Saturday, March 31, 2007

Recruiters tell you what you "NEED". Surprise, it is NOT what you WANT.

Jim Stone, a blogging recruiter, wrote two days ago in his "dochunterdiary" about what he knows he "does well".

Number 3 on his list was:
"Persuasively dealing with physicians to help them differentiate their WANTS from their NEEDS"

And here we go with the recruiter dilemma: "We have those positions to fill - out there in the country. They are a little remote, and we know that they are not the greatest jobs, but we get paid only if we fill them."

Unfortunately most of those pesky spoiled physicians prefer to live in the big city, but we just can't get those jobs. They practically fill by themselves. What do we do now?

Well, let's just try to convince the doctors that "WHAT THEY WANT" is different from "WHAT THEY NEED". Physicians need to be educated about "What they need"!

Can you wrap your mind around this kind of arrogance? A recruiter knows what I need, a recruiter "helps me differentiate between what I want and need"? After 12 years of training and extremely hard work someone is trying to tell me what I really need? What qualifies a recruiter to make a statement about what I need? His common sense, his heart, his humanity? His common sense and humanity should tell a recruiter to leave personal choices of physicians alone, period!

If I want to live in a big city, that is just where I want to live. This is not rational, I know, I know, I know. This is pure fancy, pure emotion. As are most of the truly important and personal decisions in our lives. This is how I decided to marry my wife. There is absolutely nothing wrong with irrational desires. Fulfilling those irrational desires is what makes me happy!

It is very frustrating that recruiters put their desire (want or need?) to sell, sell, sell above everything else. Just because they do not have jobs in desirable locations, they try to change them minds of physicians to make them "fit to the jobs available".

Once recruiters do not have what you want, they try to tell you they you do not really need what you want! What you really need is what they have! WOW!

It's like the legend where the Inn Keeper either cuts off part of your leg if you are too tall for the bed - or puts you on a stretching device and tortures you until you are long enough for the bed. In either case, you suffer and die.

No wonder people dislike recruiters. Trying to "educate" a physician that he may "want the big city", but that he does "not need it" is utter disrespect! Of course I do not "need" the city, I just like it. Hey, all I really need is 2 meals a day, a roof over my head and some clothes!

After the amount of training, work and sacrifice I went through to become a physician, after all that - I just want what I want. And I am going to get it! And if YOU, dear recruiter, do not have what I want, then I do neither want nor need you or your services!

I am going to get that nice job my way: buying all addresses of all doctors in my preferred area with a few clicks on the Internet (Info USA, WebMD or any other list provider), and then I will mail them my polished cover letter and CV and then I will have the job. And if I do not have the time, then "" will do it extremely well for me!

And if that really does not work, then I will open my own practice.

Here is what recruiters need:
Learn to listen.
Respect your candidates and their wishes!
Don't sell, facilitate!
If you can't get a job where the candidate wants to go, be honest and say so!
Tell people how to find the jobs where they want to live and work. Stop pretending that you do not know how to do that. Hey, maybe there could be a fee for that!

And then, in time, you will earn back the respect you have lost. And with the respect will come communication and understanding and repeat business.

Your Matthias Muenzer, MD

Friday, March 30, 2007

When a recruiter calls....

Whenever you look through recruiter websites, you find notes on the "advantages" of talking to recruiters as well as appeals to "answer that call".

I have put together a few ways of answering recruiter calls. Pick your favorite and practice it:

1. "Thank you for calling! I am actually looking for a job, but really only and exclusively in Manhattan, Downtown LA, downtown Atlanta, downtown Boston, etc etc - (insert your favorite city here) because I have family there and I need to be close to them."
Then hear them squirm and listen to the excuses why their company - that has "the best jobs" and "thousands of opportunities nationwide" - just happen to be out of jobs in that particular location. An instructional approach, teaches you how the recruiter handles a request he or she can never fulfill.

2. "Hey, I heard you get 20K for placing me. What about a deal? You get 60%, I get 40%, after all, without me, there is no placement" This answer qualifies you as a future leading administrative physician executive.

3. "Hey, I have heard you get 20K just for placing me. I propose a deal. You get 20%, I get 80%. Whaddaya say?" This answer shows that you are a future HMO executive.

4. "You say somebody would pay 20K just to have me work for them? I don't believe that, nobody pays that much for me". Too depressive, not recommended. But it is true, people are willing to pay that much to have you work for them. And then they get the 20K back from your collections and then they make much, much more off of your blood sweat and tears.

5. "No, I am not Dr. Watson. But I know Dr. Watson very well, he is the doctor that leads my therapy group here on the psych floor, he is a really nice guy. But you can talk to me, I'll relay him the message...."

6. "A recruiter, you say? You fxxxxxx bxxxxx, the last so called opportunity from your kind turned out to be xxxxxx xxxxxx and xxxxxx xxxx! You are a xxxxxxx xxxxxxxx!" and hang up.
While this is a passionate response and while it is most certainly understandable, this is just not appropriate. Not professional, not recommended.

7. "Take my name off of your list and put me on your companies do-not-call list". Very matter of fact. Fully appropriate. Treat telemarketers as telemarketers. Saves a lot of time, which you then can use to search for a job the right way.

8. "Sorry, I am on the other line answering invitations to several interviews in the area that you said was "oversaturated". Good bye". Excellent answer. Will give the recruiter something to think about.

9. "I am no longer looking, since I already found a job. I mailed my CV directly to a number of physicians and got a job right where I wanted. Maybe you guys should use direct mail too". Also an excellent answer. Will give the recruiter food for thought.

10. "You are asking which of my colleagues is looking for a job? Sure, I can tell you. But first I will send you a contract and each name of a colleague I tell you will cost you 10K". Excellent answer, you are a savvy businessperson. Give them some of their own medicine.

11. "Can you call me when you work pro-bono? I can't stand the thought that those poor hospitals will have to pay 20,000 just to have me work there." You are clearly the son / daughter of a community service lawyer. You are compassionate and feel for the underprivileged. You deserve a job in the big city. Call and you will find it. Don't bother with recruiters, they have only the less desirable jobs.

Your Matthias Muenzer, MD

one experience with iHirephysicians

There is a good idea out there that someone turned into a web service: If you are a doctor searching for a job, we email and fax your CV to all registered recipients in an area code of your choice. For free, or for a fee, and then we promise to make it more effective by emailing plus faxing it.

Sounds good. I tried iHirePhysicans, it didn't work. And now I get email notifications every other day of internal medicine jobs in Texas and Wyoming - something I really need like a hole in the head.

The idea is good. Why not email your cover letter and CV? Simply because physicians as a group are embarrasingly far behind with email and internet. Some of us have realized how convenient, efficient and easy it is, but most of our colleagues are still in the telephone era, or - hey, much more advanced - in the fax era.
Also, email is easily considered spam and deleted. At least I delete most emails of senders I do not know.
Other doctors are still in the phase where you switch from one email provider to the next. I had my yahoo address for 10 years now.
There is little guarantee that your CV will arrive looking as you would like, well unless you send it as PDF. Although I believe everybody can open a Word document with all formatting intact.

So, those are reasons why it may be too early for email campaigns. But, wait, maybe in two to three years.

Until then, stay away from iHirePhysicians. Good old mail seems to still be the best way to get your cover letter and CV in front of potential employers.

And, 73 emails sent, and no answer? How come? How reliable were those email addresses? Who gathered, collected them? Did they check them?

I believe it is best to get all mailing addresses of all the doctors in your field and in your target area and send them all your cover letter and CV on nice paper.

Your Matthias Muenzer, MD

A recruiter comment about my blog

A few days ago Dave Freireich (Core Search Group) left a comment on my "Why do you dislike physician recruiters?. I loved it. Here it is:

"Warning: I am a recruiter! However, I do not recruit physicians.

My firm is based on the premise that our customers (candidates) are not interested in being treated the way you have been. I have witnessed all the tactics you describe and then some and agree that they are stupid. I learned three very powerful words from some of the top recruiters in the US- "don't sell, facilitate." This has become our mantra.

