset to any facility or medical staff, recruiters don’t hesitate to make sure their colleagues know that.
Your spouse can review job postings online and screen the email alerts for you. (Register at PracticeLink to receive alerts of new jobs in your specialty.) If your spouse clicks through the posting and replies with a CV and cover letter, the turn-around time is cut for both you and the practice.
Use one email address for the job search and try to use one phone number - the physician’s cell. Many missed connections and dropped balls in recruiting occur because responses went into a rarely-checked or home phone voicemail.
James Lopez, M.D., reviewed new job postings himself, but he talked them over with his wife, Melissa Lopez, a critical care RN, before responding.
"Melissa and I had gone through an exercise my University of Wisconsin family medicine training program conducts for residents and their spouses. We each had to rank order 10 elements, like proximity to family, cost of living, access to our favorite activities and nights on call. But we had to do it without talking, without peeking at each other’s ranking," he says.
The exercise kept them from responding to some intriguing ads that weren’t aligned with their priorities.
Provide examples of your spouse’s commitment to care.
A spouse can enhance the recruiter’s perception of how well the physician candidate fits the job criteria. Being nice, personable and articulate are great, but the details the spouse provides can move a candidate from the middle of the electronic stack to the hot burner.
Sophia Song, DMA, had no idea how important her role was when she called the anesthesia group office on behalf of her husband, Kenneth Song, M.D.
The anesthesia group was preparing to staff a brand-new hospital. Hospital administration wanted world-class service at the new facility, so the group promised that every anesthesiologist would speak with the patient’s family.
In the screening call, Sophia said, "I just have to tell you one story that sums up my husband. We were supposed to go out for a special dinner recently to celebrate my pregnancy. Ken called and let me know that we might not make it to dinner. He needed to stay because family members of his patient were delayed - not arriving at the bedside until early evening."
He told her: "This family was unusually concerned about the anesthesia during this complex neurosurgery procedure, and they will have a lot of questions." He talked with the family for over an hour.
The anecdote was included in the summary email that went to the shareholders on the recruiting committee.
There were typically 10 or 11 CVs a week to review, and candidates with ties to the area usually got the shareholder calls. Song’s fit with the group’s immediate service "hot button" secured a phone interview and invitation to interview.
Song landed the job on his own merits, but his wife’s anecdote moved his CV ahead of other qualified candidates in a highly competitive job market.
One Physician recruiter cringes when she hears the phrase, "I’m handling my spouse’s job search," ever since a particularly colorful site visit.
A candidate who looked great on paper put a hospital team through a bewildering site visit experience seemingly intended to prove a point to his wife.
The wife handled 90 percent of the communications and nobody on the hospital side picked up on the husband’s frustration in brief conversations with the physician.
He did not want to move and was angry with his spouse for continuing to engineer relocation.
"Now, if I cannot speak directly with a candidate after the initial phone conversation with the spouse," says the recruiter, "I direct my attention to other, more accessible candidates."
Sometimes a spouse has the wrong verbal filter setting for the environment. One physician relations director recalls a spouse who gave too much detail about her husband’s problems with his employer.
"I could not believe my ears," the director says. "This surgeon’s wife described the candidate’s contentious interactions with his group practice. . . . It seemed so odd for her to paint such an unflattering picture of her husband’s ability to get along with other physicians. Of course, we used those clues to get specific on reference calls, to determine if his interpersonal skills might affect his position here."
Pediatrician Nancy Lataitis, M.D., says that one of the biggest contributions a spouse can make in the face-to-face setting is non-verbal.
"Eye contact, smiling, leaning into the conversation tell us that this family wants to be part of our family," says Lataitis, partner with Partners in Pediatrics in Denver. "Joining a practice is like entering a marriage. If the spouse does not look happy to be here and excited about the practice, it’s a red flag to us," says Lataitis.
Should your spouse accompany you on the facility tour and appointments? The answer is a definite "maybe." Your recruiter or practice administrator will let you know what’s expected for their typical itinerary, and the safest path is to follow their lead.
Some employers feel the impact of the visit is enhanced if the spouse is included in most of the itinerary. Others include the spouse in meals, but not the facility time.
If you request that your spouse be allowed to accompany you, most practices will say yes.
