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Christopher R. Hood JR, DPM
Premier Orthopaedics and Sports Medicine, Malvern PA
Fellowship Trained Foot and Ankle Surgeon
#ASMDC
CRH
Non-CECH Young Physicians-Practice Management: Lunch and Learn
Christopher R. Hood JR, DPM (YP)
Being a New Doctor: Transition from Resident to Practitioner
Robert J. Toomey III, DPM (YP)
How a Young Podiatrist Grows His Practice Within a Practice
CRH
Roadmap THIS IS A HUGE TOPIC
What to do as a:
Resident
Practitioner
What to do during a transition from:
Resident to Practitioner
#ASMDC#jobsearch
#resume#employment
CRHLegend of the PPT
Blue (Barracudas) – items repeated throughout the presentation
Green (Monkeys) – my opinion*
Silver (Snakes) – shameless plug
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Resident Life – General
Stay Organized Stay Ahead
Do well in residency. (Obviously) Be a good resident to your patients, co-residents,
attendings.
Get exposed. Rotations, conferences, etc.
Office rotations – learn how to bill!!
Networking. (1st-3rd year)
Be involved. You only get these 3 years once. Take advantage of
everything offered.
Societies, community service, etc.
Research*
CRHResident Lift (cont’d) Pass boards. (Obviously, and a MUST*)
Board Review Course (Goldfarb; Midwest)
CBPS (Boards by #s; Board Master)
Texts, manual, etc
Prepare for the job search.
(fellowship?)
Learn more about yourself.
End game? Change in goals?
CRHResident Life (cont’d) Determine what you want…
(again, what does this mean?) “Best” job
Intensity of a job
Type of job Office based, hospital based, combo; VA; “well-rounded” or
“focused”; large/small group, solo; wound care, nursing home, etc “mandatory” duties; hospital call? Weekends? Evenings?
Geographic location of a job
Thoughts about possible fellowship? Can determine this up to spring of PGY-2, then you must* start
applying.
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Fellowship Route? Ask yourself “Why do I want to do one?”
Where? “Style?”
ACFAS; APMA/CPME; MISC/non-accredited
When ?
Start visiting PGY-2 spring, if not earlier
Review application process, requirements
Tips:
What does each program offer?
Network at conferences, with old fellows, other prospective applicants;
Continue the job search concurrently
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Transition Points:(Resident Practitioner)
Be prepared:
Start “early” for job search
Start “early” for job start (more on this later)
Move:
Give yourself (family) time to settle in so you can start day 1 with no distractions.
Start paperwork ASAP: (4-6 months)
Job should guide you (license, credentials, insurances, etc)
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When should I start? Answer: Now!
The big question:
Do you want the best job (ex. What you specifically want to be doing, highest salary, best practice/name) vs.
Where do you want to live?
(or, Do you want to do a fellowship? )
Once you decide on the above, then begin your search…
What else can you do now?
Everything – be involved, do research (manuscript, poster), attend conferences, network, visit.
Think
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What kinds of jobs exist? Solo Practitioner/Contractor
General Practitioner (Pod Owned)
General Practitioner (Multi-Specialty)
Hospital Employed/Contracted
HMO Employed
Military/Government Employed
Academic Institution Employed
Industry
Research
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Where To Look for A Job????
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Where To Look For A Job? Websites: (http://www.footankleresource.com /
http://jobs.onpodiatry.com/)
APMA, ACFAS, Pod Job Success, Podiatry Management, Podiatry Exchange, AAPPM, AOFAS, AOFAS, JAMA, DocCafe.com
Local State Organization Websites; School Websites
Monster, Indeed, Glassdoor, HealtheCareers.com, Craigslist
Word Of Mouth: Mentors, attendings, family/friends, device reps
Conferences (APMA, ACFAS, State Mtgs)
Google Maps Search terms “podiatry”, “foot and ankle”, “orthopaedics”,
“multi- speciality”, “hospital”, etc.
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How to prepare yourself? Cover Letter / Letter of Intent
CV/Resume
Business Cards Name, program, candidate year, address, phone, email, website?
Website (?) www.footankleresource.com/
***Make sure multiple people review each of these items prior to “final publication.”
***Make sure to update accordingly, often (every 1-2 months take a look).
***Have your printed resume, “email-prepped” resume, and/or business cards available at all times!
CRHFirst Impression Your first impression often is not a personal face/face
but a reflection of you through your Cover Letter and Resume.
You can be the nicest, coolest person in the world, but…
If your organization skills suck, grammar sucks, resume is weak, you will not get your foot in the door.