I'm sorry for the frustration and disappointment you've gone through. I hope now you've learned the game you can continue to educate others. Also I think you should start a physician recruiting firm that is run to treat people the way you would have wanted to be treated. You have identified the need."

Sometimes I feel bad about going on and on about how bad recruiters are for your health and your job search.

But just when I decide to stop bashing recruiters I google the sentence "physician job" and THERE THEY ARE, hundreds of them, thousands of them, they are everywhere, they have so many websites, so many ads, banners blinking squares on every website you look, there are so many references to them, everybody seems to be talking about them, they just seem to be the way to go if you are looking for a job, they seem to be unavoidable - yes, the physician recruiters.

They love to portray themselves as "professionals you turn to when you need the best job out there", as the "solution to your job search", as your "search agent", overall as the experienced professional person with far-reaching contacts and with "thousands of opportunities nationwide" ready for the picking. You biggest problem seems to be just which job to choose! They have so many jobs, so may "opportunities" and they get more very day, all the time! Of course your physician recruiter will "match you with the perfect practice" out of all the wonderful opportunities they have to offer, because he "loves it every time the magic happens". How romantic!

You just have to choose and you will find yourself in your dream practice shortly. It is that easy, thanks to their "years of experience", thanks to their "thorough screening", thanks to their far reaching contacts. And of course your physician recruiter has "many clients with repeat business". They might tell you "Oh, I found one associate for them 10 years ago and and then another one, and now we are close friends and blablabla". Should they really not have the perfect practice right now, then they will CERTAINLY have the perfect job very, very soon, because they "always get the great jobs in that area". And, the best is yet to come, all this is FREE for you! Wow, who could say no to that? A job search is really easy!

This "recruiter myth" is a completely fabricated, shameless illusion of salespeople dealing in left-over jobs. It is so misleading, so miserably false, so dangerous that I have to go on.

And, as you saw from the above comment "I have witnessed all the tactics you describe and then some" means, we have to warn our graduating colleagues. Nobody should fall into the recruiter trap and end up in some Podunk town or give up the dream of living and working in the attractive city where he or she went to medical school. None of our colleagues should feel that "the good jobs are just not available".

Please support my attempt to educate the graduating residents about the risks of even answering recruiter calls and about the truly efficient ways of finding a job just where you want - by reading my blog or by going to ""!
Please link to my blog, please email my blog to a graduating resident you happen to know. It could save them months of headache.

Your Matthias Muenzer, MD

Thursday, March 29, 2007

MomMD makes a bad recommendation

Mom MD has an article on their webiste:

"Physician recruiters - making career transition a snap". This article desperately needs a comment. It presents the typical recruiter sales pitch: If you want to switch careers, call a recruiter. He or she will be your exclusive search agent, will go out there, find and review offers for you and present the best ones to you, saving you time and effort - and it's free.

This statement could not be more wrong and could not be more dangerously misleading!

Based on my personal experience as a physician both looking for a job and looking to hire a new associate I very strongly recommend using recruiters only as a last resort or, even better, not using them at all.

Too few jobs are accessible through recruiters:
85-90% of practices decline to work with recruiters, according to a telephone survey of 1000 practices. Even the most optimistic estimates done by recruitment firms calculate that only 1/3 of jobs are filled through recruiters! By starting your job search or career transition with a recruiter, you limit yourself to about 20% of available jobs.

Recruiters repeatedly have told me that they do not get jobs in areas with “more applicants than jobs", which applies pretty much to every desirable area in the US. "The function of recruiters in the physician marketplace is to fill the less desirable positions".
By starting your job search with recruiters you limit yourself to the less desirable jobs.

Employers usually try to fill jobs through word of month, then, months later, through advertising in print media and with direct-by-employer ads on the Internet. Only if that fails, will the usual employer resort to calling a recruiter. By this time, months to a year have passed already since the position became available.
By starting your job search with a recruiter, you limit yourself to the jobs that have been available for quite a while. A few people have looked at the job. A great job would have been gone by that time. You limit yourself to the leftovers.

The $ 18-20,000 to pay a recruiter for finding the candidate have to come from somewhere. In fact, this amount is usually budgeted as expense or overhead and is attributed to the incoming physician. It will most likely impact her or his salary, in a more or less silent way. And don't believe anybody who tries to tell you otherwise. By starting your job search with recruiters, you likely get a job that pays less.

By starting your job search with a recruiter, you place yourself at a severe disadvantage.

It would be even worse if you actually limited yourself even further and selected one single recruiter as your "search agent"! Recruiters do not all belong to the same network and they do not all share their job opportunities. Now you have limited yourself to a fraction of the less desirable jobs, to the leftovers and to the less well paying jobs.

And recruiters do not "network for you", no matter what they advertise - there is no such thing. All they do is type your short profile into a general recruiter database and check if there is another recruiter job in that database that might loosely fit. That is what they call "networking".

So, why on earth would a good, reliable, well meaning website such as MomMD publish such nonsense?

Most likely this is the result of a lack of knowledge. Writers, publishers, journalists fell prey to recruiter marketing. Jouirnalists mean well and try to inform. When researching a topic, they turn to sources that are available and approachable. We physicians usually are neither readily available nor interested in talking or writing on the subject of "career change" or "job search". Recruiters are very available. They want to get their sales pitch out there, as often as possible. They welcome journalists, they court them, they look for them, they aggressively go after any kind of PR. After all, they live off it.

And so it is not surprising that recruiter Marsh pretty much reads off the recruiter “press kit”. And recruiter Marsh actually pitches the dream of any recruiter. Following her "recommendations" would literally guarantee her the commission. While this serves her wallet well, it severely handicaps and delays the jobs search for the candidate. It will make the career transition everything but a snap. This recommendation helps ONLY the recruiter. Sadly, this is what naive and uninformed journalists print all to often.

It is time to correct this recruiter sales pitch ad to reveal what is really behind it. This nonsense has the same relevance for your job search as one of those "get rich quick" infomercials that air at 04.00 AM.

Please MomMD, save your readers the disappointments and the frustration that are guaranteed to result from following recruiter Marsh's "recommendation". Please make their career transition truly a snap by following my active search recommendations. They were earned in time and are based on experience and objective research. Unlike the recruiter infomercial, they do work. You can do it yourself, or you can have a company such as "" do it for you.

The best, most powerful and most successful way of finding a job

Decide where you want to work and live.

Buy a list of all addresses, phone number and fax number of the physicians in your specialty in that area. You can do this online by going to, to WebMD or to MMS (the marketing arm of the AMA) at You can drill down very accurately to the selection of physicians you need. Go on and try it. It typically costs 75 cents for an address with telephone and fax number.

Have your CV and cover letter written or at least reviewed by a professional writer, e.g. (NOT by a recruiter, even if they claim to see many CVs a day). This will cost another $200-300.

Mail-merge your cover letter with the address list to create personalized letters.

Mail your cover letter and CV to all doctors in your target area.

You may also fax your cover letter and CV (or maybe just your cover letter) to all physicians in your target area. Do this using, a fax broadcast system that allows you to Mail-Merge your letter with your list of addresses with the same ease as Word. You can literally fax your letter to hundreds of physicians with a single click. This costs about 6-10 cents per fax. Please consider the laws about unsolicited faxes - you are doing this at your own risk.

The response rate will be 1-2%, sometimes even up to 4%. This means that if you mail or fax 1000 letters, you will receive about 10-20 responses. The more physicians you contact, the more interviews you will get.

This is the least expensive and most effective, most successful way to find a job - and you can find it exactly where you want it. Obviously, you may repeat this after a few months if it does not work the first time.

And use "passive" search methods in addition, to comliment your active search, so that you do not miss anything.

