Sunday, September 23, 2007

What Physicians Think of Recruiters

A quote posted by "PsychMD" in one of the forums of, which I am adding to the other quotes from physicians who somehow have arrived at the same view of physician recruiters as I have. I have described this very extensively in my past blogposts.

Just a general comment re. recruiters mailing you. Everyone starts getting junk mail recruiting around the time when they start to appear listed in several databases (available free for anyone who looks), such as medical licensing boards, the Specialty Board Certification site, hospital privileges staff lists, even final year resident rosters which are available on many programs' websites.

I wouldn't encourage anyone to pick a job pitched by a recruiter who has your name from a database and has no clue who you are and what you want. Plus, of course, they will all tell you that the "market" is pretty tight in the major cities, because most major hospitals in most major cities do not even go through these recruiters; they have their own in house recruiters, or recruit staff through internal networking; they have where to pick from. Look for a job based on where YOU want to live and where YOU are familiar with the local medical scene. Do your homework well. Lots of jobs picked through recruiters are jobs that are not already filled locally for a variety of reasons, not all of them good, in many cases.

All that aside, there are some rural area jobs that are GREAT, and the only reason they don't get filled is their more remote location. For someone who doesn't have a lot of pre-existent family obligations (such as a spouse who also needs to find work in a non-medical field), or are just starting their families, and do not mind being 1-2 h. away from a major airport or other larger city amenities (nowadays a lot of stuff can be available on line anyway!), some of these jobs are true gems.

(This pertains to all specialties, not just cardiology.)

Recruiters Have the Less Desirable Positions

A colleague whom I know from emails, but with whom I have never spoken about recruitment or recruiters, sent me an email today which I am quoting literally after having removed his name on request.

I am amazed how closely his experience mirrors my experience with recruiters.
May I point out that he finds that positions coming through recruiters are in "...less desirable practice locations...a candidate must keep in mind that these recruiters work FOR the hospitals, and not the candidate...these recruiters usually will not heed the candidates' needs...since stopping my search, I continue to receive recruitment flyers and e-mails (as I am sure many of you do)...those who would take these job opportunities may lack the insight into the economic realities of private practice..."
Recruiters may argue as much as they want, this is how they come across to a majority of physicians. And, please, do not tell me "it's a few bad apples", those few bad apples seem to incredibly busy and seem to just pop up everywhere!

"As a relatively recent recruit to (2003), and subsequent recruiter (2005-6) for my former practice, here are my observations.

When I was searching for a position, I looked at these incredible and unbelievable offers. I too, looked at Merritt, Hawkins, and Associates' findings over the last 6 years. I then observed a trend when I actually called these opportunities / offers. Although not universal, most of these positions offered by "recruiters" such as Merritt, Hawkins & Associates are in less desirable practice locations. Not necessarily rural, but nonetheless less desirable. Factors including geographical location, payer mix, competition, etc., may all come into play.

One must ask why a hospital needs to utilize these search firms and pay them tens of thousands to recruit a urologist. A candidate must keep in mind that these recruiters work FOR the hospitals, and not the candidate. Even if a candidate specifically mentions he/she does not want to join a multispecialty practice nor want to be on the east coast, these recruiters usually will not heed the candidates' needs and will contact the candidate anyway when they have any job offer remotely resembling (or NOT!) what the candidates want.

Since stopping my search, I continue to receive recruitment flyers and e-mails (as I am sure many of you do) advertising $500,000 starting salaries almost on a weekly basis. I know of one such offer and its exact location if anyone wishes to move to a rural Arizona town. Contact me directly and I won't even charge you a finder's fee!

Now the question: How do all these practices afford to pay these huge salaries with all these benefits? I will bet the practices are not paying these costs. These incentives are subsidized by the hospitals.

I can not imagine offering these incentives and having the recruit be "let down" in year 2 when the hospital subsidy ends and reality hits. The short term gains may be great for the candidate, but one must evaluate the long term consequences of taking such a job position.

Those who would take these job opportunities may lack the insight into the economic realities of private practice, and may not be ideal candidates whom I would want to eventually call "partner". Experienced managers know the emotional, production, and financial costs of having to replace an employee. Imagine the headache of having to replace a urologist... It's true that this recruitment process is like choosing a life partner (for both the practice and the candidate); one must chose very, very carefully."