CRHAre Residencies Really Preparing Doctors for Practice? Lowell Weil JR, DPM (5/4/16) “I am flabbergasted at how ill prepared many of the
applicants are in their ability to secure a job and worse, how they will be able to survive once they get a job.”
“With the amount of online resources to help guide the creation of these important documents that are the first look at a person, it is surprising that résumés and CVs are so poorly constructed,” and are “difficult to read, poorly formatted, not updated, incomplete and just look bad.”
“…the candidate did not take a few seconds
to personalize the letter.”
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The Cover Letter / Letter of Intent Generic Specific
Create a generic 1-2 versions of the letter, and then make it specific for each job you apply to.
Generic. This includes:
Introduction
Education
Extracurricular; Awards
Specific. This includes:
Who it is for – Doctor(s) name / Practices name
Podiatry v. Ortho; Academic v. Private/Community
Who is the jobs target patient?
What can you offer the practice?
CRHThe Resume Purpose – to “sell” you; highlight personal/professional
success
“Brag about yourself” with achievements (that are relevant) – not every experience is appropriate
Include most recent/relevant information
Achievement-like manner (reverse chrono order)
Organized; format/layout;
Update every 2-3 months (“achievement log”)
Paper should match online profile (LinkedIn, etc)
CRH Name, address, phone,
Employment (likely blank/omit)
Education
Residency Training 2-3 bullet points of program
highlights
Fellowship Training
DPM Licensure State location number, NPI,
DEA (?)
Advanced Training/Workshops
“Hands-on”, certificate
Research Projects / Posters
Publications
Professional Development
“Hands-off”
MISC
Previous Employment (?)
Professional Interests
Personal Interests
• Adam Perler, DPM – adamperler.com• www.footankleresource.com/
The Resume
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Personal References You may include this as part of
your resume, or… You may hold off on this
(“professional references upon request”), and…
Have a sheet/supplement ready to distribute with that information.
Consider who to use… Residency Director Attending close with Outside DPM reference Old job, related to field or
medicine. Co-resident NOT family
1st = Ask the people who you are using if that is OKAY.
2nd = Make sheet Doctors name, titles,
relationship, office address, phone/fax, email
3rd = Let those doctors know that “Dr. X” may be reaching out to them so they have a heads up, or so they can be on the look-out for a faxed reference statement sheet. Especially if the employer
requests the Reference email or fax.
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Should I Apply for It? YES!
Apply for any and all jobs that you come across that you have the slightest interest in, whether it be based on geography or job scenario.
Apply to practices that are not even hiring.
But do not waste peoples time… If you truly know you aren’t interested;
If you are vastly under qualified (self-reflection/assessment)
Personal examples… The wrong degree
The wrong locations
The not hiring practice
Persistence
Do not get discouraged – you will all find a job.
CRH
The Process Apply for job.
Wait and be prepared. Know the practice, the doctors names, what kinds of things they
do/not do, literature by practice clinicians.
Pre-phone interview.
Screening Calls.
Face/face meeting with doctor, partners.
Possibly a second meeting, visiting the office, shadowing, etc.
…then the Contract.
Make sure to get everything in writing that may have been discussed prior to this point.
The interview STARTS
when you APPLY.
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Interview Prep Research () – the company; the
interviewers
Research ()– is this place for you?
Review – how you present yourself (CV)
Dress – business formal vs casual
Questions – come with them!
“It takes a hiring manager roughly 10 minutes to form an
opinion on a job seeker during an
interview.”
“Companies aren’t just making a decision based on how you
answered questions in an interview. They are
evaluating how you were throughout the
entire process.”
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Know Yourself and Your Skills Employers will want to know/ask…
About your family;
Your education, residency, etc. & experiences;
Skills you offer (strengths, weakness);
Billing/patient experience (Office and Surgical knowledge);
Possibly case (office v surgical pathology) situational work-ups;
Employers are judging you all the time.
Know what’s going on “in real life.”
Be Truthful to both THE EMPLOYER
…and YOURSELF
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The Contract – Sections Term and Termination
Year, multi-year; renegotiation terms.
Duties – Office, WCC, NH
Vacation and Leave True vacation v sick v CME
days.