“Passive” means you do not actively approach potential employers, but you look on websites and in journals for offers. Here are the best places to search for job postings on the Internet and in journals. They are the best because they have a large number of offers and a high number of direct-by-employer offers: This website used to be the "ACOG job website" referred to until 2005. It has a large number of direct-from-the-employer ads. The Jobs are listed in a convenient way: alphabetically by state and location.

At you will find jobs advertised by hospitals and health care systems. Very often these are good jobs in practices and offices. Answering these ads will put you in touch with "in-house recruiters" that will pass on your CV and information to the employers / private practices., the new website that ACOG links to. It has a good number of direct-from-employer ads. You can access it directly on the web or through the ACOG website.
Besides these two there are several thousand (!) other websites that mostly cater to recruiters, some of whom even proclaim to be "specialize" in ObGyn, but they rarely are useful. All-purpose websites such as or are utterly useless.  

Look in widely distributed print publications (throw away journals) such as in
Contemporary Ob/Gyn,
Ob/Gyn Management or,
Ob GynNews or
The green journal also has good ads, but they are a bit expensive for private practices.
c. Check the websites sites of large hospital chains such as Humana, Tenet Health, Columbia, UHS, HCA (Hospital Corporation of America). Go to their website, e.g. Tenet, click on “Career center”, then on “For Physicians”. Fill out the inquiry form, and you will receive answers. You will also find contact information to as many individual hospitals as you want – choose your area. HCA, another large hospital company, owns hundreds of hospitals. They do their own recruiting (in-house recruiters) and/or help their affiliated physicians and groups to hire doctors.

d. Create a Google Alert to help you in your search. An alert is a search that is run automatically for you every day or every week etc. You can for example search for "physician opportunity ObGyn San Diego" and "ObGyn job San Diego" Physician need ObGyn San Diego" etc. You can create as many alerts as you want, then track them over a few days and weeks. Delete the ones that do not yield results, keep the ones that work. Every day you will find the results of these searches in your Gmail inbox. this way I found several excellent hints and tips.

Please spread the knowledge about these truly effective job search methods, so that fewer of our colleagues end up as victims of the recruiter marketing nonsense.

Your Matthias Muenzer, MD

The Dark Side of Employment: Our Honorable Colleagues Will Abuse You!

Unfortunately too many of our colleagues will try to take advantage of you - you, the young physician, who is coming fresh out of residency. You may still be full of trust and full of respect towards you superiors, since your "superiors" just taught you everything that is the foundation for your career. But these colleagues, the ones offering you a position, are not those teachers anymore. These are physicians in private practice that run a business and want to make money. They know that you are not familiar with the economics of private practice. They know that you are not aware yet how to make money and how much each service you provide pays. They know that you are not familiar with what you are able to collect.
Unfortunately too many employers will try to take advantage of this and pay you a lot less than what you bring in.

The Miami area, where I interviewed a lot, seems to be a gathering ground for doctors who can't wait to take advantage of you.
There was that female doctor who straightforward told me that I could "easily collect 400K" in my first year in her practice, but that she could only pay me 125K! At the end of the year I would receive a bonus that brings me up to 35% of collections.
When I asked her why 35%, she answered: "I don't know, maybe because we are three doctors in the practice" - an answer that obviously is pure financial and economical non-sense and might have been meant as a distraction. The only correct answer would have been: "I have overhead costs of 55% and I also have decided to keep 10% of what you bring i. Therefore, you will keep 35% of your collections. And she is aclever business woman. An answer such as "Oh, I don't know" is unbeliveable from the getgo. And the best was still to come: When I left the office I walked past her partners Porsche and then past her shining new black Jaguar coupe with a license plate saying "Women mean business". I thought "how true" and told her I would have to think about taking her offer. She seemed not too happy with that answer and immediately told me that there were "two other candidates that are very interersted and I have to let them know by Monday". Another very transparent trick to pressure a candidate. I declined the job. The new candidate that took the job left a year later with her partner to open their own practice.

The list of stories about experienced physicians trying to take advantage of the newly graduated colleagues that I could tell her is embarrassingly long.

You have to know what you are getting into before accepting a job!

You have to get an idea how your potential employer truly feels about you! The crucial question to ask during an interview is: "Will I have access to the financial data about what I bill and collect each month?" and then, a little later during the interview: "Are you willing to put that in writing in the contract?" And also, later during the talks, and before signing the contract: "How much did your practice and how much did you collect last year?"

The answer to this question separates the honest employers from the ones that have something to hide. Why would you not give a future partner access to the books? That is the best way to teach your new associate the importance of coding, billing, purchasing and which procedures pay well and which not - something that may guide your decisions on what to market and what not.

There is nothing dirty about money, nothing private. There is nothing to hide, especially not when it comes to money that YOU make, money for services YOU provide. Unfortunately, many employers are not interested in that. They consider such knowledge secrets of success and prefer to keep it to themselves. Or maybe they are playing the "bait and switch" game, or maybe they want to take advantage of you as long as possible, they may want to keep on telling you how "expensive" everything is and how little they earn, just to keep your salary down.

Yes, an employer deserves a part of your earnings, but I believe you are entitled to know exactly how much. After all, you are colleagues, and in a good practice you are supposed to be trained to be a good businessman as well. And for that you need access to the books.

Don't be shy about asking! And I urge you to be extremely careful if you are not permitted access, no matter under what pretenses. Do not listen to the explanations, just remember the bottomline
- Will I have access to the financial data - Yes or NO?

I personally have no doubt whatsoever that any practice owner that does not give you access to the financial data also does not consider you his or her equal and does not see you as a future partner.

Also, I have learned to be very suspicious if your potential employer wants to do any of the following things listed below, they are all red flags:

·Withhold benefits for the first 6-9 months, such as 401K etc. That's plain cheap.

·Give only very limited benefits - one employer actually thought that benefits consisted of giving me "a pager" and, as reason why he did not even offer health insurance went on to tell me “I don’t have health insurance for myself, I only have it for my son” This happened in Miami too. The same practice owner told me he collected 1.3 million last year, but that he could only pay me 140K. Considering an overhead of 50% in a moderately well run practice, and calculating that I would have brought in 40% of the business in my first year, I would have collected 650K. Substract the 50% overhead from that figure and you come out with 325K as my share of profit. He wanted to pay me 140K. Where would the other 185K go? You have a choice: new apartment, boat, car, lawyer to sue me if I left, you name it.
This is why you should know what the financial situation of the practice is and how much you collect every month. I guarantee, it will be an eyeopener!

·Not give you insurance contracts, but bill your services under their own insurance contracts. Since you do not have your own insurance contracts, you stay dependent of the owner, since you are not able to separate from your employer’s practice and open your own practice unless you have insurance contracts. You ask if the insurance contracts will be in your name and in case they should not be in your name, politely ask to change this. Another similarly evil move is to cancel all your insurance contracts once the owner knows you are going to leave the practice.

·Make you sign contracts that do not allow you to practice within a certain number of miles from the office after you leave (restrictive covenant, which is illegal in a number of states, including MA). Watch out for the number of miles on these limitations and negotiate the number of miles. Make sure that you could practice at the next, closest hospital. Do not accept a restrictive covenant it if this would force you to move 15 miles or more away. Consult an attorney if these restricted covenants can be or are usually upheld in court.

Witholding financial information is a huge red flag! Every practice owner knows with absolute precision how much he or she collected last year, how much the overhead was, how much the profit was. If he or she decides to withhold that information it usually works to your disadvantage. You are not supposed to know how much he or she makes, so that he can pay you less! This usually means that the owner makes a lot more than you think. Should you not own your salary you can be guaranteed he would share THAT with you immediately.

·Give you a contract that asks for you to pay money back if you leave. A Framingham, MA, hospital used to offer such contract and consequently had a lot of difficulties finding doctors. Never ever sign such a contract! You incur a financial risk if you do not like the job for whatever reason, even if it has nothing to do with you.

Try to make you assume a financial risk for the practice, such as putting up a collateral for a loan or cosigning a loan for the practice. That is the responsibilities of the partners! That is what partners do, they take the risk and are rewarded for taking the risk. This is not the responsibility of an employee!