Monday, September 17, 2007

Great books for Physician Job Search

Two useful publications for physician job seekers:

The first is the surprisingly good "The Ultimate Guide to Finding the Right Job after Residency" by Koushik Shaw, published in late 2005. This is probably the most useful book for the physician job search that I have come across so far. It is short, concise, to the point (sometimes a bit too short), but it covers absolutely everything that is relevant from getting to know your personal preferences in your work life to determining where exactly you want to live and work, how to find a job, how to interview, and - kudos for this section - how to analyze a practice you are looking at, what questions to ask a potential employer to uncover risks and possible mismatches early. The author goes into details of analyzing benefits offered by an employer and negotiating a contract. He even goes into the basics of opening your own practice.

Overall very well written, in good style, very easy and quick to read and extremely informative. One smart book everybody should read at least once and at least one year before graduation. It fits the motto of my blog perfectly "What I wish I had known as a resident". I highly recommend it.

Here is a review by Paul Gill on
"This book is an absolute must have for any graduating resident. The author has put an enormous amount of research into a concise and organized fashion, allowing even the time restricted resident to conquer this book in a few short sittings. I have discussed this book with several junior attendings and private physicians, and they are all amazed at how much accurate and insightful information is hidden in this short concise book. It will save you weeks or even months of research and grant you an amazing head start into identifying and obtaining the right career. I truly believe this book will substantially increase your chances of a successful and happy career choice plus teach you to avoid many of the common pitfalls."

Published by McGraw Hill it costs $21 at Amazon or at your local book store. If you are a physician searching for a job and only want one resource, read this book. If you have a bit more time, read my blog "The Summary on Physician Job Search" too, where I have summarized my experience and my knowledge about this topic.

While we all would love one single access point to the job search, it does not exist yet. It is doubtful it will ever exist, because there are so many different people and so many different ways of going about finding a job. New interesting websites for job seekers are added all the time, recently it was, a site worth visiting, exploring and watching.

A free publication is also worth mentioning: The recruiting firm Comphealth's "Best Friend's guide to find a job", which you can download for free here. It is a remake of Weatherby's booklet with the same title. Caution, you get what you pay for. It is free, because is a marketing tool for Comphealth and on every other page you stumble across sentences like "If you have any questions about xxx, call your Comphealth representative, who is well trained and very experienced, especially in xxx". And so on...

The information is good though and you can't complain about the price. As you would expect, the information is severely restricted to anything that will help to make you a client of Comphealth and make you more sell-able to Comphealth. A better CV, a better cover letter etc will ultimately make you more sell-able and therefore will benefit Comphealth. Any information that would lead you away from Comphealth and make you an independent job seeker such as tips for networking and for approaching hospitals directly and for direct mail are absent. But that's what you can find on my blog. Comphealth's "Best Friend's guide to finding a job" is an excellent complement to my blog.

As a side note - I would demote anybody from the rank of "Best friend" who would try to recommend that I use recruiters as my main way to find a job. After all recruiters know about maybe 50% of all jobs, not more. And here I am overly optimistic in my estimate, since a maximum of 30% of jobs are handed out through recruiters, according to a recruiting companies research. The real percentage of jobs brokered by recruiters might be lower, since nobody can accurately estimate the size of the "hidden job market" and the number of jobs filled without any participation of the public. The only way to approach the hidden job market, and that means all those jobs that either are not advertised yet and all those jobs that might be filled before they are ever advertised (because they are so attractive), all those jobs are off-limits to recruiters. But YOU can easily find them by networking, by sending your cover letter and CV to EVERY doctor in your target area and by using "", who can do the legwork of direct mail for you for a fee.

There is another book available on the topic of physician job search. It is called:
"The Physician's Job-Search Rx: Marketing Yourself for the Position You Want" J. Kashani, W. Allan and K. Kelly. I DO NOT recommend it. It was published in 1998, it feels outdated and actually is outdated. The internet and its possibilities are not discussed as you would expect, and overall it just pales compared to the excellent style, balanced handling of topics and thorough research of Dr. Koushik Shaw's book.

Saturday, September 8, 2007

Physician Recruiters Love Direct Mail, But Will Never Recommend It To You

Recruiters are hired by an employer and they are the agents of that employer. The recruiter is NOT working for you, the searching candidate, simply because you are not paying for the recruiter. When you contact a recruiter, you are dealing with someone who is looking to fill a position in order to get paid, not to help YOU FIND a position. You are NOT dealing with someone whose job it is to help YOU, the candidate. A recruiter is NOT YOUR AGENT. Recruiters are called recruiters because they recruit. The recruiter is pursuing YOU, he is a "headhunter or "doctor-hunter" or "doc-hunter". Rumor has it that in a far far away and remote corner of the web there even a recruiter website called "".

Do not expect a recruiter to behave or function as a "candidate search agent", "search advisor", a "career advisor", a "career consultant". They do NOT get paid for any of that, so why should they do it?