Benefits Standard (medical and life
insurance, 401k) Ancillary Bonuses Employee Business Expenses
(CME, phone/car) Moving Expenses
Professional Liability Insurance Consulting
Payor Contracts, Patients, Records, Histories Intellectual property
Restrictive Covenants Confidentiality (to the
organization) Restrictive
duration/region/centers, etc
Co-ownership Path to partnership; shares
Sick Pay Period, Disability,
MISC Provisions Tail Coverage ($?) What goes to your “bottom-
line”
Google – “Physician Employment Contract Guide” (pdf re: ACP; Columbia Med)
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Salary VERY VARIABLE
“podiatry salary 2015” = median $183k
“starting salary podiatry” = range $68k-$118k
The Best Healthcare Jobs in 2015 (Forbes)
Median = $116,440; #9
Salary.com
Median = $188k ($155k-$250k)
Philadelphia = $196k
*Bureau of Labor Statistics (May 2015)
Median = $119k (75% = $171k)
ACFAS
Median = $174k ($85k-$348k); n = 473
Age (20-35) = $155k
CRHSalary
Consider low starting, ∴ low threshold for bonus
Run the numbers
Salary; Bonus at 30% of 3x Salary
Ex – Salary and Net $350,000 to practice
$80,000 $110,000 x 30% = $33,000 = = $113,000
$100,000 $50,000 x 30% = $15,000 == $115,000
$120,000 (-)$10,000 x 30% = $3,000 == $120,000 OR $118,000
Graduated Compensation
Ex. $300-$350k = 30%; $350-$400k = 35%; +$400k = 40%
CRHWhat I’ve Heard About Salary All anonymous contracts:
Fellowship = $50k-$60k
Jobs $70k base; 30% over $240k
$80k base; 30% over $240k (3x salary)
$80k base; 40% over $160k (2x salary)
$90k base; no bonus; inc $15k q2 years x2 cycles; partner consideration
$100k base; 30% over $300k (3x salary)
$105k base; no bonus; re-negotiate in 2 years
$110k base; 30% over $330k
$250k base; no bonus (Hospital, Community mid-west)
$300k base; no bonus (Hospital/Academic Ortho)
CRHThe Contract Remember, you are a doctor. You treat foot and ankle
problems. You are smart, but not that smart…
LAWYERS!!!
Contracts are confusing.
Language is different.
They do this for a living.
Ask friends/family/past residents for referral
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Lawyer-Up They will rip-apart the contract.
…because you are paying them to do so.
Consider what is/isn’t important to you when re-negotiating with employer after lawyers advice/comments.
Level of Involvement Contract Review
Negotiation
$$$ Contract Review = $500
Hourly Rate $350
Make sure employer uses
lawyer for contract
construction.
CRHContracts - MISC Attendings can be helpful to review contracts. Look to
ones who you admire/respect the practice they have built. They are as much physicians as businessmen
..but remember who they know.
…consider if they may be a future employer.
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So you have a job…(!!!)
…now what do you do?
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The Wrong Job It happens…
Mean tenure for workers aged 25-34 is 3.2 years (jobsearch.about.com)
You can always quit.
Be honest with the employer about any issues.
Be adult. Be professional. Be respectful.
CRHCo-Residents… 1 job, 1 year (multiple)
1 job, 5 years
2 jobs, 14 months (less than 6 months)
2 jobs, 2 years
2 jobs, 3 years (x3-4)
2 jobs, 5 years (less than 1 year; 18 months)
3 jobs, 5 years (3rd job for 3 yrs)
CRH
CRHTips On Navigating The ‘Real World’ Of Podiatric PracticeChristopher R. Hood JR, DPM (August 2016)
- Insert shameless plug here…- (however, this is how you get known…)
- Things to do…- EMR
- Billing
- Protocols
- Staff training
- Canvassing
- Learn local doctors
- Learn local geography
- Social media presence? (LinkedIn, Website, Facebook, Twitter)
CRH
Back to Basics Review office coding rules
and billing practices; ICD, CPT, modifiers
Learn how to bill surgeries (profitably, legally)
Review common office pathology for treatment.
Learn the EMR
Quicker charting, less work later
Templates (nails, callus, bunion/HTs, tinea, PF, gout, etc)
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Study Your Geography Know the local geography.
Target any and everyone: Local referral doctors (Primary Care, Family Medicine, MSG,
Rheumatology, ID, Orthopaedics, other DPMs, Geriatrics, Pediatrics, PMR, Pain Mangaement, Vascular, Neurology/Physiatry, Clinics)
Emergency Rooms, Urgent Cares
Physical Therapy
Schools (MS/HS; ADs and ATs); Sports teams / clubs
Lawyers (Personal Injury/Workers Comp, Auto, Malpractice
Nursing Home, Rehab Facilities, Retirement Communities, etc “Just because they have a podiatrist, doesn’t mean they’re happy with their
podiatrist.”