Beware of doctors who want you to take over the unpleasant work, so that he or she can kick back while earning the same or more. They may say, “I have done it for so long, now it is somebody else’s turn”. One woman offered me a “position” where I would work two evenings at which time I would also take the following two night calls, and this for half the usual beginner’s salary. The idea was that one of the two women did not want to do any more night calls and just wanted to coast along doing regular day office hours only. How convenient for her...

Beware of colleagues who want you to take more night call than they are willing to do. This may soon turn into even more night call for you and none for them - all the while they make all the money from the 2 AM deliveries.

Some practice owners try not to come through with the partnership promise at the time it was planned for – usually 2-3 years. They may delay partnership talks. They may always be "too busy" to sit down with you to talk about it and continue to make excuses. The goal is to keep you on salary, since this is to their great benefit. Young physicians often are baited with future improvements such as higher earning, participation in profit, partnership, and better benefits. Unfortunately it often changes once you are working in the practice. You may never get a chance to talk to the senior partners, or they may always seem very busy or they may brush you off with “everything has gotten so much more expensive” “the reimbursements have gone down” “let’s talk about it next month, next year…”. And then they never offer you the promised improvements or – worse – they just fire you before the benefits arrive or before the partnership talks come.

This is known as the “Bait and switch”.

Make sure your contract contains written explicit detailed information about the promised improvements in unmistakable wording. Have this reviewed by your lawyer. Should the employer hesitate to do this, you may rightfully suspect that he or she wants to take advantage of you.

These are all things that I have learned from my very own personal experience and from what I have heard from immediate friends and colleagues. To assure you that this is not made up, that this is not my personal bias and to reassure you that I am not paranoid, I am including a section of an AMA publication that speaks about this issue.

Regretfully abuse and being misled is a common experience of young physicians. Here is a copy of the "Young Physicians Section" of the AMA that has been published on the AMA website, "Contracts, What You Need to Know" It contains quotes, stories and advice from young colleagues:

Beginning of quote:·Talk with other physicians who have been in the group, hospital, or the practice. Ask, "Why do they need me?" Get the inside story--ask about the practice's reputation, its competitive situation, the market for physicians. Decide if your personality is a good fit. If there has been a high turnover rate, find out why.

·After more than three years of working with him, he "was not ready" to make me his partner even though I was performing 80% of the work and receiving 20% of the income.

·I learned from my fellow employee physicians that partnership negotiations had been going on for over five years.

·My section chief had a nurse telephone all patients prior to setting the appointment; she took a history and asked for information as to insurance status. Naturally, the chief selected only those patients with a high probability of demanding surgery that also had good insurance; I got the leftovers.

·After working as it were my own practice and doing well over fifty percent of the work, I asked for specifics about the transition to partnership. I suspected that our practice was generating more income than I was led to believe. I presented my estimates of our income and asked to see the "books." I was told it was none of my business and that I would have to accept what I was given as my "half." The next thing I knew, I received my 90-day termination notice.

·Each contract I reviewed was different; however, they all protected the group or senior partner. Each was presented as a "take it" or "leave it" proposition.

·I became a "partner" but the only income that was shared by all partners was the profit from the department, which contracts with the hospital. However, the rest of the partners keep 100% of the profit from their own practices. How is that for a fair agreement?

·When I arrived at my hospital, I found many surprises. There was no written contract with regard to my position; I had originally inquired about a contract but was informed that physicians were not given contracts at this institution. Then I discovered that the salary I was quoted was actually a loan, which I was expected to repay. Then I discovered I had to pay all of my routine expenses, including malpractice premiums, out of my own pocket. I also had been told that I could do my own billing, but when I arrived I was informed that the wife of my section chief would do the billing for 7% of my fees. Furthermore, I was informed that I was expected to pay a secretary additional money under-the-table each month.

·The most important thing a young physician can do is to assess the practice style, honesty, and ethical standards of the individuals he or she is considering a partnership with.

·Specific terms were not outlined in the initial three-year independent contractor arrangement. I asked that it be included, and I was made to feel I was being not trusting.

·Don't let a shiny brochure fool you into thinking the contractor knows what it's doing. A plan needs to be run well and offer you adequate support, or it can become a nightmare.

·He kept postponing signing the final contract. Finally, when it was presented to me for my signature, the buy-in agreement was missing. He said he needed clarification from his attorney. I didn't want to make any waves, since I had a lot to lose. Two months later, he said the practice wasn't doing well, and I had to leave. I was also told I had to look elsewhere to practice since our agreement had a non-compete clause.

· I made all the mistakes that the College of American Pathologists professional guidelines warned not to do. I failed to discuss the position with a previous employee of the group. If I had contacted this doctor, I would have discovered that the group never had any intention to make any employees partners.

·If you have questions that were not answered in a straightforward manner, do not take the job. We live in an era where the hiring doctor should do his homework, have a clear idea of the job description of the prospective new doctor, and know all of the proposed benefits. Any practice that has failed to plan for the new doctor is a potential nightmare for the junior partner.

·I knew there were some drawbacks. The first year salary was considerably lower (30-40% lower) than other salary offers I received in the city; but the future income potential, as a partner would more than compensate. The partners were making four times the starting salary of their employee. The other major drawback was that it was essentially five years to full partnership. Toward the end of the first year of employment, the group would vote to add an additional partnership track contract which consisted of an additional four years of service with yearly salary raises, higher bonuses and equal voting privileges. Two weeks before my employment contract was to expire, they told me there were insufficient votes to offer me a partnership contract. What they then offered was a second year of employment without any future job security. As I reflect back, I don't believe they ever had any intention of making me or any other future employee a full partner. Their goal was to form a limited partnership where only a few made high salaries. I believe they purposely delayed their decision to essentially force me to work another year for them.

·In the presence of a third person, he verbally promised me I'd become a partner at the end of the first year if I were comfortable. The contract stated however that the partnership would be agreed upon prior to the termination of the three-year contract, with the details to be determined at that time.

·Contracts should state a maximum number of hours. He told me he could order me to work 200 hours a week if he so desired. I worked all public holidays. He took four weeks vacation during which time I was on call all the time. I was told I would be compensated for this extra work. He promised a bonus at the end of the first year. Just prior to the end of my first year, I asked about the bonus and partnership. He said, "What bonus? What partnership?"

· He had the office manager and other staff eavesdrops on my conversation with my patients and their families. If you notice that your conversation with a secretary is immediately interrupted as soon as the senior doctor walks into the room, watch out!

·Academic physicians sharing part-time jobs in the Veterans Administration or federal system need to beware of problems with benefits. Often, the VA does not offer a contract until the first day of work. This can be a problem for physicians who were hired by the associated medical school, only after committing to a move to find themselves in the VA personnel office, with the VA giving very different information than did the department chair. The government has mysterious ways and rules often unknown to departments. Insist on everything in writing, including commitment to reimburse for moving expenses! The VA also has problems with pensions. A doctor working part-time at the VA can find himself without a vested university pension, because of requirements about a certain minimal number of hours worked at the university each year.

·The pension plan was structured with entry dates such that I did not qualify for my first year of participation until after I had been with them for 16 months. They terminated me after my first year and told me I didn't qualify for their plan so they didn't have to make a pension entitlement.

·I had several concerns, which no one would address. I finally sent a certified letter asking that I receive a response to my concerns. I received a return letter stating I should plan to meet with them the day before my contract expired. At the meeting, with their attorney present (I was without counsel on the advice of several good attorney friends), they demanded my pager, cellular phone and told me to vacate the office within the hour. I was given a termination letter which did not state any reason whatsoever for the termination. I later found out they had done the same thing to another physician a few years earlier.

·Read the fine print in your contract. Hire an attorney to review the contract. And, don't trust anybody: The people I went into practice with were my professors in medical school. After five years, I left the group with hard feelings on both sides.

·Don't be dazzled by a generous salary. The practice I joined was an old, established group with a dwindling reputation. They wanted fresh blood to come in and save them. Basically, the young, hard-working guys supported the older guys.