Nevertheless, sometimes recruiters work in the job seekers interest, when it happens to coincide with their goal of filling a position. Such a match or coincidence is possible. Recruiters will support you, the job seeker, as long as it is in their main interest. Their main interest is closing the deal.

Let's assume for a moment that a recruiter is really, truly on your side, on the job seekers side. In that case, your recruiter would tell you how to find a job independent of his listed jobs, he would tell you, teach you, instruct you how to network, in that case the recruiter would point you to the most informative and most helpful websites for job seekers, the best job boards with the most job postings, the journals with the best ads. A recruiter that was truly on your side, on the job seekers side would advise you to call hospitals and their physician liaison departments (yes, some actually do that!), and finally he certainly would advise you to mail a letter to every physician in your specialty in the area where you want to work (NO recruiter will do that).

A recruiter that is on your side would give you pretty much the advice I am giving in my blog. Right? Take a close look at it. I have summarized most of my tips and tricks on the blog "A Physician on Job Search". My blog is not a "logging of current events", no, it is a publication of experience and recommendations. Please look at them and compare that with your typical recruiter information.

Reality check:
Now, compare what information recruiters offer you with what I am offering on my blog. Recruiters offer you tremendously helpful tips such as "how to answer a recruiter call", "how to get along with your recruiter", "what information to have ready when a recruiter calls" "why the countryside is worth taking a look at", "Disadvantages of city jobs" (we know where that comes from) and they of course help you with truly grave decisions such as "should I contact one or more than one recruiter during my job search?". You get the picture!
Oh, sorry, yes, they may give you a few hints about how to improve your CV and how to behave during the interview, after all, that makes you more marketable....

Too many graduating residents are not aware of these rules. Too many graduating physicians still believe that using recruiters is a mainstream way to find a job. Too many graduating physicians are not aware that they do not need recruiters at all. It is the employers who needs recruiters, not the job seekers. Employers need to fill positions.

Recruiters need physicians, "candidates". On their blogs they muse about the ideal candidate - someone who is happily employed and doing a great job, and not even thinking about switching jobs. They have names for good candidates, they call them "MPC" - most placeable candidates. They think about the tip of the iceberg - the candidates that are actively seeking and think there must be a large number of candidates below the surface, just like the iceberg has most of its mass below the surface. Recruiters look for ways to find those candidates, to tap that untapped mass of candidates...If they just could find a great approach to all those hidden candidates!

This is of absolutely no concern whatsoever to a job seeker. Job Seekers need jobs. They do not care about the hidden iceberg of silent candidates. They are the candidates.
Job seekers assume correctly that advertised jobs, and especially jobs coming through recruiters, are only the tip of the iceberg. The larger number of jobs is hidden under the surface, often never advertised. Jobs constantly change hands in big cities and only the insiders know about it. This is called the "churn of the job market", the hidden constant movement. Physicians change jobs all the time, from one hospital to the next, sometimes within one community, sometimes they switch to the neighboring hospital or health care system. These jobs are not posted, they are talked about over coffee, over lunch, in the locker room, on local CMEs, on informal department meetings, on the golf course and so on.

Recruiters hardly ever have access to the hidden job market - and here I am just trying not to be too radical by saying "no access at all". The churn of the job market is like the "gray" or the "black market" - a semi-underground affair.

Yet, you the job seeker can easily break into that hidden job market! Not just by networking, but even more easily by direct mail. Job seekers can find easy access to this hidden job market by sending their cover letter and CV to every physician in their area of interest. I have frequently described how in the smallest detail. Please go to my blog "A Physician on Job Search" and check the posts "Active Job Search" among others. You can also have others do the leg work for you by going to "". This company will optimize your cover letter and CV, merge the cover letter with a list of doctors in your area of interest, send you all the letters. You sign them, put them in envelopes and stick a stamp on the envelopes.
It works.

And because this method is a threat to recruiters, they will never recommend it. It makes you, the job seekers completely independent, self-sufficient. You do not need anybody's help and yet, you can reach every single doctor in your area of interest.
Recruiters are extremely familiar with direct mail, they use it. They appreciate it, they love it. The NAPR routinely send out massive amounts of mail to all physicians looking for positions and for candidates. Yet, you, the lowly job seeker will never hear about this from any recruiter.

Direct mail is the most basic thing. I want a job. I send a cover letter and CV to a doctor who might have a job. Repeat a thousand times. It is so simple.

Direct mail is the job seekers ticket into the hidden job market! You have to know about it if you want to find the best possible job for you!