Christine Darr, M.D., medical director of the pediatric division of CarePoint in Denver, likes to see couples compartmentalize their due diligence on interview visits with her emergency medicine group.
If the spouse attends, she explains, "I do think that the candidate should be asking the questions about the job, not the spouse."
Darr suggests that the spouse ask questions about real estate, schools (if they have kids), and prospects for their own job search if they are working outside the home.
If your spouse is a health care professional, it’s more common for them to sit in on meetings because of the common ground, and because the spouse may also potentially work at the facility.
James Lopez, M.D., the family medicine resident at the University of Wisconsin, asked if his wife, Melissa, should show up with him for his appointment with the CEO of the hospital and tour of the facility where he would admit patients if he got the offer.
Melissa is a critical care nurse, so it was beneficial for all parties to include her. Melissa "sees the facility through a different lens; she kept me from undervaluing some elements and overemphasizing others," he says.
Melissa’s personality and obvious enthusiasm for the facility and community also helped secure financial support. The hospital hopes that Melissa will join the nursing staff when the couple’s newborn twins are older.
At a time when the economy forced hospitals to turn down many requests for assistance, the hospital CEO pushed through the package to help the family medicine practice sign Lopez.
Marshall talked about how hard it can be for spouses who are accomplished professionals in their own world to play the spouse role on interview visit dinners.
He maintains focus by keeping a running tab of things to discuss with his wife when they have their debrief back at the hotel.
"With six to eight people at a dinner, it’s impossible for my wife to have meaningful conversations with everyone there," he explains. "It’s my job to listen and gather information and impressions that she might miss at her end of the table."
Marshall advises spouses to watch the alcohol intake at interview dinners. "The hosts at recruiting dinners are sometimes in an extravagant mood because the dinner is a business expense," he says.
Candidates and their spouses are often tired, hungry, and an unfamiliar climate or altitude can increase the effects of alcohol.
"When someone offers you another glass of Chateau Margaux, it’s very hard to say no." But, he says, "it may be a wise choice."
One important thing a spouse can do is make sure the childcare arrangements are in place.
A director of business development recalls an interview lunch with a physician and his 2-year-old.
The recruiting team hadn’t offered to set up a bonded, licensed babysitter because the physician and his wife were staying with family in the area.
It hadn’t occurred to the recruiting team that there would be a toddler on the interview without any advanced discussion.
"Particularly not one who won’t sit in a high chair," the director says.
One physician recruiter points out that a spouse of a physician needing visa waivers has a huge job in the many months between the initial interview and their spouse’s start date.
The recruiter has nothing but admiration for one physician’s wife who has been working with the hospital team and immigration attorneys for nearly two years.
She maintained meticulous records of every communication with the recruiter, with the immigration attorney and with the myriad of state and federal government entities involved in visa waiver and licensure.
"She told me of nights they had to spend outside the U.S., completely at the mercy of the consulate, not knowing if they would be able to return," the recruiter says.
Practices unanimously agree that spouses should stay out of the contract negotiation, even if (especially if) the spouse is an attorney or medical practice manager.
Ruth Benton, MBA, is the CEO of New West Physicians, an 80-provider primary care group spanning much of metro Denver. Benton has hired a lot of physicians in 16 years of recruiting, and she is very sensitive to early indications that a spouse with professional expertise will have trouble respecting boundaries. "If they are disruptive in the interview and employment contract discussions," she says, "it’s only going to get worse when they are married to a shareholder."
HCA, Inc. physician contract coordinator Carrie Robey loves spouses who read relocation guidelines and addenda.
"Bring on the questions!" she says. "Every question asked and answered in advance prevents frustration down the road," she explains. "If the family rents that storage unit or books an early move outside of the terms of the contract, we have no leeway to bend the rules and pay for it."
Robey often works with spouses of her hospital system’s physician recruits as they enter private practices.
"Our team is here to help physicians get reimbursed for every dollar the hospital has written into the contract," she explains. "But we function under strict rules, under threat of significant penalties if our hospitals violate the statutes governing payments to private practice physicians. An organized spouse can help us make sure the family is not leaving money on the table - money the hospital intended them to have." l
Therese Karsten, MBA, CMSR, is a frequent contributor to PracticeLink Magazine.
* Name Changed