·If it sounds to good to be probably is."

Last updated: Dec 08, 2004, The preceding content provided by: Young Physicians Section, Copyright 1995-2006, American Medical Association.

End of quote

Shocking what our estimated and respected colleagues can do! Watch out, and keep your eyes open. You have been warned!

Your Matthias Muenzer, MD

Friday, March 23, 2007

Should physician recruiters tell you about their limitations?

If one of my patients has a problem that I cannot solve myself, I acknowledge the problem my patient has, and I tell her who can solve it. Then I give her the name, address and telephone number of colleague who can solve it. Anything else would be unacceptable and unethical.

Should not recruiters inform us that they are not able to find jobs in attractive cities or about anywhere where there are more applicants than jobs? They do not. Recruiters are fully aware that jobs are first advertised by word of mouth, then in print media and on the Internet as direct-by-employer ad, and if all this is not successful, months later, a recruiter is called.

Do recruiters refer you to someone else you can find you a job in the area you want, such as in Los Angeles, New York, San Franciscio, Miami or Seattle? NO!

Why do we not apply the same kind of standards to physician recruiters that we apply to ourselves?

For several years, every recruiter who has contacted me has heard my request "I want a job in Attractive City only, nowhere else. And only one, just one single veteran recruiter ever said, "Listen, a recruiter cannot help you there, we do not get those jobs, you have to do it yourself. Just call all the offices".

Rather than helping you achieve your careeer goal, out of a sense of responsibility, recruiters tend tell you that the good jobs are "not available".

One example from the Cejkasearch website: "If you have your heart set on Los Angeles, Miami, New York, San Francisco, or Seattle, join the club. That's the problem: Such highly desirable locations in terms of lifestyle may be highly undesirable from a professional standpoint. Large metropolitan areas are either already swamped with managed care or about to be. And because competition for jobs is intense, practice opportunities are fewer, compensation may be less, and your financial future may be shakier than in less populous locales."

Or, in plain English: "City not good, country side good! Where you want to be, not good, where we have jobs, good!"

On recruiter blogs you will read musings about "what do you the doctor really need to be happy, do you really have to be in the big city, could you do with less, could you not live in the countryside?".

This lack of responsibility for a client is what really turned me against recruiters. I find it discouraging that recruiters do not intend to help you, they do not intend to give you advice, they do not feel any responsibility towards you or your career. No matter what their emails, brochures and websites say.

After years of dealing with recruiters I am convinced that they are just interested in the "quick buck". Here is an enlightening posting on a blog by a former recruiter:

Before I started my coaching business, I learned the traditional selling process while working in recruiting and sales for a national consulting firm. To say that I am familiar with prospecting would be an understatement. While working there, I burned up the phone lines each day, constantly dialing the phone in search of potential clients. The headset became a permanent fixture on my head as I "smiled and dialed" for dollars and for fresh prospects.

On an average day, I made around 100 phone calls and spent at least 3 hours actually on the phone (time spent dialing the phone or taking a break in between calls didn't count towards my daily activity goal). As part of that routine, I left multitudes of messages, dialed hundreds of wrong numbers and heard the phone slammed down in my ear - all in search of the next prospect, that potential candidate who was ready to hear my shtick about new "practice opportunities."

......Aside from reaching a certain activity goal each day, the purpose of my incessant dialing of the phone was clear. I was on the hunt for a certain number of prospects that could possibly fill the practice opportunities (jobs) our team represented. For any given job, I hoped to find at least 4-5 prospects in hopes that one of them would work out and actually take the job. If not, then I was back to the drawing board, since my compensation was directly tied to the number of interviews and number of placements (jobs filled) that I could help make happen.

Many days, I often wondered how our firm could do things differently - to better reach the prospects and potential clients in our target market. I knew there had to be a better, more effective (and efficient) way to build relationships with our potential clients. To establish trust and credibility, so that they contacted us when they were ready for our services, instead of us hounding them until they either cried "uncle" or changed their phone number.

Many of us on the team had ideas on how we could improve our sales cycle and produce even better results. No such luck. These suggestions fell on deaf ears, as "management" was not interested in changing the process. Based on their responses, it seemed that the executive team had no interest in actually developing relationships with our candidates and clients. They were focused on the short term - finding as many deals to increase profits today, regardless of the negative backlash it created both within the company and among potential candidates. But that's another story for another time...

This is an excerpt from a posting on the blog of Michael Port "Book yourself solid". I do not have to anything to add. It could not be clearer.

Fortunately for job seekers, Direct Mail and companies like "" make it easy for you to get a job just where you want it.

Your Matthias Muenzer, MD

Tuesday, March 20, 2007

How to get the job you really want

You can search passively or you can search actively. They are very different and yield vastly different results.

Passive search means that you look in journals and on websites and check if you come across an appealing position. Passive search will not reward you with a good job or an outstanding job. In the last post of this blog I have written about the time that passes between the moment when a practice owner perceives the need to hire someone and the time the ad finally appears in a journal. It can easily be a year. If you wait for a recruiter to offer that very same job, it may be one and a half years.

Recruiters usually are called only after word of mouth and advertising fail to fill a job. Why? Recruiters cost 20,000. It is as simple as that. If a practice owner can fill a job for free (and everybody tries to do it) he will never contact a recruiter. And if a recruiter contacts him during that time, he will hesitate to look at the recruiter's candidates, at least at first. Only when the practice owner is worn out and lost hope, then he will give in to the recruiter offers.
So, passive search shows you the jobs after they have been available for a while, late in the game!

Active search on the other hand, means you go out there and ask around, call employers and call or write hospitals in your target area. Active search means, most importantly, that you get a list of all doctors in your target area and send them your polished cover letter and CV. Either do it yourself or go to or and let them do it for a very reasonable price.

Active search means you are in command, you do something, you do not delegate. This keeps you in control and prevent others from side-tracking you. Who could side-track you? Recruiters love to do that. You look for a job in Attractive City. Not surprising, recruiters do not have one. But they counter immediately - as the good salesmen they are- with something like: "I do not have Attractive City, but I have Podunk, which is 'near' Attractive City", and " Podunk is a great place to raise a family, has very affordable real estate and you get the good feeling that they really need you!" and "Podunk is close enough to Attractive City and they still respect doctors!" and "Podunk is a great place to practice medicine". And so on and so on. Since they do not have what you want, they try to sell you what they have. They try to sell you what you do not want. Do not let them sidetrack you!

You should know that many recruiters use "phrasebooks", a list of canned, prewritten answers to overcome any objection you might have. Click here to see one example Sometimes the "phrasebook" is part of the recruitment software itself. If you want to read more on this topic, go to Black Dog software and download the free demo of the recruitment handbook and read around. Click here. Very instructive! When a recruiter calls, you are about to leave the protective educational environment and you are about to be exposed to cold hard sales strategies and tactics. While you trained to do deliveries, they trained to convince people, to sell stuff, to win people over, to sell, sell, sell. I recommend also for that reason alone that you DO NOT ANSWER recruiter calls. What do you have to loose? Your valuable time. What do you have to gain? A less desirable job. So, don't answer that call.

I recently emailed a recruiter: "I am looking in Attractive City. On your website I did not see any jobs posted in Attractive City. Will you get any in the near future?"
And the answer of the recruiter was: "In Attractive City there are more applicants than jobs, and therefore we usually do not get jobs there" Thank you, thank you, thank you! That is a polite way of putting it. Wherever there are more applicants than jobs, recruiters do not get jobs! My words exactly since the beginning of this blog!


Dear colleague on the search for a job, if you want to find a job in an area that is in demand, in an area that is beautiful, attractive, offers a great lifestyle, in a desirable area, then there will be more applicants than jobs! What else did you expect?

We know that situation where there are more applicants than slots quite well. Remember how we got into medical school? What was the ratio again, 6 applicants, 1 position? So, we are used to being where the competition is and we have a track record of getting in. We are the ones who will get a job in the desirable area, even when there is competition.