Community Programs Sports teams (sponsorship?), YMCAs, Retirement Centers, Better Business
Bureau/Chamber of Commerce, Local Newspaper (Ad?)
Talk to your local/new hardware reps…
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Hitting The Pavement Canvassing v. Appointments
Bring: Business Cards
Introduction Letter
Have: Personal background
(especially if local),
Educational background,
What skills offered (procedures, patient-types)
Office locations, days, hours.
Know: Office capabilities,
Insurances accepted.
Create: Remain local to office to
be available for anyone
Make lecture/topic powerpoints (bunion, hammertoe,
arthritis, bone health, etc)
Online Presence: Healthgrades, etc
Website (personal, practices)
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Let People Know You Exist
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IDEAS: Local athletic clubs (sponsorship); local gyms; hospital CME; community events; residency events; blogs; online sources, etc…
Networking
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Saying Thank You
***Have office locations, hours, surgical privilege location, etc. (insurances? Cell?) below signature
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Social Marketing& Online Presence Practice website bio/photo
Twitter account? Facebook account? Personal website?
Make sure LinkedIn profile is U2D
Blogging?
Does your practice have a blog? Should they start one?
Can you get in on someones blog? Hospital?
Blogging cross-promotion?
Local business collaboration?
YMCAs, Running Stores, DME stores, etc
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Promoting Your Social Media
Recognition: Patient / Physician / Profession / Geography
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Review Websites
4 reviews (8/16/16 – 11/2/17)
IMPLEMENT CARDS in FEBRUARY 2018
10 reviews (3/9/18 – 6/7/18)
CRHStill with me?
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Practice Pearls 5 A’s:
Availability/Accessibility: be there, know ppl
“Make best use of office visits,” “Timely/resourceful treatment”
Sit at work all day; give cell out*; local during wknds;
Accommodate patients, boss, associates, referral sources.
Accountability: notes, f/u, call PCPs
Affability: likeability, friendly
“It’s about delivering care with empathy”
Ability: Walk the walk
“Well trained,” “keeping U2D,” “admit don’t know everything”
Attitude: more important than you think
(Affordability: cost-conscious medicine)
http://www.hcplive.com/journals/internal-medicine-world-report/2014/october-2014/the-three-as-of-medicine
CRHAvailability The most important “A” when starting off.
Sit at work or be local for you 8-5 hours.
Giving cell phone out to local contacts (personal choice).
Ex. Sports teams, ED
Staying local during the weekends.
Accommodating not just patients, but your associates or boss.
CRH
Practice Pearls 2 P’s:
Persistence:
Achieve your goals
Never give in or up
Perseverance:
“Stuff happens”
Bumps & bruises
“P.O.C.’s”
20934105
Lamm BM. JFAS,2010 (20934105)
CRHIn The News… Healthgrades / MGMA Report (7mil reviews)
“62% of patients favor non-clinical factors when reviewing physicians” (3/28/18)
Choosing a Physician… Compassion, comfort, personality, bedside manner
“Demanding” accessibility and transparency
MISC: 70% of reviews 5★ (2-4★ < 10%; 1★ ~22%)
80% prefer ability of online appts
Time spent w physician/Q&A as important aspect
Staff interaction important
http://www.clinical-innovation.com/ (2018)
“The patient
experience extends
deeper and further
than the walls of a
surgical suite
or exam room,”
CRH
Board Qualified Certified Read ABPS (<7 years)
220 Document (Explains rules for putting cases together, numbers, and diversity requirements – just like residency)
Log
Need:1. PRE-OP XR before surgery.
2. POST-OP XR in OR. (required w/in first 72 hrs) Immediate ( <72hr) // ~4wks p/o // Final Healing
3. Operative Report (with you as surgeon of record)
4. Office Notes
5. MISC: Podiatric H&P; OP report; Anesthesia record or circulators notes; Pre-op labs; Progress notes; Discharge summary; Radiographs/imaging
CRH
You’ve Made It!!! Actually, you haven’t.
Graduate College...
Graduate Podiatry School…
Complete Residency…
Obtain a job…
Board Qualified Certified
Practice for 10-15 years…
OK, now I’ve finally made it.
CRH
And don’t forget to read…
Question?Contact me at:
[email protected]@crhoodjrDPM
www.premierortho.com610-644-6900
#ASMDC#jobsearch
#resume#employment