So, you will feel very comfortable with the active job search. It will put you far ahead of the competition. Let the others gaze at the journal ads and let them be bombarded by recruiter emails about less desirable jobs! We mail our cover letters and CV to all colleagues in our favorite area, we get the interviews and we get the jobs.

And when a recruiter calls you, you know that he only tries to fill the less desirable jobs. And we know that the recruiters try to gloss that over, we know that they do not advertise that fact.
But do YOU want a less desirable job?
Please tell your residency program director about direct mail and, tell you fellow residents, tell your third years. Get the word out, there is a new, better way to get a job! Direct, on target, months ahead of the competition, where you get what you want, where you want. Please tell everybody who will listen for 10 seconds that direct mail is by far the best way to find the right job!

Your Matthias Muenzer, MD

Monday, March 19, 2007

Understand what happens BEFORE a job is ever advertised !

For young physicians searching for a job it is very helpful to know what goes on in the mind of a practice owner before a job is advertised.

Usually the practice owner has a growing practice and works more and more, harder and harder and starts to get tired. He starts delegating more, may hire additional staff, and then after many months, the thought arises that he might need an additional physician to prevent burn out. He may toss that idea around in his head for a few months, since it is not an easy decision. Then he may talk to his wife about it, or to a partner in the practice. Then, when the decision gets ahead, he might talk to his accountant and think about the cost of a new physician. Then he may make a detailed business plan with a cost analysis for an additional colleague in the practice. Then, after one or several more months to about a year he may make the final decision "Yes, I will hire a new physician".

Then he will ask around in the hospital for a few weeks, put the word out, mention it to the colleagues who cover his call, then maybe to the head of the department, maybe to the medical director if he happens to know him better. He might, after one or two months, contact the closest University and he may speak to the residency program director "Any good residents that might be interested in joining me?".

Then, if after a few months, if nobody materializes, he might advertise in one of the journals. Usually an ad yields several CVs. Maybe one of the candidates is a fit and the search is over. Maybe nobody has the right qualification and the right chemistry. Then he may advertise again in the same journal, or maybe now in all three or four commonly used journals, or he may advertise, hopefully on or It is now 3 months after the first ad was placed.

And here is the important point: ONLY AFTER ALL THIS WAS NOT SUCCESSFUL, will he consider, for the first time consider, calling a recruiter. Why? Very simple, there are 20,000 solid green reasons NOT to call a recruiter....

Between perceiving the need for an additional physician and the advertisement usually 6-12 months pass by and then another 6 months at least until the owner will consider giving the job to a recruiter.

This means that you, the smart uptodate physician, who searches jobs actively by using direct mail or a direct mail service such as have a window of 12-18 months to find a job before everybody else knows about it! By the way, many recruiters know this and routinely send their ads out to practice owners hoping to catch just the right moment - but don't worry, there are those 20,000 reasons that work very much in your favor!

Imagine that! Your CV just seems to pop out of nowhere and lands on the doctors desk. Surprise, a qualified, willing physician looking for a position right where the practice owner is and right now, at this fortunate moment!

I am not kidding. I had these reactions "God must have heard my prayers", "It is most fortunate that you sent my your CV at this time" "Your CV reaches me at a great time".

So, you are truly welcome if you send out your cover letter and CV, you actually relieve the practice owner of further searching, or at least you raise that hope. And, your CV shows up without any competition, at the right moment. You cannot have better chances than that!

That is why services like can advertise high success rates. I have tried it with the do-it-yourself method and had the above surprising results. It works like a charm, I can highly recommend it!

The function of physician recruiters is to fill the less desirable jobs! When a recruiter calls, stop and think: Do I really want a less desirable job?

Good luck and happy searching!
Your Matthias Muenzer, MD

More help with deciphering physician recruiter ads

I forgot one term in recruiter ads that is easily misunderstood. This contributed to my disappointment in recruiter jobs. It's "metro area". I was thrilled when I come across ads featuring jobs in a "metro area in Massachusetts" and thought, metro area means population over 500,000. At least, that is "metro" for me. If I hear metro areas I think of Atlanta, New York City, Denver, Houston, Boston etc. To my great surprise, recruiters use the (formally correct) metro definition of the US department of statistics. And they define metro area as an area with a population of 50,000, in words fifty thousand. No wonder the recruiters advertise "metro" jobs and no wonder I was disappointed. I had not expected to find out that that "metro" job was in Worcester or Lawrence instead of Boston. And I bet I was not the only one disappointed. So, remember, Podunk is a "metro area". And, yes, recruiters have jobs in "metro areas"! They are right!

By the way, when I speak to my colleagues about recruiters, I usually get grumbling answers and spontaneous reactions like "Oh, they're the worst" - which stands in strange contrast to what the recruiter websites want to make you believe. On recruiter websites you read testimonials from "satisfied physicians", who usually have a first name and a letter as a last name, such as "Jonathan L from Arizona" who supposedly said: "You guys are the best, your service was phenomenal" and similar things. Were are these happy recruiter clients? I can't seem to find them! And I keep asking around collecting ideas for this blog. Maybe because I work in the city of Boston? And maybe because the recruiter clients mostly work in a Masachusetts "metro area" - somewhere out there far away? They all work "close enough" to Boston, "near" Boston, with "easy access" to Boston! NO colleague at my hospital found his or her position through a recruiter, not a single one.

The function of recruiters in the physician job market is to fill the less desirable jobs. When a recruiter calls, ask yourself: Do I really want a less desirable job?

Your Matthias Muenzer

Saturday, March 17, 2007

Why do you dislike physician recruiters?

Since three years I teach Obstetrics and Gynecology to the residents of a Family Medicine Program in Boston. Two years ago I started giving a lecture on "How to Find Your Ideal Job" after I learned about the advantages of the direct mail method.

My present recommendation to my students is the following: Figure out where you want to live and work, buy the addresses of all docs in the target area from a list service, polish your cover letter and CV and mail it to all the doctors on your list. Or have a service like "Thedoctorjob" do it for you! I have summarized this method earlier in this blog.

After my second lecture one of the faculty members asked me: "Why are you so negative about recruiters?” Here is the answer…. Well, it was a long learning process over years, with not just a few, but many dozens of big and small bad experiences and big and small disappointments. And when I looked at the balance between the good experiences, which I can count on one hand and the hundreds of bad experiences, my sentiments will be easy to understand.

I started out with a great attitude towards recruiters, and with great hope. Here are these people that "hundreds", no "thousands of jobs nationwide", that have "the best jobs", that "personalize a search for you", that can find "The perfect practice for you" and so on.
I was living in Boston and wanted to stay there. And with Boston I meant really Boston, inside the I-95 ring. So I sent my CV to more and more recruiters but strangely, even the recruiters that advertised jobs where you can "Enjoy all Boston has to offer" "Boston suburbs" etc did not have jobs within the I-95 ring. The "Boston suburbs" turned out to be very creative defined, since it was Methuen, Framingham, Worcester, Plymouth etc. Not my exact definition of suburb. Driving distances in ads were routinely understated; places "30 minutes from the city" always were an hour away. Would that have something to do with the fact that none of the recruiters turned out to be familiar with Boston?
Oh, and then there actually was a job IN Boston, and I rushed to find out what it was. Obstetrics only, and underpaid. At the time the usual starting salary was 150-160, this employer offered 120. This was the first of many, many experiences that later let me conclude that "within-city-limits" jobs coming through recruiters had serious flaws.

Recruiter jobs were never great, there was always something off, and the jobs always seemed to have a flaw, some drawback, not just in location. When going out from the inner city there is a distance where my comfort zone ends. And that was usually the area where the recruiter jobs started! I wondered why...And I grew more and more cynical when reading the oh-so-promising ads!

A few years later I went on another job search, and this time it lasted over 4 years. I wanted a position in (gasp!) Miami. I found Physicianwork, registered and again was very excited and hopeful – over 75 jobs in Florida! There had to be something in Miami among them! For starters, it is very frustrating to guess where jobs are, the typical recruiter jobs are cryptic and vague. I understand the reasons for this very well, the location of the job and name of the employer is the only chip a recruiter has! But it is still frustrating. I would have liked to screen the jobs by location and salary – and that is exactly what they never tell you. Pathetic! The clouded salary may not all be the recruiter’s fault, but they usually do not nudge the employers enough to post a salary range. I sometimes suspect they are afraid to “lock themselves in” by mentioning a salary range. Or maybe it is not “good to talk about money” or “nobody should know what you earn”, since it is “private”. All nonsense.
I also found out while searching on Physicianwork, that many jobs are listed multiple times by multiple recruiters and recruiting companies. Great…
And the same frustrating game started all over again. “Oh, no I do not have anything in Miami”, But what about Lakeland, and Tampa, and Jacksonville, and the panhandle and, and, and. Lots of jobs, just not where I wanted one.
Then I listed myself in Physicianwork as looking “strictly in Miami, nowhere else”, not Fort Lauderdale, not Naples, not Orlando, no Tampa. After all, I have family in Miami…

This did not deter recruiters from sending me literally countless emails advertising jobs in Florida – anywhere in Florida, except where I wanted one. It started to sound like Miami was the new Boston. The jobs all started where my comfort zone ended.

And apparently none of the many, many recruiters that sent me emails responding to my profile that said “Miami only” obviously had read my profile or – hey maybe they did not care?! I now believe they do not read the profiles, but just collect the addresses and send out the emails hoping I might change my mind, or hoping they can sell me something else. They actually act very much like spammers.

Sometimes the spamming style emails were pretty crass. I had just spoken to a recruiter in person and explained that I was looking really only in Miami, sorry, really nowhere else…and to my surprise next day I get an email about a remote California location (“home of the California puppy”, of course far away from the action, “a short drive” of 75 miles from LA). It really makes you wonder – what is it? Did the recruiters not hear me? Did they not care? Did they not take me seriously?
Sometimes I think what would happen if I treated my patients that way – “Dear Mrs Jones, I don’t care if you just want the pill, here, read this leaflet on hysterectomy”

And then, I started answering my emails with: “Thank you for contacting me, but I am searching exclusively in Miami”. Bam, I get the “Miami area” emails, ads and job postings. The “Miami area” suddenly seemed to stretch from the Keys to West Palm Beach. What kind of map are these people looking at? What are their concepts of distance? Do they ever commute? One excited recruiter told me that I could live in Miami, but work slightly north of Fort Lauderdale. Another one who has never been on I 95 in rush hour…

Then I started to add one more sentence to my answer to all those recruiter emails:
“I am only interested in Miami, and only in a practice that has a phone number starting with the area code 305” Aaaahhhh, that usually worked, and it even brought me a grin and chuckles from a recruiter during a phone call. He seemed to understand exactly why I was saying it. At least now the number of email about Naples and Orlando went down.

Quite a few times I got the answer “I do not have anything in Miami at this time, but I’ll call my clients I that area to see if they have something” Oh, yeah, buddy. And, sure enough, none of these “clients” ever had anything – just what I had suspected to begin with.

And now, here is the outstanding, rare, single, amazing experience with a recruiter – an actual, true and honest answer: “If you want to work to find a job in Miami, you have to call the practices yourself, one by one. And if it does not work the first time, then try again in three months”. I was blown away, a recruiter that actually does not try to convince me that Podunk is better, but gives me a tip how to land a job in the city I want.
This, my dear readers, happened only once, one single time, on one lonely occasion, one remarkable afternoon, in several years of searching, after literally thousands of emails and several dozens of calls and telephone conversations! The truth! The first true tip from human being to human being, no salesmanship. It happened ONCE.

Do you begin to understand why I do not like recruiters?

You cannot believe how many emails I received and still receive about jobs from West Virginia to North Carolina to Indiana and Idaho, even jobs in other fields of medicine like anesthesia and pediatrics! The recruiters who are sending me these emails really read my profiles, my registrations and my emails well!
And all this fits in so perfectly with one of their marketing slogans “we personalize your job search”. Sure, it was really, really personal – Idaho instead of Miami!

By now I believe that recruiters just do not care. They sell, sell, sell, and they go for volume, and they go for the numbers. The more emails they send out, the more people they contact, the more chances they may have to sell one of their jobs. They may think, oh well that email was a little off, but who cares…That is why they remind me of used car salesmen and telemarketers. The ads are just the nice marketing face. By now, I do not believe a word. They sell, that’s it. And they do not care if you find the job you want or if your career is delayed for that matter. I wish I had known from the start.

And then, I found “” They explained what they do – direct mass mailing. They have a very informative website. After reading the info on their website, suddenly the behavior of recruiters made sense and it became clear why they did not have the jobs I wanted – and why they never will!

I tried the direct mail myself, and it worked like a charm. One mailing and I had seven interviews and three job offers. In a city that was “oversaturated”, where there were “no jobs”. Later I tried mass faxing with the same success. And mailing and faxing is so easy, the lists are readily available on the Internet, there are services that review and improve your cover letter and CV and ….of course there is “” that offers all this in one neat package for a very reasonable price.
And, no, I am not related, I am not part of the company, they do not pay me (I wish), I am not on commission, nothing – I just love the idea, the method and above all the results.

Dear reader, if you like what I wrote, please spread the word. Save your colleagues and friends the frustration I had to go through. Do them a favor, tell them about “” and show them my blog with the description of the method.

The function of the physician recruiters is to fill the less desirable jobs – but they won’t tell you that! Stay away from them!

Wednesday, March 14, 2007

Who needs a physician recruiter? (3)

Recruiters fill about 10-15% of all physician jobs.

What 10-15% are those? The most attractive, the top ten or the least attractive, the bottom 10?
Who do you think needs to pay someone $20,000 to find candidates - the employers with the attractive jobs or the employers with the not so attractive jobs??

As a former recruiter said:
The function of recruiters in medicine is to fill the less desirable jobs!
And therefore: The next time a recruiter calls, ask yourself: Do I want a less desirable job?

The Internet should over time make recruiters unnecessary. Employers post jobs on several well known job boards, candidates post their CVs on those boards as well, they find each other. Happy end.

I do not see any reason to introduce a third party into this quite simple process, especially when the third party are non-physicians with modest understanding of our work and especially when the third party consists of salespeople that all too often behave like a cross between a used-car salesman and a telemarketer.

The Internet "happened" to the travel agents, Zillow may do it to the realtors, and where is the software, website or job board that is going to do it to the physician recruiters?

My very first experience with recruiters was enlightening: I was invited to a "job fair" where "ObGyn departments" would be "looking for candidates". Even though I was sceptical (at the time ObGyn was very popular and they would certainly not need to show up on job fairs), the recruiter confirmed repeatedly on the phone and by mail, that yes, there would be ObGyn job offers. After taking a day off and traveling by train for several hours - no ObGyn jobs, just peds and internal medicine. I had the distinct impression the recruiter just wanted me to show up to impress the employers with the number of candidates her could mobilize.

And that was my introduction to physician recruiters many years ago. But it was only the first in a long series of disappointments with this "profession".

Remember: The function of phycisian recruiters is to fill the less desirable jobs!
And when a recruiter calls, think: Do I really want a less desirable job?

Sunday, March 11, 2007

More "physician recruiter speak"

Did you ever wonder why recruiter "opportunities" are rarely located in attractive cities? Recruiter "opportunities" mostly seem to be in locations described as ...

..."A great place to raise a family".
What this truly means is - there is really nothing else to do in that place except raising a family! Maybe watching satellite TV. It's a guarantee for boring. If you are married and like the countryside, you may consider it, but if you are single and looking to meet someone, or if you enjoy theater, opera, live music, cafes and similar aspects of urban life, don't even think about it. If you hear "a great place to raise a family" - run!
Did someone ever describe New York City or LA or Boston or Miami as a great place to raise a family?

...having "Low pollution" - sure, rural areas have low density, low concentration of cars and therefore low pollution. Did pollution ever bother you when visiting Manhattan?

...having "Low crime" - sure, the last few criminals fled the place due to boredom.

And last, not least, recruiters always add that sentence that the location is "a great place to build a practice" - apparently just the fact that they are offering a job and are willing to shell out 20K is sufficient proof of that. But please do not ask for any real proof, such as a marketing analysis. Sentences like these are just thrown in to make you feel better.

Always remember:
"The function of recruiters is to fill the less desirable jobs"

And the next time when a recruiter calls, stop and think "Do I really want a less desirable job?"

Who needs a physician recruiter (2)?

You do, if you....

1. Have absolutely no clue how the physician job market works.
2. Do not mind getting a $20,000 income reduction.
3. Do not mind working in a second rate location
4. Do not mind taking a job that a few other people have declined.

Always remember: The function of physician recruiters is to fill the less desirable jobs!

Before you answer that recruiter call ask yourself:
"Do I want a less desirable job?"

What do those terms in physician recruiter ads really mean?

After speaking to physician recruiters and responding to their emails for over 7 years I realize that one of the challenges of becoming a physician recruiter must consist in re-learning English and adopting "recruiter speak", a different version of English, where words assume different meanings. To help you translate "recruiter speak" into everyday English, I am listing a few typical recruiter phrases below - and explain what they really mean:

“At no cost to you”……………………so they want you to believe, but if not you, who else is going to pay? The cost of recruitment will be paid by the employer, who has already factored it in into your "cost", into the overhead that is attributable to you. Rest assured that the recruitment costs will be silently deducted from your salary - and most likely you will never be told.

“We help you with your resume”……something which is occasionally advertised, but somehow never happens. No one ever helped me, not even with feedback such as "this or that is good / not good". The only, really only feedback in all those years was “your CV is just fine”. Once I submitted it to a professional CV writer it changed drastically – for the better. All the recruiters I asked for help with my CV did not respond to the request.

“We help you with your interview”. Nope, has not happened for me in all those years. And physician recruiters actually could help candidates in a meaningful way. They could reveal to the candidate what the true requirements of the employers are, what they are really looking for, what they need and what they do not need or want. Not a single recruiter told me any information of this kind. All the “help” I received was “Dr. Soandso is waiting for your call, let me know how it went”. They are salespeople, not advisors, they are not in the business of helping you, they are simply selling you an "opportunity".

“We screen our candidates” ………if you have a pulse and a license, you have passed the screening test. Well, well, well…an older colleague of mine had tremendous difficulties personally and financially after a divorce and lost his license in Massachusetts since he was unable to pay the abusive malpractice insurance of 70,000. He needed to leave the state. He was over 60, teeth in bad repair, a very long time since residency training, no particular honors, awards etc. He posted a profile on "" and within two days had received 60 responses from recruiters who were only too happy to “help him find a job”. My colleague was overjoyed that recruiters apparently did not care about his age or drawbacks. This is another proof that recruiters simply work on closing a deal and getting the money, no matter with whom. They are not selective about candidates and they are not selective about practices. They take what they can get. It’s all sales, sales, sales. Remember, for a recruiter you are a meal ticket, or a 20K check, however you want to see it.

“We screen our practices”…………nobody, but absolutely nobody screened my practice when I was hiring. When I was looking for a candidate, recruiters asked me about 4 or 5 questions about my practice, nobody came to visit me or see the practice. If you show willingness to pay, you have passed the screening.

"We match perfect candidates with perfect practices" I think that prefect candidates do not need recruiters, they are approached by employers directly, they have a good network and find their jobs that way or they create their own jobs (a few of my colleagues at Harvard did that). So, perfect candidates do not need a recruiter. Should you truly need a recruiter to find a job, then there might be something suboptimal about your CV, about your past or even about you! At least you do not know the best job search techniques, as described in my blog and as offered by “ “ or “”.

Oh, and “perfect practices” are not commonly located in Podunk. Whereas a significant portion of recruiter “opportunities” are located in Podunk. Physician recruiters have to describe the locations of their practices in some way that masks the lack of attractiveness. And so, locations of practices are mostly described as “Close enough to” - followed by the name of the city where you wish you could find a job.

Recruiters seem to get these impressions of "close enough" by looking at a cheap, small globes, where New York and Philadelphia actually seem to touch each other. In reality, once you personally are in an area described as "close enough to" you realize it is a long, long drive of usually one and a half to two hours to the city you wish you had a job.

The other common description of practice location is “Easy access to”. Again a grandiose euphemism. It means you drive for 20 minutes through winding streets and forests, over hills, through little villages to the Interstate ramp, and then you take another “easy ride” lasting 60 minutes to the city you wish you lived in.
Another common location is described as “Easy access to city A, city B and city C”. Wow, access to three cities! in reality this is even worse: the location of the practice is in the dead middle between these three cities, outside of the suburban areas of all three cities, outside of the range of all three commuter transport systems, in a nowhere land, in an area not belonging to any of the three cities, where nobody really wants to live if they can avoid it - which is exactly the reason recruiters get the task of luring you into that area.

Physician recruiters may cite driving distances to the city you wish you had a job. They may write “30 minutes from” = oh yes, but those thirty minutes always seem to be clocked at 4 AM on a Sunday morning in a state police cruiser with blue lights flashing and driving well above any legal speed limit. At least double the time for a realistic estimate!

Always remember what a former recruiter said: “The function of recruiters is to fill the less desirable jobs”.

Before you answer that recruiter call, think: “Do I want a less desirable job?”

Who needs a physician recruiter?

Definitely not you!

Residents about to graduate and looking for a job are inundated by recruiter emails and phone calls.
Since physicians see their job search as a temporary "pain in the neck" they do not know much about it, and this lack of knowledge is abundantly taken advantage of by physician recruiters.
Out of 100 available jobs out there 100, or the full amount, are accessible to personal networking (you knew that) as well as to direct mail (you most likely did not know that!), about 30 are posted in journals and magazines and about 10-15 are available to recruiters. Yet, since a recruiter's income depends on it, they peddle their jobs and "services" like nobody else. Judging by the noise they make on the internet you might be mislead into believing that recruiters have a meaningful place in your job search. Nothing could be further from the truth.

Before returning a recruiter call, know this:

A. They charge around $20,000 (actually an average of 18,000).
B. They get paid when and only when you sign the contract with the new employer (this applies to contingency recruiters, the most commonly encountered type).

These two facts are at the root of all shortcomings of physician recruiters. These shortcomings do not change, they are inevitable, invariable, no matter how nice and "professional" they may appear on the phone:

Since they are expensive, 80-90% of practices refuse to work with recruiters (result of a phone survey of private practices. Working with a recruiter, you lower your chances by 80-90%.
Good practices in desirable locations will not work with recruiters, since they can get candidates without paying a fee. Do you think a practice in Boston with an office with harbor view needs a recruiter? Can you guess why so many recruiter jobs are not "in" but "near" or at "one hour drive to" the city you would like to work and live?
Recruiters usually do not get the jobs that are "in", they get the jobs that are "outside".
Since they are expensive, practice owners will recoup the money spent on a recruiter by deducting it (usually silently) from your first year income. Recruiters definitely will not tell you about this, since it would be bad for business and they try to keep up the myth that their services are "at no cost to you" (meaning the candidate). One recruiter even told me that it was part of the contract that the employer should not mention this to the candidate.

Since they only get paid when you sign on the dotted line, they tend to sell you to the practice and the practice to you, without regard of a "match".

Always remember what a former recruiter told me:
"The function of the Physician Recruiter in the job market is to fill the less desirable jobs"
This is a very polite statement, I would have worded it differently.

Before answering that recruiter call ask yourself: "Do I really want a less desirable job?"

There are infinitely more effective ways of finding a job. These ways are discussed in my blog.